euthanasia ocr a level essay

Essay – Full mark 2018 essay on euthanasia & Natural law

October 8, 2018.

Assess the view that natural law is of no help with regard to the issue of euthanasia. OCR Paper H573/2 June 2018

Here is an answer written in the actual June 2018 exam that secured full marks. I have added comments to demonstrate what is good and not so good about this answer. You don’t have to write a perfect answer to gain full marks. Read my comments in italics and see if you agree. PB

Natural Law is a religious ethical theory that puts reason at the centre of moral thought and decisions. Euthanasia is a modern practice where a person/persons can be killed on their own terms, whether passively (switching of a life machine) or actively (lethal injection). In terms of the practices of euthanasia and whether it should be accepted, natural law is of no help and instead situation ethics should be adopted to the issue of euthanasia.

There are a number of good things about this opening paragraph: it has a clear thesis – situation ethics is to be preferred, although the candidate might have briefly hinted as to why. The opening emphasises reason, a point many candidates miss. And there is a clear definition of two types of euthanasia, with good issue of brackets for economy. Ia m not sure that euthanasia itself is an issue – there are issues involved in the moral debate such as slippery slope arguments or sanctity of life arguments. These might also have been hinted at rather than taking a broad approach.

  Euthanasia is being widely adopted in modern western cultures as secularism is becoming more popular. There is more emphasis being placed on the quality of life rather then sanctity of life. Natural Law theory places special emphasis on the sanctity of life arguing that only God should have the power to take away a life.

Natural Law is an ancient theory deriving from the Greeks and particularly Aristotle. Aquinas took Aristotle and attempted to reconcile his theory of ethics with Christianity. So what the candidate is talking about here is Aquinas’ version of natural law which has been a dominant moral theory in the west, as it informs the moral theology of the Catholic Church. Note the synoptic link to the Christian Thought paper and secularism.

  Natural Law is focused on the primary precepts and upholding its main components; worship God, live in an ordered society, reproduce, to learn and to defend the innocent. Euthanasia goes against possibly three of these primary precepts, and is therefore forbidden under natural law. The secondary precepts would argue that euthanasia is wrong as it goes against the precepts of defending the innocent. Killing someone voluntarily or non-voluntarily and worshipping God as only God should be able to take life away. In a period where quality of life is emphasised, natural law is incompatible with modern culture. Natural Law upholds the sanctity of life and any practice taking away life is wrong – in a society which allows this natural law is outdated. Aquinas lived when the church dominated society and culture and now the church and state are separate, showing now natural law should be adapted.

Aquinas finally gets a mention.  The word ‘adapted’ is interesting as secondary precepts are meant to be adaptable, so Aquinas argues. Secondary precepts are ‘proximate conclusions of reason’. The candidate hasn’t really explored the tantalising hint in the first paragraph that natural law is a theory of human reason. I like the mention of three precepts here: for example, candidates often miss the implications that might exist for an ordered society if euthanasia was adopted (rise in court cases for example as relatives argue about whether passive euthanasia should be applied!).

  Natural law also prohibits euthanasia on the grounds of real and apparent goods. Killing someone passively is an apparent good because it does not achieve long-term gratification as the person would be dead. However this view can be criticised as a person’s suffering would be cut shirt so best for the long-term – there is no more suffering. Many agree with natural law also b saying that euthanasia sets a dangerous precedent and makes a possibility of a ‘slippery slope’ when killing becomes natural. This is against human nature.

There seems to be a misunderstanding here about what a real and apparent good is. According to Aquinas, we cannot willingly and rationally do evil because we are by nature orientated towards the good. So if we objectively do evil it is because we subjectively believe through a defect of our reason that we are actually doing good. Because of a lack of clarity this paragraph doesn’t take the argument forward and could easily have been deleted in its entirety.

  Another weakness of natural law is that it contradicts itself. Although the primary precepts prohibit euthanasia as it actively kills a person, the doctrine of double effect allows it. If a doctor keeps prescribing a patient more medicine, which eventually leads to an overdose, the is not the doctor’s fault and is permissible through the doctrine of double effect. This is a weakness as it seems to contradict earlier teachings from Aquinas. However it could also be seen as  strength of natural law. The doctrine of double effect is a better developed by the catholic church in response to situation ethics ; it allows euthanasia to certain degree as well as upholding religious aspects  – many see this as favourable and may provide a way to treat the issue of euthanasia.

It’s only a contradiction if you misunderstand the relationship between the absolute primary precepts and the secondary precepts which are never absolute. Aquinas, not the catholic church, introduces double effect way back in the thirteenth century – so it cannot be in response to the twentieth century theory of situation ethics.

Natural law is of no use to euthanasia and so situation ethics should be adopted. Joseph Fletcher was the founder of situation ethics and was at one point president of the euthanasia society in the USA. Situation ethics allows the practice of euthanasia as it focuses on the quality of life more. Firstly, Fletcher’s view of agape is much stronger as it accounts for the most loving thing to do. In certain situations, the most loving thing is to switch of the life support machine so that a person’s suffering is ended. The most loving thing to do allows the families of patients to say goodbye allows for patient’s to assess future possible situations themselves through living wills. Situation ethics follows the propositions of pragmatism, personalism, positivism and relativism. Each one important to the issue of euthanasia. Pragmatism allows a practical approach to euthanasia and where practicality of a situation is focused on. Personalism puts people above laws so full agape can be achieved. Although a partly legalistic theory situation ethics is also antinomian where people should be making their own decisions above the law. Positivism allows the practice of euthanasia because in most cases a positive effect is being produced. Relativism is most important because it allows the situation to be weighed on a case by case basis (natural law is unable to do this as it is absolute). These propositions provide more clarification on euthanasia and allow the issue of euthanasia to be clarified.

Natural law is not absolute in terms of its secondary precepts. The name Fletcher gives to his four principles is ‘working principles’ not ‘propositions’.

  Another supporting factor for euthanasia is the six principles which seek to fulfil agape. For example, the third principle that justice is love seemed upholds the value of love distributed. The other fundamental principles also seem to clarify how love is best served and how agape is applied in different situations. In the real case of Simon’s choice, a man was diagnosed with motor neurone disease and in months ahead lost control of his bodily functions and was dependent on support. Simon made the choice to go to Switzerland to die. Natural law would not have permitted this as it breaks the precept of the sanctity of life however situation ethics would allow Simon’s choice to die based on his quality of life. The shows the more practical and reasonable approach of situation ethics is more useful.

However, situation ethics can be criticised. By describing it as relativism, euthanasia is judged on a  case by case basis, which can lead to dangerous precedents. If someone is allowed to be euthanased because they are blind, it could influence other people. With sensory issues to seek euthanasia. Even if they have a decent quality of life. Euthanasia can thereby lead to a slippery slope, where euthanasia becomes too common. This raises the question of where to draw the line with euthanasia, and situation ethics provides no guidance on this. Also doctors swear by the Hippocratic Oath, to uphold the life of the patient. Situation ethics dismisses this – instead going against the doctor’s primary role. A judgement is made about the future: in some cases a patient may get better. Overall however, these weaknesses don’t create a strong enough basis for dismissing situation ethics.

On balance, therefore natural law is of no help in regard to the issue of euthanasia and instead situation ethics should be adopted. Situation ethics is stronger as it takes  a teleological approach seeking to uphold the quality of life – this secures someone’s autonomy and secular views which are being adopted by western societies – such as Switzerland. Natural law is also absolute and deontological, upholding the sanctity of life which seems outdated. The precepts are also incomplete with modern society Fletcher’s four working principles are much more practical and relevant. Overall therefore natural law is of no help with regard t the issue of euthanasia and instead situation ethics should be adopted.

40/40 Grade A*

What is excellent about this essay (and often not achieved by candidates) is the precise focus on the question set. The very clear thesis is referred to again and again, elaborated and clarified. The justification for the case is complete. You can reconstruct the question from the answer itself. However, the answer is rather long and a bit repetitive. If you can develop your won slightly tighter style, it allows you to add even more excellent analysis. One glaring omission in this answer is the failure to develop and discuss the idea that natural law is a theory of human reason, which is mentioned in the opening paragraph. There are two concepts Aquinas introduces to confirm this: synderesis (the intuitive knowledge of first principles – the primary precepts) and phronesis (the practical wisdom we develop to judge secondary precepts rightly and make nuanced judgements about the application of double effect). Being critical, I also feel there are a number of misunderstandings here – about real and apparent goods, for example and the persistent claim that natural law is absolute and contains hard rules like Kantian ethics. Aquinas never argues for a hard form of deontology. Human beings are designed by God to use our reason to face hard choices and take responsibility for them.

