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?
Position: Morally speaking, there is no difference between refusing life-sustaining treatment and taking a fatal dose of painkillers. The patients who make one of these two choices have decided that they want to die. Yes different methods are being used but the final outcome will be the same, and both patients have the knowledge and understanding of the outcome of their decision. Is it immoral for a patient to choose the way in which they die? This is a part of their autonomy. As long as the doctor is not the one who administers the fatal dose of painkillers and it is the patient who takes the dose on their own accord, it remains within moral boundaries.
The key point in this case is that both patients are terminally ill, meaning they will eventually die. The patient who chooses to actively ingest the fatal dose of painkillers merely chooses to die sooner and feeling no pain, while the other patient chooses to die naturally. As a healthy person watching from the sidelines it is easy to dictate what we think is wrong or right in this delicate situation. However we cannot place ourselves in their position. Suffering from a terminal condition may make a person readjust their idea of what is wrong or right in terms of euthanasia. According Hwang we currently have a cultural antipathy towards active euthanasia, or suicide as he calls it, is largely because of Western Christian influence. He goes on to say that quality of life is important and that the decision to end ones life because of intolerable conditions can be a sane and dignified option that is the thoughtul result of reasoned judgemnt (Hwang, paragraph 5).
Since these patients are terminally ill, continuing to live would be a burden on medical resources and the medical staff. Continuing their treatment would only delay their death and perhaps prolong their suffering and even the suffering of their loved ones who are taking care of them. In fact, Hardwig would suggest that it is not onlymoral for them to choose one of the cited options of euthanization but that it is an obligation. They have a duty to die. Therefore, there is no moral difference in choosing passive or active euthanization. Both result in the same outcome and both are a direct and autonomous decision of the patient.