Euthanasia: Murder or Relief? en

By Xghost on Tuesday 9 December 2014 12:53 - Comments (14)
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In many countries, committing suicide and helping someone with committing suicide is considered as an illegal act(1). Moreover, according to most religions, it is seen as a ‘sin’ to do so(2). As religion played an important role in the development of many countries, the actual laws originate partly from said religions(3), causing committing suicide to be an illegal act. In Christianity, suicide is considered as disrespecting the body which was given to you by God(4). In another large religion, the Islam, suicide is also seen as an unforgivable sin(2).

But what if suicide is used as a means for alleviating pain or to escape from endless suffering instead? This way of committing suicide is often referred to as Euthanasia. Euthanasia can be practised in a passive and an active form. Passive euthanasia is a form in which no action is taken to perform the euthanasia, by not prescribing antibiotics, for example, and thus letting the patient die slowly. On the contrary, in active euthanasia, an action is performed, for example giving muscle relaxants and sleeping medicine, causing a patient to die(5).

Since laws and beliefs are differing between countries, euthanasia rates are also differing. While in the Netherlands, 2.59% of deaths are caused by euthanasia, in Denmark and Italy 0.04% and 0.06% respectively are caused by euthanasia(6). A cause of this difference might be found in the fact that the Dutch are more progressive and accepting in taboo subjects like drugs, sex rights, and even euthanasia as it seems.

A moral problem arises if it comes to the practise of euthanasia. On the one hand, performing euthanasia acts against respect for human life, as it can be seen as murder. Besides, euthanasia might be viewed as an act not suitable for medical personnel, as it is not the act of curing but the act of killing patients.

On the other hand, the question is whether a patient with such a bad health and prospect, would even have a worthy life. For example, a man with Alzheimer’s disease in a highly developed state could be seen as a whole other person by his friends and family, as the disease totally changes the behaviour of someone. Moreover, the patient himself is not even aware of the situation his person is in. The life of this patient would be called unworthy by several people, including his family. Would the harm that this situation would bring to the family and friends be of greater severity than the harm of releasing the man from suffering? In addition, could euthanasia be a part of a doctor’s task to care for patients? And in what way would euthanasia differ from murder?

As stated, there are several moral contradictions present when it comes to euthanasia. In this article, this moral problem will be evaluated using a care ethics perspective. First of all, the care ethics perspective, its components and the reason why it is used will be explained. Secondly, passive euthanasia and active euthanasia will be separately assessed along this ethical theory.

Care Ethics
If a moral problem is to be evaluated with the care ethics approach, a normative evaluation is given. In other words, the given care is evaluated whether it is good care or not(7). Besides, the agents on which the given care applies, between the care giver and the care receiver, should be both evaluated, whereas ‘relational autonomy’ is considered as an important principle which has to be taken into account(7). Relational autonomy can be seen as the normal capacity for reasoning, not being blocked by any emotional, psychological or pathological factors(8).

According to Joan Tronto, a care practice takes place only when the four elements of care are present: ‘caring about’, ‘taking care of’, ‘care-giving’ and ‘care-receiving’ respectively. With these four phases, four moral elements are matched: attentiveness, responsibility, competence, reciprocity(9).
The aim of the given care is to fulfil the good of the patient(10), which can be divided in clinical good, the good as perceived by the patient, the good of the patient as a human being, and the ultimate Good.
The care ethics approach will be used in evaluating this moral problem, because euthanasia is not an intrinsically moral act. With the use of virtue ethics or deontology, the moral problem could not be analysed as well as with care ethics, since it would never be the virtue or duty of someone to kill oneself. With the use of care ethics, a normative evaluation is given, which will consider the given care in a doctors and a patient’s perspective.

Ethical evaluation
For this ethical evaluation, a patient who is suffering badly from metastasized cancer is used as a casus. He is considering euthanasia as treatment. First of all, the aim of the care practice will be evaluated.

The aim of care is to fulfil the good of the patient. The question, here, is what the good of the patient who is undergoing euthanasia is. For a patient with metastasized cancer, the clinical good is the best thing that could be done in a clinical point of view. In metastasized cancer, curing the disease is highly unlikely, if not impossible. The only treatment is to delay the disease, and thus delay death. This can come with pain and suffering. So in the end, the clinical good would be resulting in death anyway. There could be said, that there is no clinical good. As for the perceived good by the patient, easing the suffering of the patient is what should be done. The only way of achieving this, is to perform the euthanasia. The good of the patient as a human being, is to be assisted in coping with dying from the disease(10). But what if a patient could not cope with the disease? This could be the case in this casus, resulting in the allowance of euthanasia. The last good is the ultimate Good. This can be seen as the personal beliefs of the patient regarding his spiritual destiny(10). If a patient beliefs that suffering is not the right way of living, and that alleviating the suffering by euthanasia is his destiny, it would be the ultimate Good of him to be euthanized.

As said before, relational autonomy must be present when good care is performed. This means that it must be clear whether the patient who wants to be euthanized, is conscious and aware of the choice he is making. If this is not the case, the euthanasia would not be good care.

Seen from the doctor’s point of view, the care practice must be subject to the four moral elements. As for attentiveness, a doctor must be open to a patient’s needs(10). In euthanasia, this means that a doctor must listen to the patient, and give him the right information to form these needs. In the responsibility domain, the doctor must ensure the neediness of the euthanasia, and if the treatment has started he must ensure that the euthanasia will be practiced. Another moral element which a doctor must have is competence. He must have the competence to inform the patient, be convinced that the patient really wants the euthanasia, and that he can perform the treatment. Lastly, a doctor must ensure that the vulnerability of the patient will not badly influence the process of care.

In conclusion, using the care ethics theory, euthanasia can be considered as a good care, even though it might intrinsically sound contradictory. As long as the patient’s own goods are evaluated well, and the relational autonomy is taken into account, assuring that the true wish of a patient is one of being euthanized. It is the doctor’s task to assure this, and to maintain a good care practice. If all said factors are taken into account, euthanasia can be considered as morally good care


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