Arguments Against Non-Voluntary Active Euthanasia
Grisez and Boyle in Life and Death with Liberty and Justice moved the debate to non-voluntary active euthanasia. The basis of their argument against it is, as with voluntary euthanasia, that to legalize it would be a violation of the jurisprudential principles of justice and liberty.
The authors reasoned that even though euthanasia advocates attempt to show that Anglo-American legal conceptions of justice have religious roots, this point is irrelevant, since “they are an essential part of the consensus upon which the legitimacy of American government rests” (p. 217).
Further, the authors pointed out “that no advocate of euthanasia has challenged the requirement of equal protection of the laws. . . . The manner in which they argue for their proposals shows they are seeking to meet the requirement of equal protection of the laws with respect to the law of homicide” (p. 217).
Instead of denying equal protection, euthanasia advocates have three ways of arguing against applying the principle:
They assert that killing some human beings is a benefit to the ones killed rather than a harm, since their quality of life is so poor: life is no longer a good to be protected by the law.
They believe that even though some human beings may belong to the human species, they don’t merit equal protection because they should not be legally classified as persons.
They argue that there is a compelling state interest sufficient to deny equal protection of the law to a certain class of people: those who are permanently dependent, institutionalized, not able to contribute to society and being cared for by public funds.
The compelling state interest they see rests on the high public expense of the care of these people, which they say is sufficient to override the right of these unfortunates not to be killed.
They further claim that the state interest overrides the “liberty [of other citizens] to stand aloof” from killing. Therefore, this class of dependent people should be killed to ease the economic burden and, it is further asserted, it would be less unjust to kill them than to let them die of neglect, as we do now.
Grisez and Boyle made the following points to refute this argument:
Killing these patients is not a necessity (that is, not the only way) to solve the problem of great economic costs. There are certainly alternatives short of the drastic one of killing the patients!
Even if the state ceased to pay for their care (a step certainly not advocated by any means), it would be no more unjust than killing them and would at least leave open the possibility that other private interests would provide the care.
Killing them would offer no hope at all. At the very least, the state, in refraining from killing them, is not violating its duty to provide equal protection of the law of homicide and has protected other citizens’ liberty to remain aloof from killing.
The authors maintained, “
Money is only a means, not a substantial public purpose in itself. The preamble to the Constitution of the U.S. mentions justice and liberty, public tranquility and the common defense, civil unity and the general welfare.
It does not mention saving money . . . [Therefore] budgetary considerations as such never offer a compelling reason to override the liberty of citizens.
Euthanasia advocates claim that these dependent people make no contribution to society in return for the economic costs of their care. Grisez and Boyle questioned why the contribution is considered only in economic terms, rather than non-economic ones:
“The non-economic contribution of the helpless to society can be much more significant if it not merely generates psychological satisfactions but provides an occasion for exercising moral qualities of compassion and fairness.” They contended that the economic and the non-economic view each represent a particular worldview and asked, “Why should it be fair to impose one of these worldviews rather than the other upon helpless individuals? Equal protection of the law of homicide ought not to be modified to leave some class of individuals unprotected on the ground that on one or another worldview – perhaps even a widely held set of ideals and interests – such individuals contribute nothing” (pp. 228, 229).
If net burden to society is the criterion, the authors pointed out that
“The wealthy consume tremendous amounts of scarce resources” and questioned whether they contribute sufficiently “to approximate the costs they impose on society.” Is a handicapped child or a millionaire a greater burden? The answer is purely subjective, depending on personal values or worldview. The rich and the powerful, of course, are in little danger of losing their right to equal protection. It might also be argued there are numerous other classes of dependent citizens receiving enormous amounts of public funds: prisoners, those in drug or alcoholic abuse programs, people on Medicaid, Medicare and Social Security, welfare recipients, farmers receiving subsidies.
The list could go on and on. It is surely unfair discrimination to single out one group as candidates for killing because of a compelling state interest in saving funds.
It Used to Be Killing
Changes in dictionary definitions reflect changed perceptions on the part of the dictionary makers as to how the public uses the word in question. Check the definitions for “euthanasia” below and ask yourself, “Have we really forgotten that euthanasia is killing?”
From a pre-1950 dictionary: “Mode or act of inducing death painlessly or as a relief from pain.”
From Webster’s Third International Unabridged Dictionary (1968): “1. An easy death or means of inducing one. 2. The act or practice of painlessly putting to death persons suffering from incurable conditions or diseases.”
From Taber’s Cyclopedic Medical Dictionary (1981): “1. Dying easily, quietly and painlessly. 2. The act of willfully ending life in individuals with an incurable disease.” (References provided by Mrs. Mary Stone, Allentown, PA.)
