Voluntary Euthanasia

‘No one shall be subjected to torture or to inhuman or degrading treatment or punishment’. 1 Imagine at the age of 40, you are diagnosed with Motor neurone disease, a fatal disease that causes degeneration of the motor neurones, which leads the wasting of muscles. You are intellectually sound but totally dependant on your spouse for physical support. You are aware of the fact that your death is imminent and will probably be painful, suffering from severe breathing problems and pneumonia before slipping into a coma.

By the age of 42 you want to end your life, leaving your two children and spouse with more pleasant memories of you, however, the courts will not allow you to end your life2. This was exactly the situation of Diane Pretty, the most recent of euthanasia case in the media. However, she died on 12th May 2002 after losing her case. Euthanasia continues to be one of the most controversial subjects of the modern world. The word euthanasia literally means ‘dying well’ and it originates from two Greek words, ‘eu’ and ‘thanatos’.

Euthanasia is defined as ‘… n action or omission which of itself or by intention causes death. ‘3 A case where a patient specifically asks to die repeatedly and receives euthanasia, which is not a decision made by a doctor or the patient’s family or friends, is one of voluntary euthanasia. There are two types of voluntary euthanasia, passive and active. Passive euthanasia is the omission or termination of treatment that is prolonging a patient’s life whereas active euthanasia is the result of a positive action, for example a lethal injection by a carer.

Although there is slight differentiation with regards to euthanasia the three main denominations of Christianity are relatively similar in their views and moral thinking. The Roman Catholic Church has the most strict view and believes that any action which is going to ’cause death as a relief from suffering is a grave violation of the law of God’. 4 Most Catholics do not find the removal of treatment to cause death morally acceptable either, however they do allow a patient to refuse any treatment that is going to be burdensome to society, family or the patient.

Again the Church of England’s views revolve around the sanctity of life and there is no possibility of euthanasia being acceptable under this principle. It’s stated that ‘because human life is a gift of God to be preserved and nourished, the deliberate taking of human life is prohibited’. 5 It recognises the many technological advances in medicine and states that the Church of England ‘ does not place on doctors an overriding obligation to prolong life by all available means’.

They also believe that euthanasia may be considered in extreme cases but only with the approval of at least two medical officials. Anglicans consider it their duty to ensure that the ‘slippery-slope’ does not claim innocent victims. Most Methodists believe that people would not consider euthanasia if there was better hospice care and if more people were engaged in relieving pre-death loneliness. Again, the common theme of the incompatibility of euthanasia with the sanctity of life is prominent and they believe it is not right for humans to ‘play God’.

Methodists are scared of the slippery slope and are concerned for people who may not have the courage to stand up against people telling them they should die. The Methodist opinion can be summed up by a quote from their statement: ‘the Christian conviction is that the life of men and women bears the stamp of God who made man in his own image. This is the source of our basic dignity… and it’s the Biblical basis for the sanctity of human life.

What God has given, we should not take away’. 6 An acceptance of the practice of voluntary euthanasia has remained consistently incompatible with the Christian belief in the sanctity of life, as a study of the Bible will highlight. ‘All the days planned for me were written in your book before I was one day old’. 7 Christians believe that God should have complete control over a person’s life and ultimately it is His decision as to when it is taken away.

They believe in the ‘sanctity of life’ philosophy, which is about how every person has a unique identity as a personal and distinct part of His creation and it is up to Him to create, sustain and end our lives. The Bible asserts a strong doctrine in the sanctity of life, as written in Job12: 12 ‘The life of every creature and the breath of all people are in God’s hand’. In the first chapters of the Bible, the killing of another person is forbidden, when in Exodus 20, the 10 commandments are set out with the sixth one being ‘You must not murder anyone’.

The Roman Catholic Church has persistently condemned the direct ending of human life. It was originally stated in 1980 that ‘Nothing and no one can in any way permit the killing of an innocent human being… furthermore no one is permitted to ask for this act of killing… nor can any authority legitimately recommend or permit such an action’8 Most Christians believe that God has ultimate control over every person’s life and that there are many alternatives to euthanasia that should be explored in every circumstance.

However in recent polls statistics did not reflect these views, 89% of atheists were in favour of euthanasia, 84% of Jews, 75% of Church of England Christians and 54% of Roman Catholics. In response to Christian statements, many people argue that in many cases of people wanting euthanasia, often their quality of life is so poor that their lives are not worth living. However Christians argue that God created and cares for every single one of His children and will help them through any suffering they may experience.