  My conclusion: to gain full marks you don’t have to have knowledge that’s 100% accurate, but you do need a strong argument, a clear thesis and a comprehensive analysis and evaluation that justifies your thesis. Candidates are often preparing for this exam in the wrong way – just by learning material rather than practising their analytical writing skills.

  Peter Baron October 2018

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Euthanasia resources, find out more, test yourself.

There are some sample exam questions - it is always better to try answering the question first then you can compare your answer with the samples given. The euthanasia chart was used when applying Kant to specific cases of euthanasia to try to determine what a universal maxim might consist of.

The following are tables with aspects of each ethical theory followed by a blank square which students should fill in themselves. At first, students should merely write in how each aspect of the theory applies to abortion (using examples if possible). An example of a filled-in table is Kant and the right to a child . As they become more confident, students can include an evaluation of each theory's responses.

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Ethics for A-Level

Part iii. applied ethics.

Chapter 7. Euthanasia

Texte intégral.

• 1 J. Hari, ‘Peter Singer: Some People are More Equal than Others’, http://www.independent.co.uk/news (...)

His enemies put it bluntly. Singer says it’s OK to kill disabled babies. Singer says seriously damaged human beings are on a par with apes. Singer says it would have been OK to kill his own mother. These charges are spat out of the sides of their mouths. One theologian I spoke to said contemptuously, ‘Peter Singer takes the most basic human instincts and tries to reason them out of existence. What does he expect us to do, hug him?’ 1

1. Euthanasia Introduction

1 There is an old adage that only two things in life are certain — death and taxes. While the morality of the latter would be an interesting topic itself (and you may look to issues discussed in Chapter 8 for some inspiration), it is the morality of an issue connected to the former that draws the focus of this chapter. Specifically, we consider the ethical issues surrounding euthanasia (sometimes labelled as “mercy killing”).

2. Key Terms

2 The etymology of euthanasia helps to reveal the meaning of the term. Like most upstanding and respectable philosophical terms, euthanasia has its roots in Ancient Greek language; it is based on a combination of the terms eu meaning “well” and thanatos meaning “death”. Euthanasia is thus the act of seeking to provide a good death for a person who otherwise might be faced with a much more unpleasant death — hence the term “mercy killing”.

3 There are different ways to categorise the various types of euthanasia and it is critical to be confident and familiar with these categorisations.

Voluntary Euthanasia

4 Voluntary euthanasia occurs when a person makes their own choice to have their life terminated in order to avoid future suffering.

Non-Voluntary Euthanasia

5 Non-voluntary euthanasia occurs when a decision regarding premature and merciful death is made by another person, because the individual to be euthanised is unable to make a decision for themselves. This form of euthanasia is most commonly associated with young infants or patients in a coma who cannot, due to the nature of their age or condition, make any decision for themselves.

6 The above offers a differentiation of types of euthanasia in terms of the person making the decision. In addition, we can differentiate between types of euthanasia based on the method involved in ending a life.

Active Euthanasia

7 If a person is actively euthanised it means that their death was caused by external intervention rather than natural causes, most likely through a lethal injection or the voluntary swallowing of a deadly cocktail of drugs.

Passive Euthanasia

8 Passive euthanasia occurs when a person is allowed to die due to the deliberate withdrawal of treatment that might keep them alive. Thus, a person who is passively euthanised is allowed to die via natural causes even though methods to keep them alive might be available. A person who has a life-support machine switched off, for example, dies via natural causes but only as a result of a decision to allow natural causes to take effect.

9 Although euthanasia that is both voluntary and passive is not particularly common, euthanasia could come in any combination of methods and decisionmakers as laid out. Legality of the forms of euthanasia varies from nation to nation; Belgium allows for voluntary and active euthanasia, the UK does not.

10 In the next two sections, we outline two different forms of medical afflictions that will ground discussion of arguments in favour and against the varying forms of euthanasia. As an applied ethical issue, it is important to make ethical claims in the light of practical and real-world factors.

3. Case One: Persistent Vegetative State

11 A person is in a Persistent Vegetative State (hereafter PVS) when they are biologically able to support their own continued existence, but they have no meaningful psychological interaction with the world around them. A patient in a PVS, according to the National Health Service in the United Kingdom, can neither follow an object with their eyes nor respond to the sounds of voices and will show no discernible sign of emotion. The vegetative state is defined as persistent when the condition is in place for up to a year and doctors view no prospect of recovery as plausible. The PVS label may seem crude or upsetting, but the message about the difference between the physical and the psychological state of the patient is stark.

12 In the US, Terri Schiavo fell into a PVS when she suffered oxygen deprivation to her brain as a result of a heart attack. Although she survived the heart-attack, her husband ultimately came to the view that her continued existence was not desirable and that she would be better off being allowed to die.

13 In the United Kingdom, the parents of Tony Bland — a victim of the Hillsborough football disaster in 1989 — made a similar decision regarding the life of their son after he fell into a PVS. Tony Bland’s parents campaigned for their son to be allowed to “die with dignity” rather than continue existing in his emaciated state. One can only attempt to imagine the emotional turmoil for the relatives in such cases and it is worth mentioning that Terri Schiavo’s parents ultimately fought a legal battle against their son-in-law in attempt to ensure that Terri was not allowed to die.

14 When considering the morality of euthanasia for patients in a PVS, it is clear that we should be considering only non-voluntary euthanasia, due to the fact that such patients are clearly unable to make any kind of voluntary decision regarding their future interests. For the sake of simplicity, we will assume there are no relevant letter of intent from such patients, written in case they should lose their faculties, describing their desires should they fall into such a condition. However, you may find it rewarding to consider the moral implications of such a letter. Would the letter provide a voluntary decision that morally ought to be respected even when the patient is in a PVS?

4. Case Two: Incurable and Terminal Illness

15 Imagine a patient who has been diagnosed with an incurable disease that will ultimately bring about their death. As the condition progresses over time, the patient knows that their ability to live a normal life will decrease and that their physical suffering will increase. You can imagine for yourselves the range of diseases and conditions that may have such unfortunate effects upon a person.

16 Unlike the patient in a PVS, the patient in this example retains the ability to ask for euthanasia themselves and so these cases can highlight moral issues surrounding voluntary euthanasia. Again, for simplicity in our discussion, we do not consider where the line can be drawn regarding patients in fit or unfit psychological states when it comes to an ability to make a voluntary decision to be euthanised, although this is also an issue that would reward further moral thought.

5. Pro-Euthanasia: Argument One

17 In this section, we consider the first of the arguments in favour of the moral acceptability of euthanasia. This argument is a general argument and would apply to both non-voluntary and voluntary forms of euthanasia. However, the argument, if sound, would also seem to suggest that active euthanasia is more morally acceptable than passive euthanasia for reasons discussed at the end of this section.

18 This initial argument can be labelled as the argument from quality of life . According to this relatively simple idea, sometimes life is actually less preferable than death. On such occasions, when quality of life is so dreadful that a person would be “better off” dead, then euthanasia would be morally justifiable. Evidently, much turns on what counts as a worthwhile life. Recalling the section on well-being from Chapter 1, there are various philosophical positions that might seek to provide a criterion to measure the quality of a person’s life. A hedonist, for example, would suggest that the quality of a life depends on how much happiness/pleasure a person experiences; a supporter of a desire-satisfaction theory would suggest the quality of a life depends on how many of a person’s desires are satisfied; an objective-list theorist would suggest that the quality of a life depends on how many objectively valuable goods a person possesses — goods including, but not limited to, knowledge and love, for example.

19 Whichever one of these views a person supports, or even if they understand other factors as being determinants of the quality of a life, there can little doubt that a person in a PVS has, at best, a non-existent quality of life in virtue of their extreme psychological limitations. Suggesting that some form of consciousness is necessary to having any kind of quality of life, Jonathan Glover (1941–) says:

2 J. Glover, Causing Death and Saving Lives , p. 45. I have no way of refuting someone who holds that being alive, even though unconscious, is intrinsically valuable [valuable irrespective of the form of being alive]. But it is a view that will seem unattractive to those of us who, in our own case, see a life of permanent coma as in no way preferable to death. From the subjective point of view, there is nothing to choose between the two. 2

20 Deprived of happiness and other capabilities, the life of a patient in a PVS seems to be at best utterly neutral and at worst negative in respect of quality of life, perhaps depending on any experience of physical pain. Patients in a PVS are not merely bed-ridden like some who might have suffered severe strokes or other such afflictions; they are biological entities lacking the distinguishing psychological qualities of typical human beings. This may go some way to explain why some (but by no means all) partners and parents of people in PVS’s are willing to favour an end to the patient’s life.

