Voluntary Involuntary And Non Voluntary Euthanasia - Essay

In 1995, the Australian Northern Territory was the first place in the world to legalise voluntary euthanasia under the Rights of the Terminally Ill Act 1995. The first person to voluntarily end their life on Sunday, 22 September 1996 was Bob Dent, a terminally ill patient with prostate cancer (Grey 1999, p.19). As a reaction to this law and Bob Dent’s death a Liberal Party backbencher, Kevin Andrews introduced the Euthanasia Laws Bill 1996 which being a Federal Act over road the Northern Territory Act making euthanasia illegal in all States and Territories of Australia.

Nonetheless, the vast majority of Australians from doctors to philosophers support voluntary euthanasia. For example, Australian philosopher, Peter Singer, actively supports euthanasia in his book of Taking Life: Human while pro-euthanasia Doctor Phillip Nitschke assisted Bob Dent to die by a lethal injection. This essay explains what euthanasia is and discusses whether voluntary euthanasia should be a right of the terminally ill.

Euthanasia means ‘a gentle and easy death’, (Oxford Dictionary of Phrase and Fable 2006) and it is usually used to refer to the induced death of those who are incurably ill and in great pain or distress in order to spare them further suffering or distress. It is often referred to as ‘mercy’ killing.

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Singer (1993, p.175) classified euthanasia as voluntary, involuntary or non-voluntary. Involuntary euthanasia means without the consent of the person who dies even if they express a wish to live and is effectively murder even if the motives are to benefit the deceased. Non-voluntary euthanasia occurs where a person’s mental age is or has always been that of an infant so that they have no capacity of express any preference to live or die such as when someone is severely disabled infant since birth or those who suffer severe brain damages after accidents and become permanently mentally disabled. Sometimes people in this situation are allowed to die by withdrawing medical services such as intensive care treatment. Voluntary euthanasia which is where a person consciously chooses an early death (Singer 1993, pp.175-177). This essay will only focus on ethical arguments as to whether voluntary euthanasia and non-voluntary should be legalised.

One argument for euthanasia is the utilitarian principle which says that the lives of some people can be sacrificed for the benefit of others deemed more worthy of care. It has been said that ‘When applying the utilitarian theory to the ethics of euthanasia, can it not be said that Self Deliverance for a “competent” terminally ill patient is an unselfish act’ (Maj 2002)? Utilitarianism is commonly expressed as ‘the greatest good for the greatest number’ (Rohnann 1999, cited in Rich & Butts 2005, p. 9).

A moral theory is utilitarian if and only if it assesses rules in terms of nothing but their utility. Jeremy Bentham, invoked what he described as a fundamental axiom – ‘it is the greatest happiness of the greatest number that is the measure of right and wrong’ (Bentham 1823).

Utilitarian’s theorise that there is the same ground for voluntary euthanasia as for

non-voluntary euthanasia as death is the benefit for the person killed but is it possible to justify ending the life of a human being who lacks the capacity to consent in the same way as where people are capable of consenting, and do in fact consent (Singer 1993).

Utilitarians consider that death will bring peace to the patient, family and friends and can be justified purely on the utilitarian grounds that a terminally ill person has lost the ability to pursue the intellectual or physical life they once had or has lost dignity by becoming dependent on others for fundamental needs such as going to the toilet. (Maj 2002). Something I can identify with having seen my once proud grandfather after a stroke having to wear a nappy. In my opinion for many once dignity and self sufficiency are lost death is a release.

The strongest argument for active voluntary euthanasia is based on respect for individual autonomy or ‘self governance’. Autonomy is the belief that “every person has the right to shape their own life through their choices” — which includes ‘the right to choose the time and circumstances of their death’ and is expressed concerning basic human dignity (Grey 1999, p.21).

The principle of autonomy is an expression Kant’s ideal that having one’s own choice whether that choice is good or bad is of paramount importance for life. Kant believes that suggesting someone knows better than yourself in such a personal thing as death is a “dubious paternalistic presumption” (Grey 1999,p.21) in many ways similar to this current governments belief that they know best what you should see or read on the internet. J.S. Mill in his expression of the “harm” principle state: “the only purpose for which power can be rightfully exercised over any member of a civilised community, against their will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” (Grey 1999, p.21)

Autonomy acknowledges an individual’s sovereignty over all acts which only affect self on the basis that it is insupportable to have someone else choose the timing of one’s own death. (Grey 1999,p.21). This is difficult to argue against since only in the most horrendous crimes do States now have the power to deprive a criminal of life yet involuntary euthanasia suggests they have the right to kill non criminals. However if a person chooses to die we should respect that wish.

Peter Singer believes voluntary euthanasia is a matter of respecting a person’s preference and ‘overall well-being, welfare or interests’ in their particular circumstances such as when they are suffering from cancer. In Holland, a nationwide government survey found that ‘Many patients want an assurance that their doctor will assist them to die should suffering become unbearable’ (Singer 1993). One argument for euthanasia which involves utilitarian theory is the need to reduce society’s costs in an ever more crowded world by reducing the number of people needing intensive care.

There are many arguments against euthanasia. The possibility of abuse is one of the most common arguments against euthanasia. Abuse may mean patents are pressured by families or medical facilities to agree to ending their own life. Family may want to see the suffering end but they may also want to see the inheritance now. Doctors may wish to free up scare medical resources for those they believe they can save and in fact hospitals make these sort of choices by withdrawing medical support for the terminally ill. Opponents argue that ‘we can never be sure that a request to be killed is the result of a free and rational decision’, particularly as they are likely to be suffering pain, very probably drugged and confused (Singer 1993).

Depression is also an issue because it is a form of pressure from within. A depressed person is more likely to choose to take their own life whether or not they are terminally ill. Another argument against euthanasia is the level of protection required to ensure it is not misused will actually make it more painful. No one who is ill is going to want to face a barrage of questions and forms to choose death yet leaving the documentation to Doctors or Family or some other party leaves open the door to abuse.

There is also the ‘opening the floodgates’or ‘Slippery Slope’ argument that if ‘society accepts euthanasia as a universal right of “competent” terminally ill patients to decide their fate’ (Maj 2002) then how long will it be before society decides what should be done with the chronically ill, handicapped or simply old who no longer contribute but are a burden on society.

The Catholic Church objects to euthanasia on religious grounds saying that the church opposes euthanasia as “that life which God has bestowed on each one of us, can never be sacrificed for the sake of the good of self-determination” as it contravenes the “Thou shalt not kill” commandment (Demarco 2003, p. 154).However, the church distinguishes euthanasia from decisions to forego ‘aggressive medical treatment’ which are “medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family’ (Demarco 2003, p. 155).

In conclusion, voluntary euthanasia may be seen as a way of giving respect to those who are in distress and paid and wish to leave life, family and friends with dignity. While there are arguments against voluntary euthanasia they are, apart from religious moral concerns, easily overcome by putting in place appropriate safeguards such as a number of independent witnesses who must ensure that the person who is contemplating euthanasia is fully aware of what they are doing and that there is no going back.

Non-voluntary euthanasia is more difficult as no consent is possible but can be justified on the grounds that the benefit to society is larger than the detriment to the individual particularly if the individual is and has been so damaged that they cannot appreciate the life they live. Singer says in his book of Rethinking Life and Death ‘We should say they’re alive but nonetheless their life is not viable. They are alive but that life is not worth living (Singer 1999)