Introduction to Ethics Lecture 22 Active & Passive Euthanasia. By David Kelsey. Rachels’ conclusion. James Rachels wants to argue that the following principle is false:
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James Rachels wants to argue that the following principle is false:
It is permissible, at least in some cases, to withhold treatment and allow a patient to die, but it is never permissible to take any direct action designed to kill the patient.
This is endorsed by the American Medical Association:
The intentional termination of the life of one human being by another…is contrary to that for which the medical profession stands and is contrary to the policy of the AMA…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 is the decision of the patient and/or his immediate family…
Rachels makes a second argument about the reasons given:
Consider again the case of an infant born with Down’s syndrome.
In cases where if there is no operation and the infant dies, the reason why such an operation is not performed is that the infant has down’s syndrome. It is thought to be better that a child born with such a condition die.
But if the life of such an infant is worth preserving what does it matter if the infant has an intestinal tract that is blocked and so needs a simple operation to preserve its life?
And if the life of such an infant is not worth preserving what does it matter if it has an intestinal obstruction?
So in such cases what’s relevant to deciding whether to perform the surgery or not is simply whether the life of such an infant is worth preserving…
Rachels wants to argue that there is no moral difference between the cases.
For Rachels, Smith and Jones are equally bad.
This is because both men acted from the same motive, personal gain.
And both men had the death of the child in view when they acted.
Thus, “the bare difference between killing and letting die does not, in itself, make a moral difference.” So “If a doctor lets a patient die, for humane reasons, he is in the same moral position as if he had given the patient a lethal injection for humane reasons.” (865)
So in conclusion Rachels claims that there is no moral difference between active and passive euthanasia.
Active euthanasia is worse than passive euthanasia because in passive euthanasia the doctor does not do anything to bring about the patient’s death. In active euthanasia, however, the doctor does do something to bring about the patient’s death for he kills him.
So the doctor who performs active euthanasia causes the patients death, but in passive euthanasia when treatment is withheld the cause of death is the ailment from which the patient suffers.
Rachels in response:
The doctor doesn’t do nothing to bring about the patient’s death. He lets the patient die. He withholds treatment…
And although in active euthanasia the doctor is the cause of the patient’s death it is considered bad to be the cause of someone’s death because death is a great evil.
Yet in cases of active euthanasia death is the preferred course of action and so not an evil...