Applying Theoretical Ethics to Applied Ethics - Essay Example

? Applying Theoretical Ethics to Applied Ethics Introduction It cannot be denied that since the coinage of the term euthanasia, it has been employed by most medical practitioners in their practice. Of particular concern is the use of active and passive euthanasia in patients who suffer from terminal or irreversible illnesses. Active euthanasia involves certain procedures such as injecting over dosage of morphine or other pain killers to end the life of a patient. Passive euthanasia is assisting the patient to die with non provision of treatment or life sustaining procedures to save the patient’s life. The permissibility of each however is bombarded with many controversies making proponents of each view provide intelligent arguments and examples to indicate their point. Generally, the argument lies on the morality of active and passive euthanasia. Rachel claims that active and passive euthanasia has no moral difference and that both should be accepted with equal treatment. A different view holds that the morality of euthanasia depends on what the person cares about. This paper is going to argue that the stand of Rachel on active and passive euthanasia uses only hypothetical imperatives. Hypothetical is defined by Foot as “acts which are good only as a means to something else”. The paper has the following structures. Part 1 is going to explicate Rachel’s argument on active and passive euthanasia. Part 2 will present my arguments using the idea of Foot that the morality of active killing and passive omission is situated on what a person cares about. Part 1 Rachel claim there is no moral difference between active and passive euthanasia. The morality depends on how people view active killing and passive omission of duty. For instance, in active euthanasia, people assert it as killing equivalent to murder thus it becomes bad on grounds that there is interference among the medical team while passive is viewed as an act motivated by doctors with a humanitarian reason and so there is nothing wrong with it. In cases where a doctor administers an injection or the nurse under the order of the physician injects the lethal drug, they are viewed as accessories of the crime. With this, death as a result of active euthanasia is always viewed as immoral. Most people look at active killing as more evil owing to the reason that the cause of death would be the action of the physician. On the contrary, if the medical team refrains from resuscitating a terminally ill patient in a situation where she/he is in cardiac arrest, it is acceptable because it is inculcated in the mind of many that it is the right thing to do. Passive method is not considered evil since the cause of death would be the illness itself although there is a deliberate withholding of foods and treatments. The ultimate result of withholding treatment is not directly seen and connected with death making passive euthanasia acceptable to most people. Another factor influencing the view of people on active killing and passive omission is how death is conceptualized by many. In most part of the globe, death is considered bad or evil since a love one is expected to die. The painful separation from that person and the unacceptable truth that death is inevitable makes death evil and people who cause it goes with that concept. If the doctors caused the death through injection, he is considered evil. Letting die on the other hand is viewed as natural death regardless of the intentional omission of a duty to care, feed, comfort, and most especially to treat the sick. Rachel is clear in maintaining his point that there is no difference in the morality between active and passive methods even in situations where the physician simply does not act. It was pointed out that omission of duty does not mean lesser evil more so that it does not justify the end. Omission of the act has the same ultimate goal with that of active killing. The difference is situated in how the act is done. For instance, a killer might shoot her victim to let her die and a doctor may withdraw drug treatments of a certain patient to let him die. This shows that the penultimate end of the action is the same however differs only in the way they were executed. In the medical field, omission is considered simple negligence of duty which is being dealt with legally depending on the consequence of the act. This is the same when appraising the circumstances surrounding active and passive euthanasia. With this, it would be incorrect to assume that “standing near doing nothing” in times the patient needs resuscitation may excuse the doctor from his simple negligence of his duty. She/he is still answerable for it, more so if the patient ask to be resuscitated and yet it was not carried out. Rachel further supported his claim on moral difference with his example on the cases of Smith and Jones. Smith killed his cousin in an effort to gain a huge inheritance by drowning him while taking his bath and arranges for everything to appear like an accident. Jones on the other hand had the same intention to kill his cousin having the same reason however his cousin died without him intervening. Instead of Jones drowning his cousin, the child slipped on the floor and hit his head. Jones witnessed the incidence but did not help in anyway. With this example, Rachel shows that both Jones and Smith have the same evil intention however executed in different circumstances and that there is no point arguing which man is more evil between them. If this is compared with the end result of active and passive euthanasia, Rachel made it clear that it is irrelevant. Both active and passive has the same intention however different execution. Lastly, Rachel claim that the morality of active killing and passive omission depends on which is more humane to apply on certain situations. Active euthanasia is deemed more humane to apply in the condition of a dying cancer patient with terrible pain that is impossible to alleviate through pain relievers. Rachel boldly pointed out that prolonging the agony of such patient through withholding treatment to be in conformity with the requisite of the American Medical Association (AMA) despite the patient’s request and his family members is wrong. The doctrine of AMA endorses that intentional termination of life, that is applying active euthanasia is contrary to the policy of the AMA and to which physicians stand for. This contention is questioned by Rachel on ground that such doctrine prolongs the suffering of patients in any form is cruel and insensitivity to the needs of a dying patient. Ending it with direct action is more humane. Administering lethal injection is quick and easy way to end the agony which is a better option compared to slow and painful method. In his other example, he cited the comment of Anthony Shaw who describe the cases of infants who were born with anomalies