Now God’s presence is with people, and He will live with them, and they will be His people. God himself will be with them and will be their God. He will wipe away every tear from their eyes, and there will be no more sadness, crying or pain. ‘9 It can also be argued that there is an example of euthanasia in the Bible and so God can excuse the practice of voluntary euthanasia in some cases. In the book of Samuel10, there is an example of euthanasia: ‘Then Saul said to me, ‘please come here and kill me. I am badly hurt and am almost dead already’.

So I went over and killed him. He has been hurt so badly, I knew he couldn’t live. ‘ It could be argued that if a man in the Bible is allowed to kill a man who is already dying, a man now is allowed to end a person’s life who has only suffering before an inevitable death in a relatively short amount of time. Admittedly, king David in the story killed this person11, but with the attitudes of society changing as time has gone on, some would argue it would be acceptable to assist euthanasia without capital punishment

The British medical association’s report 199812 stated that life is ‘God – given’ and it claimed that it is not for doctors to play at being God by shortening it: nature must be allowed to take its course. This report therefore seems to be re – affirming the Christian beliefs in the sanctity of life. Currently in the Hippocratic oath, which doctors have to swear before they are allowed to practice, it states that: ‘I will… never do harm to anyone.

To please no one will I prescribe a deadly drug nor give advice which may cause his death… but I will preserve the purity of my life and my art. 13 Hippocrates was alive in about 500AD and it was said that: ‘He provided an example of the ideal physician after which others centuries after him patterned their existence. ’14 Therefore doctors today still hold the view that they should maintain human life for as long as possible, a view which coincides with the Christian view in the sanctity of life. Wilcockson states that ‘The main problems with the sanctity of life lie not so much in the principles but in the application to situations which become more and more complicated as medical science blurs the boundaries between life and death’.

Some supporters of the sanctity of life argument argue that the killing of a person can be justified if that person’s life is determined ‘not worth living’. This diluting of the argument has led to many believing that the sanctity of life argument in its traditional form is collapsing with a changing society, for example Peter Singer says; ‘the traditional ethic has collapsed because people now think that the low quality of a persons life… can justify her in taking her own life or justify someone else in killing her life at request’. 16

There are weaknesses in the sanctity of life argument. If the life of a person is in the hands of God, then surely it is not acceptable to prolong a person’s life with medication and machines because this is not the way God has planned that person’s life? The counter argument to this would be that God has given us the intelligence to develop this technology and so we should use it to our advantage. However, He has also given us the intelligence to advance our technology in the field of euthanasia, so some people would argue that could we not take advantage of this intelligence as well?

Within the Christian religion there are different interpretations of the Sanctity of life argument, as medical advances have made it increasingly difficult to determine when ‘life’ is still a life. Another weakness it that the sanctity of life argument is essentially deontological as it reflects the assumption that a person believes their life is valuable to God. Therefore it cannot be relevant to a non-believer. It also has strengths however, because a Christian would very much believe that God does have control over every life and this would be a very valid point.

Some may argue that for the non-Christians, it would play on their conscious and it is their compassion, or agape, which makes them feel this guilt. For the non-believer it stops the risk of a slippery slope, and people being killed for convenience. As a Florida physician said: ‘We shall start by putting patients away because they are in intolerable pain and haven’t long to live anyway and we shall end by putting them away because it’s Friday night and we want to get away for the weekend’. 17

The sanctity of life argument can sometimes have adverse affects; it could be regarded that ending a person’s life can have more positive effects than negative. For example if the person is deeply suffering and has a sincere wish to end their life and the family are happy with their choice in the situation, it maybe more pleasant and beneficial to allow euthanasia because it leaves everyone with happier memories. It also means that socially it is less expensive and it means there are more hospital beds that younger patients with a chance of regaining a normal life can use.

There are many ethical philosophers who have produced ethical theories about the acceptance of the practice of voluntary euthanasia. Saint Thomas Aquinas who lived from 1225-74, developed the deontological argument of natural law, and that situations in our lives should conform to these absolute principles. He argues that the principle of natural law depends on establishing the purpose of human life, which Aquinas maintains is to ‘live, reproduce, learn, worship God and order society’. 8 He developed many of ideas from those already established by Aristotle, and, as explained by Thompson he believed that ‘if everything is created for a purpose, human reason, in examining that purpose, is able to judge how to act in order to conform to that purpose,’19 He therefore decided that people decided how to act in situations based on natural laws, which were devised from Christian morals.

