Thursday, April 12, 2012

Euthanasia and the distinction between killing and letting die

Some time ago we discussed the moral status of euthanasia in my Philosophy and Public Issues class. We talked about it a bit again today. As some of you might now, James Rachels has argued that there are two main reasons for accepting the moral permissibility of euthanasia: respect for autonomy and reduction of pain/suffering. He also argues that cases of passive euthanasia (where a patient is allowed to die due to "natural causes" by, for example, allowing him/her to stop eating or unplugging his/her respirator) are at least morally on par with cases of active euthanasia (where a patient is killed by, for example, a doctor that injects him/her with a lethal dose of a drug). In addition, many follow Rachels in thinking that active euthanasia is morally preferable to passive euthanasia. This is because the two aforementioned reasons for accepting euthanasia can be applied to both passive and active. Also, if a patient wants to die and is "better off dead," it seems to many that she should have the option to die as painlessly as possible. Since dying from a morphine overdose is less painful than dying due to starvation or asphyxiation, there's an argument to be made for thinking that active euthanasia is morally preferable to passive euthanasia.

Some challenge this reasoning by suggesting that there is a moral difference between killing and letting die. The idea is that if killing is worse than letting someone die, then passive euthanasia ought to be considered morally preferable to active euthanasia. But is this true? Consider the following two cases:

Killing: I decide that Larry Bird must perish. I go to his house and shoot him with a gun. He dies as a result.

Letting Die: I happen to be sitting next to Larry Bird on an airplane. I notice that he is chocking on a peanut. I consider trying to save his life, but decide not to help him. He dies.

How do these cases compare morally? Rachels argues that there isn't necessarily a moral difference between killing and letting die and that they may sometimes be morally on par. But what do you think?

* You might be tempted to say that, in the first case, I am guilty of first-degree murder but that, in the second case, I am not guilty of any crime. This, of course, is a legal point. I'm not concerned with that. I'm worried about the moral status of these cases.

* It might help to imagine that I've got the same ill-will toward Larry Bird in both cases. Suppose that I despise him with every cell of my body and that I relish his demise. Does this change your assessment of the cases?


Sherry Troutman said...

I am not sure whether or not I'm for it now or not. I guess when you look at both of your scenerio's of Larry Byrd it's still considered killing--because you're letting him choke when you could obviously help him out and save his life. The other scenerio is unjust no matter which way you look at it. I thought I was for euthenasia before but after this class today I'm now somewhat confused. Could you give another example besides the Larry Byrd that would make it more humane?

Sherry T

Jesse Steinberg said...

I'm not sure I know what you mean, Sherry. If you're asking for a case of letting die that is obviously morally preferable to a case of killing, then you might think about this pair of cases:

(K) I'm in a boat wreck and I see one of my fellow passengers in the water. I row over to her and hit her over the head with an oar until she dies.

(L) I'm in a boat wreck and I see one of my fellow passengers in the water. I don't have enough water in my dingy to keep us both alive and so I decide to let her drown and in the hopes of preserving my own life.

It seems to me that I'd be acting worse in case K than in case L. It seems more morally reprehensible to kill a person in that fashion than to let a person die in that fashion.

Is that what you're looking for?

Sherry T said...

Yeah, that is somewhat better. I've got a better understanding now. I guess I'd probably be for passive then for active--but in all reality I can't see either of them if I'm not for one or the other. So I guess what I'm probably going to say now is that it's wrong to kill someone, but it is also wrong to suck up resources as well. I guess it would be okay to kill someone if they didn't feel pain or suffering.

Sherry T said...

I also have to consider people waiting for those resources that their lives could be saved and they could live longer, the doctors who take their time to care for people who are in dire straights, and the suffering of their families--with all that being said--I guess it would be different.

Desiree` Lamer said...

