Active and Passive Euthanasia

Active and Passive Euthanasia by James Rachels

• Rachels argues against the common view that active euthanasia is immoral, but passive euthanasia is not
• Active euthanasia is "the intentional termination of the life of one human being by another"
• Passive euthanasia is “the cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent"
• The American Medical Association (AMA) permits passive euthanasia but condemns active euthanasia
• Rachels finds the AMA’s policy misguided and offers arguments against it

Rachels' Arguments Against AMA Policy

• Passive euthanasia can lead to more suffering than active euthanasia
• Active euthanasia can be a morally better option for a dying, suffering patient
• Passive euthanasia contradicts the decision to not prolong life
• The AMA policy leads to life-and-death decisions on irrelevant grounds
• Doctors and parents may not prolong lives of infants with Down’s syndrome plus a physical malady (bowel obstruction)
• The justification is the bowel obstruction, but Rachels believes the real reason is Down’s syndrome and poor predicted quality of life
• Rachels argues the reasoning is flawed because the moral status of euthanizing infants with Down syndrome should not depend on bowel obstructions

Evaluating Moral Judgements

• Rachel examines the assumption that killing someone (active euthanasia) is more morally problematic than letting them die (passive euthanasia)
• He argues that killing is not always morally worse than letting die
• Smith drowns his cousin to inherit money
• Jones finds his cousin injured and drowning, and lets him die to inherit money
• If killing is morally worse than letting die, Jones' behavior is better than Smith's
• Rachels says both men are equally bad because they acted on the same motive (personal gain) with the same view in mind

Euthanasia Analogy

• Rachels acknowledges the examples are not directly analogous to euthanasia because doctors don't financially gain from patient deaths, nor do they intend to kill healthy children
• The examples support the point that the mere difference between killing and letting die does not inherently create a moral difference
• Withholding treatment can intentionally kill a patient, blurring the moral line between active and passive euthanasia
• Any situation justifying passive euthanasia also justifies active euthanasia

Euthanasia, Philippa Foot

• Philippa Foot defines euthanasia as "inducing or otherwise opting for death for the sake of the one who is to die”
• The moral status of euthanasia is evaluated based on how acts of euthanasia manifest or violate justice and charity
• Justice concerns what people owe each other in noninterference and positive service, involving rights & duties
• Justice does not concern itself with what is good for another person
• Charity is "the virtue which attaches us to the good of others"

Justice vs Charity

• There is no direct connection between people's rights and what is good for them
• An action can show one virtue and lack the other, like keeping a person alive who wants to die
• Killing the person would be unjust, but keeping them alive would not be charitable

Retreading Army Analogy

• A retreating army abandons wounded soldiers in a wasteland where they will starve or be captured by a cruel enemy
• The army offers to kill the soldiers to spare them from this fate, but one demands to be kept alive
• Killing the soldier would be unjust, even if letting him live would not be good for him

Active vs Passive - A matter of Perspective

• Unlike Rachels, Foot considers the distinction between active and passive euthanasia morally relevant
• The right to life creates a duty of noninterference, which is more widespread than duties of care
• Respecting the right to life only requires noninterference
• Active euthanasia directly interferes with lives, violating the right to life in a way that passive euthanasia does not

Actions against Virtues

• Foots challenges Rachels' interpretation using the two examples to deny moral significance between active and passive euthanasia
• Unethical actions in each example are inconsistent with justice and charity
• Drowning the child was unjust and uncharitable
• Allowing the child to drown showed a lack of charity
• Because "the requirements of justice and charity coincide” in each example it was possible and easy to satisfy both virtues simultaneously
• Foot’s retreating army example demonstrates that “charity would have required that the wounded soldier be killed had not justice required that he be left alive”
• Justice and charity impose different requirements, occasionally coinciding or conflicting
• When they conflict, the distinction between active and passive euthanasia matters

Conflicting Requirements

• Rachels' argument that active euthanasia is more humane is weak in Foot's analysis
• Active euthanasia that infringes rights is morally wrong, even if more charitable
• If a patient cannot communicate their desires for euthanasia, active euthanasia is immoral, but passive is not
• The right to life remains even when desires are unknown
• Active euthanasia violates this right, and caregivers must not directly kill the patient
• Passive euthanasia does not infringe on this right

Voluntary Request

• Active euthanasia is not unjust if the person requests to be killed
• Such a request would rescind rights to life and exempt caregivers from typical non-interference
• Active euthanasia might still be uncharitable
• A request exempts caregivers from justice but not charity

Justice Focus

• Foot focuses on the virtue of justice to analyze voluntary and involuntary active & passive euthanasia
• Involuntary active euthanasia is unjust because it violates the patient’s right to life
• Voluntary active euthanasia and both forms of passive euthanasia do not violate rights, thus are consistent with justice

Virtue of Charity

• An act of euthanasia that does not infringe rights is more likely to be in favor of charity
• Involuntary active euthanasia always infringes rights, so charity would advise against it
• To be killed against the virtues, requires the decision to be their own

