Introduction
There exists no difference between killing and letting die. Experts and academicians alike have attempted to establish a moral difference between active and passive euthanasia. The idea behind the distinction is that it is acceptable to withhold medical attention and let a patient die, but it is unacceptable to kill a patient deliberately. The moral reasoning for active euthanasia is that a patient should be accorded with the death they want in the case where they are suffering from a terminal disease and their inevitable end is death before which they have to undergo extreme suffering. On the other hand, if refraining from giving medical attention to a patient so that they can die is morally right then helping them with the dying process by actively inducing their death through active euthanasia should be morally right as well. The reasoning is the foundation of Rachels' argument in his article, "Active and Passive Euthanasia." In the essay, I will discuss Rachels' argument and then highlight some of the areas where his case needs support.
Support of Rachels' Argument
In support of his argument, Rachels has made three cases. In the first argument, he claims that active euthanasia is more humane in some instances than passive euthanasia. He supports the claim with an example of a cancer patient. If the patient opts for passive euthanasia, they would have to endure pain for days or weeks as they waited for their time to die. However, if they decided to go with active euthanasia, their agony would be short-lived. Additionally, the results of active and passive euthanasia are the same, and it seems more humane to relieve a person's suffering instead of prolonging it.
Traditional Doctrine Creates Dilemmas
In his second case, Rachels indicates that the traditional doctrine creates dilemmas because it leads to a decision about life and death on grounds that are of no value. He uses an example of infants who have Down's syndrome who need to have an operation for congenital disabilities that are unrelated to the Down's syndrome. In some cases, the doctors decide not to operate, and the babies die, and in some, they are no defects, and the babies live. He questions on the potentials and lives of such infants and concludes that a matter of life and death is based on irrelevant grounds (DeGrazia, Mappes and Brand-Ballard 397). According to the conventional doctrine, if an infant had an internal defect, a decision would be made on whether to let the infant die but if they did not have any defect, they would not be killed because it is not right. As such, it would be more humane to end the lives of such infants more quickly since the parents already decided on letting the infants die. Therefore, the conventional doctrine only leads to absurd decisions and should ultimately be rejected.
No Ethical Difference
In his third argument, Rachels argues that the reason why people champion passive euthanasia is that actively killing a person is ethically worse than allowing to them die. He gives an example of the cases of Jones and Smith. Smith and Jones intend to murder their cousins for inheritance, but one allows their cousin to die while the other is actively involved in their cousin's death. Smith who killed his six-year-old cousin drowns the child while Jones watches as his cousin drowns to death without lifting a finger. None of the two men behaved better because they acted on the grounds of personal gain (DeGrazia, Mappes and Brand-Ballard 397). The case scenarios are equal morally, but their distinction is ethically irrelevant. Rachels derives his conclusion about the absurdity of active and negative euthanasia from the example. If letting a patient die is accepted then killing them should be allowed too.
AMA's Position and Rachels' Conclusion
The AMA supports the standard view that distinguishes between passive and active Euthanasia and allows passive euthanasia while simultaneously prohibiting active euthanasia. Rachels' argues against the conventional view and maintains that the decision of whether to pursue extraordinary means in critical patients solely lies in the hands of the patient and the family and not the physician. The responsibility of the doctor is to provide freely available advice for the patient and their family (DeGrazia, Mappes and Brand-Ballard 396). The ultimate goal in Rachels paper is to establish that there is no moral distinction between euthanasia in its active or passive form and if passive euthanasia is accepted, active euthanasia should be permitted and preferred as well.
Critical Evaluation of Rachels' First Argument
In the critical evaluation of Rachels' first argument on the permeability of active euthanasia, it is essential to consider the principle of nonmaleficence. Under the principle, a doctor has no right to kill, to cause suffering or to incapacitate (Lewins 28). As a result of the current advancement in medicine, doctors can accord patients with medication that is life-prolonging such as respirators and life tubes and even painkillers that alleviate pain. The patients stay alive for more extended periods, but they live a reduced quality of life. It would be reasonable to say that such technology prolongs dying. However, it is always important to consider that the ultimate goal of any medical practice is always to keep the patient alive.
An Alternative Perspective
Another argument against Rachel's second argument that justifies active euthanasia would be that deciding to kill suffering patients for their own good would be playing God. The parents and the physician who choose to kill the infants who have congenital disabilities are exercising power over life and death. The doctors should follow the principle of nonmaleficence and try to save the lives of the infants. The choice of not to operate on the infants is sometimes preferable because they child may die even after the operation. The infants cannot comment on their condition, and they surely cannot choose between passive or active euthanasia. As such, it would be preferable to let the infants die over time than to take direct action and kill them. The argument presented by Rachels is anecdotal because the symptoms that would lead to the death of the infants should be considered as opposed to their natural condition.
Conclusion
In his paper, James Rachels seeks to justify the permitting of active euthanasia as much as active euthanasia. Active and passive euthanasia serve the same purpose of ending the life of the patient, and they should both be an option. He also states that the traditional doctrine creates dilemmas in the case of euthanasia. A critical analysis of his arguments on the permissibility of active euthanasia would defend its prohibition based on the principle of nonmaleficence. The doctor should not play a role in the death of a patient. Secondly, a critic would be against Rachels' second argument because the infants he speaks about have no option of choice about their condition and they should, therefore, be let to die naturally. Nonetheless, Rachels has made a strong case against the morality of active and passive euthanasia which calls for further deliberation on the issues.
Works Cited
DeGrazia, David, Thomas A. Mappes, and Jeffrey Brand-Ballard. Biomedical Ethics. New York: McGraw-Hill Higher Education, 2011. Top of Form
Lewins, Frank W. Bioethics for Health Professionals: An Introduction and Critical Approach. South Melbourne: Macmillan Education Australia, 1996.
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