First, summarize the difference between active euthanasia, passive euthanasia, and physician assisted suicide (PAS), and explain the morally-significant advantages or disadvantages of these various practices. Next, explain why the medical system, a system that has traditionally been devoted to saving lives, should or should not provide any type of euthanasia or PAS.
C HAPTER 2
O O O
The mercy killing of patients by physicians, whether called “active euthanasia” (as
it is here) or simply “euthanasia,” is a topic of long-standing controversy. Can
active euthanasia-especially in response to the request of a competent patient-be
morally justified? Should _it be legalized? Parallel questions can be raised about
physician-assisted suicide, a closely related topic that has also generated intense
discussion. This chapter is designed to deal with ethical and social-policy questions
about active euthanasia and physician-assisted suicide.
EUTHANASIA: SOME IMPORTANT DISTINCTIONS
There is both a narrow and a broad sense of euthanasia, and the difference between
the two is best understood by reference to the categories of killing and allowing to
die, although the distinction between killing and allowing to die is itself a contro-
versial one. Understood in the narrow sense, the category of euthanasia is limited to
mercy killing. Thus, if a physician believes a terminally ill patient is better off dead
and for that reason (mercifully) administers a lethal dose of a drug to the patient, this
act is a paradigm of euthanasia. On the other hand, if a physician allows a patient to
die (e. g., by withholding or withdrawing a respirator), this does not count as
euthanasia. Although the narrow sense of euthanasia is becoming increasingly com-
mon, many writers still use the word in the broad sense. Understood in the broad
sense, the category of euthanasia encompasses both killing and allowing to die (on
grounds of mercy). Of course, the underlying assumption in conceptualizing the
withholding or withdrawing of treatment under the heading of euthanasia is that the
physician withholds or withdraws life-sustaining treatment (mercifully) for the pre-
cise purpose of bringing about the patient’s death. Those who employ the broad
sense of euthanasia typically distinguish between active euthanasia (i.e., killing) and
passive euthanasia (i.e., allowing to die).
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