Therefore he concluded that the Ten Commandments must be kept and so voluntary euthanasia is therefore not acceptable because it goes against the commandment; ‘You must not kill’. 0 The absolutism of Natural Law can be considered a strength and it has been described as ‘a simple, universal guide for judging the moral value of human behaviour’. 21 It states how humans and God share the same rationality, therefore making this philosophy more accessible. However, for those without faith in God it is not necessarily suitable for basing morals and ethical decisions on and it may be seen as too absolutist in solving complicated ethical problems.

When applying Aquinas’ theories to the debate on euthanasia, it would appear that because it does not promote life and God’s power over this life, it is not compatible. By taking away a life that God has no chosen to do, we are ‘playing God’ and this is wrong according to Aquinas. Joseph Fletcher in the 1960’s although he did not initiate the idea, developed the consequentialist concept of situation ethics, which is based upon Luke10: 27 ‘Love your neighbour as you love yourself. ‘ It uses the Agapeistic calculus, the measurement that will always choose the most loving alternative in any choice of actions.

Therefore in some situations, depending on the circumstances, a follower of situation ethics would advocate voluntary euthanasia. Fletcher maintained that there was a middle way between legalism and antinomianism and this lay in the application of agape, love, which will enable us to achieve the greatest good. However, situation ethics are sometimes not a good principle to follow because there are instances where if Fletcher’s theory was applied on the basis of love, things could be justified that are usually seen as morally wrong, for example adultery.

Also the theory is teleological and so it is impossible to be unfailingly accurate in calculating the consequences. The exact consequences of an action are unattainable until they have actually happened, therefore this principle can never be entirely reliable. Situation ethics has been praised for enabling individual cases to be judged on their own merits and not stating anything is intrinsically right or wrong except love.

However this has also been seen as a weakness because it seems contradictory to say that there are no laws, except one, love. Another strength is that it is based on the teaching of Jesus and so can be considered as a Christian approach with good intentions of love to help other people. However, simply because an action has been done out of love, it doesn’t make it acceptable. For example if a person murdered someone because they believed that individual had the intention of harming their sister, this does not make it any more right.

It has been considered that perhaps Fletcher was too optimistic about human capability to make good moral decisions. Fletcher’s philosophy is not entirely incompatible with euthanasia, every case needs to be analysed individually. He maintained that there is more to being alive that merely being alive and believed that any action can be justified, if it coincides with the principles of love. Therefore in some situations euthanasia may be considered to be the most loving thing to do, in which case it is morally acceptable.

However because each situation is different, voluntary euthanasia is not always the correct action to take. Immanuel Kant, who places a strong emphasis on autonomy; the freedom to determine one’s own actions and behaviour. 22, is another philosopher with his own approach to the topic of morals. His argument is a priori so it is independent of experience, this means that it takes into account that not all situations are the same and the consequence for one incident does not necessarily follow for another; an important strength.

However it is possible for two absolute morals to conflict, therefore making it hard for a person to choose the right course of action, also different people have different opinions and one person’s reaction may not be the same as another’s. ‘Nothing in the world… can possibly be conceived which could be called good with qualification except good will’23. Superficially this may seem to permit euthanasia if one had a compassionate intention. However Kant only allows ‘will’ to be good if it entails acting from respect for the moral law.

He therefore would not be able to permit euthanasia because although it may be done out of love for a person, it means breaking the moral laws, which is not permissible All of these previously mentioned philosophers believe that there are absolute values, and that some actions are intrinsically evil and others are intrinsically good. The alternative to this approach is one of relative values. One of these arguments is the utilitarian argument, developed by Jeremy Bentham, John Stuart Mill and Henry Sidwick in the nineteenth century.

This is a teleological principle, which adopts the idea that ‘right actions are those which produce the greatest total pleasure for everyone affected by their consequences and wrong actions are those which do not produce the most happiness. ’24 Bentham introduced the phrase ‘greatest good of the greatest number’25. He argues that there are seven things which should be taken into account; intensity, duration, certainty, propinquity, fecundity, purity and extent of the pleasure. Therefore in some cases, voluntary euthanasia may be considered acceptable under Bentham’s proposal.