In either of your Larry Byrd cases the killing or the letting die are both morally impermissible because in cases of euthanasia it has to be a good death where the person is better off dead. In neither of your cases is Larry better off dead. In cases of euthanasia though if a person wants to die that is suffering then they should be permitted the right to make that decision. In passive euthanasia we choose a loved one to make the right decision for us in a time of dire need so why shouldn't we also be able to make a decision for ourselves before we are in the position to need someone to make our decisions for us. Obviously the list of stipulations to qualify for euthanasia would be extensive but it should be morally accepted. Euthanasia should be a moral right that we are all granted.

nicki kellogg said...

I think that killing and letting die is somewat similiar. In the first scenario , it is seems ver immoral because Larry does not want to die and wouldnt be better off dead (except in your personal opinion). Also in the second scenario it is immoral because in the words of Singer "if you can stop something bad from happening without sacirficing anything of comparable moral significance then you should do it". SO fyou should have helped him. Euthanisia I believe is moral killing if the person will be in less pain. you shouldnt just shoot people because you believe they would be better off dead. Thats just common sense. I think a lot of these issues are simple but are made complicated when we forget common sense

Michael Spong said...

I have to agree with Desiree on this one. You dont take someone's life or stand back and watch them die, that is just morally wrong.But if someone is suffering and has the desire to die, why cant they be granted that wish? Why should this person have to suffer when they have no quality of life & they are just going to be miserable until their death?

Christopher Salerno said...

I think that euthanasia is a good thing as long as there is a good reason. Like we said in class on how if your feeling depressed and or don't think you can go on mentally but physically you are in great shape and can last many years to come then no thats not an ok thing. YOu get someone who is brain dead and cannot move, the doctors have ran several test and know that there isn't anything else to do and before the individual who is brain dead got into this situation they ask to be taken off life support than yes there is nothing morally wrong with it. If individual specifically said to not take them off then one should not remove the life support. In the case where the person did not request either way that one is a lithe more tricky and has to have a lot of thought in the status they are in and the chance to come of recovery. In the sense of you could be opening a free bed to someone with a better chance or taking a life of a person. it is difficult to think about and understand what your doing. I feel that person has no chance of recovery and is completely brain dead and cannot move then it is morally acceptable to remove the life support and let person die of natural causes.

Michael Eiswerth said...

I myself also agree with Desiree. Neither of the cases that were presented would be a permissible form of euthanasia because in neither case Larry Byrd did not want to die. It is the same with the other case you proposed about the boat wreck. In either case it seemed that the fellow passenger did not want to die so therefore it is was wrong to kill her. It would be wrong to just let her drown. However, say the person drowning wanted to die for whatever reason, then I believe that killing her would be morally permissible because that was that persons will.
In the case of euthanasia, it seems like an obvious answer that it should be morally permissible. Of course we can't go about killing every teen or young adult that is depressed but we can have stipulations that need to be meet in order to qualify for euthanasia. Things such as is this person going to die anyway, or is this person in an unbearable amount of pain, etc.

Audrey Wenger said...

I find this topic to be a very difficult one. As I said in my group’s presentation on this topic I feel that active euthanasia is immoral, but passive euthanasia is moral. Although the arguments for this stance are not very strong, I would like to take another shot at it. Trying to put religion aside, euthanasia is murder. The intentions behind euthanasia are different than murder, but in the end a life is being taken.

In order to take my stance on passive euthanasia, I feel that I must clarify the definition. I feel that we must morally do what we can to maintain our life. This would include taking medication for diabetes, infections, or the flu, but at the same end, we should not try to stop death. What I mean by this is that it is morally permissible to refuse some medical assistant such as ventilators, or other medical devices that limit a person’s ability to function. For example a person can get dialysis and be a productive person, but on the other end a person who is in a permanent coma and depends on a ventilator to keep their lungs breathing is no way to live. Therefore when I support passive euthanasia, I define passive euthanasia as a circumstance where an individual ceases or stops or chooses not to use a medical device which completely replaces the function of a vital organ. I do not find passive euthanasia (with that definition) as murder, because that is the cycle of life. At some point, people are born, live, then die.

