Active Euthanasia - A moral conundrum
14. November 2018 at 20:56
by Ashna D
In the light of the recent judgement of Common Cause v Union of India, various opinions surrounding the moral debate on euthanasia were brought to the forefront. While holding that every individual has a Right to Die with Dignity, the Apex Court laid down the law relating to the legalization of the practice of passive euthanasia. Active euthanasia however, still remains illegal.From a moral point of view, individuals are mostly in favour of passive euthanasia, and against active euthanasia. Is there an actual difference? This article seeks to clear the air around this moral conundrum of active versus passive; crime versus act of benevolence.
An act that intends and results in death is almost always viewed as a gross miscarriage of justice. However, the popular debate where individuals find themselves morally inclined towards the practice of passive rather than active euthanasia is one filled with ambiguity and confusion. This article shall attempt to do away with the popular moral justification that passive euthanasia receives over active euthanasia (herein referred to as euthanasia). To clarify, it speaks of voluntary active and passive euthanasia at the request of the patient when death is imminent. Morally, such a difference does not really exist and this article presents arguments to justify the same. It is important to keep in mind that we live in an age where our ‘progressive’ laws claim to place freedom of the individual on the highest pedestal.
Euthanasia refers to the physician’s deliberate act, usually the administration of lethal drugs, to end an incurably or terminally ill patient’s life. This is often distinguished from passive euthanasia which is a process that allows one to die by not acting to stop death. Perhaps the most ludicrous argument put forth is the one that refers to euthanasia as murder, as opposed to assisted suicide. This is fundamentally flawed because no reasonable individual would consent to murder. In cases of euthanasia, the patient is consenting, voluntarily asks for his life to be put to an end, and most certainly wants the act to be successful. It is possible for one to commit suicide through the agency of another.
The next conflict arising out of this debate is regarding the moral (not legal) duties of a medical practitioner. Religious ethics dictate that it is the Creator who has the sole power over life and death, and a doctor is expected not to interfere with this natural process. But is not every single form of medical treatment an interference just the same? Critics wrongly assume that a doctor’s primary duty is to preserve the life of his patient, for as long as possible. Yet, on a close observation of the Hippocratic Oath, we find that it only requires the doctor to use treatment to the best of his abilities and judgement; never to cause injury and wrong-doing. The fallacy lies in assuming every instance of ending life (even one that reduces a patient’s pain and suffering) as a wrong-doing. Although death is the end result of both actions, somehow, a quicker, deliberate act is evil while withholding treatment is compassionate. The act of injecting a lethal medication is cruel; but that of unplugging life support is merciful.
Simon Blackburn beautifully puts this flawed human logic into words: Thus, suppose I wish you dead, if I act to bring about your death I am a murderer, but if I happily discover you in danger of death, and fail to act to save you, I am not acting, and therefore, according to the doctrine, not a murderer.
Our moral compass has dangerously tricked us into believing that human life is sacred and must be prolonged at any cost, irrespective of the pain and suffering it causes to the patient. If I ask a doctor whether he felt less guilty while pulling the plug or not administering lifesaving medication when required rather than while injecting a lethal dose, would our logic still hold good?
Euthanasia as a method of ending life, is much faster and less painful. We must realise that passive euthanasia on the other hand, can be subjective, and might cause prolonged pain. The choice comes down to ensuring that the least amount of pain is caused to the patient.
The next argument relates to the principle of non-maleficence. It abides by rules that ask one ‘not to kill’ and ‘not to cause pain and suffering’. But this principle is not absolute. Many a time, some amount of pain might have to be undergone in order to get ultimate relief. The defence taken relates to the counter principle of beneficence which requires a doctor to act in ways that best promote the welfare of his patients. And in our case, euthanasia makes the inescapable event of death, a little less painful.
The next principle used to morally critique the wrongs of euthanasia is the principle of ‘double effect’. According to the principle, sometimes it is permissible to cause harm as a side effect (‘double effect’) of bringing about a good result even though it would not be permissible to cause such a harm as a means to bringing about the same good end. This is basically saying that it is okay for a doctor to administer a drug which is meant to alleviate pain, knowing that it is likely to cause death; but not okay for him to inject one lethal dose, only meant to cause death. This argument is flawed because it allows a doctor doing the former, to get away without holding him responsible for the consequences of his act, although he was fully aware of them.
Another problematic paradox relates to attempted suicide. In India, for example, attempted suicide is not punishable. Yet, euthanasia is illegal. This only encourages patients who do not wish to prolong suffering to attempt to take their lives in secret, or without a doctor’s instructions. This becomes dangerous and only breeds injustice.
Indeed, permitting euthanasia also has its own risks, but they are risks which can be countered with the help of effective regulations, comprehensive laws and stringent supervision. As far as this article is concerned, the logic behind preaching passive euthanasia as humane and euthanasia as inhumane is unsound. There exists no moral distinction between killing and letting die. For, death is not an absolute evil to be avoided at all costs, and life is not an absolute good to be maintained and preserved at all costs.