Active and Passive Euthanasia

Active and Passive Euthanasia 

In this essay, I will focus on showing that James Rachels claims pertaining to the moral difference between active and passive euthanasia or causing one’s death is likely to be wrong. In validating this thesis, I begin with an overview of passive and active euthanasia, which will be supplemented by the AMA statement on it, followed by an outline of the argument presented by Rachels on the understanding of this statement. The AMA statement and Rachel’s argument about it will form the basis upon which I will argue that a morally relevant difference exist between actively and passively causing someone’s death, unlike the stance taken by Rachel. 

n his paper, Rachels has one specific goal, which is to critique and show that the AMA statement regarding active and passive euthanasia or ‘mercy-killing’ is flawed because it offers unsupportable distinction between the two forms of causing a person’s death. Generally, euthanasia refers to a form of killing that tends to be merciful to a patient or person in suffering. However, it is critical to have a clear distinction between active and passive due to its role in medical ethics. In medical ethics, practitioners uphold a notion that it is allowed or permissible in some cases to allow a patient to die by withholding treatment but it is not allowed in any case for a medical practitioner to participate in direct action aimed at killing the patient. The American Medical Association (AMA) endorses this distinction as evident in their statement, which says, “the intentional termination of the life of one human being by another – mercy killing – is contrary to that for which the medical profession stands and is contrary to the policy of the American Medical Association” (p. 297). The AMA statement further goes on to clarify the distinction by saying, “ the cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient and/or his immediate family. The advice and judgement of the physician should be freely available to the patient and/or his immediate family” (p. 297). In essence, Rachels provides various reasons for the critique against AMA statements. 

First, Rachels’ argument against the doctrine that distinguishes active and passive euthanasia focus on the prolonged suffering of a patient before death following withdrawal of treatment. Rachels note that the process involved in allowing a patient to die can be relatively slow and painful compared to lethal injection that is painless and quick, which then seems to undermine the purpose served by passive euthanasia. The second argument Rachels presents for rejecting the conventional doctrine is that is leads to making decisions relating to life and death on irrelevant grounds. Since active and passive euthanasia are both done for humane reasons with no personal gains, Rachels argues that they two do not have any morally difference. “If a doctor lets a patient die, for human reasons, he is in the same moral position as if he had given the patient a lethal injection for human reasons” (p. 300). In this case, Rachels argues that killing and letting die are equally the same and none is worse than the other considering that both methods serve the same purpose. 

The morally difference used to differentiate active and passive euthanasia is the core issue that Rachels strives to critique in the AMA statement. Rachels claims that opponents of passive euthanasia may argue that the key difference between it and active euthanasia is that the doctors does not do anything to cause the death of the patient; thus, the patient ends up dying of the illness already in them. Rachels refutes this claim by arguing that it is not correct to say that the doctor does nothing in passive euthanasia because withdrawing treatment and watching as the patient dies is an activity performed by the doctor that contributes to the death of a person. Rachels says that the moral difference should not be on the action but the decision, “the decision to let a patient die is subject to moral appraisal in the same way that a decision to kill him would be subject to moral appraisal…” (p.301). In other words, Rachels focus on the lack of morally relevant difference takes into account the process involved in deciding to kill or let a person die. 

My critique of Rachels stand regarding the moral difference between active and passive euthanasia is relatively narrow. For starters, I want to note that moral ambiguity is at the root of the difference between active and passive euthanasia, which means that it is highly likely that some of the reasons provided for supporting passive euthanasia have the same moral principles with active euthanasia. In both cases of euthanasia, the primary purpose is to reduce the suffering of a person for human reasons, which may imply that killing and letting a person die have the same moral foundation. However, Rachels’ conclusion that no morally relevant difference exists between active and passive euthanasia is likely wrong when we focus on the actions involved in both methods to cause the death of a person. 

As I have started, both passive and active euthanasia results in the death of a person, and doctors take this step for humanitarian reasons to lessen the suffering of a person. On this basis, I want to concur with Rachels that at the decision level passive and active euthanasia have no morally relevant difference. In both cases, the doctors have examined the patients and concluded that no form of treatment can help them become better; thus, death is the only solution to end their suffering. In other words, the decision making process in both cases may be subjected to the same moral appraisal, and provide exact outcome. However, the moral difference arise when it comes to the actions taken to contribute to the death of a person. In active euthanasia, the doctor may give a patient a lethal injection that will end his life quickly and relatively painless. In this case, the death of the patient would have not been caused by one’s illness but by the actions of the doctor; thus, making active euthanasia morally unacceptable. On the other hand, in passive euthanasia, the doctor may focus on reliving the pain experienced by the patient, while waiting for the person to die. In this case, the doctors does not do anything to contribute to the death of the patient. Instead, the doctor may be helpful in reducing pain that the patient may be experiencing, but ultimately the person will die because of the illness that has been ailing them. In the end, the death of the patient in passive euthanasia will be a result of their illness not the interference of the doctor; thus, making it morally acceptable and justifiable. Therefore, although both passive and active euthanasia have the same ending and seem to serve the same purpose, which may make them subject to same moral appraisal, Rachels’ conclusion that no morally relevant difference exist is likely wrong when one focusses on the actions that ultimately leads to the death of a person.

Reference 

Brennan, S., & Stainton, R. J. (2010). Philosophy and Death: Introductory Readings. Broadview Press.