21 The case of Diane Pretty is informative when considering the quality of life of a person with a terminal illness who is nearing the end of their life. Diane Pretty suffered from motor-neurone disease and although she remained mentally proficient, the worsening of her condition over time led her to request to be allowed to die quickly and without undue suffering. Although the point in time cannot be sharply labelled, it seems extremely plausible that many of those with worsening terminal illnesses will reach a point in time where their quality of life is non-existent or negative in virtue of their physical suffering and their inability to enjoy life, satisfy desires or acquire objectively valuable goods. I recall, as a young teenager, listening to Diane Pretty express her desire to be allowed to die and wondering how anyone could reach a point where they would not want to see one more sunrise or live one more day — these questions, I suggest, reflected more of my inability to empathise with her daily existence than they did with undue depression on her part.

22 Thus, if we focus on the quality of life for patients in a PVS, or for those nearing the final stages of a terminal illness, we may well grant that there is a time when quality of life either becomes negative or ceases to be relevant. If we suggest that a life with no discernible quality of life is not worthwhile, then euthanasia may appear morally justifiable.

23 If you find the argument from quality of life convincing, then you may judge that active euthanasia is far more morally defensible than passive euthanasia; after all the judgment that euthanasia is morally acceptable may seem to be the load-bearing judgment, with the choice of method more of a practical than a moral issue. Indeed, in this context, passive euthanasia might seem to be the worst of all worlds.

3 P. Singer, Practical Ethics , p. 186.

24 According to Peter Singer, “Having chosen death [as a morally acceptable course of action] we should ensure that it comes in the best possible way”. 3 The best possible way, if we remain interested in quality of life, might seem to be a lethal injection designed to send a patient painlessly to sleep before shutting down their organs, or a selection of drinkable liquids that have the same effect. The best possible way might not seem to involve turning off a life support machine or withdrawing proactive treatment in order to allow nature to take its course, when the course of nature may be directed by starvation, dehydration or secondary infections. Although these passively viewed deathcausing effects may be managed with pain killers, Singer’s relatively simple thought is that if death is deemed morally desirable, then why not simply provide death actively rather than passively?

25 In addition, if we recall the ideas of Situation Ethicist Joseph Fletcher (as outlined in Chapter 5) then we may wonder whether or not (assuming death is morally desirable) passively allowing death to occur is actually less loving than actively bringing death about. As a relativistic normative ethical theory, Situation Ethics provides no absolute guidance regarding the moral acceptability of euthanasia in any of its forms; situation-specific, practical and pragmatic judgments will need to form the basis of moral judgments in individual cases. However, it is important to consider how loving active euthanasia might actually be in the circumstance where the death of the patient is actually our ambition.

6. Pro-Euthanasia: Argument Two

26 The second argument we can offer in support of euthanasia — both in voluntary and non-voluntary forms — can be labelled the argument from resource use . Whereas the former argument attempted to defend the moral acceptability of euthanasia by utilising the perspective of the patient and their associated quality of life, this argument may seem a little more detached and you may or may not view this as a strength or weakness.

27 According to Peter Singer, the non-voluntary euthanising of a severely disabled and suffering young infant child (who cannot express any wishes regarding their future) may be justifiable on the following grounds:

4 Ibid. , p. 163. When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed . 4

28 Singer’s suggestion may sound callous, and if you view killing an innocent life as an absolute moral wrong then you may view his claim as immediately morally out of bounds (this kind of objection to euthanasia is considered in a later section). For now, however, let us take Singer’s claim at face value. Being a preference utilitarian (further detail on this theory is available in Chapter 1), Singer makes his judgment regarding how to act in such a case based on the quality of life of the individuals involved. So, on his view, the disabled infant may have a lower quality of life than a healthy child who might be born in their stead because the latter, and not the former, can secure greater preference satisfaction. Thus, we morally ought to bring about the situation in which the healthy child is born.

29 If we assume that those who are in a PVS, or those suffering near the end of a terminal condition, have a low quality of life then we might think that spending our limited medical resources on maintaining their existence, rather than spending those resources elsewhere, is not morally desirable. This kind of argument will appeal to a teleologist rather than a deontologist, for it ascribes moral values to actions based on consequences rather than duties . In this setting, the consequences of spending resources on PVS patients may be less positive than spending those same resources on effectively treating other diseases or funding medical research to benefit future generations.

5 Madison-St. Clair Record , http://madisonrecord.com/stories/510564252-nursing-expert-testifies-that

30 Some financial figures may put this possible argument into context. According to the Madison County Record, Christina McCray (a patient in a PVS) had medical bills that average out to $ 250,000 per year. 5 If we consider the years of life that a patient in a PVS may have, along with the number of PVS patients that exist, then the cost of keeping such individuals alive becomes clearer. If medicine is sometimes about making difficult decisions, then it may become clear why non-voluntary euthanasia of such patients might be considered desirable (at least with the support of the family). In addition, if a patient with a poor quality of life, who is facing future suffering with associated expensive care, voluntarily requests euthanasia then it may be that their death will allow resources to be better directed to other patients who might have their suffering reduced more significantly.

31 It is worth noting, for those uncomfortable with this kind of resource allocation planning when it comes to treating ill, suffering and frail patients that decisions in the National Health Service are already being made in the light of teleological and quality-of-life based reasoning. The NHS utilises QALYs when making financial planning and treatment costing decisions. QALY is shorthand for Quality Adjusted Life Year, a measurement designed to consider the benefits of different treatment costs in respect of their payoffs to the patients involved. If a potential treatment will lead to a patient being free from pain and able to perform daily activities (this is a somewhat rough definition, but enough for our purposes) then the year in which this outcome is expected can be given a value of 1. Each following year can then be given a value between 0 and 1 according to the expected lasting impacts of the treatment. Thus, allocating spending to different forms of treatment for different patients can be objectively calculated against a common standard in order to inform those spending decisions in terms of where the better consequences might be secured.

32 The argument from resource use is, therefore, an extension of the use of a QALY to inform medical decision-making. If the positive consequences of spending money on treating patients who might be cured or helped to have a higher quality of life are greater than spending money to keep people alive who either wish to die and have a diminishing quality of life or who are in a PVS, then spending on the former is morally defensible rather than spending on the latter. Again, you might consider how loving it is to spend money keeping a patient in a PVS alive versus investing in research for cures and treatments that could improve the quality of life for other patients in a world where resources are finite.

7. Pro-Euthanasia: Argument Three

33 The final argument we will offer in favour of euthanasia is an argument often viewed as the most powerful in this applied ethical area, the argument from personal autonomy . This argument proceeds from the fairly plausible assumption that people should have the right to make their own decisions and should be able to decide the paths of their own lives. If the right to choose our own path applies in life, then why would this not apply in respect of our choice of how and when to die?

34 Perhaps the most famous philosophical proponent of a right to personal autonomy and decision-making was John Stuart Mill. As discussed in Chapter 1, Mill elucidated the harm principle, which suggested that the only legitimate government interference in a person’s life is to stop that person from harming others; all other interference is not to be justified. If you subscribe to this principle, then you seemingly must believe that a person voluntarily requesting euthanasia should not be denied the right to die, unless their dying would cause harm to another person. If we discount emotional harm (because many normal things that we do seem to cause emotional harm to other people — getting a job over another candidate, for example) then it is not easy to envisage a circumstance in which a terminally ill patient, requesting a merciful death before their suffering becomes too extreme, would have a death that causes physical harm to another person. Therefore, if we believe in the power and moral right of the individual to act in the way that they deem correct, unless physically harming another, then we must seemingly allow that voluntary euthanasia is morally justifiable. Singer sums up the position:

6 P. Singer, Practical Ethics , p. 195. … the principle of respect for autonomy tells us to allow rational agents to live their own lives according to their own autonomous decisions, free from coercion or interference; but if rational agents should autonomously choose to die, then respect for autonomy will lead us to assist them to do as they choose. 6

35 We have spoken above of voluntary euthanasia specifically, for the patient in a PVS obviously cannot choose how to die. If we return to the earlier mentioned possibility of a letter of intent , written prior to the condition taking hold, then in certain instances non-voluntary euthanasia may also be justified on this basis — though of course, such cases seem to a species of voluntary euthanasia.

