Euthanasia is a relevant topic in medical profession leaving the professionals under an ethical dilemma. In many cases, they may be compelled to go against their conscience in upholding the wishes of the patients. Dan W. Brock in the article “Voluntary Active Euthanasia” through a series of arguments supports its legalization. The claim for his support is based on the two principles of “freedom of self determination” and “individual’s well being”. However, it is noticed that the arguments advanced and organized in support of legalization of Euthanasia are flawed.
According to Brock, legalization of euthanasia implies that the individual enjoys the freedom of self determination. In other words, it allows people to live and die according to how they conceive “a good life” (p.180). Individual has the satisfaction that they have the control over their life and death, which is what a dignified life is. The next argument following this one focuses on individual well being, which according to the author is possible only when the choice of euthanasia is available to the individual. Life is valuable for its own sake or is intrinsically valuable. In other words, the life should be preserved on the premise that it is worth living.
Brock goes on to support his arguments on legalization of euthanasia on the basis of good consequences following euthanasia. He advances the case of Netherlands, where voluntary active euthanasia is legalized, yet the cases of euthanasia are very low in that nation. The point that author makes is that Netherland supports “self-determination” of patients (p.182). In the U.S, according to the author, where life-sustaining treatment is allowed, the number of patients refusing this option is low, indicating that very few patients would actually want the option of euthanasia in the U.S.
Brock claims that polls have indicated that a majority of Americans want legalization of euthanasia, that is, people should have the right to opt for euthanasia, if they want it. This is the second good consequence argument that Brock supports because it upholds an individual’s dignity, while granting them their right to self-determination.
The “argument from mercy” is advanced as the third good consequence following out of legalization. Voluntary active euthanasia could bring about a peaceful death and end of pain to terminal patients who undergo unbearable suffering. Therefore, their right to die to end the pain and suffering should not be denied. Finally, the loved one are left only to remember good times. This restores dignity to both the patients as well as their loved ones.
Brock next goes on consider the arguments of the opponents and attempts to demolish them as Bad Consequences. The first bad consequence Brock identifies is the concern of patients and their fear of doctors and medicine, if euthanasia is permitted. Their role would be incompatible with their perception as “healers to care for patients” (p.183). People would perceive doctors as killers. Brock counters this charge with the contention that active euthanasia should be permitted only in cases that are truly voluntary, then no one would have the reason to fear physicians.
The second bad consequence argument relates to the high cost of medical care, while euthanasia is a cheaper alternative. However, the author claims that there is no evidence favoring erosion in the quality of care in dying patients who used their right to refuse treatment. In addition, only a miniscule percentage of people actually want euthanasia as found in the Netherlands. According to the third bad consequence argument, people may not feel determined to fight if an option to die is available. The author counters this argument with the claim that the right to refuse life sustaining treatment already exists, and there is no evidence to suggest that percentage of patients refusing life sustaining treatment has increased.
The other bad consequences Brock identifies relate to prohibition against homicide and illegal execution of euthanasia. Brock claims that discontinuing life support does not amount to killing. In addition, putting strict procedures in place might possibly eliminate or severely diminish the possibility of foul play.
Brock goes on to finally recommend a system and a procedure to address the issue of euthanasia to make it free of error, foul play and controversy. Accordingly, he recommends that law should permit only qualified doctors to perform this act. The procedure should be well laid down and should be scrupulously followed. Patients must be informed and the procedure is carried out safely. The persons given the authority to perform this act should be limited and should be held responsible for their action.
The point author makes about only a small number of people wanting euthanasia entails that if larger number of people would want to go with euthanasia, it might deserve reconsideration. In other words, ethical right or wrong depends on the number of people, which is a utilitarian perspective. According to this perspective greatest happiness to greatest number of people is ethical. On the other hand, the author speaks of the right to self-determination of individuals. These two ethical positions are incompatible; hence the author appears to contradict himself with his arguments.
Yet another contradiction evident in the logic of the author is as follows: Several cases of patients refusing life sustaining treatment have their basis in religion, while the same religion is against committing suicide or letting someone else commit suicide. In addition, the author speaks of physical pain endured by patients suffering terminal illness, but what about the psychological pain? Taking psychological case into consideration might hurt the case of legalization of euthanasia because the number of patients might rise. In addition, measurement of psychological pain is unreliable jeopardizing the case in favor of euthanasia.
There would be safeguard procedures in place to protect patients against abuses of euthanasia, according to the author. These include psychiatric evaluation and definite physical signs. Incorrect diagnosis even with second opinion is not very rare, while a hasty euthanasia entails death sentence for them. It is nearly impossible to eliminate human error despite the strict procedures in place.
In conclusion, Dan W Brock has offered a systematic case for legalization of active voluntary euthanasia with a number of arguments and cases, yet his case has flaws and drawbacks. Euthanasia is a sensitive topic and therefore a rigorous case and debate on the topic is warranted. The author supports the case with the ethics of dignity and freedom of choice. However, the subject of life and death should also take religion into account because it is in life and death that an individual encounters religion at the most intimate levels. In addition, there are a large number of issues including the procedures to identify genuine cases deserving euthanasia and possible frauds likely to arise with legalization that need to addressed with more rigor than it has been.
Brock, Dan W. 1992, “Voluntary Active Euthanasia”. Hastings Center Report. March\April pp. 11-12, 14-17, 19-21. (10)