Medical Ethics PHIL 148 @ Binghamton University, Sum 11


Euthanasia Debate

Question: If one terminal cancer patient refuses necessary life-sustaining treatment and another terminal cancer patient purposefully takes a fatal dose of necessary painkillers for managing the pain of the cancer, are these two circumstances of death morally different?


There is a moral difference between refusing treatment and taking a lethal dose of medication. Both situations are voluntary euthanasia; the major distinction is that the first is classified as passive euthanasia while the second is active euthanasia. The moral distinction according to Callahan would be that active euthanasia is killing while passive euthanasia is letting the person die. Although the end result is the same they are morally different. In one case you are adding something to cause death while in the other you are removing something to let the person die however they would in nature. In active euthanasia you are doing something to cause the death of the person while in passive euthanasia you are letting something happen, that isn’t your fault, which will result in the person’s death. While it can be agreed upon that killing another person is wrong, it can be said that letting a person die when there is no possible chance of cure or treatment is never wrong.

In the case of active euthanasia another person’s involvement to some degree is required. Unless the person steals the drugs used to end their life they had to get them from someone, usually a doctor. This request for the drugs to end their life would be a demand of treatment which the doctor does not have to respect or follow. This also has the possibility of creating a moral conflict for the doctor which would be morally wrong for the patient to do. This agrees with care ethics which would disregard the autonomy of the patient in exchange for caring for the patient and the interpersonal relationship with their health care professionals especially doctors. Refusal of treatment has the possibility to involve no one, although comfort measures are often taken which would involve health care professionals. The doctor also has an obligation to respect the wishes and autonomy of the patient who is informed and understands the implications of their refusal.

There is also the controversial argument that in some cases active euthanasia may actually be the more merciful option. In some cases comfort measures are not sufficient enough and do not provide the necessary relief from pain that would make passive euthanasia bearable. In these cases it can be argued that it is morally wrong to let that person suffer through the process of passive euthanasia. While passive euthanasia can take days, weeks, months, or years, active euthanasia provides immediate relief from suffering. This of course depends on the euthanasia being voluntary and the patient being well informed of all their options and competent to know what is right for them removed from any outside pressures.

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