36 However, if we would trust loved ones to make other important medical decisions for us if we were incapacitated, then perhaps the same should apply in this context and non-voluntary euthanasia might be justifiable in virtue of properly respecting the choices made by one relative on behalf of another. It is for you to consider if a theory of personal autonomy can be extended to familial autonomy in such a way.

8. Anti-Euthanasia: Argument One

37 Thus far we have only outlined pro-euthanasia arguments. In fact, we have really only provided pro-active euthanasia arguments in virtue of Singer’s suggestions regarding the undesirability of passive euthanasia. It is now time to give anti-euthanasia, and anti-active euthanasia, arguments their fair hearing.

38 The first objection to euthanasia may be termed the objection from Sanctity of Life . The Sanctity of Life ethic is usually founded on religious, and specifically Christian, thinking. Essentially, a belief that life is sacred suggests an absolute value to life, of a type that means it is worthwhile in all circumstances; in Glover’s earlier words it is the view that life has an intrinsic value that supersedes any qualitative aspect. For Sanctity of Life theorists and supporters as described in this section, problems with the quality of a life never undermine the ultimate value and worth of a life.

7 Genesis 1:26, https://www.biblegateway.com/passage/?search=Genesis+1%3A26-28&version=NIV

39 It is not necessary to be religious to hold the view that all lives are worth preserving, irrespective of quality. A non-religious person may prefer to speak of an absolute right to life that cannot be taken away through non-voluntary euthanasia, and cannot be revoked by personal decree in the context of voluntary euthanasia. However, more often, the view is supported by Biblical reference. In the Bible, we are told that God said: “Let us make mankind in our image, in our likeness”. 7

8 1 Corinthians 3:16–18, https://www.biblegateway.com/passage/?search=1Corinthians+3&version=NIV

40 In addition, our bodies are described as sacred and as containing God’s Holy Spirit: “Don’t you know that you yourselves are God’s temple and that God’s Spirit dwells in your midst? If anyone destroys God’s temple, God will destroy that person; for God’s temple is sacred, and you together are that temple”. 8 These quotes not only reveal the sanctity of our bodies and the cause of that sanctity — our creation in the image of God and the presence of God’s spirit within us — they also reveal the punishment for those who might take life; might this relate to doctors who administer euthanasia?

41 Whilst the arguments from quality of life and use of resources were avowedly teleological in nature, considering the painful and potentially costly consequences of continued life, the argument from Sanctity of Life is deontological in nature since it relates to a duty to avoid killing. Linking the Sanctity of Life view to both abortion and euthanasia, Mother Teresa gave a statement of the appeal of this ethical stance:

9 J. Chaliha and E. Le Joly, The Joy in Loving , p. 174. For me, life is the most beautiful gift of God to mankind, therefore people and nations who destroy life by abortion and euthanasia are the poorest. I do not say legal or illegal, but I think that no human hand should be raised to kill life, since life is God’s life us in us . 9

42 All human life, whether in the womb or in a PVS, is of sacred and God-given worth such that killing (including euthanising, as a form of killing) is morally impermissible.

43 The notion of a sacred life lays behind Catholic teaching on the issue of euthanasia. A 1980 Catholic Declaration of Faith is clear and absolute in nature:

10 Sacred Congregation for the Doctrine of the Faith, ‘Declaration on Euthanasia’, http://va/ … no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly, nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offence against the dignity of the human person, a crime against life, and an attack on humanity. 10

44 The language is somewhat complex but the key points are given in our previous discussions in this chapter — life is sacred and so euthanasia, whether voluntarily requested or non-voluntarily encouraged for someone else, is morally impermissible. No legislator, guided by moral ideals, can ever morally recommend this type of killing, whether motivated by a mistaken sense of mercy or not.

9. Anti-Euthanasia: Argument Two

45 A related objection to euthanasia, premised on a commitment to Christianity, is the objection from valuable suffering (keep in mind that not all Christians, by any stretch, would defend an objection of this type). Let us return to the 1980 Catholic Declaration of Faith. The document states that:

11 Ibid. According to Christian teaching, however, suffering, especially suffering during the last moments of life, has a special place in God’s saving plan; it is in fact a sharing in Christ’s passion and a union with the redeeming sacrifice which He offered in obedience to the Father’s will . 11

46 Thus, even if someone requests euthanasia in order to avoid pain, that request should not be granted because it deprives a person of an element of God’s plan for them; the experience of suffering at the end of life brings that person closer to sharing in the experience of Christ. This does not mean that Christians oppose palliative care (a type of care that does not attempt to extend life, so much as make an individual as comfortable as possible as they face the end of their life). However, it does explain why a life should be seen through to its natural end and why it might therefore be viewed as morally wrong to shorten it.

10. Anti-Euthanasia: Argument Three

47 The third anti-euthanasia argument to consider can be labelled the slippery slope objection (sometimes called the Wedge argument ). This objection does not require any view regarding the Sanctity of Life or a deontological duty not to kill; indeed, the slippery slope objection is both teleological in nature and does not even require a denial that euthanasia might be desirable in certain instances when viewed in the abstract or in isolation.

48 The slippery slope objection is that if euthanasia were to become legal in some situations, then it would lead to euthanasia becoming legal and acceptable in situations where it is actually morally undesirable. To see the strength of such an objection, consider earlier pro-euthanasia arguments couched in terms of resource allocation and personal autonomy.

49 If euthanasia can be justified on teleological grounds when resources would be better deployed elsewhere, then what is to stop us justifying not merely voluntary and non-voluntary euthanasia, but involuntary euthanasia also? If euthanasia is justified on the basis of money and time being better spent on some patients rather than others, then why would permission be required from the patient or the patient’s family?

50 If morality is determined by consequences, and consequences justify euthanasia, then we seem to be slipping down a dangerous slope to euthanising people without their consent. After all, if you are a teleologist (perhaps, an act utilitarian) you have already given up ideas concerning absolute rules against certain actions. It therefore may be objected that either life is sacred, or it is not, and if it is not then we may end up in a situation we find utterly morally indefensible even if we start from apparently moral motivations.

51 In addition, if personal autonomy is respected to the degree that someone can choose when to end their life, then what is to stop a seriously depressed person who is otherwise physically healthy from opting for voluntary euthanasia? Most people might view such enabling of suicide for patients with mental health needs as being very different from euthanasia for PVS patients or the terminally ill, but if personal autonomy justifies euthanasia then how can we justifiably draw a strong enough line so as to allow some people to choose death, but not others? Again, it may be objected that either personal autonomy matters or it does not. If we enable a person to have their life ended, then it is obvious they can never come to a different view on the value of their life at a later stage, as they might have had they still been alive. On this issue, it may be worthwhile revisiting the discussion from Chapter 1 regarding a person’s preferences and whether they are only morally relevant if they stand up to some sort of psychological testing and counselling; the relevant idea is due to Richard Brandt.

52 In addition, opponents of euthanasia often suggest that if one group of people are euthanised, others may begin to feel pressure to take up that same option. If non-voluntary euthanasia is granted, and a legal, moral and cultural line in the sand is thereby crossed, may not elderly patients feel pressured to not be a burden to their families? May not the financially well-off elderly feel pressure to allow their children to inherit any accumulated wealth rather than see that wealth spent on their own care? Granting non-voluntary euthanasia in even a small number of cases may, over time, send us down a slippery slope to the non-morally defensible euthanising of many other types of patients who, as things stand, are quite content to remain alive since they have no reason to consider other options.

• 12 The following article highlights the use of the law in Belgium: ‘Belgian Convicted Killer with “In (...)

53 Of course, an easy response to any slippery slope objection is simply to deny that a change in one fact must lead to a suggested negative change elsewhere. Why think of negative consequences from a change in the law, when these consequences might not happen? Indeed, some slippery slope arguments are logical fallacies if they are premised on the idea that a possible negative outcome must, of necessity, follow from some change in policy. However, we should not “straw-man” the objection in this way (i.e. phrase it in such a weak way that it is easy to argue against). The slippery slope objection suggests that the negative outcomes might be probable, rather than be certain. Thus, a response should deal with the issue of probable negative consequences, rather than cheapening a plausibly reasonable objection through wilful misrepresentation of its structure. Researching the situation in Belgium, where the law regarding euthanasia is perhaps the most liberal in the world, should provide a good grounding to either support or oppose this line of thought, as would considering the application of Rule Utilitarianism. 12

11. Anti-Euthanasia: Argument Four

54 A fourth anti-euthanasia objection is the objection from modern treatment . This objection brings together two distinct, but relevantly similar, lines of thought. Firstly, it might be suggested that to euthanise those who are terminally ill, or those in a PVS, is to kill people earlier than would otherwise happen and thereby to artificially eliminate their chances of living to experience a cure to their condition. At the very least, if not a cure, euthanised people are not around to benefit from any step-forward in treatment that might alleviate their suffering.

