Section Ten: Further Considerations

Non-voluntary, active, and passive euthanasia

In contrast to voluntary euthanasia, non-voluntary euthanasia would occur when individuals have not expressed any wish to die, perhaps because they are not physically or mentally capable of doing so. While the patient does not give consent, relatives may do so. This kind of euthanasia might arise in cases where a patient is comatose, is on a life-support machine, or is a newborn, defective baby.

Active euthanasia, on the other hand, would involve direct action to kill a person such as a lethal injection or a lethal overdose of drugs. It is the intentional termination of the life of one human being by another, and there are many instances when — despite the fact that it is against the law — both individuals and doctors have actively taken the life of a person in order to relieve what could only be a long, painful and drawn-out death. Passive euthanasia occurs when treatment is withheld so that the patient is allowed to die naturally.

Contemporary medicine has the skills to prolong life indefinitely, even though a patient may exist as a non-thinking being for several weeks, months or even years. Allowing such a non-person to die naturally when there is no point in continuing treatment is often a sensible thing to do. Similarly, severely defective newborn babies are sometimes left to die. The problem in this latter case is that allowing a baby to die naturally is likely to cause considerable suffering, unlike the comatose patient, for example. Then, too, it is a fine point whether letting someone die and actively killing him or she is so radically different. If someone is drowning in a lake and I don’t reach out my hand to pull him or her out, I may be just as guilty of active killing — and certainly mentally so.

Passive euthanasia may also involve cases where the patient is capable of making the decision not to be given further medical treatment to prolong life when the quality of that life can only be at best very poor and diminished. Whose right is to be respected here? Should an individual have the right to refuse further treatment? Or has a doctor the right to impose treatment on that person?

And how does a doctor balance the saving of life with the alleviation of suffering in such instances? These are the greyer areas that occur with the issues of passive versus active euthanasia. Somewhere between passive and active euthanasia is indirect euthanasia that occurs when death is hastened as a side-effect of the medical treatment given.

Objections to euthanasia

The main objection put forward against euthanasia — even voluntary euthanasia — is that its acceptance may well be a slippery slope from legitimate euthanasia to abuse of it. Legal acceptance of voluntary euthanasia would be a shorter step to non-voluntary situations – the termination of the permanently insane, of some psychotic criminals, of the very old and senile and of new-born babies that are not seriously defective, such as those with a harelip or cleft palate. The practicalities of euthanasia are difficult in cases of non-voluntary euthanasia for it is easy to see that there might be some individuals, or even some societies, that might justify it; Nazism is a case in point. And there may be individuals who are more anxious about the burden they are placing on their family and who request euthanasia for unselfish rather than medical reasons.

Those objecting to euthanasia, make the valid point that ill health may cause depression — enough to prevent a patient making a rational decision. Then, too, medical decisions are not infallible, and a patient may be given an incorrect prognosis — eventually recovering sufficiently to regain quality of life. There are certainly a few cases of regression, also, when patients experience a cure.

But the principle of euthanasia is a different matter. Those who oppose it in principle often do so on religious grounds, believing that it is God who gives life and, therefore, God who should decide when it should be taken away. They believe in the sanctity of life given by the divine. Others claim that life, not death is natural and that euthanasia goes against the natural goal of survival that is inherent in all creatures.

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