17. Euthanasia, Killing, and Letting Die

James Rechels

The purpose of the essay is to examine a doctrine that is held in an absolute form by many doctors. The doctrine is that there is an important moral difference between active and passive euthanasia. The latter is sometimes permissible, the former is always forbidden.

1. To examine the relation between active euthanasia and passive euthanasia:

Rachels only argues that the two forms of euthanasia are morally equivalent—either both are acceptable or both are unacceptable .

　

2. Definitions of active euthanasia and passive euthanasia

2.1.Active euthanasia means taking some positive action designed to kill the patient.

2.2. Passive euthanasia means simply refraining for doing anything to keep the patient alive.

3. Doctors’ response to the two kind of euthanasia:

3.1.Killing (active euthanasia) is wrong and it is against doctors’ duty—to save and protect life.

3.2.Letting a patient die with dignity (passive euthanasia) is to respect the patients’ right to death.

3.3.Question: “Can doctors get out of the moral dilemma?”

174. The policy statement of the American Medical Association:

4.1.Killing patients is absolutely forbidden; however, it is sometimes permissible to allow patients to die.

4.2.Three conditions of letting die:

5. Is the distinction morally important?

5.1.Rechels thinks: “The real difference between them is, rather the difference between killing and letting die, both of which are actions for which a doctor, or anyone else, will be morally responsible.”

5.2.“Is killing someone is morally worse that letting some die?

5.2.2. Two cases:

Conclusion:

AMA Statement is false. There is no general moral difference between active and passive euthanasia; if one is permissible, so is the other.

　

1.The definition of death:

1.1.Two ways to define Death

1.1.1. A whole brain-death criterion

1.1.2. Traditional heart-and-lung criteria

1.2. Question:

Why is it all right to declare a human being dead because he or she is brain dead?

1.3. The purpose of the essay:

To productive future conversations on the definition of death

　

2. The theoretical dimension of the definition-of-death debate

2.1.A multi-level debate on the criteria for determining death

2.2.A concept—a criterion— a way of testing or measuring

2.3.The brain-death criterion implies that it simply no longer matters that the lungs and the heart are still working

　

　

　

3.The whole brain-theory dispute

3.1.Challenges (Zaner) focus on the failure of existing whole-brain theories to attend to the two central functions of the human brain:

3.1.1.The integrative functions of the lower brain and the cognitive functions of the higher brain

3.1.2.The whole-brain theorists appeal to only the brain’s integrative role.

3.2.We need an ethical justification

　

　

4.The higher brain-theory dispute

4.1.To determine death solely on the bases of the organismic functions

4.2.Using both criteria

4.3.Some metaphysical judgments

4.4.Challenge to The higher brain-theory and the theoretical arguments supporting it

5.Fundamental Philosophical divisions at the theoretical level

5.1.The notion of “fact finding”

6. The public policy dispute

　

　

Conclusion: Work at the criteriological and testing levels of the debate is critically dependent on our definitional or conceptual starting point. The conceptual level of the debate was interested in this essay. The definitional controversy is one of the most philosophically rich areas of biomedical ethics.