55 In addition, given the modern advances in palliative care it might also be argued that end of life care is now so advanced that euthanasia is not necessary in order to avoid suffering and so cannot be justified even on quality of life grounds. It might be thought plausible that a person with a severe and worsening disease who is not euthanised could have their condition and pain carefully managed by skilled healthcare professionals so as to greatly diminish any suffering.

56 In response to these types of objections, Singer grants that were euthanasia legalised then some deaths may occur for people who could have been treated had they been kept alive. However, he urges that:

13 P. Singer, Practical Ethics , p. 197. Against a very small number of unnecessary deaths that might occur if euthanasia is legalised we must place the very large amount of pain and distress that will be suffered if euthanasia is not legalised, by patients who really are terminally ill. 13

57 On balance, Singer suggests, euthanasia would cause more pain to cease than pleasure missed by those who die early. Whether or not palliative care is able to reduce suffering to the extent suggested by the objection is something you may wish to consider and further research, as it would seem to be an empirical claim requiring contemporary evidence to further the discussion.

12. Allowing versus Doing

58 James Rachels (1941–2003) sums up the supposed moral importance of the distinction between allowing and doing in the euthanasia debate:

14 J. Rachels, ‘Active and Passive Euthanasia’, p. 511. The distinction between active and passive euthanasia is thought to be crucial for medical ethics. The idea is that it is permissible, at least in some cases, to withhold treatment and allow a patient to die, but it is never permissible to take any direct action designed to kill the patient. This doctrine seems to be accepted by most doctors. 14

59 Thus, according to Rachels, most doctors at the time of his paper — and not much seems to have changed in the UK context since — would think it permissible to allow a patient to die (passive euthanasia, on our definitions) but think it impermissible to kill a patient even if they request it or if it is deemed to be in their interests (active euthanasia).

60 The plausibility of this distinction is supported by consideration of the Doctrine of Double Effect, as drawn from the normative Natural Law moral theory discussed in Chapter 4. Recall from the chapter on Natural Law ethics that one of the primary precepts for human beings is the preservation of life. No moral prescription, we might think, could speak more strongly and absolutely against euthanasia — especially given the Catholic background of Aquinas’s Natural Law stance and the earlier reference to Catholic views in the context of the Sanctity of Life ethic. A secondary precept, derived from this primary precept, would certainly seem to deny the moral acceptability of artificial shortening of life. However, Natural Law theorists are able to to have a nuanced stance in the euthanasia debate.

61 A Natural Law theorist, via the Doctrine of Double Effect, can describe an action as moral even if it results in an outcome that might not be considered morally permissible in the abstract. If an act is directed by a desire to do moral good, yet has a foreseeable but unintended consequence of a bad effect, then this action may be moral so long as the bad effect was not aimed at, does not outweigh the good effect and is not directly the cause of the bad itself. If this brief comment is unclear, it is critical to look back to the relevant discussion of the Doctrine of Double Effect in the chapter on Natural Law.

62 Now, let us apply this doctrine directly to the context of euthanasia. A doctor may be aware that a patient has not long to live and is suffering immensely. The doctor may prescribe a multitude of painkillers to treat the pain, even though this will have the foreseeable but unintended effect of killing the patient as a result of the side-effects of the drugs. Indeed, a doctor may simply refrain from offering painful treatment methods in order to avoid causing suffering, with the unintended but foreseeable consequence that the patient will die as a result of the non-intervention. These actions are not morally wrong, says the Natural Law theorist, because death is not intended directly but rather the morally good end of pain reduction is intended directly. Thus, the doctor who engages in active euthanasia by provision of a lethal cocktail of drugs in order to artificially kill a patient so that their suffering is reduced is morally wrong (for the good of “suffering reduction” is directly achieved by the bad of killing), while the doctor who withdraws treatment in order to relieve suffering, with the unintended but foreseeable outcome of death, acts morally justly (for the good of “suffering reduction” is achieved by not administering painful treatment, death is just a proportionately acceptable side-effect).

63 Both Rachels and Singer have little time for the distinction between allowing and doing, and the Doctrine of Double Effect, in this debate. Rachels says that:

15 Ibid. . If a doctor lets a patient die, for humane reasons, he is in the same position as if he had given the patient a lethal injection for humane reasons… if the doctor’s decision was the right (to not intervene on the patient’s death) one, the method used is not itself important. 15

16 P. Singer, Practical Ethics , p. 183.

64 Meanwhile, Singer comments that “We cannot avoid responsibility simply by directing our intention to one effect rather than another. If we foresee both effects, we must take responsibility for the foreseen effects of what we do”. 16 Singer gives the example of a business seeking to save money in order to hire more workers. This outcome is good and motivates bosses to act to save money on their recycling bill, with the foreseeable but unintended consequence of polluting a local river. If we would not excuse the company for ignoring a foreseeable consequence, says Singer, then we do not really believe we escape responsibility for allowing death in the euthanasia context.

65 The application of the Doctrine of Double Effect, and Natural Law ethics in general, to the euthanasia debate should be considered carefully and in the light of the earlier chapter outlining the normative theory itself. Despite both Singer’s and Rachel’s attack, Natural Law and the Doctrine of Double Effect retain many proponents. If one views moral outcomes as based on more than consequences alone, then this approach may seem to have more merit than a preference utilitarian like Singer might grant it; this is for you to judge.

• 17 J. D. Velleman, Beyond Price: Essays on Birth and Death , https://www.openbookpublishers.com/reader (...)

SUMMARY Euthanasia is an applied moral topic that has profound implications; successful moral arguments may lead to legislative changes that quite literally shorten or extend lifespans. There are a host of subtleties in the debate to which we can only pay lip-service — such as the acceptability of active euthanasia of depressed patients, the importance of pre-injury requests for treatment or for death; the best way of allocating medical resources; the powers of people over both their bodies and the bodies of incapacitated family members. Further issues are discussed in works such as that by J. David Velleman, and we suggest the references below as a guide to useful and enquiring texts. 17 However, we hope that you now feel confident to explain and evaluate the key arguments both in favour and against the various methods of euthanasia and the various contexts in which those methods may be employed.

COMMON STUDENT MISTAKES

• Making the slippery slope objection simpler than it is — it focuses on likelihood of future consequences, not certainty of future consequences.
• Dismissively suggesting that not being religious is enough to oppose Sanctity of Life claims out of hand. Life might have absolute value for non-religious reasons and this is an idea one should engage with.
• Dismissing the quality of life argument just because of a religious faith without proper engagement — the idea that a life should be prolonged even in the face of suffering needs suitable defence.
• Misrepresenting the Doctrine of Double Effect in application to euthanasia — keep in mind the more detailed knowledge gained from the chapter on Natural Law ethics.
• Thinking that pro-euthanasia views must be secular and that antieuthanasia views must be religious. All options remain open.

ISSUES TO CONSIDER

• What makes a life worth living? Is a life ever without value?
• Should the Doctrine of Double Effect be ethically relevant? Is there a moral difference between allowing and doing?
• What is assisted suicide? Is it different from Euthanasia?
• If euthanasia is morally acceptable, should passive euthanasia ever be viewed as an acceptable method?
• Can the slippery slope objection be blocked in this context? Answer with reference to the development of euthanasia laws in Belgium.
• Is Rule Utilitarianism the only teleological theory that survives the slippery slope objection?
• Is there something morally uncomfortable about the argument from resource allocation? If so, what?
• If you were designing euthanasia laws, what would they look like?
• Should a Sanctity of Life ethic have any role in twenty-first century medicine?
• Is the morality of euthanasia determined by empirical factors such as levels of palliative care available?
• Should a depressed patient ever be allowed euthanasia? Is personal autonomy something we must always respect? If not, when should it not be respected?
• Could involuntary euthanasia (euthanasia against a person’s wishes) ever be justified in any circumstance?

