Active/Passive Euthanasia

To distinguish between killing and letting die is an easy distinction to make for most people. There seems to be a clear cut line between harming someone, and letting harm happen to them. Where we do not positively act, causing the harm to happen, we are not morally responsible for its occurrence.* In medical ethics, this principle finds itself being applied to cases of euthanasia. In this essayette, I argue that making a conscious decision to omit to act, and acting to remove life support should be classed as killing, rather than letting die. Furthermore, these acts of killing are morally acceptable. It follows therefore, the principle is not sufficient to make moral decisions with.

When we make a conscious decision that medical practitioners should not attempt resuscitate us in the event that we stop breathing, or our heart stops beating, we make a morally acceptable choice. Clearly, it is up to us what happens to us. But when medical staff agree to this, according to my argument, they make a very morally significant choice. They have decided that they will allow someone to die, and will not attempt to bring that person back to life, even though they have the power to do so. One way of looking at it, and the way I suggest it should be looked at, is that the patient would be alive longer, if the medical practitioner had chosen otherwise. Therefore, the medical practitioner has killed her patient.

The case is clearer when we remove feeding tubes, or decided to turn off life support. In this case, we positively act in such a way that causes someone's life to prematurely end. If the next of kin had acted differently, the patient would be alive longer. Therefore, the next of kin has killed the patient.

Rather than condemn the medical practitioner or the next of kin, I believe they have undertaken acts that are both benevolent and courageous. They act completely without self-interest, as it is in their interest to have that patient alive. “Passive” euthanasia is admirable and moral.

But that is a side issue of my argument. I wish to remove any distinction between “active” and “passive” euthanasia, because passive simply reduces to active. Both of the examples above show that action is required, even with passive euthanasia. One example, a conscious decision to obey a duty, and the other involves taking active steps to end someone's life. Because these two are morally acceptable acts, all voluntary euthanasia is morally acceptable.

* A large exception to this principle, is when we act, even though a known risk of harm is attached.