Euthanisa

The applied ethical issue of euthanasia, or mercy killing, concerns whether it is morally
permissible for a third party, such as a physician, to end the life of a terminally ill patient
who is in intense pain.

The euthanasia controversy is part of a larger issue concerning the right to die.
Staunch defenders of personal liberty argue that all of us are morally entitled to end our
lives when we see fit. Thus, according to these people, suicide is in principle morally
permissible. For health care workers, the issue of the right to die is most prominent when a
patient in their care (1) is terminally ill, (2) is in intense pain, and (3) voluntarily chooses
to end his life to escape prolonged suffering. In these cases, there are several theoretical
options open to the health care worker. First, the worker can ignore the patient\'s request
and care can continue as usual. Second, the worker can discontinue providing
life-sustaining treatment to the patient, and thus allow him to die more quickly. This
option is called passive euthanasia since it brings on death through nonintervention. Third,
the health care worker can provide the patient with the means of taking his own life, such
as a lethal dose of a drug. This practice is called assisted suicide, since it is the patient, and
not technically the health care worker, who administers the drug. Finally, the health care
worker can take active measures to end the patient\'s life, such as by directly administering
a lethal dose of a drug. This practice is called active euthanasia since the health care
worker\'s action is the direct cause of the patient\'s death. Active euthanasia is the most
controversial of the four options and is currently illegal in the United States. However,
several right to die organizations are lobbying for the laws against active euthanasia to
change.

Two additional concepts are relevant to the discussion of euthanasia. First,
voluntary euthanasia refers to mercy killing that takes place with the explicit and voluntary
consent of the patient, either verbally or in a written document such as a living will.
Second, nonvoluntary euthanasia refers to the mercy killing of a patient who is
unconscious, comatose, or otherwise unable to explicitly make his intentions known. In
these cases it is often family members who make the request. It is important not to confuse
nonvoluntary mercy killing with involuntary mercy killing. The latter would be done
against the wishes of the patient and would clearly count as murder.

Like the moral issues surrounding suicide, the problem of euthanasia has a long
history of philosophical discussion. On the whole, ancient Greek thinkers seem to have
favored euthanasia, even though they opposed suicide. An exception is is Hippocrates
(460-370 BCE), the ancient Greek physician, who in his famous oath states that "I will not
prescribe a deadly drug to please someone, nor give advice that may cause his death." The
entire oath is presented below, which places emphasis on the value of preserving life and
in putting the good of patients above the private interests of physicians. These two aspects
of the oath make it an important creed for many heath care workers today. In medieval
times, Christian, Jewish, and Muslim philosophers opposed active euthanasia, although the
Christian Church has always accepted passive euthanasia.

During the Renaissance, English humanist Thomas More (1478-1535) defended
Euthanasia in book Utopia (1516). More describes in idealic terms the function of
hospitals. Hospital workers watch after patients with tender care and do everything in their
power to cure ills. However, when a patient has a torturous and incurable illness, the
patient has the option to die, either through starvation or opium. In New Atlantis (1627),
British philosopher Francis Bacon (1561-1626) writes that physicians are "not only to
restore the health, but to mitigate pain and dolours; and not only when such mitigation
may conduce to recovery, but when it may serve to make a fair and easy passage."

One of the most cited contemporarly discussions on the subject of euthanasia is
"Active and Passive Euthanasia" (1975) by University of Alabama philosophy professor
James Rachels. Rachels argues that there is no moral difference between actively killing a
patient and passively allowing the patient to die. Thus, it is less cruel for physicians to use
active procedures of mercy killing. Rachels argues that, from a strictly moral standpoint,
there is no difference between passive and active euthanasia. He begins by noting that the
AMA prohibits active euthanasia, yet allows passive euthanasia. He offers two arguments
for why physicians should place