KEY TERMINOLOGY Doctrine of double effect Palliative care Persistent Vegetative State Well-being Sanctity of Life Straw-man

Bibliographie

‘Belgian Convicted Killer with “Incurable” Psychiatric Condition Granted Right to Die’, the Guardian (16 September 2014), freely available at https://www.theguardian.com/world/2014/sep/16/belgium-convict-granted-right-to-die

Bible , New International Version, freely available at https://www.biblegateway.com/

Chaliha, Jaya, and Le Joly, The Joy in Loving: A Guide to Daily Life with Mother Teresa (London: Penguin, 1996).

Glover, Jonathan, Causing Death and Saving Lives (London: Penguin, 1990).

Madison-St. Clair Record , freely available at http://madisonrecord.com/stories/510564252-nursing-expert-testifies-that-plaintiff-s-bills-could-be-8-4-million%20

Hari, J., ‘Peter Singer: Some People are More Equal than Others’, freely available at http://www.independent.co.uk/news/people/profiles/petersinger-some-people-are-more-equal-than-others-551696.%20html%20

Sacred Congregation for the Doctrine of the Faith, ‘Declaration on Euthanasia’, freely available at http://www.vatican.va/romancuria/congregations/cfaith/documents/rc_con_cfaith_doc_19800505_euthanasia_en.html%20

Singer, Peter, Practical Ethics (Cambridge: Cambridge University Press, 2011), https://doi.org/10.1017/cbo9780511975950

Rachels, James, ‘Active and Passive Euthanasia’, Biomedical Ethics and the Law , 5 (1979): 511–16, https://doi.org/10.1007/978-1-4615-6561-1_33%20

Velleman, J. David, Beyond Price: Essays on Birth and Death (Cambridge, Open Book Publishers, 2015), https://doi.org/10.11647/OBP.0061 ; freely available at https://www.openbookpublishers.com/reader/349

1 J. Hari, ‘Peter Singer: Some People are More Equal than Others’, http://www.independent.co.uk/news/people/profiles/peter-singer-some-people-are-more-equal-than-others-551696.html

2 J. Glover, Causing Death and Saving Lives , p. 45.

4 Ibid. , p. 163.

6 P. Singer, Practical Ethics , p. 195.

9 J. Chaliha and E. Le Joly, The Joy in Loving , p. 174.

10 Sacred Congregation for the Doctrine of the Faith, ‘Declaration on Euthanasia’, http://va/

12 The following article highlights the use of the law in Belgium: ‘Belgian Convicted Killer with “Incurable” Psychiatric Condition Granted Right to Die’, https://www.theguardian.com/world/2014/sep/16/belgium-convict-granted-right-to-die

13 P. Singer, Practical Ethics , p. 197.

14 J. Rachels, ‘Active and Passive Euthanasia’, p. 511.

17 J. D. Velleman, Beyond Price: Essays on Birth and Death , https://www.openbookpublishers.com/reader/349

Le texte seul est utilisable sous licence CC BY 4.0 . Les autres éléments (illustrations, fichiers annexes importés) sont « Tous droits réservés », sauf mention contraire.

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RE euthanasia for and against

Ought Euthanasia be legalised

INTRODUCTION

         Euthanasia means a good or happy death and comes from the Greek, ‘eu’ and ‘thanatos’ which mean good death. It can be seen as mercy killing or murder depending on which view is taken on it. There are different types of euthanasia which include, active euthanasia, which is purposely ending the life of a patient with something specific e.g. by lethal injection. Passive euthanasia, which is taking away any treatment that is prolonging the patients life e.g. switching off a life support machine. Voluntary euthanasia is when the patient asks to terminate their life. Involuntary euthanasia is when the decision to end the life is taken for the person by another as they are incapable of expressing their view. Assisted suicide is providing the necessary components so another can end their life.

ETHICAL QUESTIONS

        Euthanasia poses several ethical questions in which some defend euthanasia and others contradict it. When asked to terminate another being’s life, it could be argued that you are maintaining their dignity so that they do not have to suffer so it is right for us to keep their dignity from them and prevent euthanasia to be legalised? Another question contradicts this one by asking is it right to terminate a person’s life if they want to live on and keep their dignity in that way? Situation ethics could also be brought in when it could be said that we have to act in the most loving way even if we have to commit an immoral act, could this still be regarded as moral even though we are terminating a life? We could argue that doctors are ‘playing God’ by being able to end a life and if doctors can do this, then where is the line drawn to set a limit on what we can and cannot do in a medical context?

LEGAL STANDING

        Euthanasia is illegal in the UK despite various Bills that have been put forward such as the assisted dying for the terminally ill bill , which was discussed by the BMA and rejected by two thirds of the doctors. Suicide is not illegal, however, assisting it is. Anyone who tries to bring about the death of another is to blame.  However, if the actions were done with the intention of compassion, a manslaughter charge can be issued instead of murder. Anyone found assisting suicide could be imprisoned for up to 14 years however for compassionate intentions, a suspended sentence can be issued.  There is also an instance where euthanasia can occur and no charges can be brought about, this is called ‘the double effect’. The ‘double effect’ occurs when a doctor gives a terminally ill patient a large dose of an opiate such as morphine that will ultimately lead to their death but they cannot be prosecuted for murder, as the primary intention is to ease the pain. As long the patient’s death was a secondary consequence of the medication, they are exempt from any charges.

PRO-LIFE/CHOICE OVERVIEW

        Two views on euthanasia are pro-life (for euthanasia) and pro-choice (against euthanasia). Pro-choice maintains the quality of life and that people live their lives to the full as long as they can. As soon as this stops being a possibility, they should have the choice to opt for euthanasia if they wish. Pro-life on the other hand promotes the sanctity of life, which is based on the view that life is sacred and God given. Once God has set life in motion, He can only bring it to an end. Christians who believe we must not allow life to become disposable for utilitarian reasons hold this view.

Different religions have varying views on the legalisation of euthanasia. Christianity, Judaism and Islam tend to have the similar view of all being pro-life.

        Roman Catholics see euthanasia as a crime against God and life. They argue that “such as any type of murder, genocide, abortion, euthanasia or wilful suicide”  is unlawful and an act against God. They would also argue that life is God given and only God can take it away. In Job 1: 20-21 it says, “The Lord gave and the Lord has taken away”. This signifies God as the only one who can take lives, not doctors. The body is a temple to the Holy Spirit and is not man’s to do with it what he pleases. Corinthians 3:17 say that we are simply hosts and ‘if any man destroys the temple of God, God will destroy him’. The Pope also condemns euthanasia. He said that society “is called to respect the life and dignity of the seriously ill and the dying” . The Pope is the leader of the Catholic Church and he directly denounces this so other Roman Catholics should follow in his footsteps.

On a wider range, Christians in general are pro-life. They believe that the icon of Christianity (Jesus) suffered a lot to save us and we should follow in his footsteps as they argue that suffering can have a positive consequence. The Decalogue states “thou shalt not kill”  and Christianity considers any type of assisted death as murder. Christians maintain that all life is God given and therefore no human has the authority or right to take away the life of another, even upon their request.

The Quakers however are more divided in their view. Some consider euthanasia as being the merciful option and by allowing the option of euthanasia to someone would be fulfilling Jesus’ rule to “love your neighbour as you love yourself” . Others however think that, “ Prayer ... may bring healing and unity”

This is a preview of the whole essay

        Judaism’s scriptures include “Thou shalt not kill” which, effectively, euthanasia is going against. Orthodox Jews would argue that this is a direct command from God and to oppose it wou ld be going against God directly. In Samuel 1:8-10, an Amalekite tries to tell King David that he had helped kill Saul because Saul had asked him to. This is an example of euthanasia however King David has the soldier executed. More recently, a rabbi on a website (who remained anonymous) has stated that, “Jewish law forbids euthanasia in all forms, and is considered an act of homicide ”. It can therefore be seen that euthanasia is forbidden in Judaism and going by their point of view, should not be legalised.

        Muslims would oppose euthanasia in every way due to the fact that there is an imperative command in their scriptures. The Qur’an says, “Take not life which Allah made sacred” . The Qur’an too claims that, “no person can ever die except by Allah's leave and at an appointed term”. This suggests that is it forbidden by Allah, then the Islamic view would too be to never legalise euthanasia.

        From a Religious standpoint, no matter how other views are looked upon, the standpoint is overwhelmingly obvious not to let euthanasia come into practise as it goes against the will of God.

