Assisted Suicide and Euthanasia: Are They Moral?

Although the Obama Administration's demand that the public accept some form of government-mandated national health care has been stymied, at least temporarily, it is still worthwhile to consider an ethical issue that was never seriously addressed over the past year: the potential role of the federal government in assisted suicide and, possibly, in active euthanasia.

In the following essay I will address two questions: (1) Does the State have a duty to either prevent an individual from taking his own life, or to prevent some other individual from assisting another in taking his own life, when the individual is terminally ill? and, (2) Is euthanasia always morally unacceptable or can it be justified by circumstance?

For the purposes of this essay I will define suicide to be an intentional, non-coerced, decision on the part of the individual to end his life prematurely. Euthanasia, on the other hand, will be considered as a willful action undertaken with the certainty that the action will prematurely end the life of another.

Regarding question 1, we will acknowledge that the individual will always have sufficient capacity to reason and that suicide can always be viewed by the individual as a rational choice given two or more possible courses of action.¹ If I take these allowances as valid, I may now ask if the State possess sufficient legal or moral authority to intervene if an individual decides to end his life. I hold that the State, with the exception of any of three circumstances, has no authority to intervene.

Since suicide represents the ultimate expression autonomy, and since it is the duty of the State is to protect the individual's free exercise of his autonomy, I can find no intrinsic power of the State to prohibit anyone from ending their own life. The State does, however, have a legal and moral obligation to intervene if the individual:

1. Is not legally an adult,

2. Has been previously declared to be mentally and/or emotionally incompetent, or

3. Is acting under duress or by the coercion of another

By logical extension, I posit that the above-listed exceptions would also apply to assisted suicide with the additional provision that the person rendering assistance is doing so of his own volition but may decline, without fear of repercussion or retaliation, to render such assistance on moral or spiritual grounds.

Before discussing euthanasia I must remind myself that according to both civil and common law, even though one person asks that another kill him the other cannot raise that request as a defense in a criminal prosecution. In other words if "A" has a terminal illness and asks that "B" kill him, and "B" complies, "B" cannot argue that "A's" request is a bar to criminal prosecution.

Euthanasia is either "passive," the result of withholding all but the bare essentials of life such as water, or it is "active," which means that someone feels that another would "be better off dead" and therefore performs some act that hastens death. By its definition, euthanasia cannot be considered as an individual "right" because it does not involve the reasoned, rational decision of the individual. The differences between active and passive euthanasia may be better understood by example.

Suppose "A" is the victim of a debilitating disease such as Huntington's disease or Multiple Sclerosis and has entered the final stages of his disease. If "B" gives "A" an overdose of medication, or writes a valid medical order to that effect, and "A" dies as a direct consequence of that act, the "B" has committed a criminal act.

Now consider, given the same situation with "A," that "A" has executed a valid "Living Will" or "Prior Directive" stating that he does not want to be kept alive by "heroic" or "extraordinary" measures. If "B" orders that all medical care, with the exception of "comfort measures," be withdrawn, has "B" committed a crime? According to most statutory and case law, he has not. This again raises my central question: is euthanasia always morally wrong?

From a purely moral standpoint, my answer would be that euthanasia, or at least active euthanasia, is never morally acceptable but I would also have to conclude that, in some circumstances and in its passive implementation, euthanasia could be considered legal if not morally acceptable. I also admit that I have not yet been able to resolve my own paradoxical position.

Admittedly, there is a very thin legal and moral line separating assisted suicide and euthanasia and it is unlikely that this issue will be resolved in the near future. However, as I stated in a previous essay, I cannot help but fear that at some point in the future society might blur this thin line and confuse the "right to die with dignity" with some concept of an individual's "obligation to die with dignity."

I hope that day never comes.

Notes

1. Admittedly, this is a simplified set of circumstances. The questions of suicide as a moral and rational decision are covered in far greater detail by Dr. Shelly Kagan in his "Philosophy 171: Death" lectures, which are presented online by the courtesy of Yale University at http://oyc.yale.edu/philosophy/death. I found these lectures to be both informative and intellectually stimulating and recommend them to you without hesitation.