Euthanasia a highly charged ethical issue in medicine. Euthanasia comes in several different forms, each of which brings a different set of rights and wrongs.
In active euthanasia a person directly and deliberately causes the patient’s death. In passive euthanasia they don’t directly take the patient’s life, they just allow them to die.
This is a morally unsatisfactory distinction, since even though a person doesn’t ‘actively kill’ the patient, they are aware that the result of their inaction will be the death of the patient.
Active euthanasia is when death is brought about by an act – for example when a person is killed by being given an overdose of pain-killers.
Passive euthanasia is when death is brought about by an omission – i.e. when someone lets the person die. This can be by withdrawing or withholding treatment:
- Withdrawing treatment: for example, switching off a machine that is keeping a person alive, so that they die of their disease.
- Withholding treatment: for example, not carrying out surgery that will extend life for a short time.
Traditionally, passive euthanasia is thought of as less bad than active euthanasia. But some people think active euthanasia is morally better
Voluntary euthanasia occurs at the request of the person who dies.
Non-voluntary euthanasia occurs when the person is unconscious or otherwise unable (for example, a very young baby or a person of extremely low intelligence) to make a meaningful choice between living and dying, and an appropriate person takes the decision on their behalf.
Non-voluntary euthanasia also includes cases where the person is a child who is mentally and emotionally able to take the decision, but is not regarded in law as old enough to take such a decision, so someone else must take it on their behalf in the eyes of the law.
Involuntary euthanasia occurs when the person who dies chooses life and is killed anyway. This is usually called murder, but it is possible to imagine cases where the killing would count as being for the benefit of the person who dies.
Indirect euthanasia means providing treatment (usually to reduce pain) that has the side effect of speeding the patient’s death.
Since the primary intention is not to kill, this is seen by some people (but not all) as morally acceptable.
A justification along these lines is formally called the doctrine of double effect.
Assisted suicide usually refers to cases where the person who is going to die needs help to kill themselves and asks for it. It may be something as simple as getting drugs for the person and putting those drugs within their reach.
However, is euthanasia simply acceptable or not? Death is a very fragile issue that should be treated with sensitivity. A doctor’s role is to prolong a patient’s life, and therefore according to this, it would be truly unacceptable. Yet, there are some patient cases, where it can be considered appropriate.