[8.2.] Utilitarianism and Euthanasia.
The term “euthanasia” refers to the practice of allowing someone to die, or helping to bring about that person’s death, in order to end his or her suffering.
The word comes from the Greek “eu” (meaning “good”) and “thanos” (meaning “death”).
[8.2.1.] Euthanasia vs. Physician-Assisted Dying and Suicide.
You should keep the following concepts distinct:
· passive euthanasia occurs when someone is allowed to die “naturally” by the removal of life-support, such as the removal of a respirator or feeding-tube.
· This is how Terri Schiavo died.
· active euthanasia occurs when someone actively intervenes in order to cause the death of the patient, such as when a doctor injects the patient with drugs that bring about his or her death.
· This is how Sigmund Freud died, with the assistance of Max Schur
If Schur had not killed him, Freud would have lived on, in wretched pain. How much unhappiness would this have involved? It is hard to say precisely; but Freud’s condition was so bad that he preferred death. Killing him ended his agony. Therefore, utilitarians have concluded that [active] euthanasia, in such a case, is morally right. (EMP 100).
· This is also the practice for which Dr. Jack Kevorkian was found guilty of second-degree murder.
· It is currently legal in only three countries: the Netherlands, Luxembourg, and Belgium.
· physician-assisted dying occurs when the patient himself or herself has been diagnosed with a fatal disease and is already dying and brings about his or her own death by taking a lethal dose of drugs received via a doctor’s prescription.
· physician-assisted suicide is the same as physician-assisted dying, except that the patient is not terminally ill, although he or she may have some devastating disease, such as Alzheimer’s disease, or Amyotrophic Lateral Sclerosis (ALS).
[8.2.2.] Legalized Physician-Assisted Dying.
Currently, physician-assisted dying is legal in five American states: Oregon, Washington, Vermont, Montana, and New Mexico (Bernalillo County only). [It is also legal in the Netherlands, Luxembourg, Belgium, and Switzerland.]
· The Death with Dignity Act was passed in Oregon in 1994. Because of court challenges, it was not implemented until 1997.
· The law requires that two physicians diagnose a patient as terminally ill and judge that the patient is of sound mind. Since the patient must be terminally ill to be eligible for this, it is only physician-assisted dying (and not physician-assisted suicide) that is legal in Oregon.
· The patient must wait 15 days after requesting the drugs before receiving them.
· The patient must administer the drugs himself or herself.
· In Oregon, the drugs most frequently prescribed by physicians under the state’s Death with Dignity Act are the barbiturates Secobarbital and Pentobarbital.
· Since the Act was passed, many people, most of them cancer patients, have requested and received the assistance of a physician in bringing about their deaths. As of February 2, 2015, 859 people have died in that manner; 105 died with the drugs in 2014.
Next we will support James Rachels’ argument in support of active euthanasia.
[8.3.] In Support of Active Euthanasia: James Rachels.
Rachels says that the strongest pro-euthanasia argument is the Argument from Mercy. He considers two versions of this argument:
1. the Utilitarian version
2. the Utility & Rights version
He identifies some serious problems with the first (Utilitarian version) and changes it to the second (Utility & Rights) version in order to avoid those problems.
[8.3.1.] The Utilitarian Version of the Argument from Mercy.
Here is the first, problematic version of the Argument from Mercy:
1. Any action or social policy is morally right if it serves to increase the amount of happiness in the world or to decrease the amount of misery. Conversely, an action or social policy is morally wrong if it serves to decrease happiness or to increase misery. [This is a statement of classical utilitarianism.]
2. The policy of killing, at their own request, hopelessly ill patients who are suffering pain [i.e., active euthanasia] would decrease the amount of misery in the world [such as in Rachels’ story about Jack, the cancer patient].
3. Therefore, such a policy would be morally right. (RTD 314)
As Rachels points out, many contemporary philosophers think that there is a problem with classical utilitarianism: it implies that happiness and the avoidance of misery are the only, or at least the most important, moral values. But there are other things that are also morally important:
· justice; and
· respect for individual rights.