Compatible Acts

• Voluntary passive euthanasia and involuntary passive euthanasia can be compatible with charity.
• Foot explores the implications, questioning the wisdom of legalizing euthanasia compatible with justice and charity
• There are concerns that doing so would make preventing unjustified euthanasia very difficult
• Legalizing permissible euthanasia could make it easier to engage in acts against those virtues

Consequences of Euthanasia

• Legalizing euthanasia could have undesirable social consequences
• There could be less incentive to care for the elderly and ill
• Society may prefer to euthanize them rather than spend resources
• Foot views it as a potential "spiritual disaster"

Defense of Capital Punishment, John Stuart Mill

• Mill defends the death penalty as punishment for murder, believing it is less severe and more merciful than life in prison
• The effectiveness of punishment depends on apparent severity, not actual severity
• No punishment makes as strong of an impression as the death penalty
• Murderers serving life sentences will suffer more for a longer time than if executed
• The death penalty inspires more terror but is less cruel than any alternative punishment

Hypocricy Debate

• An objection claims killing murderers is hypocritical as it is impossible to respect life by taking lives
• Also, it cannot deter people by inflicting suffering on others
• Human feelings are sacred, not the physical ability to exist
• The aspect of human life that needs respect is the capacity to suffer
• Deterring by suffering is the purpose of penal justice
• The objector's reasoning leads to absurdities when applied to other crimes
• Fining criminals doesn't show contempt for property, and imprisoning doesn't show contempt for freedom
• Executing murderers shows deep respect for life by enforcing the principle that violating others' right to life forfeits their own

Executing Innocents

• Executing innocents is a serious, irreversible miscarriage of justice
• It is the greatest objection to capital punishment
• Mill would withdraw support if the legal system was too corrupt for fair trials
• The British system is adequate and gives defendants a fair chance, making such executions rare
• The common British attitude in 1868 was to reduce judicial punishment severity which was so prevalent Mill described it as mania
• This attitude makes executing innocents very unlikely

Arguing About the Death Penalty, Hugo Adam Bedau

• Modern death penalty arguments focus on factual questions like deterrence, racism, discrimination, executing innocents, and recidivism
• Unanimous agreement on these issues wouldn't determine if the death penalty should be prohibited, preserved, restricted, or expanded
• Even if data shows the death penalty is flawed it should not always be replaced because life imprisonment has flaws

Resolved Moral Disputes

• Empirical facts cannot resolve death penalty disputes as policy conclusions cannot be deduced from factual premises alone
• Arguments must include normative propositions
• Disputes can be resolved if there is agreement with the norms
• Normative propositions express social goals or moral principles that achieve in confinement with morals
• Bedau lists five goals that punishment should achieve, which include:
• Punishment that should reduce crime
• Be economical
• Rectify injustice caused
• Serve as a channel for public indignation
• Turn offenders into better people

Defenders View

• Capital punishment defenders argue it achieves the first two goals
• Opponents deny this claim without opposing the goals
• Both sides agree to the goals, disagreeing on the death penalty's effectiveness
• One cannot support reforming and the death penalty
• Impossibility to rectify harm caused by a murderer can be rejected by both sides

Moral Theories

• Death penalty proponents agree more with the fourth goal than abolitionists
• Punishment with that goal must adhere to specific moral principles
• Enforcing moral principles would make capital punishment impermissible, such as torture
• Methods, such as torture would make society's hatred clear

Contraints

• After discussing the goals of punishment, he attempts to identify the moral principles that constrains them
• No one’s life may be deliberately and intentionally taken by another unless there is no feasible alternative to protect the latter’s own life
• The more severe a penalty is, the more important it is that it be imposed only on those who truly deserve it
• The more severe a penalty is, the weightier the justification required to warrant its imposition on anyone
• Whatever the criminal offence, the accused or convicted offender does not forfeit his rights and dignity as a person
• There is an upper limit to the severity – cruelty, destructiveness, finality – of permissible punishments, regardless of the offence
• Fairness requires that punishments should be graded in their severity according to the gravity of the offence
• If human lives are to be risked, the risk should fall more heavily on wrong-doers (the guilty) than on the others (the innocent)
• Bedau claims society accepts these, so he doesn’t not need to support them

Resolve the Debate

• The crucial task is determining to what extent these seven principles can resolve the debate
• The first five principles provide more support for the anti-death penalty side because of no exception in counsel
• The sixth and seventh provide strong support
• If there is a murder, principle six says it must be punished and should be graded base don severity
• Moral better to murder the innocent - in order to preclude them from murdering again that to just abolish it

Disagreements

• Bedau disagrees with his application that it violates the original principals - as there must be a reasonable estimate
• Believes the death penalty projects a false misleading picture
• Kant believed for murdering to the ends, can result in execution
• People should decide how to live their purpose and goals
• By executing murderers we treat them justifiably