Killing Yourself: The Ethics of Suicide and Euthanasia

Definitions:

Suicide: killing oneself

Assisted suicide: killing oneself with help from another, e.g. taking pills that someone else gets for you, injecting yourself with poison using a machine that Dr. Kevorkian set up for you.

Euthanasia: killing someone else for their own good (active euthanasia), or deliberately letting someone die for their own good (passive euthanasia).

Voluntary euthanasia: euthanasia at the request of the patient.

Non-voluntary euthanasia: euthanasia in cases where the patient cannot give consent, perhaps because he or she is in a coma.

Involuntary euthanasia: euthanasia against the patient’s will. The only difference (if any) between this and murder is that it is meant to be for the good of the patient, who would supposedly be better off dead. Popular with the Nazis (by which I do not mean their attempt to kill all Jewish people -- that was meant to be for the good of the glorious Aryan race.  The Nazis killed something like a quarter of a million Aryans just because they were handicapped.  That was supposedly an act of mercy, even though the handicapped people did not see it that way.).

All of these acts are related, so arguments for or against one can often be used in connection with others.

Arguments against suicide:

Pythagoras (6^th century B.C.): the soul is temporarily imprisoned in the body by God and it is a crime against God to let it out.

Plato (c.427-348 B.C.): we are the gods’ property and so have no right to destroy ourselves.

Aristotle (384-322 B.C.): suicide is cowardly, and is a crime against society.

Augustine (354-430 A.D.): suicide is a blasphemous rejection of God and His gift of life.

Aquinas (1225-1274): suicide is against the natural law of self-preservation, it is a crime against the community (cf. Aristotle), and it is a crime against God (cf. Plato).

Kant (1724-1804): it is irrational (and therefore immoral, since reason is what is highest in us) to use our free will to destroy our own freedom.

Arguments in defense of suicide:

The Stoics, e.g. Seneca (c.4 B.C.-65 A.D.): respect for human dignity sometimes requires suicide. "The foulest death is preferable to the cleanest slavery."

Hume (1711-1776): Suicide cannot be a crime against God or the natural law, because (a) God gave us the ability and, sometimes, the desire to commit suicide, (b) it is not wrong to go against nature by building dams, diverting rivers, etc., and (c) it is not wrong to interfere in matters of life and death, otherwise life-saving surgery would be wrong. Nor can suicide be a crime against the community because being a hermit is not wrong and suicide just takes this withdrawal from society one step further. Finally, suicide cannot be a crime against the self because the individual knows best what is good for him or her.

Contemporary views on euthanasia:

J. Gay-Williams

Euthanasia means intentionally taking the life of someone with no real hope of living further, so it is not euthanasia to stop treating someone who is beyond help. "Passive euthanasia" is not euthanasia at all, and is OK. Real euthanasia, active euthanasia, is not OK, however.

The argument from nature: euthanasia is against nature because we have a natural instinct to survive.

The argument from self-interest: it is better to stay alive when diagnosed with an incurable disease because the diagnosis might be mistaken, a new treatment might be developed, spontaneous recovery sometimes happens, and the desire to die might exist only out of a concern not to be an emotional or financial burden on others.

The argument from practical effects: allowing euthanasia might harm doctors’ and nurses’ commitment to saving lives, and might put us on a slippery slope leading to involuntary euthanasia.

James Rachels

There is no real moral difference between active and passive euthanasia. The intention and the outcome are the same. As long as the doctor’s motives are humanitarian, killing a patient is no worse than letting him or her die, and might be much better if the death is quick and painless.

Joanne Lynn and James Childress

You would think that deliberately starving someone to death (one form of passive euthanasia) would always be wrong, but in certain circumstances it is not. These circumstances are (a) futile treatment--if the patient is going to die anyway and the intervention necessary to provide nutrition would be very painful, (b) no possibility of benefit--if the patient has permanently lost consciousness and the family opposes intervention, (c) disproportionate burden--if the prognosis is uncertain but providing artificial nourishment seems much more likely to increase pain and suffering than not providing it.

It does not matter that food and water are parts of "ordinary" care, what matters is whether the patient will benefit.

It is not good policy always to continue a mode of treatment, because such a policy might make doctors reluctant even to start some modes of treatment.

If death is the best available option for the patient, doctors should get over their unwillingness to be the unambiguous cause of death.

Starving someone does not show a lack of care or humanity, because true humanity is concerned with the ultimate benefit of the patient.