Active and Passive Euthanasia

In 1973 the AMA (American Medical Association) declared that euthanasia should indeed be practiced but only in a passive way such as withholding treatment from the patient. But in an essay written by James Rachels in 1975 entitled Active and Passive Euthanasia, He argues against the AMA statement about euthanasia claiming that once the decision has been made to allow the patient to die, active euthanasia should be used in place of passive euthanasia. He claims that this method is not only relatively faster but most importantly it is less painful.

Through various examples and hypothetical scenarios, Rachels sets out to show how inaccurate the AMA statement is about euthanasia, how active euthanasia is the appropriate method, and how the present AMA statement could even lead to damaging results.

Rachels opens up his essay with an example and what he calls, “a familiar situation.” He begins to tell a story about a man with cancer who is experiencing an immense amount of pain. He states that this man is “certain to die within a few days” and that even with the assistance of modern day medicine, he will die. The family and the patient eventually agree to end his life and the doctor agrees to withhold treatment from the patient, which is what the AMA allows.

Rachels states that even though this passive way is indeed effective, it could actually take longer for the man to die then if more direct actions were taken. Not only does he endorse active euthanasia at this point, but he also uses this example as a strong statement to prove that “once the initial decision not to prolong his agony has been made, active euthanasia is actually preferable to passive euthanasia.” Rachels in this statement alone reveals how he feels about the AMA statement on euthanasia which declares that only passive euthanasia is acceptable.

As the essay continues, Rachels begins to try to make an emotional appeal to his audience by bringing up the issue of babies with Down syndrome. Down syndrome, now a day, is quite common and the result of it many times can fatal. Realizing this fact, Rachels decides to use this disease as a way to prove how the AMA statement towards euthanasia is flawed and that, in certain cases, active euthanasia should be practiced. He declares that simply being “allowed the die” can be a relatively slow process and painful process, but on the other hand, take for example lethal injection, is more efficient as well as less painful to the patient.

He argues that babies with Down syndrome who are “allowed to die” should not have to suffer so much pain as their life is literally being sapped out of them. He exclaims that this goes against everything that a doctor is taught, which is to try to save lives. Instead he is forced to sit there and watch a baby slowly dehydrate until he/she is no more. He then attacks the AMA statement by stating that “the doctrine that says that a baby may be allowed to dehydrate and wither….seems so patently cruel.”

Rachels appears to make his strongest point when he declares that the “conventional doctrine to decisions concerning life and death” are made on irrelevant grounds.” He starts off by continuing on the subject of babies with Down syndrome. He uses a hypothetical scenario of a baby who has an intestinal obstruction that needs to be operated on. But at the same time, the child has Down’s syndrome so the parents and the doctors agree that it would be better to let the child die indeed of forcing him to endure all pain that awaits him.

He argues that this thinking is absurd and that if the baby’s life is worth saving, then what does it matter if an operation is needed? He then states the opposite view, to show how much the decision of life and death is made on irrelevant grounds, that if it is better for the baby to die, then what difference does it make that he has an intestinal obstruction? He goes on to say that the fact that many decisions on life and death or made on irrelevant grounds is the exact reason why the AMA doctrine should be rejected. They have no idea of what exactly the situation is so therefore their set doctrine or statement about euthanasia is not only flawed, but it could also be quite damaging to a person affected by it.

As the essay progresses, Rachels, realizing his main opposition, begins to focus on the moral aspect of active and passive euthanasia. He starts off by stating the common belief that killing someone is morally worse than letting someone die. At this point, he begins another hypothetical scenario about a man who decides to kill his 6 year old cousin because if he dies, he will gain a large amount of inheritance. While the boy is taking a bath, the man(named Smith), decides to drown the boy. He then carries out his gruesome plan by drowning the kid and then arranging things to make his death look like an accident.

Rachels then tells a story of another man who is in the same situation that decides to murder his cousin as well. But as he enters the bathroom, he sees the child slip, hit his head, and fall into the water. The man is happy because the job is basically already done for him so he just sits there and watches the child “accidentally die.” Rachels argues that there is absolutely no moral difference between the two men because they both “acted from the same motive, personal gain, and both had exactly the same end in view when they acted.”

Rachels wants to stress that there is no moral difference because of the decision that both man had made to kill the child so therefore, killing someone and letting someone die are in essence the same thing because of the goal that is wished to be obtained. Rachels then continues on by declaring that doctors that use passive euthanasia is the same morally as active euthanasia because the doctor is physically taking steps to make sure that the patient does not leave. This is the same as killing someone because you are obviously making an effort to end the person’s life. Rachels isn’t the only one who views this crucial issue this way.

In an article written by
Quantonics.com
regarding the “ethics of euthanasia,” Gary LeBaron(the author), states that “it is sometimes claimed that the passive techniques are morally acceptable because they allow for a natural death, while active techniques independently cause death. But in the modern setting, these terms and distinctions are ephemeral.”

As the essay begins to come to a close, it becomes even more clear of what Rachels intentions are. He again begins to attack the AMA’s argument and its many flaws. He states that doctors are being unfairly forced into something that many of them may not believe in. As he stated early, doctors have been trained to help people and not just sit there and watch them die, so why then shouldn’t active euthanasia be legalized?

Gary Lebaron, the author of “The Ethics of Euthanasia,” claims that the AMA statement is basically against what we(the USA) stand for as a country. He argues that we, as well as doctors, are being forced to do something that we may not necessarily want to do. He states that the doctors are handicapped because of the fact that “force used to impose on others, against their wishes, makes what one thinks is best is not allowed.”

Therefore not only does the AMA statement inflict pain on the patient, but it also limits the power and freedom of the patient, the doctor, and the patient’s family. Rachels then wraps it up by declaring that there should be not set of official statements regarding euthanasia(like the AMA statement) because there are just so many different ways you could look at it; the AMA statement basically “leads to decisions concerning life and death made on irrelevant grounds.”