Introduction
Euthanasia is a contradictory issue from an ethical point of view because it is difficult to say for sure whether it is morally right to assist a person, whose death is foreseeable, in dying. In this essay, I will argue that even though life is highly valuable and killing is morally wrong, euthanasia is morally permissible if it is administered to terminally ill patients according to their will. I will prove it by showing that depriving terminally ill people of euthanasia leads to unhappiness and the infringement of autonomy, as well as an impossibility of dying with dignity. I will argue that the prohibition of euthanasia contradicts utilitarianism and the principle of quality of life in particular, and can hardly be supported by paternalism since the ban does not benefit an individual’s life.
Defining Euthanasia
To support my position on euthanasia, I chose to analyze the case of Rodriguez v. Attorney General of British Columbia. The appellant was Sue Rodriguez, a terminally ill middle-aged woman, who appealed to the court to get permission for euthanasia but lost the case. However, before proceeding to the analysis of the case, I will define the key term of the paper. Generally, euthanasia means a quick and painless killing of a person with the purpose of relieving his or her sufferings.
There are different kinds of euthanasia, depending on an individual’s willingness and awareness of undergoing it and the way it is administered. Voluntary euthanasia is conducted with a person’s informed consent, while involuntary one is performed under coercion. Nonvoluntary euthanasia is administered to people who cannot make decisions for themselves, for example, comatose patients; in this case, their proxies decide for them. Further, active euthanasia means killing patients by giving them special medications, while passive euthanasia is the discontinuation or non-commencement of life-supporting treatment. In the Canadian Criminal Code, the term “medical assistance in dying (MAID)” is used to refer to euthanasia. In this paper, I will utilize the term euthanasia to mean active voluntary euthanasia because it was the matter at stake in Rodriguez v. British Columbia.
Utilitarianism and Quality of Life
The first philosophical issue at stake in the presented case is the value of life. To determine the relationship between euthanasia and life value, one should explore the utilitarian theory. According to utilitarianism, morally right actions are those, which bring people happiness and pleasure. If an action increases unhappiness and pain, it is considered wrong. Utilitarianism is closely related to the principle of quality of life. In accordance with this principle, the value of life is not constant; it depends on the amount of happiness and positive experiences that make a person want to continue his or her life. Life is worth living as long as one can feel happy and satisfy one’s desires.
I may argue that the quality of life principle justifies killing in the case of an individual who finds no happiness in life and does not consider life worth living. I can support my claim by the assertion made by Rodriguez in court. She stated that, if the government did not satisfy her need for receiving aid in dying in the chosen time, she would have to suffer until she died or commit suicide before she wanted to (SCC, Rodriguez, 1993, p. 609). Therefore, by not granting her wish of receiving help in dying in the chosen time, the government would cause her to experience prolonged pain or end her life before she was willing to do so. Since utilitarianism regards actions that result in unhappiness as wrong, and the quality of life principle allows for assigning different values to lives, I conclude that euthanasia would be morally acceptable in this case.
Autonomy and Harm Principle
Another philosophical issue at stake in the presented case is autonomy. Although some people regard autonomy as the ability to do different things without someone’s help, others consider this point of view doubtful since it implies that disabled people do not possess autonomy. Therefore, I will use the term autonomy in the sense of self-determination, that is, one’s ability to make weighed decisions for oneself without external influence.
The principle of autonomy was mentioned in Rodriguez’s claim and the judges’ dissenting opinion. Rodriguez asserted that depriving her of the possibility to choose what to do with her body infringed her autonomy and human dignity and, therefore, contradicted the principles of fundamental justice (SCC, Rodriguez, 1993, p. 592). Madam Justice McLachlin agreed to the appellant’s claim, supporting it with s. 7 of the Charter that defends people’s right to security and liberty (SCC, Rodriguez, 1993, p. 618). According to McLachlin J., the concept of security included human dignity that involved individuals’ autonomy in making decisions as to their bodies (SCC, Rodriguez, 1993, p. 618). Given these claims, I can conclude that the prohibition of euthanasia violates a person’s right to autonomy. Generally, people who ask a physician to help them end their lives are not able to do it themselves because their terminal illnesses weaken them badly. Therefore, they cannot exercise their autonomy, and the law prohibits other people from assisting them, thus making them helpless and suffering. Such treatment from the government cannot be considered ethical since it infringes the autonomy principle and deprives people of dignity.
The principle of autonomy is related to the harm principle. It means that the law should not intervene with a person’s life as long as his or her actions do not harm others. An important clause is that if one gives one’s consent to being harmed, the law also should not interfere in this case. In the presented case, Rodriguez gave her informed consent to being harmed, that is, to being deliberately killed by a physician at the time of her choice. At the same time, her death would not cause damage to anyone else. Therefore, I conclude that, according to the harm principle, the law should not have prohibited her from committing an assisted suicide. I would apply this conclusion not only to Rodriguez’s case but to all patients whose death was foreseeable and who gave their informed consent to euthanasia.
