There is a sharp distinction between active and passive euthanasia. The former is the voluntary act of ending life or “mercy killing” while the latter is the cessation of the activities used to prolong a patient’s life. There have been strong debates concerning the moral permissibility of the active euthanasia. In this essay, I will present the arguments put forth by Rachels and Callahan concerning the issue and argue that the active voluntary euthanasia is not morally permissible.
In his justification of the active voluntary euthanasia, James Rachels stands that judging from moral grounds active and passive euthanasia are the same, and that in some cases active euthanasia can even be considered morally better. He states that present moral, as well as legal grounds for the euthanasia, assume that taking life voluntarily is worse than depriving the person of treatment and letting her die by herself. He presents an argument that compares killing and letting die in regard to euthanasia with killing and letting die in another context. Rachels suggests an analogy. Suppose, Smith is going to get a large inheritance in the case something happens to his young cousin. One day this cousin is taking bath and Smith slips into the bathroom and kills the cousin by drowning him. Later, he sets everything up so that it would look like an accident. Suppose also Jones who is in the same circumstances as Smith is – he is going to gain something big if anything happens to his cousin. The child is taking a bath while Jones slips into the bathroom planning to kill him. But in contrast to the former situation, the child accidentally slips and hits his head. The child is drowning while Jones is watching ready to finish his job. But for his delight the child drowns by himself and Jones does nothing neither to save him nor to make him die (Rachels 217). According to the account of the ones who support the moral difference between killing and letting die, Rachels infers, the actions of Smith and Jones would be treated differently as in one case the life of a child was taken intentionally while in the other case the life was taken by accident but nothing was performed to save the life. Rachels proceeds by stating that anyone would hardly count the latter less morally abhorrent than the former. He asserts that both Smith and Jones acted out of their personal gain and that even that Jones killed the child by himself and Smith merely let him die and did not do anything to save him, none of these deeds are better than the other. Rachels argues that if Jones's action would be morally better than the one of the Smith then if he would defend himself with the claim that he did nothing but only let the child die by himself, then it would have some weight. But eventually, he asserts, it does not. Rachels agrees that the situation with euthanasia is not similar to any aspect of the one presented by him. The doctors do not act because of personal gain and do not kill healthy children, but the key point in his analogy is that in both cases there is no moral difference between killing and letting die. He suggests that if the doctor helps a patient to whom the life has become a burden by terminating his life, he is in the same position as if he lets the patient die by himself (Rachels 217-218).
Daniel Callahan stands the opposite stance and argues that there is genuine difference between active and passive euthanasia. The main argument presented by him is that when someone says that killing and letting die are the same in terms of morality, the causality and culpability are confused. The former he defines as being the actual cause of the action. The latter he explains as being attributed with moral responsibility for an action. Callahan suggests that the culpability and causality are first of all confused when killing directly and depriving of treatment necessary to prolong life are treated as being the same. He argues that giving lethal injection causes death while the omission of treatment does not cause death. It can only lead to the disease taking the life of the patient in the absence of treatment. And in this sense, the doctor can only stand morally responsible for the death of the patient if we agree that it was a wrongful omission. So in the first case, the lethal injection is the actual cause of death while in the second the omission can only be subject to moral responsibility. Callahan illustrates the genuine difference between these notions by stating that if the lethal injection is given to both healthy and terminally ill person – death would be the consequence in both cases. At the same time, when the same healthy and ill person are deprived of the treatment, then the ill person would eventually die of disease while the healthy person would be unaffected (Callahan 224). Another important point that he makes is that patients ask for euthanasia when they consider their life unbearable. But how can unbearable be defined? It is evident that such characteristic depends not only on the physical conditions the person is in but also from the values one has. For a doctor to agree to the patient, he should share the values of the patient and then decide that the patient’s life is no longer worth living (Callahan 223).
The active voluntary euthanasia is not morally permissible because killing and letting die do not stand the same moral position. The argument put forth by Rachels is unsound because as Callahan argues, the culpability and causation are confused. Rachels asserts that both Smith and Jones should be considered morally culpable for the same degree, however, it is evident that one of them can be officially charged with a murder while the other one cannot. Smith’s actions have become the cause of the child's death. This act is indubitably bad in itself. Jones’s action also led to the death of the child, but his actions did not directly cause death. The difference is that if Smith did not sneak into the bathroom, the child would stay alive while if Jones abandoned his plans on killing the cousin that night and walked by, the child would still die of the accident. So, accordingly, Jones' defense indeed stands. It is important to remember that aside from positive and negative moral positions, there is a neutral one. While Smith committed a bad act and is responsible for it, Jones only failed to accomplish good act (to save a life) and, thus, stood the neutral position. Accordingly, as one cannot be blamed for the absence of virtue, Jones cannot be blamed for not saving the child. The same difference is between voluntary active and passive euthanasia. While the former act is bad in itself, the latter is not.
It is also very important to consider practical aspects and outcomes of the decisions concerning moral status of euthanasia. The first issue rising in this light is, how can one detect whether the suffering if the patient is unbearable. As Callahan asserts, there are no objective measures to this characteristic. Secondly, if the active euthanasia would be legalized, there would definitely be an abuse of the law controlling it out of economic, and personal reasons. When the treatment of the terminally ill patient would be considered ineffective, euthanasia would be the next reasonable step (Callahan 225). Thirdly, the active voluntary euthanasia puts less responsibility on the patient for his life. This responsibility is shared with the doctor implying unpleasant consequences on both doctor and the patient.
The judgments upon the moral permissibility of euthanasia are of great practical importance for humanity since a large number of people are terminally ill and do not want to continue to live. This question is obviously not only of purely philosophical interest but because there are so many human lives involved. I've presented the arguments put forth by James Rachels and Daniel Callahan elaborate on whether killing and letting day share the same moral position. While their positions were the opposite, I agreed to Callahan's account of the issue and argued that the active voluntary euthanasia is not morally permissible. The question of deciding the euthanasia morality is of even more importance than simply deciding if the patients who consider their life a burden would be able to ask their doctors to relieve them of their suffering. If the active voluntary euthanasia is legalized, there will be a line of consequences for the society following it. The abuse of the regulatory law would be inevitable and accordingly would cause long going implications such as involuntary euthanasia and others.
References
Callahan, Daniel. When Self-Determination Runs Amok. P. 222-226. Print.
Rachels, James. Active and Passive Euthanasia. P. 216-219. Print.