ETHICAL THEORIES:

UTILITARIANISM

Jeremy Bentham devised utilitarianism it can be seen that utilitarianism strives for the greatest good for the greatest number. Bentham clearly expresses this when he states, “The principle of utility is meant to... augment or diminish the happiness of the party in question” . This is the greatest good for the greatest number and it can be argued that perhaps terminating someone’s life might be the greatest good as their loved ones no longer have to see the patient suffer.

In his book utilitarianism 1863  John Stuart Mill favoured rule utilitarianism because it was similar to the original; however, this version followed some rules to provide the greatest good for the majority. An example of this is driving on the left side of the road in England. It might not be convenient for us but is good for everyone else in England as it helps maintain order. People in favour of following this type of utilitarianism would say that as long as we have a set of rules, we could all be as happy as possible.

        Negative utilitarianism tries to eliminate all pain altogether. Although this is good in theory (having no pain in the world), this would mean that we would use any pain that we did come across as an excuse for euthanasia such as a tiny pinprick that might make us select euthanasia.

Preference utilitarianism is distinguished, as everyone’s experience of satisfaction is unique, as we cannot decide what is good as it differs for different people. We could apply this with statistics to see who would approve of euthanasia, as everybody’s opinion would be different.

        A criticism of euthanasia is, what stops one person’s pleasure being carried out? If an insane person liked to kill people and a sane person liked to watch television, we would then (following utilitarianism) have to give equal weight to the insane person because he is still getting a pleasure out of killing someone as the sane person is, watching television.

FLETCHER AND S.E.

        Joseph Fletcher devised situation ethics. Situation ethics (a teleological theory) is a guide to know how to show the most agape love in a particular situation, “the situationist follows a moral law or violates it according to love’s need” . Unlike utilitarianism, this can deal with the individual case. There is however a major flaw in this argument, which is that it, is a slippery slope argument. It over steps some ethical boundaries such as if we were to legalise euthanasia, then it could lead to lots of justifications such at infanticide and other things that can be reasoned with using situation ethics.

The flaw of situation ethics is that it can be used to justify virtually anything. If a doctor performs involuntary euthanasia behind the patient’s back, he could use situation ethics to rationalise that the patient was suffering and since in this individual case, it was the right thing to do, he would be right. This is an abuse of the system and some will abuse it.

        Immanuel Kant considered humans to be obligated to follow a moral obligation such as “thou shalt not kill”. He feels we are duty bound to follow these obligations. In reference to euthanasia, he would be against it, as he does not believe euthanasia to be a moral obligation. Kant believes that we just do know what to do because he said we have categorical imperatives, which are a set of immutable rules that we all follow. In 1785  Kant argued that, “ morality is not the doctrine of how we may make ourselves happy, but how we may make ourselves worthy of happiness”.  He means we must do things that make us worthy of contentment. In this case, doing the right thing is to not allow for the legalisation of euthanasia.

DEONOTLOGICAL ETHICS

        For deontological ethics, the important thing is not the result, but how we get there. If the action is wrong to start of with, do not do it at all. They would say that we should not kill because the act of killing is wrong in itself. If we take an example of torturing a prisoner who has valuable information, they would be opposed to it no matter the outcome because the act of torture is bad. When applied to euthanasia, they would hold the view that we cannot end someone’s life because the act of ending someone’s life is not right even if the consequence is good.

FOR EUTHANASIA (including keeping dignity)

        Euthanasia is already a legal practice in countries such as Switzerland and the Netherlands. Keeping someone alive with medical treatment knowing that they will not survive is costly. Although brutal, the fact still remains that giving them the option of euthanasia can greatly reduce hospital bills, costs for other patients and provide more free beds.

        It can be argued that the opportunity of euthanasia can allow people to maintain their dignity if they do not want to allow their family to see them like this or want to stop being what they might perceive as a burden. The human rights declaration states, “Everyone shall have the right to freedom of expression” . This includes the freedom of being able to choose whether or not they should be able to die or not, when they choose.

The humanist  Thomas More argued that if one is undergoing “a torturing and lingering pain… they may choose rather to die since they cannot live in much misery” . It seems that More is arguing that euthanasia is a merciful and loving option even if it does end a life. More can be seen to promote the pro-choice movement and therefore the legalisation of euthanasia.

        John Stuart Mill argues that the choice does not concern others who are not experiencing the same trauma as the patient. He explains, “In the part that merely concerns himself, his independence is sovereign”. Mill argues that our opinions should be respected. This view is upheld by the VES  as they state that we have the right to choose our own destiny, which includes when and how we should die. This suggests that it should be made the law because if people should be given the choice to control their destinies, then why is the law acting as a barrier against this?

        David Hume supported a libertarianism view. He said, “By liberty, we can only mean a power of acting or not acting” . Being a libertarian, he believed that we are free to make our own choices and we should not have anything ‘determined’ for us whether it be by destiny or law.

AGAINST EUTHANASIA (GENERAL)

        Some would be blinded by their pain and think for the short term. They could decide that the pain is too great and they would be happier if the moment stopped. Do people who ask for euthanasia (who are in great pain) really know what they are asking for? Many people with painful periods in their life can look back and be glad that the law did not allow the option to tempt them and that they can live the rest of their lives in full.

        Hooker argues that mistakes could be made. He disputes euthanasia by saying, “after a person has died, it would become apparent that the diagnosis was incorrect” . Hooker suggests with the intention of expressing the view that not all doctors will get a diagnosis exact and the consequences could be dire. By not allowing euthanasia, this problem is eradicated.

        Elderly relatives could think that they are being a harsh load on their families and want to take some weight off their shoulders. They could choose death as an option and choose euthanasia. This would be abuse of the system and in fact not be the best option when they still have a potential to lead a fulfilling and satisfying life. Jonathan Glover (British philosopher) notes that people will act depending on others, including if the consequences are dire for them. This type of mistreatment of the law can be stopped by not allowing euthanasia to be legalised.

        A hospital is a place of safety and somewhere where people go to get better. If this place is tainted with the option of voluntary euthanasia, people could feel intimidated to go to hospital in fear of a doctor deciding for them whether or not they should live or die if they can no longer respond.

        The case of Tony Bland (UK) was after the Hillsborough disaster of 1989. He was left on life support machines and although able to feed and breathe, he was in a coma. The case resulted in his life support machine being switched off. The outcome was that his doctor could not be expected to preserve his life at all costs. This however leaves the moral question of should it have been switched off even though more could have been done? This case from a practical point of view supports euthanasia as it shows that the doctor’s time and government’s money can be used elsewhere where it can actually be of a benefit.

PATIENT CHOICE vs. DOCTOR RESPONSIBILITY

        the patient has the right to make a choice whether or not they opt for euthanasia however the doctor also has a responsibility to make a choice whether or not a patient should undergo euthanasia or not. some christian doctors (xtian doctors) have refused as it goes against the commandments whereas others (not christian) refuse to do it because it goes against what being a doctor is about, they should be saving lives not ending them. others would argue that we couldn’t legalise euthanasia because some doctors would look to lower costs and perhaps recommend or perform euthanasia unnecessarily. the hippocratic oath that a doctor takes because they are there to save lives, “i will neither give a deadly drug to anybody who asked for it, nor will i make a suggestion to this effect”. one could argue that to stay true to their pledge, they must not accept euthanasia and be very much against its legalisation., bma view (will put this into my own words but for now i just need the information on it).

The British medical association is against euthanasia. It argues that there are ethical issues at stake.

“The moral arguments that killing is intrinsically wrong, alien to the ethos of medicine and potentially diminishes societies that permit it as a solution for social problems are reinforced, in the BMA's published view, by practical concerns”.

If the doctors who are the ones that will be carrying out the act of euthanasia are not willing to do it, we cannot pass this law.

The recent ‘assisted dying for the terminally ill’ bill was rejected by BMA doctors by 163 to 88 doctors refusing it. This is almost double rejecting the statement, maybe because of religion or perhaps morality but nevertheless, it is still a rejection from the doctors and their view as well as the patient’s must be respected.

ALTERNATIVES TO EUTHANASIA

We can also discuss the various alternatives to euthanasia such as living wills. A living will is a written document, a witnessed oral statement and other ways, which contain evidence that outlines the treatment, which the person would like to receive if they become seriously ill/lose mental capacity. Believers of pro choice support this view as it has a trigger effect that allows you make your own decision (that you have previously written) when the time comes. If going by this, then euthanasia can be legalised because people can decide for themselves way in advance.

        Craig Donellan wrote an article called ‘The ethics of euthanasia’ (2005) explaining what living wills were, mainly giving a concise explanation on how beneficial and easy they are to get. Referring to websites such as ‘ ’. this shows how easy it is to get a living will and information is readily available.