To illustrate this point, Rachels focuses on freedom of religion:
… people might be happier if there were no freedom of religion, for if everyone adhered to the same religious belief, there would be greater harmony among people. There would be no unhappiness caused within families by Jewish girls marrying Catholic boys, and so forth. Moreover, if people were brainwashed well enough, no one would mind not having freedom of choice. Thus happiness would be increased. But, the argument continues, even if happiness could be increased this way, it would not be right to deny people freedom of religion, because people have a right to make their own choices. Therefore, the first premise of the utilitarian argument is unacceptable. (RTD 315)
He then considers an even more extreme example, one that is more relevant to euthanasia: the right to life:
Suppose a person is leading a miserable life—full of more unhappiness than happiness—but does not want to die. This person thinks that a miserable life is better than none at all. Now I assume that we would all agree that the person should not be killed; that would be plain, unjustifiable murder. Yet it would decrease the amount of misery in the world if we killed this person—it would lead to an increase in the balance of happiness over unhappiness—and so it is hard to see how, on strictly utilitarian grounds, it could be wrong. (RTD 315)
So, we value things other than happiness, including personal freedom and autonomy:
autonomy (df.): a person’s capacity to make decisions for himself; the ability to guide one’s own life. [from Greek auto, self, and nomos, law]
So happiness, it seems, cannot be the only standard of morality.
[8.3.2.] The Utility & Rights Version of the Argument from Mercy.
But obviously, happiness is morally important. We don’t have to abandon utilitarianism entirely. As Rachels says, “when an action or a social policy would decrease misery, that is a very strong reason in its favor.” (RTD 315)
With this in mind, Rachels proposes a second, stronger version of the Argument from Mercy.
1. If an action promotes the best interests of everyone concerned [modern utilitarianism] and violates no one’s rights, then that action is morally acceptable.
2. In at least some cases, active euthanasia promotes the best interests of everyone concerned and violates no one’s rights.
3. Therefore, in at least some cases, active euthanasia is morally acceptable. (RTD 316)
This version differs in two important ways from the first version:
· it refers, not just to happiness and misery, but to peoples’ best interests [in essence, he is shifting from classical to modern utilitarianism]
· it incorporates a concern for individual rights
Discussion: is this argument valid? [yes] Is it sound? [it is up to you to form your own opinion about whether the premises are true…]
Stopping point for Wednesday March 4. For next time:
• Study today’s online lecture notes.
• Read all of RTD ch.17: “The Singer Solution to World Poverty” by Peter Singer. Your final response paper is over this reading—that response paper is due via email on Friday March 6. This class will next meet on Monday March 9.
 For a timeline of the Terri Schiavo case, see http://www.miami.edu/index.php/ethics/projects/schiavo/schiavo_timeline/ , accessed February 21, 2012.
 Kevorkian died in June 2011. An obituary is here: http://topics.nytimes.com/topics/reference/timestopics/people/k/jack_kevorkian/index.html, accessed October 3, 2011.
 “Vermont Legalizes Assisted Suicide,” May 21, 2013, URL = <http://rt.com/usa/vermont-assisted-suicide-legalize-591/>, retrieved October 17, 2013.
 “Annual Report” on Oregon’s Death with Dignity Act, State of Oregon Department of Human Services, URL = < http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf >, retrieved March 2, 2015.
 The U. S. Dept. of Justice sued the state of Oregon, claiming that Oregon’s law violates federal laws governing the use of controlled substances. In particular, the federal government claimed that the practice of physician-assisted dying violates federal drug control laws, because giving narcotics to terminally ill patients with the intention that they will use the drugs to kill themselves is not a legitimate medical use of those drugs. The Supreme Court heard arguments in this case in 2005 and issued a ruling on January 17, 2006. They ruled in favor of the state of Oregon, finding that the federal government did not have the right to decide whether a physician prescribing a fatal dose of narcotics to a terminally ill patient constituted a legitimate medical use of those drugs. The court ruled 6-3 against the Justice Department, with Scalia, Thomas and Roberts dissenting.
This page last updated 3/4/2015.
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