but denied surgery instead allowing them to die and wither slowly in the nursery as more heartbreaking on the part of the doctors, parents and might even be to the infants themselves. Rachel still views this as inhumane giving the reason that if they are allowed to die just the same, why let them expire slowly while there is a short cut way to it. Allowing patient to wait for his death without medical intervention is similar with the concept of torture. This examples cited by Rachel are among the real scenarios happening in the hospitals in which physicians experience dilemma. Furthermore, it should be considered that although it is a common knowledge that physicians have the obligation to preserve life, they also have the responsibility to provide treatment which may result to minimal suffering even in the verge of death. In situations where the patient asks for active euthanasia, it should not be taken for granted by physicians. Patients have the right for a dignified death so that if a certain patient asks for it, it must not be denied but rather respected (Rachel, 1). Part 2 Looking at the arguments of Rachel on the morality of active and passive euthanasia, there are two reasons to agree with him. One is his explanation on how the perception of active and passive euthanasia affects its morality and acceptability. Generally, people really view active euthanasia as “bad” because of the nature of the act. The participation of the physician makes the act morally evil since it seems it is all to his likeness and decision. It is ironical that people view them differently when both have the same penultimate goal. If only people go deep to consider the surrounding circumstances, then they would probably learn that indeed it has the same end. Another idea I agree with Rachel is his distinction of the cases of Smith and Jones as morally irrelevant. It was clearly explained that their interest and actions demonstrate that both active killing and passive omission are morally evil despite the difference in how the action is carried out. It was clear that Jones applying passive omission does not make him a better man than Smith who applied active killing. Although, I have shown agreement with Rachel on two accounts, I still need to prove that his view on active and passive euthanasia is based on hypothetical imperatives. Hypothetical imperatives as defined by Foot involve actions that are good only as a means to achieve something. Actions are with purpose or desires. An example of this would be to give a direction to a person finding his way to a church that he must turn left on certain angles with the assumption that you wanted her to reach the place. My first argument to prove that Rachel uses hypothetical imperatives would be the assumption of Rachel that active euthanasia is good for every terminally ill patient. It is implied in his view that all patients are amenable to go through active euthanasia when they are in situations such as chronic illness and vegetative body state with the purpose to end their sufferings. In the view of Rachel, active euthanasia in these situations becomes morally justifiable because their life is considered miserable. Rachel however forgot to include the feelings, values and beliefs of patients which are more important when considering euthanasia. Indeed, there are patients who had been suffering for a long time and yet they do not wish to die. Some still longed to live despite their challenging condition. To them, they consider value in suffering and that euthanasia might not be in their interest. This might be the test for them to concentrate on important things, to control their surrounding, and their ego. Speeding the death of terminally ill patients through active euthanasia is denying them the opportunity to do such things. Not because their life is surrounded with miserable illness that they should be subjected to active killing. Rachel concentrated his argument on this premise. Although, there were patient who opted for euthanasia, their number should not speak of the whole population of those terminally ill patients. He also gave more importance to the action of the doer as there is no consideration if the doer possesses a moral judgment. Foot asserts that the morality of an act depends on what the person cares about thus he stated that euthanasia should be done for the genuine benefit of the patient, that is if the patient wishes to die through euthanasia, that is the time it should be exercised. However, if the person wants live despite her agony, it should not be presumed that they wish to because they are compelled or influenced by the idea of others. For active euthanasia to be considered good in itself, it should not be accompanied with certain purpose such as to end agony or suffering but it should be carried out because it is for the patient’s benefit. I would also like to prove that active euthanasia is not applicable in all situations but in selective cases only. Although, Rachel clearly gave a distinction that there is no moral difference in the cases of Jones and Smith, in the hospital setting where euthanasia is almost a part of treatment, the case of Jones and Smith is impossible to apply in all situations of the patients. It is unusual for medical practitioners to kill their patient for their own personal gain and interest. In fact, if they apply euthanasia, they are bounded with their medical standard or the duty ethics stipulated in their American Medical Association (AMA). To illustrate further that active euthanasia is selectively applicable in certain cases, an example of a terminally ill patient is considered. If a terminal cancer patient with metastasis requests for resuscitation in times she is going to need it, it is in the decision of the physician not to carry it out. This is because the doctor has to weigh first the professional code of ethics with the adverse effect of resuscitation on the health of the patient. Although, it is the wish of the patient to be resuscitated, it is medically futile making it a form of active euthanasia in this case. Treatments including euthanasia are unique to all patients and not every case is the same. In this case, it would be morally right to apply passive euthanasia. In cases where physicians carry out euthanasia, their actions are based against their medical standard but not because of their inclination. No doctor would ever plan for the death of their patients nor connive with them but they act in accordance with what is ethically right. Although, Rachel made it clear that doctors are concern with life which is useless or become burden to other members of the family considering euthanasia, it should not make active euthanasia morally acceptable. Another example demonstrating hypothetical imperative is a case where a patient is in a vegetative state where the patient’s life is viewed as useless. This is exemplified in the case of Daniel James, a