What is euthanasia? How and when is it administered? What is the American Medical Association’s
position on this issue? These questions
and many more will be addressed within this essay. The topic of euthanasia, or assisted suicide,
has been one that has puzzled philosophers since the beginning of time. We shall look at arguments presented by both Rachels and Foot and see how they defend their positions on
euthanasia. Furthermore, we shall look
how the American Medical Association’s position can be incorporated with both
of Rachels and Foot’s views on euthanasia.
Before we can delve into whether
euthanasia is moral or not, we must first get some basic background on
doctors. Hippocrates, the celebrated
Greek physician, was born in the
I swear in the presence
of the Almighty and before my family, my teachers and my peers that according
to my ability and judgment I will keep this Oath and Stipulation.
To reckon all who have taught me this art equally
dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep
abreast of advances in medicine. I will
treat without exception all who seek my ministrations, so long as the treatment
of others is not compromised thereby (I), and I will seek the counsel of
particularly skilled physicians where indicated for the benefit of my patient.
I will follow that method of treatment which
according to my ability and judgment, I consider for the benefit of my patient
and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a
lethal dose of medicine to any patient even if asked nor counsel any such thing
nor perform the utmost respect for every human life from fertilization to
natural death and reject abortion that deliberately takes a unique human life
(II).
With purity, holiness and beneficence I will pass my
life and practice my art. Except for the
prudent correction of an imminent danger, I will neither treat any patient nor
carry out any research on any human being without the valid informed consent of
the subject or the appropriate legal protector thereof, understanding that
research must have as its purpose the furtherance of the health of that
individual. Into whatever patient
setting I enter, I will go for the benefit of the stick and will abstain from
every voluntary act of mischief or corruption and further from the seduction of
any patient.
Whatever in connection with my professional practice
or not in connection with it I may see or hear in the lives of my patients
which ought not be spoken abroad, I will not divulge,
reckoning that all such should be kept secret.
While I continue to keep this Oath unviolated may it be granted to me to enjoy life and
science of medicine with the blessing of the Almighty and respected by my peers
and society, but should I trespass and violate this Oath, may the reverse be my
lot.
It is the numbered sections of this
oath that will be called upon later in this paper to be used in conjunction
with Foot and Rachels’ claim’s.
As we are about to define the American
Medical Association’s (AMA) views and policies on euthanasia, I believe it must
first be ascertained what is meant by euthanasia, and to which definition we
shall base our arguments on. According
to the AMA euthanasia is the administration of a lethal agent by another person
to a patient for the purpose of relieving the patient’s intolerable and
incurable suffering. However, the Shorter
Oxford English Dictionary states euthanasia as follows, 1) a quiet and easy
death, 2) the means of procuring this, and 3) the action of inducing a quiet
and easy death. It is fairly presumable
to say the AMA’s definition and the third definition presented in the Oxford
Dictionary are in essence the same. With
this being the fact, we shall from now on out use the definition in the Shorter
Oxford English Dictionary as our basis for defining euthanasia. We shall do so because this definition
presents us with definitions for not just one type of euthanasia, but also
many. With our definition of euthanasia
established we might now move on to the AMA’s doctrine on euthanasia. The AMA acknowledges that while it might seem
more humane to allow euthanasia, the abuses that could come from allowing such
a doctrine would be too harmful to society.
Furthermore, they state instead of euthanasia physicians should respond
to their patients needs when they are close to the end of their life. However, they do recognize one might stop
administering life prolonging drugs and services, when it is definite the
patient shall die soon, with the consent of the patient and their immediate
family.
We can use an example from Rachels to show how the AMA’s doctrine leads to life and
death decisions on irrelevant grounds.
Let us suppose two babies were born with Down’s syndrome. Now to complicate this a little more one of
the two is born with an extra problem, an intestinal obstruction. Obviously based on the AMA’s doctrine doctors
may not perform euthanasia on the baby with just Down’s syndrome for they would
be actively killing the baby. Yet, this
same doctrine allows doctors to do nothing to the baby born with Down’s
syndrome and the intestinal obstruction because they would not be killing them,
the obstruction would be. It must be
stated the surgery to relieve such an obstruction is not a complicated one,
thus cannot be a factor in not surgically helping the baby. It is accepted if a passive euthanasia were
performed it is for the benefit of the patient and no one else. However, if the surgery to remove the
obstruction is not a complicated one, and can be fixed easily then why do we
choose to let this baby die while the other one lives? The basis for performing a passive euthanasia
on the second baby is the doctor and parents decide it is better for the baby,
yet are their reasons valid? People with
Down’s syndrome can live normal lives and have relationships, so how is it in
the best interest of this baby to die?
