Introduction – Euthanasia is a term that refers to ending a life in a manner that eliminates pain, suffering, discomfort, or the inability to engage in reasonable life experiences prior to natural death. In the United States, there are additional definitions of euthanasia that include intentionally withholding a life-saving medical procedure (passive euthanasia), or assisting a patient or loved one in their own death (criminally assisted euthanasia). The practice remains an extremely controversial one, and takes into consideration numerous topics that are philosophical in nature: quality of life, a person’s right to choose their death (e.g. knowing they will become debilitated), and what constitutes a painless or “happy death” (Borry, Schotsmans, and Dierickx).
Historical Paradigm- In the Ancient World, specifically Greece, Rome, and Egypt, society believed that if a person had no interest in continuing their life, then society had no bond to force them to continue it. Of course this was meant for the upper classes, in the hierarchy of the time, the lower and slave classes had no rights at all. In the Christian dominated Europe after the fall of Rome, suicide as well as aiding in such was a criminal act. In the 1930s, non-voluntary euthanasia was practiced by the Nazi regime in order to eliminate diseased, disabled and undesirable people (handicapped, etc.) . In the 1930s, organizations like the Voluntary Euthanasia Society and Hemlock Society were established to aid in the awareness, education, and eventual legalization of voluntary suicide and assisted suicide. The issue became a media frenzy in the late 1990s when Dr. Jack Kevorkian was imprisoned for assisting in the euthanasia of a patient in the final stages of ALS disease. Kevorkian subsequently served eight years in prison but claimed assistance in over one-hundred other cases (Sandhyarani).
Contemporary Viewpoints – Medical science has now progressed to the point where certain heroic measures can keep the body functioning. Unfortunately, this does not always mean that the quality of life, or the min, is also functional. Besides Dr. Kevorkian, the polarization of the issue reached international attention in the case of Terri Schiavo. Schiavo was diagnosed as being in in a persistent vegetative state, causing her husband to petition the Court to remove her feeding tube. This was opposed by Terri’s parents and a host of other conservative and pro-life movements, including U.S. President George W. Bush. In total, the Schiavo case involved 14 appeals, numerous motions, petitions, and hearings in Florida, and five in Federal District Court, the Florida Supreme Court, Federal legislation, and four denials of certiorari from the U.S. Supreme Court. Finally, after 15 years of legislation, the local Court’s decision to disconnect Terri was carried out in March, 2005 (Goodman).
The Pro-Euthanasia Arguments can be summarized as dealing with the rights of the individual and the idea that living and life are not synonymous:
Legalizing euthanasia would help alleviate the suffering of the terminally ill. It would eliminate their pain and lengthy time for demise.
A person has the right to choose what is best for them; individual rights should be an extension of natural rights.
Passive euthanasia has been part of the human paradigm since recorded history; it is a misplaced morality that makes it illegal.
Healthcare cannot “fix” everything; life on a feeding or breathing tube is, for some, not life (Information for Research on Euthanasia).
The Anti-Euthanasia Arguments, however, do not distinguish between types of killing – mercy killing, to them, is still homicide. Suicide is still altering the natural process of life:
Human life deserves exceptional protection. Hospices and institutions in which a patient can be made comfortable are preferable to euthanasia.
Medical science has advanced, but cannot predict remission or recovery; seemingly miraculous recoveries have taken place long after all hope had been lost.
Mercy killing would case decline in medical care, victimization of the most vulnerable in society, and provide a resurgence of eugenics (Overview of Arguments Against Euthanasia).
Legal Implications – Legal argumentation focusing on euthanasia typically follow natural law, coming from a more religious tradition that the sanctity of human life exists in divine, rather than human hands – or set by nature and binding human behavior across cultures and chronology. Natural law theory goes back to Ancient Greece, but became seminal to the development of English common law, and most especially the writings of Locke and Rousseau and the establishment of modern democratic thought. In modern jurisprudence, national law refers more to the idea that certain contextual issues (e.g. human life) cannot be determined except for moral principles (utilitarianism) – rights are given not by Kings, but by the Creator (Finnis, 2007).
In contrast, we have a strict interpretation – legal positivism that says law is what the sovereign (government, state, King) says it is. Natural law, as seen above, is law that is universal and part of a grander scheme. Then, we have the legal realist perspective, which says that whomever enforces the law counts for more than how the law is written. The law, then, is a process that includes biases based on a number of issues – these issues reflect in the way law is interpreted. Euthanasia is a prime example of this based on geography and the manner in which society’s view personal rights and death. In some states, and a few countries (Japan, Netherlands, etc.) the concept is legal under Death With Dignity statutes. However, in other countries, despite the overwhelming views of the medical and legal community, it remains a crime, based largely on pressure from natural law theorists and conservative religion pressure (Beatty and Samuelson, 15-18).
Ethical Dilemmas – Because law, at its heart, is a reflection of the moral and ethical values of a society, at the very center of the debate on euthanasia lies the core of individual and societal ethics. Ethics is a philosophical concept that attempts to explain the moral organization within a given chronological time and cultural event. It is more concerned with understanding the way that ethnical ideas are presented, than judging those concepts within the construct of the society. However, when one looks at the history of any philosophical subject, it is important to note that differing concepts of philosophy often arise “out of” that very historical and cultural fabric of the time – and then evolve so that they become more acceptable to future generations rather than contemporaneous ones. The principles of ethics that have particular relevance to our subject center on the juxtaposition between utilitarianism and deontology. Even prior to the formalization of the terms utilitarianism and deontology, the core ideas of each have been debated for centuries. The Ancient Greeks argued over the needs of the individual as opposed to the needs of the State (Athens, for example); and throughout history generals and heads of state have had to balance out the ends versus the means of attainment (Haydn).
Utilitarianism holds that the most ethical thing one can do is any action that will maximize the happiness within an organization or society. Actions have quantitative outcomes and the ethical choices that lead to the “greatest good for the greatest number” are the appropriate decisions, even if that means subsuming the rights of certain individuals (Troyer, 256-52). It is considered to be a consequential outlook in the sense that while outcomes cannot be predicted the judgment of an action is based on the outcome – or, “the ends justify the means” (Robinson and Groves). Deontology is a compatible, but alternative ethical system that has its roots in Ancient Greece. In utilitarianism, the focus is on outcomes, or the ends of an action; in deontology the actions themselves must be ethical and moral, or the outcome is moot. Deontology argues that there are norms and truths that are universal for all humans; actions then have a predisposition to right or wrong, moral or immoral. Kant believed that humans should act, at all times, as if their individual actions would have consequences for all of society. Morality, then, is based on rational thought and is the direction most humans innately want. Roughly, deontology is “the means justify the ends” (Kamm).
Because there are differences in types of euthanasia, so too there will be differences in the utility of the act. We can group topics (e.g. incurable disease, horrific pain and suffering, lack of quality of life), but each individual decision, based on classic utilitarianism, will judge the act based on the individual circumstances. This is indeed why the issue of utilitarianism and deontology is also inexorably tied with the right of the individual to make decisions based on their personal definition of life and/or quality of life. If there is no written documentation, then the considered opinions of those closest to them based on a standard of utility would need to suffice. Empirical research, for instance, voluntary active euthanasia in Holland, suggests that the worries and comments about illegal mercy killing and situational abuse are really not too apparent. For utilitarianism to work, then, the decrease in suffering and increase in autonomy are enormous positive contributions to the right of the individual to decide on their own manner of death (Hooker).
Legally and morally, then, the concept of euthanasia may be argued from a number of principles – all valid, all based