Should Voluntary Euthanasia Be Legalized?: Second Thoughts
The propaganda onslaught for legalizing voluntary euthanasia has been “sweet talking” the nation into believing that this is a beneficial private choice imposing no burdens or harm to others so why should those who wish it for themselves be denied the legal right to have it?
On the contrary, we argue that the legalization of voluntary euthanasia would impose enormous harmful consequences on the lives of many, including the person requesting it!
Harm to the Patient Requesting Euthanasia
It would rarely be a truly free choice. It would be very difficult to obtain valid informed consent. It is rare to find a patient with a fixed, rational, enduring wish to die. Fear of pain, rejection, loneliness and lowered self-esteem because of dependency are all variables that can influence the patient’s wishes. As these needs are met the desire for death recedes.
If a patient is depressed or in pain, informed consent is not possible and the physician may not be able to assess depression in a patient he does not know well.
The result could be that a goodly number of patients would be killed who didn’t really want it. Uncontrolled depression and pain are thought to be the two most frequent reasons why patients seek euthanasia. Both can be controlled so that the reason for seeking euthanasia vanishes.
Diagnoses and prognoses are not always accurate. Errors would lead to unnecessary deaths for some patients.
Harm to Others
There would be subtle pressure on other patients to request death to ease the burden on family and overworked doctors and nurses. There would be financial pressures, especially for the elderly, incurably ill or disabled. This might be in conflict with the patient’s moral code and real desire to live, and could cause enormous suffering for the patient already burdened by his illness. If such a patient actually did sign for euthanasia it would be a totally invalid consent.
For patients morally opposed to euthanasia who courageously accept their difficult end, the temptation to take the easy way out of suffering could cause great conflict, weakening their resolve to do the right thing. With little support from society, this could impose an additional burden on their already overburdened lives.Care and advances in treatment may deteriorate for those so-called “better off dead” patients who refuse the option to die.
Some families of patients choosing euthanasia will be morally opposed and angry at the patient for causing conflict. Or the family may feel they let the patient down in not meeting his needs for care and, just as in cases of suicide, feel guilt and anger directed against the patient. Death under such circumstances would hardly be the peaceful one promised by the death-with- dignity crowd.
Giving doctors the legal power to kill their patients gives them power that no human being should have. Killing an innocent human being, for whatever reason, can have terrible moral consequences for the killer. It is unfair to demand that the healer become the killer on request! And nurses are inevitably involved as parties to the killing. To be obligated to work in a profession contaminated by killing turns the hospital into a schizoid world of curing some and killing others.
There could be a loss of trust in their doctors by patients fearful of the healer/killer role. (In Holland elderly people are often afraid to go into the hospital, where doctors might kill them!)
Physicians and nurses might be required to participate in what is to them morally and ethically wrong.
Harm to Society
Voluntary euthanasia would soon lead to non-voluntary euthanasia. If legalized, voluntary euthanasia statutes would eventually be brought before the Supreme Court. The Court would have to decide that these laws are either a violation of the unalienable right to life or that there is an unalienable right to die. If it decides the former, then euthanasia could not be legalized, but if it decides the latter, then all people would have to be allowed the same constitutional right to die. Then guardians could demand this right for children and incompetent persons. State-appointed guardians could exercise the right for the mentally ill or mentally retarded who have no next of kin. Thus we have non-voluntary euthanasia. It would also extend to those who are not terminally ill, since the law may not discriminate but must be granted to all as a constitutional right. This would extend the killing on a massive scale, and would be very tempting as a solution to skyrocketing medical costs of federal and state budgets! But think of the moral cost of all this killing to our American society!
Granting a constitutional right to die as a fundamental right would so undermine the fundamental constitutional right to life that it would be virtually cancelled out as a guaranteed right. This would put the protection of all citizens’ lives on very shaky legal ground. (Fortunately, in Cruzan v. Harmon, in 1990, the U.S. Supreme Court found that there is no right to die in the U.S. Constitution. The U.S. Supreme Court also found in Cruzan v. Harmon that a patient’s medical care can be cut off pursuant to state law if the patient has previously expressed a wish that medical care be cut off under the existing circumstances, even if cutting off medical care would cause the death of the patient.)
Granting a private right serving no public interest and indeed causing so much harm to others and society would involve the government in sanctioning killing merely to serve the private interests of the few at the expense of the many whose liberty and life would be put at risk. Those who request that euthanasia be legalized may come to realize that it would be unfair to impose such harm on others merely to “benefit” the few.