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Article: “Active and Passive Euthanasia” by James Rachels

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    Author’s Thesis: There is no principal difference between active euthanasia and passive euthanasia.

    Argument for Rachel’s Thesis: Active euthanasia is in many cases more humane than passive euthanasia. Intentions and actions are two separate ideas which cannot be compared. He also explains how inaction is still an action because there is a consequence. When performing euthanasia, no matter the intentions, someone still dies. There is no moral distinction between letting die and killing someone because the action’s result is the same. If letting a person die is morally permissible then killing someone is also, and vice versa.

    My Thesis: James Rachels’ argument in the article “Active and Passive Euthanasia” challenges the traditional distinction between active and passive euthanasia, stating that there is no important moral difference between the two. While he is correct in saying that it is wrong to prolong a dying patient’s suffering needlessly, his idea that the distinction between active and passive euthanasia is not crucial for medical ethics is wrong. The reason it is unmistakably incorrect for active euthanasia to be thought of as no different from passive euthanasia is that there is an inherent moral distinction between killing and letting die.

    Assumptions to Criticize:
    – The conventional doctrine leads to decisions concerning life and death made on irrelevant grounds. Killing someone is not worse than letting someone die.

    “It is not exactly correct to say that in passive euthanasia the doctor does nothing, for he does one thing…he lets the patient die.”

    Intro:James Rachels’ argument in the article “Active and Passive Euthanasia” challenges the traditional distinction between active and passive euthanasia, stating that there is no important moral difference between the
    two. While he is correct in saying that it is wrong to prolong a dying patient’s suffering needlessly, his idea that the distinction between active and passive euthanasia is not crucial for medical ethics is wrong. The reason it is unmistakably incorrect for active euthanasia to be thought of as no different from passive euthanasia is that there is an inherent moral distinction between killing and letting die.

    Part I: In “Active and Passive Euthanasia”, Rachels argues that there is no distinction between active and passive euthanasia. According to the moral standings of today, there is a significant difference between the two that, “although the latter is sometimes permissible, the former is always forbidden.” Rachels disagrees with this idea for many reasons: he believes active euthanasia is normally more humane than passive euthanasia, the conventional doctrine leads to people making decisions concerning the termination of life on “irrelevant grounds,” there is no moral distinction between killing and letting die, and simply the arguments supporting the doctrine are incorrect.

    There is a doctrine that exists which is what the medical world bases its actions upon, and it is this argument which Rachels believes is irrelevant to the human condition: “The intentional termination of the life of one human being by another mercy killing – is contrary to that for which the medical profession stands and is contrary to the policy of the American Medical Association. 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/pr his immediate family. The advice and judgement of the physician should be freely available to the patient and/or his immediate family.” Rachels argues that there is a strong case to be made against this doctrine. His first example is that of a patient who is in a terrible state, knows he set to die very soon due to his incurable cancer, even if the present treatment is continued, so he would rather end his life as quickly and painlessly as possible instead of living in excruciating pain. Taking all of this into consideration, the patient asks the doctor to “pull the plug”, which his family also agrees to. If the doctor were to agree to the patient’s request,
    he would be abiding by the conventional doctrine, since there is no need to prolong his suffering needlessly. However, if treatment is simply withheld, it is possible for the patient to take longer to die, consequently living with more pain than if no “direct action were taken and a lethal injection given.” It is this thought that gives substantiality to the fact that once the decision to end pain and suffering has been made active, “euthanasia is actually preferable to passive euthanasia, rather than the reverse. To say otherwise is to endorse the option that leads to more suffering rather than less, and is contrary ti the humanitarian impulse that prompts the decision not to prolong his life in the first place.” Part of Rachels’ point is that it is normal for the process of being “allowed to die” to be slow and painful, opposed to the option of a lethal injection, which is relatively quick and painless.

    Rachels’ argues that the common perception of passive and active euthanasia is misconstrued due to the thought that morally, killing someone is worse than letting someone die. To investigate this issue, Rachels makes use of two cases that are exactly alike, except for one involves killing whereas the other involves letting someone die. In the first case, a man by the name of Smith is certain to gain a large inheritance if anything happens to his six-year-old-cousin. While the kid is taking a bath, Smith sneaks into the bathroom and drowns the child, afterwards making it seem like an accident. The second case involves Jones in the same situation as Smith: his baby cousin stands in the way of him receiving a large inheritance. Jones sneaks into the bathroom, planning to drown the child, only just as he enters, the child slips, hits his head and falls face down in the water. Jones passively watches his cousin drown, all the while overcome with happiness. The only difference between the two cases is that Smith actually killed the child, whereas Jones simply let the child die. “That is the only difference between them. Did either man behave better, from a moral point of view? If the difference between killing and letting die were in itself a morally important matter, one should say that Jones’s behavior was less reprehensible than Smiths’s. But does one really want to say that? I think not.” It is at this point that the decision of euthanasia stands as a strictly moral issue, with the Smith and Jones case proving the fine line
    between human morality and personal gain. This does not apply however, to the world of medicine.

