Assisted Suicide or Euthanasia
One of the most critical issues underlying the question of justified killing in medicine is whether the act of assisting persons in bringing about their deaths causes them a loss or, rather, provides a benefit.
Assisted Suicide is a person’s voluntary suicide with help from another individual. Individuals who elect to kill themselves with the assistance of another person typically have an incurable illness or are experiencing extreme physical suffering.
On the other hand, euthanasia is a practice of mercifully ending a person’s life in order to release the person from an incurable disease, intolerable suffering, or undignified death.
The term assisted suicide can be referred to the act of providing an individual with the means to commit suicide, knowing that the recipient plans to use these means to end his or her own life.
If a doctor provides medications or other means of committing suicide with the understanding that a patient may intentionally use them to end his or her own life, this action is referred to as physician-assisted suicide.
The fundamental ethical issue regarding assisted suicide is whether acts by physicians that help others kill themselves (or let others die) can be morally justified, not whether these acts should be legalized.
Those who believe assisted suicide is morally prohibited maintain that it is impermissible for a doctor to kill a patient and that a defensible distinction exists between killing a person and letting a person die. However, this distinction has proved difficult to define and explain precisely.
Those who support assisted suicide maintain that any distinction between killing a person and letting a person die that may exist is actually irrelevant to the question of whether assisted suicide can be justified.
Advocates of assisted suicide note that it is generally agreed that killing is justified under some conditions—for example, in cases of self-defense.
Therefore, they argue, correctly applying the label “killing” or the label “letting die” to a set of events does not, by itself, indicate whether an action is acceptable or unacceptable. Instead, supporters argue, rightness and wrongness depend on the justification underlying the action.
Medical Ethics Stand
Medical ethics agree that physicians may forgo treatment when a patient or the patient’s authorized representative refuses treatment.
Thus, valid refusals justify physicians to “allow” a patient to die when the patient could be kept alive with treatment.
Supporters of assisted suicide believe that some acts of assisting in bringing about death can be framed similarly to refusals of treatment. Such actions could then, in principle, be justified by a request of the patient.
They contend that a patient’s request for a fatal medication is analogous to a patient’s refusal of life-sustaining medication.
However, the traditional view in professional medical ethics is that a request for assistance in dying by a competent patient does not have the same authority and obligatory force in law and morality that a valid refusal of treatment has.
Therefore, such a request does not justify an action of physician-assisted suicide.
If a person chooses death and sees that event as a personal benefit, then helping that person bring about death may neither harm nor wrong the person and may provide a benefit or at least fulfill the person’s last important goal.
On the one hand, avoidance of intentionally causing the death of patients is a deep and primitive restraint encouraged by many reservations that society has long had about killing innocent persons. To change this perspective would seem to be sweeping and dangerous.
Opponents of assisted suicide fear that doctors will become less committed to saving lives, that families may respond to financial pressures by subtly encouraging suicide, and that limitations in the resources of the health-care system might dictate decisions of life and death.
On the other hand, some people question whether physicians should be restricted by law and morality if they may benefit patients in ways other than just by healing and providing noncurative pain relief.
Euthanasia, though similar to assisted suicide, has its own differences. In this case, the act is a suicide (intentional self-inflicted death), because the patient actually causes his or her own death.
Euthanasia is a practice of mercifully ending a person’s life in order to release the person from an incurable disease, intolerable suffering, or undignified death.
The word euthanasia derives from the Greek for “good death” and originally referred to intentional mercy killing.
When medical advances made prolonging the lives of dying or comatose patients possible, the term euthanasia was also applied to a lack of action to prevent death.
Active euthanasia involves painlessly putting individuals to death for merciful reasons, as when a doctor administers a lethal dose of medication to a patient.
Passive euthanasia involves not doing something to prevent death, as when doctors refrain from using an artificial respirator to keep alive a terminally ill patient.
In voluntary euthanasia, a person asks to die (by either active or passive euthanasia). Nonvoluntary euthanasia refers to ending the life of a person who is not mentally competent to make an informed request to die, such as a comatose patient.
Tom L. Beauchamp (B.A., M.A., PhD)
Beauchamp is a professor of philosophy and Senior Research Scholar. He is also the author of Philosophical Ethics and other books. ‘Assisted Murder’ and ‘Euthanasia’ are articles contributed by the author to Microsoft®