Euthanasia has been a topic of debate for a long time and for many reasons with individuals from all professions and backgrounds bringing up new facts to either support or dispute this practice. One of the main topics in this debate is whether a patient with a disability is able to make the decision to end their life while in a rational state of mind. A big problem in this topic is that many have a hard time determining whether some one with a physical disability is rational or not. Society has formed many notions about disabled people that make them think that as soon as some one is disabled, they can no longer be rational. Karen Hwang tries to tackle this problem by arguing that a disabled person can make rational decisions about suicide and also how to combat these man-made beliefs. She believes that by abandoning society’s view of the disabled and looking at each individual’s case, we can determine whether the decision was made rationally or not. Looking at this issue through John Stewart Mill’s utilitarian point of view doesn’t seem to give an adequate answer to the decision’s morality however. His views can be used to both support and dispute the issue depending on the number affected and the overall happiness of the people in question.
Mill’s theory of Utilitarianism judges morality based on the consequences an action brings. For people to act in a Utilitarian way, actions must bring about good consequences. Mill’s view of a good consequence is an action that brings about pleasure or happiness and decreasing pain. According to Mill’s Greatest Happiness Principle, to act morally an action must bring about the greatest amount of happiness for the greatest number of people. Mill would even go on to say that sacrificing one’s own personal happiness can still be moral as long as that person’s action bring about the greatest happiness overall. According to Mill there are also different types of pleasure. He talks about higher pleasures that stimulate the intellect while lower pleasures are much simpler and stimulate the body. Ultimately it our goal as humans to aim for these higher pleasures because they bring about greater happiness than lower pleasures. To be a judge of whether a pleasure is lower or higher a person must have experienced many different pleasures. For someone to act morally through his or her life depends on the different circumstances of a situation, but as long as the consequences of the actions result in the greatest overall happiness then it is reasonable to deem that person moral.
The problem with Mill’s theory is that it focuses on the consequences of an action and not the decision-making process leading up to that action. Much of the debate against euthanasia is that the desire stems from depression and other influences that would alter a person’s state of mind. This change in thinking may go against a person’s values when they were rational and may actually want to be stopped from committing suicide. This may not always be the case, but it has become the general assumption in society, whether it is against the patient’s morals or not. Mill’s Utilitarianism does not take these factors into account. In one situation, suicide could be moral according to the Utilitarian school of thought, and in another it could be immoral; it all depends on how much happiness is brought about with the loss of that person’s life. Generally, euthanasia would bring about more sadness than happiness, but there are the few circumstances where some one’s death might be the better option. Mill’s theory also takes more into account other people’s views rather than the one making the decision. A person with a disability would not be able to make decisions for themselves and must make them for the sake of others under this way of thinking. There may be few times where the views of the patient and others will coincide, but this is more likely the exception rather than the rule. It is because Mill’s Utilitarianism cannot take a firm position on the morality of euthanasia that it is not best ethical theory to use to analyze the issue.
Hwang’s opinion provides a more specific view of when a decision to commit suicide is moral and justified and when it isn’t. In Hwang’s article, she mentions that the decision should be made rationally in order for it to be acknowledged, rational being, “a desire for death that is independently attained, stable over time, in accordance with the persons basic values, and free from any perceptual inaccuracies or financial motivations.” (Hwang) She feels that disabled people have the ability to make rational decisions, but that they are either not acknowledged due to their disability or because of social devaluation. As before mentioned, society has the preconceived notion that a human life is valuable and that it should always be saved, whether it is in the best interest of that person or not. It is because of this that individuals with physical disabilities feel that they have lost control of their lives and can no longer make decisions for themselves. They see this treatment as a fate worse than death and therefore ask that they be able to end their lives. In her essay, Hwang suggests that society needs to approach these individuals and their circumstances with an open mind and listen to their pleas and their reasons. For example, one way Hwang suggests to fix this problem is through the psychological principle of locust of control. By showing that we acknowledge a person’s choice to end their life and, in turn, acknowledging that they have control over their own lives, their feelings of suicide may dissipate and their overall quality of life will improve. She goes on to argue that a request from a disabled person to end their life should be treated equally with some one who is not disabled and wants to end their life.
I feel that Hwang’s argument provides a better analysis and response to euthanasia. One reason, as before stated, is because Hwang’s argument provides a clear line as to when suicide is acceptable and when it isn’t, unlike Mill’s theory. She determines that if the decision has been made rationally, that is taking the time to assess one’s life thoroughly without any outside motivators, then the request should be granted. Hwang also says that this rationality should be able to be proven through, for example, a psychological exam to make sure that the patient took the time needed to make this difficult decision and not made for the wrong reasons or too quickly. Another reason is that Hwang provides suggestions to promote rational thinking and make the decision more comfortable for people with physical disabilities. One of the main suggestions she gives is for a society wide acceptance of the thought that suicide can be a rational decision and that disabled individuals can rationally make a decision to end their lives. Hwang talks of how in today’s society, people with physical disabilities are subject to victimization. This victimization forces the disabled to feel that they need to be protected and therefore are unable to make their own decisions. As mentioned before, by allowing the open acceptance of this decision, a disabled patient may feel that he or she still has some control over his or her life and in turn could improve the quality of his or her life as well. Another argument for acceptance of the disabled’s ability to think rationally that Hwang brings up is between doctors and their patients who refuse medical treatment. In this relationship, doctors focus more on the disease a patient might have and treatment methods may be against that patient’s values. It is because of this view that some doctors have of their patients and the sick are sometimes forced to take medication that may cure a symptom of a disease but also have side effects that could be worse that the symptom is alleviated. With the treatment, many patients refuse medicine as a way to end their lives. This very idea of refusing something the could save one’s life seems like a ridiculous notion and therefore those who do try to refuse their treatment are considered mentally incompetent and could not make a rational decision to commit suicide. Again, be discarding this societal belief and analyzing each individual’s case, it can be seen that these stereotypical ideas cloud our vision and that we devaluate those who have made a rational decision to end their life. As Hwang puts it, “Those who misinterpret a thoughtful request as an expression of temporary depression risk trivializing the request and degrading the doctor-patient relationship into a battle of competing wills.” (Hwang) To avoid this “battle” doctors should take a patient’s request to end their life seriously and make sure that the decision was made rationally and not have the plea blindly ignored. By Hwang being disabled herself, we can see that she already has the experience of being disabled and is a much better candidate to speak on the topic while Mill, on the other hand, only speaks of life in general and is unable to provide a clear view on the topic.
To determine whether the decision to commit suicide was made rationally is a very difficult matter and needs to be examined thoroughly from patient to patient. According to Hwang, the first step is being able to do this is accepting that fact that a disabled person is able to make the same kind of decisions and that their disability has no effect on that. An individual who was able to evaluate their lives in the present as well as in the future and come to the conclusion that suicide is the best option should be allowed their wish to end their pain and be able to have their choice respected. Mill’s Utilitarianism could possibly allow euthanasia whether the reasons were irrational or rational, but this shouldn’t be the case. If an individual wants to end their life, the reasons should be able to justified and be within that person’s personal set of morals.