    Doctors are not concerned with personal gain or the intentional murder of an individual, they only wish to apply the correct procedure if that ensures the patient has no further use for his or her life. However, “the point is the same in these cases: the bare difference between killing and letting die does not, in itself, make a moral difference.” It is in human nature to assume killing is worse than letting die, mainly due to the actual consequences of killing someone being much worse than letting someone die, along with the evil associated with killing, which is why the moral dilemma exists. In the medical world, “the decision to let a patient die is subject to moral appraisal in the same way that a decision to kill him would be subject to moral appraisal: it may be assessed as wise or unwise, compassionate or sadistic, right or wrong.” This notion should concern doctors since a strict moral doctrine is enforced upon them by the law, making it virtually impossible to defend themselves should any situation go terribly wrong.

    Rachels admits that there may be important moral differences between active and passive euthanasia considering their consequences, but this only strengthens his idea that these differences make active euthanasia the preferable option.

    Part II: It is simple to criticize the argument of Rachels by saying that the intentions of an action are more important than the outcome of an action. Consider this situation: a baby with intestinal problems is born to parents who would rather let the baby die than have the doctor perform lifesaving surgery that would keep the baby alive, but leave it forever handicapped. This action is deemed immoral due to the parents’ wish for the baby to be dead if it meant it would be challenged for the rest of its life. This situation proves that although there may not be a concrete distinction between killing and letting die, there is always a conscious decision made that evaluates the morality of the situation.

    The argument of Rachels that killing someone is not worse than letting someone die in regards to passive and active euthanasia is morally unsound for a number of reasons, one being the precious entity of human life. Although Rachels is correct in saying that active euthanasia is considered more human than passive euthanasia in the situation of a terminally ill patient who is experiencing unneeded amounts of pain and suffering, the preservation of life is something that needs to be considered. According to philosopher Daniel Callahan, people suffer, but suffering is as much a function of the values of individuals as it is of the physical causes of that suffering. In other words, a person’s condition is sometimes more mental than physical, so it its ineffective ad improper to use active euthanasia on an individual who is worsening their condition by way of mentally discouraging themselves. For example, there have been many survivors of terminal variations of cancer, so there is always a possibility of survival. It is the people who repress their will to live because the going gets tough that stipend this miracle. The natural right to life is not something that should be taken lightly, especially when the challenge of living seems too much to overcome.

    The contemporary philosopher Daniel Callahan stands for the notion that “if we fail to maintain the distinction between killing and allowing to die, moreover, there are some disturbing possibilities. The first would be to confirm many physicians in their already too-powerful belief that, when patients die or when physicians stop treatment because of the futility of continuing it, they are somehow both morally and physically responsible for the deaths that follow.” It is this notion that needs to be abolished, not strengthened. There is no need to burden doctors with the underlying pressures of deciding if the continuation of a patient’s life is necessary, since when the decision is made to end a life that can only get worse, there should be no afterthought, only relief felt by abiding by the correct action.

    There does exist, however, a moral dilemma between the distinctions of passive and active euthanasia. Passive euthanasia, also known as letting someone die, in the medical world holds no responsibility for the physician.
    The physician is not forced to make the decision to ends someone’s life prematurely, he simply is letting life take its course. On the other hand, active euthanasia, not so popularly known, as killing someone, requires a significant code of moral ethics and decision-making, on not only the physician’s part but also on the patient and/or the family of the patient. The physician is placed in the position of placing a value on human life, and then sharing his opinion to the devastated individual whose life is close to an end. With the flip of a switch comes more than just a body to dispose of properly, it is the emotional strain and moral dilemmas of the situation at hand that classify the decision to make use of active euthanasia as a test of the moral compass.

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    Article: “Active and Passive Euthanasia” by James Rachels. (2017, Feb 01). Retrieved from https://graduateway.com/article-active-and-passive-euthanasia-by-james-rachels/

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