Natoya Barnes said...

Morally, I do not think that killing and letting die are two different things. I think they are similAR. To me, neither the killing and letting die of Larry Bird is moral.

I find this debate about euthanasia to be very diffeicult. I do think that people do have a right to say that they wish to die but is it always okay to oblige? I do not think that you can say one type of euthanasia is immoral without saying the other one isn't either.

What about the cases of people who are in comas and cannot coomunicate. Should the plug be pulled because there is a chance that they are in pain? What if they do not want to die and their family members decide to pull the plug anyways?

I think that euthanasia can be morally permissible or impermissible but I think it all depends on the attentions of the person or doctor. If it just to end that person's misery and not for some selfish gain, then it can be permissible.

Kevin Morgan said...

I am writing my research paper on active euthanasia and how it is morally preferable to passive euthanasia, so I definitely agree with that. It makes more sense to allow for someone to die with the least amount of pain, even if it is done by the doctor himself and not by disconnect from the feeding tube. I know I'd rather die that way than to asphyxiate or starve.

For the second part, I really don't see the difference between killing someone and letting them die. If you're in a situation where you have to save somebody's life, particularly Larry Bird, you have a moral duty to do that. If not, you might as well have killed them. Plus it just seems to be the right thing to do to save someone's life. I think there could be other situations where you can easily get away with not saving someone's life, but that doesn't make it okay to do that.

Alyssa McQuirns said...

I agree with what Rachels had to say on how killing and letting die are actually morally on the same page but in the cases of euthanasia that killing is actually more morally permissible over letting die. I know that this may be a controversial stance because many see active euthanasia as immoral but I feel that passive euthanasia causes so much more suffering for the individual. One way to do passive would be to stop feeding the patient and this seems like too much suffering for something that could be done with much less pain. If I saw a family member in massive amounts of pain and they were going to die, I would want to end that suffering in a quick way and painless way instead of watching them go through it. That is why I feel is cases of euthanasia that killing is actually more morally permissible than letting die.

Jacob Klock said...

I believe that the person is only guilty for the first one when he walks into the persons house and shoots him to kill him. Although sitting next to him on the airplane he did not help him, he as a person is not obligated too. As bad as that sounds and even though I think that the person should help him there is nothing saying that he has too, and with good reason at times too. With today’s society people sue people for anything and everything and there have been cases where a person tries to save a person and they end up getting sued for it, for some reason or another. So in my opinion they are definitely a lot different. Even if the person sitting next to them on the airplane doesn’t like them I still feel as though they have no obligation to help them, but that is just my personal opinion, and the only reason that I have that opinion is because of the legal issues that we are all faced with in society today.

Kayla Swartz said...

After reading your examples about Larry Bird, I still am for passive euthanasia, but against active euthanasia, due to religious beliefs, so I’ll leave that part out. The reason I do not find the Larry Bird examples convincing to say that letting die and killing in this care are on the same moral ground is because in those examples he isn’t suffering from a long-term illness. The only way I believe passive euthanasia is morally acceptable is that if the person is terminally ill and all options have been tried to save that person’s life. Ultimately, it is an individual’s choice in that situation if they want to live or not and that’s why advance directives and living wills were created. If someone is on life support for 3 months and is showing no signs of recovery, what is the intent in keeping them “alive.” They are unable to communicate; it is an emotional burden on the family members (usually) coming in everyday seeing that their loved one has a machine breathing for them or a filtering their blood. It’s very hard on family members and I know this because I have been in the situation twice. Yes, it is hard to let go of loved ones, but everyone has the right to die, and I believe in instances such as this your prolonging a life that can’t be saved and it is honestly better to let that person die a pain-free, peaceful death with the uses of palliative care (things such as Hospice).