well known rugby player who accidentally injured himself during one of their practice causing him to be in a vegetative state. Rachel pointed that individuals whose life is useless like James are good candidates for active euthanasia because it is more humane to apply such than the passive euthanasia on grounds that they do not live a quality life but prolonging their sufferings. However, in the case of James, he did not visit Zurich because his life is useless but accepting euthanasia is his genuine desire to do with his life. He gives importance to a dignified death where he finds happiness to be freed from such state of health. While some culture views vegetative state of health as a useless life, it should not be a basis to say being in that similar state is a burden to the family. This is another concept of Rachel demonstrating hypothetical imperative and applying euthanasia because of a goal to get rid of a useless life is similar to murder. Some culture, caring for their sick even for a long time is a part of their values, beliefs, and a way of life. It would seem then to say that a vegetative state of health is a burden to the family and individuals in this state ought to die. Having argued with the hypothetical concept of Rachel, I now wish to use Foot’s concept on morality that euthanasia should not be of hypothetical imperative in nature. The morality of active euthanasia could be reflected in duty ethics which involves duties that are morally right to the person performing the action. To Foot, this is the missing link to make the action morally right. For the end of the action to be justified, the recognition of a duty must be present. However, the duty must be accompanied with a moral virtue to make the doer moral and so with the action. A doer without moral has no moral ends thus his behavior is considered not moral. The action is contemplated as ultimately good if the doer’s goodwill is taken into consideration. The actions are acknowledge as wrong if the motive of the individual acting is not in good faith regardless of the good consequence accompanying the action. For instance, if the intention of the doctor is to inject poisonous drug to the patient because he is his enemy and wants to kill him which rarely occurs in the medical setting, then it would be considered morally wrong. However, if the motive of the doctor in injecting the patient the poisonous drug is because it is the desire of the patient to end his agony, then it is justified to be morally right. Another example to illustrate a moral act is on the action of a policeman in shooting offenders. If the action of a policeman in shooting a burglar is intended to hit or kill him because he wanted to be promoted in his position, the act becomes morally wrong despite saving property and other lives. However, if he has done it in relation to his duty to keep the premise safe, it becomes morally right. This shows that the justification of the acts lie in the pure intention of the doer in getting to his end. Whether the doctor is going to apply active killing or passive omission, the morality of each method depends on the virtue and the moral of the physician doing the action but not because it is the right thing to do for patients suffering too much and too long. In like manner, shooting a burglar to save a property with purity of the act is morally upright. Some people might respond to my argument in saying that legalizing active killing gives it its moral difference just like in countries that legalized it. However, this response fails because legalizing active euthanasia does not make a moral difference. Although, there were countries which were successful in making it legal, there are still debates on whether it is moral or not in those countries. Besides, it would be difficult to control medical practitioners who are amoral or any person without moral desires from practicing active killing even in situations where it should not be practiced. For sure, legalizing euthanasia has many disadvantages as presented by Foot. One disadvantage would be that patients who are chronically ill and in pain might be easily persuaded to go through active killing which is more difficult because it would take effort to design certain procedures to protect those who are vulnerable. It might be that patients will agree to the execution of active killing on them because of the pain they cannot tolerate. They might as well be also easily persuaded to agree if it is offered as an alternative to end their pain or if they are told they are a burden to the family. Foot also manifested that if active killing continue to prevail, it may cause some adverse social consequences. The duty to care and to comfort for the sick member of the family will be forgotten and gives way to an easier method of getting rid from the responsibility. Euthanasia might be used out of context and people who wish to get rid of their elderly or family members whose life is considered a waste or useless might seek the use of active killing for their own comfort and benefits and not for the benefit of the person afflicted. This proves that people will stop caring for things they use to care about such as personal values and beliefs (Foot, 315). Although, supporters of legalizing euthanasia will argue that laws limiting the range of options available to a person will diminish the person’s quality life even more and leaves him a feeling of powerlessness, it does not make euthanasia moral in itself. Again, quality of life is balanced against the values and beliefs of the person. The experience and their own perception of quality of life should have a substantial weight in the decision when applying euthanasia on them. Assuming it would be legalized, it would not solve the morality of the act. Debate on opposing sides continue to prevail and remains to be a problem. It would lead to ethical, psychological, and religious challenges and have implications for health care practice. The only way euthanasia becomes acceptable is using a categorical imperative instead of hypothetical imperative to attach a moral value in its application so that the act would also be moral. Conclusion The argument on the permissibility of euthanasia cannot be relied on establishing moral distinction between active and passive euthanasia. It remains to create dispute among experts in the legal arena, medical field, and philosophers more so if analyzing it is through the use of hypothetical imperatives. Euthanasia would only be accepted by majority if the act involving its application is accompanied with moral value. It is only interesting that medical practitioners who execute euthanasia are bounded with their ethical standard to guide them. Works Cited Foot, Philippa. Euthanasia. Retrieved from www.rci.rutgers.edu. on November 24, 2011. Rachel, James. Active and Passive euthanasia. Pdf. Retrieved from www.sunysufolk.edu. on November 24, 2011. Read More