        TENS machines are another alternative as they send electrical signals that simulate nerves to prevent pain. They are a good idea in theory, however when it comes to practise, in situations such as childbirth, they become nullified. They can be compared to placebos, as patients sometimes do not really know when they are receiving these signals and when they are not. This is not a valid substitute for euthanasia as in the latter stages of illness, when the patient is in chronic pain, euthanasia may seem like the better option at that point in time. Research, by the surgical unit of Westminster hospital, showed that they were ineffective at times of great pain such as childbirth and immense pain, “ we conclude that TENS … does not reduce postoperative pain” . This asks a question, are they really a successful alternative to euthanasia for those in chronic pain?

        Hospices are there to attempt to relieve pain and provide support for a patient, their family and friends. There are only about 100 hospices in the UK so it is very difficult to get a place. The three main aims of hospices are, to relieve pain, to help face death and to care for emotional needs of family and friends. The hospice ethos is that of encouraging the patient to still have a fulfilling life in the time they have left and give up. Hospices however are expensive and some people do not want to be a financial burden on their family. Ultimately, we ask ourselves, can hospices, really lure us away from the ‘easy way out’ and provide such a service that substitutes our thoughts of stopping all the pain instantly?

SLIPPERY SLOPE ( I will break this information down later)

People think that if we legalise euthanasia, we will ultimately fall into the trap of involuntary euthanasia and doctors will have lots of power over our fate.                 It is not possible to register every act of euthanasia voluntary, as there would be some cases of involuntary where the patient has their destiny decided for them.        Elderly, weak, lonely and depressed people could feel that euthanasia is the right way to go and a doctor who is not particularly worried about his patients, rather his efficiency, he would encourage the act.

“This is called the slippery slope argument. In general form it says that if we allow something relatively harmless today, we may start a trend that results in something currently unthinkable becoming accepted.”

There is a significant difference between terminating someone’s life on mutual terms and simply going ahead and doing it without permission.   “A 1998 study found that doctors who are cost-conscious and 'practice resource-conserving medicine' are significantly more likely to write a lethal prescription for terminally-ill patients”.

In conclusion, there is no way we could accurately and conclusively predict the effects of euthanasia. If we were to claim that it would go badly, we can look at Netherlands or Switzerland and see that things run smoothly over there. We could equally use the example of Harold Shipman and argue that his type of abuse of the system can be repeated by other doctors but even more dramatically and often, as they would have the law to support them. Euthanasia is a topical issue that will constantly be discussed and put forward as an option by people. However, for now, people (such as the 163 to 88 doctors rejecting the ‘assisted dying for the terminally ill’ bill as explained previously) will favour opposing it, as at the moment, it seems as if the system currently intact is working and there is no decisive reason to change it to change it would.        

        The question still posed is why do people still want to turn to euthanasia if there are alternatives? The answer is that euthanasia will end it all and cause no burden on the families or prolong the person’s suffering no matter how the hospices make it feel or how much the TENS machine buffer the pain. Euthanasia is a realistic option based on its alternatives, it should be legalised.

        The argument that brings the euthanasia dispute to a dilemma, is what happens if a mistake is made? What happens if a patient it misdiagnosed, opts for euthanasia? We cannot bring someone back when they are dead but we can help them while they are alive. “Suffering, especially during the last moments of life, has a special place in God’s saving plan” .

References taken from the following sources:

• “Ethical Studies”                                Robert Bowie
• Any websites mentioned in the footnotes.

 June 29 2006

 Homicide act of 1957

 Suicide act 1961

 information from paragraph based on ‘Sarah K Tyler, Raithly, Lawrence &Co Ltd 2000’

 Statement from the Roman Catholic Church

 Pope Benedict XVI

 Exodus 20:13 6 th  commandment

 Mark 12:31

 Quaker yearly meeting 1995

 Ohr.edu

 Al-An’am 6:151

 ‘Principles of Morals and Legislation’ 1781 Chapter II

 Fletcher, ‘Situation Ethics, The New Morality’

  Fundamental Principles of the Metaphysic of Morals

 Article 19 point 2

 One who gives importance to human beings

 From his book ‘Utopia’ 1516 chapter 8

 Voluntary Euthanasia Society

 ‘An enquiry concerning human understanding’ 1748

 Hooker 1997

 http://www.bma.org.uk/ap.nsf/Content/Euthanasiaphysicianassistedsuicide~Euthanasia

 http://www3.interscience.wiley.com/cgi-bin/abstract/112200476/ABSTRACT?CRETRY=1&SRETRY=0

 http://www.bbc.co.uk/religion/ethics/euthanasia/against/against_4.shtml

  Arch. Intern. Med., 5/11/98, p. 974

  Declaration on Euthanasia - Rome 1980

Document Details

• Word Count 4134
• Page Count 8
• Level AS and A Level
• Subject Religious Studies & Philosophy

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Tips for A level students. Lesson ramblings for teachers (helpful ideas too!)

“What would Aquinas say about Euthanasia?”Tackling the Application Essays

The application topics work as follows:

• Natural Law and Situation Ethics as applied to euthanasia
• Kant and Utilitarianism as applied to business ethics

My understanding is that there are three possible types of questions you might be asked in ethics:

• Specific topic and issue (e.g. Natural law provides a helpful approach when dealing with issues surrounding euthanasia )
• Two topic comparison with issue (e.g. Utilitarianism is more helpful than Kantian ethics when dealing with ethical dilemmas )
• Just issue (e.g. Evaluate the view that the religious concept of sanctity of life is outdated)
• A question might say ‘ethical dilemmas’ or ‘ethical issues’ which means you still need to talk about the related application topic, even if it is not specified (like Q2.)
• If the question is just on the issue, you still need to draw in arguments from one or both topics, not just a general discussion of the issue (like Q3.)

So here are my tips to help you handle an application question. These four steps will work with any type of application question.

Step One: Work out the Five Paragraph Rule (see The Five Paragraph Rule for more guidance) for the topic/s

Step Two: Identify the ‘issues’ you wish to discuss (e.g. Euthanasia focuses upon sanctity of life, personhood, quality of life, slippery slope etc.)

Step Three : Plan ways to link the topic with the application issues.

Step Four: Work out your line of argument (is the topic helpful etc.)

The table below gives you a structural overview for Q1:

Note: I use words such as ‘may’ or ‘might’ so ‘may indicate’ and ‘might argue’ as you can only ever make assumptions about the application. Never say: Natural Law would be against because (as you just don’t know)

The table below gives you a structural overview for Q2:

Utilitarianism keeps the structure of the essay for two reasons. One because it is the topic mentioned in the question first, so by starting the paragraphs with Util means you are always keeping the question in mind. Secondly I advise you to stick with the same topic at the start of your paragraphs to avoid adding further complications (one paragraph starting with Utilitarianism another starting with Kant etc. just sounds messy). So even if the topic is not specified in the question (such as Q3) I recommend you structure your essays using the themes from one topic.

As you will notice there are only four paragraphs in this essay structure above (not the ‘five paragraph rule’ I advocate). This is because you will be comparing two topics with evaluation and application issues, therefore each paragraph will be quite lengthy = less paragraphs.

Please note: the two tables above are to show how to structure an essay, not demonstrating how to write coherent and eloquent arguments (as this would take a much longer paragraph). With this in mind don’t forget to add ‘defense’ arguments, books, quotes, other names etc.

Further Note: in the comparison section only link to one theme from the other argument per paragraph as well (so Util and pleasure vs Kant and duty), so at any one time you are only comparing one theme from each topic with one application issue.

For examples of student’s work see  “Natural law provides a helpful approach when dealing with issues surrounding euthanasia”: Student’s Work  And  “Utilitarianism is more useful than Kantian Ethics when dealing with ethical dilemmas” Discuss

For further guidance in developing your essay technique  just click on the image below to be transferred to the shop.

Check out this Tips from a Tired Teacher Preview on How to Write an Application Essay:

To continue watching this Top Tips video as well as having access to all 30 revision podcasts and Mark with Me’s then join I Think Therefore I Teach’s exclusive membership on the Home page.

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'How effective is Situation Ethics when applied to euthanasia?' Essay PLAN OCR R.S A Level

Subject: Philosophy and ethics

Age range: 16+

Resource type: Assessment and revision

Last updated

6 October 2023

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Really detailed essay plan covering how effective situation ethics is when applied to euthanasia. Includes many amazing evaluative points and will help with access to top marks!

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