Arqam someone lets the person die. Passive euthanasia

Arqam Chara

2203 – Healthcare Ethics

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Prof. William Koch

New York City College of Technology





Is there any important ethical difference
between active and passive euthanasia? Be sure to explain fully what each of
these terms means and argue fully for your view on their similarity and
difference. Discuss fully the articles by Rachels and Callahan on this issue
and explain what you agree with, and why, and argue against those things you
disagree with. Do you think that it is ethical for a doctor to perform active
or passive euthanasia or take part in physician-assisted suicide? Argue fully
for your position and against the opposite position.







Euthanasia, in simple words is defined as bringing
about the death of a person for his/her own sake. Euthanasia can be divided into two broad terms, passive
euthanasia and active euthanasia. In active
euthanasia a person such us a physician or a surgeon intentionally and
knowingly causes the patient’s death. Active euthanasia is basically killing a
person through an act, for example, an overdose of pain-killers eventually
kills a person.  On the other hand,
passive euthanasia no one take’s the patient’s life, they just allow them to
die as a sign of mercy. In other words, Passive euthanasia is when death is
brought about by an omission – i.e. when someone lets the person die.
Passive euthanasia can be directed in two ways, by withdrawing or withholding

Withdrawing treatment: for example, switching off the
ventilator that is helping a person breathe.

Treatment: for example, patient not giving consent to a surgery that can extend
their life

Active and passive euthanasia can also be differentiated in terms of
voluntary and non-voluntary.

Euthanasia: Voluntary euthanasia happens at the request of the person who is

Euthanasia: Non-voluntary euthanasia occurs when the person is unconscious or
incompetent to make a hard choice between life or death, and a suitable person
who is competent enough to make a hard decision like this, takes the decision
on their behalf.

Non-voluntary euthanasia also includes a situation where a patient is a
child under the age of eighteen which is considered a legal age to start taking
decisions for themselves who is mentally and emotionally able to take the
decision, but is not regarded in law as old enough to take such a decision, so
someone else must take it on their behalf in the eyes of the law.

Involuntary euthanasia occurs when the person chooses life and is killed
anyway. This is usually called murder, but it is possible to imagine cases
where the killing would count as being for the benefit of the person who dies.

Death, traditionally was defined as the stopping of breathing and
heartbeat. Due to the medical advances in technology there is whole new
definition of death. An individual is declared dead when his/her brain stops
functioning permanently, known as Brain Death.

An act-utilitarian might see euthanasia as morally permissible because
it is beneficial to everyone and results in the greatest happiness for all
concerned. An act-utilitarian could also consistently say that euthanasia is
contrary to the goal of maximizing happiness because killing an individual rule
out any possibility of that person’s future happiness. A rule-utilitarian might
say that a general rule permitting some kinds of euthanasia would do more harm
than good—or that such a rule would maximize happiness in the long run. A
Kantian theorist could consistently reject euthanasia because it entails
treating people as use and throw things. Or he could consistently maintain that
individuals in comas or persistent vegetative states are no longer persons, and
therefore euthanasia is morally acceptable.

Arguments in favor of active voluntary euthanasia are often based on a
right of self-determination and a duty to help others in distress. Some
arguments for euthanasia, however, depend on the alleged equivalence between
active and passive euthanasia. Active voluntary euthanasia is wrong because it
leads to bad consequences, such as an increased risk of unjustified killings.

James Rachels, in
her article Euthanasia tries to explain that killing a patient is not the worst
thing than letting the patient die. He is arguing for the moral validity of
active euthanasia. James Rachels in his article claims that there is no ethically
significant distinction between killing and allowing to dye. Daniel Callahan,
on the other hand in his article
Killing and allowing to die, protects the consistency and moral
importance of the distinction between killing and allowing to dye. Callahan does
not support active euthanasia and argues that killing a patient is conflicting
with the role of the physician in a modern society. Callahan argues that the duty
of a doctor, a physician and a surgeon must be to cure and comfort his patients
and in no circumstances to kill his patients or let the patient die.

 James Rachels argues in her article about
withholding treatment. According to her, it takes time for the patient to die
and they suffer more by withholding treatment. It may be better for the patient
to go ahead with active euthanasia. A surgeon can administer a dose of a lethal
drug and can end the patients suffering. James Rachel also believes that the
main reason people still think there is an important moral difference between
active and passive euthanasia is that they think killing someone is morally
worse than letting someone die, however both has the same idea and the same

James Rachel argues that physicians are
concerned with the fact that whether the patient’s life is worth living,
whether the patient’s life has become or will soon become a burden on himself
or on the other people around him. He argues that if a doctor lets a patient
die, for humane reasons, he is in the same moral position as if he had given
the patient a lethal injection for humane reasons. He indicated that it’s the
doctor’s humanitarian motivation that accounts for different reactions to the
different cases. In his opinion, the doctor’s decision to let a patient die is
subject to moral appraisal in the same way that a decision to kill him would be
subject to moral appraisal. Death is no greater an evil than the patient’s existence
and cited that doctors are more concerned about the legal consequences of
active euthanasia which is forbidden by the law and active euthanasia is
condemned not merely as illegal but as contrary to that which the medical
profession stands.

According to Callahan, killing or
allowing to dye is an act of commission or an act of omission and that lives
can end as a result. This does not include the deaths that are caused by human
action and those caused by non-human events. Some challenges to this view is
that people can become equally dead by our omission as well as our commission
i.e. if we intend their death, it can be brought about as well by omitted acts
as by those we commit. According to him the crucial moral point is not how they
die but our intention about their death. We can then be responsible for the
death of another by intending that they die and accomplish that end by standing
aside and allowing them to die. To bring the life of another to an end by an
injection kills the other directly, our action is the physical cause of the
death. To allow someone to die from a disease we cannot cure and that we did
not cause is to permit the disease to act as the cause of death. He argues to
cease treatment may or may not be morally acceptable, but it should be
understood in either case that the physical cause of death was the underlying

After reading the two articles by
Rachell and Callahan, I strongly agree with Daniel Callahan. He talks about the
clear distinction between active and passive euthanasia and it involves a
decision of two separate acts which at the end has an outcome. The active
euthanasia involves some intervention, in this case, the administration of a
medication. On the other hand, passive euthanasia, the cause of the death would
be a result of the disease. Additionally, if one would apply the act of
omission and commission to their work, both can have legal consequences.