Euthanasia

In July of 1973, a handsome 25-year-old jet pilot and rodeo rider named Dax Cowart was ready to drive home with his father after inspecting some land for sale in East Texas, but only one of them would make it back and not until a year later. Below the ground beneath their car, a gas pipeline was leaking. When Dax started the car and the engine sparked, the gas exploded, engulfing the two men and the surrounding area in flames. 

Dax escaped the car and ran over a mile through the fire in search of help until collapsing. At that point, his entire body was covered in burns except for the soles of his feet. A nearby farmer heard his screams and told his nephew to call an ambulance. While the two waited for the ambulance, Dax asked the farmer for a gun to end his life, believing that he would die soon anyway, but the farmer refused, gently saying "I can't do that."

At the hospital, Dax repeatedly asked his doctors to let him to die, but all his requests were denied. For 14 months, he was subjected to excruciating treatments, including being bathed in water laced with bleach, a torment he said felt like being skinned alive. His eyes were removed, his hands were amputated, and his face was left disfigured. Knowing he could never return to his former life, he tried but failed to kill himself several times. 

Dax's doctors believed that his desire for death would pass. Once healed, they thought Dax would be glad to be alive and grateful for their help. They were only half-right. After his release, Dax did decide to keep living, but he spent his life advocating for the right to die and arguing that his doctors were wrong to save him. It was his life, and so it should have been his choice. Dax Cowart died from leukemia and liver cancer in April of 2019.

Dax's story is oftend
Can life cease to be worth living? Do we have a right to die? Do doctors harm us if they refuse to help us pass?  

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Euthanasia is the act of killing someone or letting them die out of mercy. The term comes from the Greek word for "death", thanatos, combined with the Greek prefix eu-, which means "good." Hence, the term literally translates to "good death," and it expresses the idea that it can be better to die than to keep living in some cases. Usually, discussions of euthanasia are about severely ill or injured patients, such as Dax Cowart.

Euthanasia can be voluntary or nonvoluntary. It is voluntary when the patient requests or consents to it. It is nonvoluntary when the patient is unable to do so. For example, euthanizing a suffering infant or a comatose patient would be nonvoluntary euthanasia because infants and comatose patients are unable to consent to anything. In such cases, their family usually decide for them after consulting with medical professionals. 

The term "nonvoluntary" is used here to distinguish cases where the patient cannot consent from cases where the patient refuses to give their consent or is not asked for it even though they could be. That would be involuntary euthanasia. However, it is difficult to imagine a case where it would be beneficial to the patient to be killed or allowed to die against their will. For this reason, we will discuss only on voluntary and nonvoluntary euthanasia.

Euthanasia can also be active or passive. It is active when the agent directly causes the death of the patient, such as by administering a lethal injection. It is passive when the agent lets the patient die by withholding or withdrawing any treatment that can be reasonably expected to prolong their life. For example, removing life support from a comatose patient would be considered passive euthanasia. In such cases, the agent lets the patient die naturally.

However, it is not considered euthanasia if a patient forgoes some treatment that would cause them great pain but have little chance of prolonging their life. For example, it would not be considered euthanasia for cancer patient to forgo chemotherapy if it had little chance of success. In this case, the goal is not to help the patient die but to spare them useless suffering. By definition, the purpose of euthansia is to help the patient die.

Likewise, it is not considered euthanasia if a patient receives some treatment that unintentionally expedites their death. For example, incurable cancer patients are often given increasingly large doses of morphine to ease their pain. This often causes patients to stop breathing as they fall unconscious, resulting in a peaceful death. This is not considered euthanasia because the intent is not to kill the patient but to ease their pain. Death is a side-effect.

Furthermore, actions that cause or allow patients to die count as euthanasia only if done to benefit the patient. Any fatal decision made solely to benefit others would not count as euthanasia. For example, suppose that a baby is born with both Down syndrome and a deadly intenstinal obstruction. Surgery could cure the latter, but the parents chose to let the baby die to avoid the burden of raising a mentally disabled child. This would not be euthanasia since it was not done for the benefit of the baby.

To review, euthanasia can be active or passive as well as voluntary or nonvoluntary, but its goal is always to give the patient a good death. That is the definition of euthanasia. Any action that causes or allows patients to die but that are not aimed at their death or that are not done for their benefit do not count as euthanasia, at least when the term is defined in the way ethicists typically use it. Keep this strict definition in mind as you continue reading and thinking about this issue. 

must be to give the patient a good death. That is the essence of euthansia. Acts that cause or allow patients to die but that are not aimed at their death or that are done primarily for the good of others do not count as euthanasia.

are not motivated by

Euthansia is compassionate by definition.

Not operating on a child because they have down syndrome is not euthanasia. It is not being done for the good of the child but for the good of parents or society. It is arguably criminal neglect by parents. The same is true of the "euthansia" programs of Nazi Germany. (Infants born with down syndrome and intenstinal obstructions. Surgey would fix the abstruction but parents chose to let it die because of the down syndrome. Babies dies of dehydraiton over several days.)

However, there are cases where doctors/parents might agree not to operate on a child with spina bifida-- opening at base of spine that causes hydrocelaphaus and mental retardation. Usually die within a few years of mental retardation or kidney failure. Policy used to be save as many kids as possible, but now doctors/parents can elect not to do if there is little chance of success-- point is not to bring about the death of the child though. Point is to avoid painful and pointless treatment.

Voluntary, Nonvoluntary, Involuntary

Voluntary E: a competent rational person requests or consents to it

Nonvoluntary E: Person is unable to request or consent because they are impotent or unconscious

Involuntary E: Patient expresses or may be presumed to have a desire not to be the subject of E.

-- It's important to realize involuntary euthansia is nearly nonsencial since it's hard to imagine a case where somebody would compassionately kill someone against their will.

Ordinary vs Extraordinary

Ordinary treatment: Treatment with a reasonable hope of benefitting patient

Extraordinary treatment: Treatment with no reasonable hope of benefitting patient

-- however the boundary between two isn't clear. What's the difference between prolonging life and prolonging death? Is using chemo on an 85 year old cancer patient ordinary or extraordinary if they have a 5% chance of living an extra two months? What about keeping a patient in a coma on lifesupport if there is little chance of recovery?

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