Possible Objections
The main objection to the morality of voluntary euthanasia comes from the proponents of the sanctity of life. This principle opposes the principle of quality of life because it states that all human lives are equally valuable, and their value is inestimably high. In Rodriguez v. British Columbia, this principle was used in the majority reasoning. The majority argued that asking for euthanasia equalled to choosing death over life, and the legalization of this procedure would devalue human life (SCC, Rodriguez, 1993, pp. 520-521). However, I doubt that it is necessary to protect every human life unconditionally just to avoid its depreciation. Furthermore, I disagree that all human lives are precious per se and equal. The assertion of the equality of lives would mean that the life of a doctor who saved hundreds of lives and that of a criminal who injured or killed many people have the same value. I cannot entirely agree with this claim; therefore, I find the principle of quality of life more sustainable.
I do not argue against the sanctity of life since human life is indeed precious and cannot be taken involuntarily. Instead, I assert that people’s lives differ in their quality, and if the quality is too low and irreparable, as in the case of terminally ill individuals, people should have the possibility of avoiding prolonged sufferings. Euthanasia is a suitable way out since it eventually increases the overall happiness. First of all, it benefits the object of euthanasia since this person avoids experiencing pain until natural death. Secondly, it brings relief to the relatives since they do not have to watch their loved one suffer. Thirdly, it can benefit other patients because the medications and other medical resources that are used for maintaining a dying person may be redirected to those who have chances for survival. Thus, although life is sacred, its quality may be so low that people will prefer death to it. In this case, euthanasia is justified and can be considered morally permissible according to the utilitarian theory since it leads to the decrease of pain.
Another objection comes from the theory of paternalism that suggests that the government should intervene in people’s lives to make them do what is beneficial for them. This theory is opposite to the harm principle because it states that the government’s control should extend beyond preventing a person from harming others. However, I argue that paternalism may be of benefit in various areas of life, but it is useless in the case of terminally ill patients seeking euthanasia. Take, for example, the smoking ban; it can benefit people in several ways. It may prevent lung cancer in people who are forced to quit smoking, and it can lead to an overall increase in people’s health. Moreover, the smoking ban may contribute to individuals’ economic well-being since they will not have to spend their money on cigarettes. However, in the case of euthanasia, the prohibition will be of no benefit to individuals. One way or another, they will die soon, and the matter is whether they will die painlessly or in sufferings. Therefore, the only way the government can benefit them is to grant their wish to die without pain.
The final possible objection is that the decriminalization of euthanasia may lead to the overuse of power. It was one of the main apprehensions of the majority in Rodriguez v. British Columbia. The majority feared that if euthanasia were permitted, it would cause disabled people to be manipulated by others (SCC, Rodriguez, 1993, p. 566). In their opinion, disabled individuals who were a burden to their relatives could be coerced into euthanasia, do their consent would not be voluntary (SCC, Rodriguez, 1993, p. 566). However, I argue that such a “slippery slope” is not an inevitable consequence of the legalization of euthanasia since the scope of its decriminalization can be limited.
I can support my argument by Chief Justice Lamer’s dissenting opinion, in which he opposed the majority’s fear of the “slippery slope.” He stated that section 241(b) of the Code infringed people’s right to equality because it overly protected vulnerable individuals from being made to commit suicide (SCC, Rodriguez, 1993, p. 525). Lamer C. J. argued that the section protected even those who did not want the protection, thus depriving them of the possibility to end their lives because of their disability, which led to inequality (SCC, Rodriguez, 1993, p. 525). He concluded that the fear of a possible increase in manipulating vulnerable individuals did not justify the inequality that the overprotective section caused (SCC, Rodriguez, 1993, p. 525). This dissenting opinion proves my point that the decriminalization of euthanasia is morally permissible. The risk of disabled people’s coercion into this procedure can be reduced by establishing certain legal norms. At the same time, the existence of such risks should not deprive terminally ill people of the possibility of ending their lives voluntary and painlessly.
Conclusion
In conclusion, euthanasia is morally permissible from a utilitarian point of view since it decreases the patients’ pain and increases their happiness by granting their wish to die without suffering. Euthanasia is justified from the perspective of the principle of autonomy because it helps disabled people to fulfill their determinations as to what they want to do with their lives and bodies. Although euthanasia contradicts the sanctity of life principle, it is better to view it from the quality of life perspective since not every life is worth saving. Finally, even though paternalism may be beneficial to individuals in some matter, it is not the case with euthanasia. Postponing terminally ill people’s death will not benefit them if they do not want to prolong their suffering.
List of Cases
Rodriguez v. British Columbia (Attorney General) (1993), 3 SCR 519 (Supreme Court of Canada)