It isn’t! The parents decide it
would be an extra burden on them, and thus their decision has been influenced
by irrelevant reasons. The decision
shouldn’t be based on whether the child has Down’s syndrome and an
intestinal obstruction; it should be based purely on the Down’s syndrome. Further adding to the objections to the death
of the second baby is one based on the Hippocratic Oath taken by all
doctors. Referring to Roman numeral ‘I’
and ‘II’ of the Hippocratic Oath, doctors must perform any treatment they
consider in the best interest of the patient and cannot refuse treatment to
anyone unless the treatment of another is compromised. They also have a duty to ease pain and
suffering, yet how do they ease pain and suffering while a baby is dying of
starvation and dehydration? This
scenario goes against what doctors have sworn to do, and hence is immoral.
Foot on the other hand disagrees
with Rachels claim that an
intestinal blockage is irrelevant in deciding whether the baby should die or
not. Foot concludes that Rachels presumption if the difference between active and
passive euthanasia is relevant anywhere, it should be relevant everywhere. The example Foot uses to show how Rachels claim is wrong is that if someone saw a child
drowning in a tub, it would be no worse to push his head under or just let him
drown. The first case is obviously
murder because you actually restrain him from getting air. However, the second case is not murder, you
do nothing to prevent him from getting air, you just
don’t help him survive. As Foot points
out though, both of these scenarios are grotesque. To show how both scenarios are bad we must
first define both justice and charity.
Justice is something dealing with what men owe each other in way
of noninterference and positive service.
While charity is which makes us do stuff for the good of others. Now with that defined it is easy to see the
first scenario obviously violated the child’s justice, and in the second
scenario charity was violated.
Furthermore, most children born with Down’s syndrome are able to live a
reasonably content life. The doctors who
decide to allow the babies to die are thinking of the “burden” these children
will put not only on the parents but also upon society.
A major drawback to Foot’s views is
easily shown by a scenario she uses herself in her paper. Suppose an army that must retreat has to
leave its wounded soldiers behind and they have forty-eight hours to live. The only options for these left behind
soldiers are starvation or torture at the hand of the enemy force that is
moving in. It is common to give a “mercy
bullet” to the soldier so they may die a quick and painless death, however if
for some reason they decide they would rather live and take the chance the
enemy might not torture them; Foot says that justice forbids you from giving
them a mercy bullet. Furthermore, it can
be argued with this situation that even charity does not allow for a mercy
bullet because according to their wishes death is not in their best
judgment. However, due to the extreme
situation they are in it can be stated they might not be of sane mind. Many reasons can make them choose life even
though we know death would be preferable to what would happen to them. Thus in the situation, one in which
euthanasia is permissible by all means for it is in the best interest of the
soldier to be dead and not get tortured, Foot’s views deny anyone of performing
an euthanasia on such grounds.
Even though I believe one has the
right to their life and may decide to terminate it at any time they so choose,
I think the AMA’s current policy towards euthanasia is the best possible one
right now. First of all, people could
honestly believe death would be the best option for them at the time because of
the bad luck they have had with life, yet they are basing their decision on
right now. Not what could happen
tomorrow, and life is a good in and of its self no matter how much harm one has
to endure. I believe euthanasia should
only be permissible on patients who are terminally ill and have no hope for a
cure within their expected natural life.
Once again I come to a dichotomy of thinking, I believe active voluntary
euthanasia should be allowed, someone inducing death with consent of the
patient, because in most cases it is more humane for you don’t make them
suffer, yet there could be too many abuses to such a policy. So in conclusion, I think only passive
voluntary euthanasia, withholding treatment so the patient may die with their
consent, can be the only type of euthanasia allowed to minimize such abuses to
this practice.
© Dan Watson 2000