1. Applied Ethics
Euthanasia （安樂死）
Chan Chong Fai

2. Euthanasia (good death)
Intentional killing of a human being for the purpose of ending his/her suffering or of removing some burden.
An act of euthanasia is for the good of the one who dies.

3. Euthanasia
Any action where a person is intentionally killed or allowed to die because
the individual would be better off dead than alive—or
as when one is in an irreversible coma, at least no worse off.

4. Euthanasia
Is it morally permissible for the doctor to perform euthanasia on fatally-ill patient?

5. Is euthanasia morally wrong or right?
Euthanasia or murder?

6. Euthanasia
In ancient Sparta,
Physically unfit, incurably ill, or useless to the state, were killed or allowed to die.

7. In ancient Greece and Rome,
Euthanasia
In ancient Greece and Rome,
handicapped or mentally retarded babies were exposed or left to die.

8. Euthanasia
Mercy-killing
Physician-assisted suicide

9. Mercy-killing
In a car crash, the driver is trapped inside and the car is burning,
the driver asks a passer-by to end his suffering by killing him, rather than burnt to death.

10. Mercy-killing
In war, a seriously-wounded soldier asks his comrade to give him the last bullet.

11. In terms of consent
1.Voluntary—actual and explicit consent made by the patient.
*Consent must be free.
*Not free if given under conditions of ignorance, fraud or fear.

12. In terms of consent
2. Non-voluntary—unable or immature to consent. Consent made by others.
Comatose
Handicapped babies, with physical or mental disability
Down’s Syndrome babies with intestinal blockage.

13. In terms of consent 3. Involuntary—against the patient’s will.
The person killed refuses or otherwise actively withholds consent, or
the person could have been asked whether he/she consented, but was not.

14. Methods of performing euthanasia
Active—do something, like, inject lethal drug or use other means that cause the patient’s death.
Passive—stop or not to start medical treatment, and let the patient die.

15. Six types of euthanasia:
1.Voluntary active euthanasia
2.Voluntary passive euthanasia
3. Non-voluntary active euthanasia
4. Non-voluntary passive euthanasia
5. Involuntary active euthanasia
6. Involuntary passive euthanasia

16. Kantian objections Ｍoral duty to seek to preserve our life。
In accords with our own natural inclinations.
Suicide or asking another person to kill ourselves when we are in severe pain is thus wrong.

17. Kantian objections
Using ourselves simply as a means to remove our sufferings or great burden.
We should act in such a way that we always treat humanity, whether in our own person or in the person of any other, never simply as a means but always at the same time as an end

18. Utilitarian support Killing a person is not itself wrong.
Right or wrong depends upon the consequence of an act.
Value happiness and the absence of suffering or reduction of misery.

19. Euthanasia is nothing wrong if
Utilitarian support
Euthanasia is nothing wrong if
the fatally ill patient’s pain and suffering can be removed.

20. Utilitarian support
Greatest happiness for the greatest number of people could be achieved if
scarce health-care resources can be diverted to and used for other patients who are not fatally ill.

21. For Euthanasia
1. All persons have a right to control what happens in and to their body.
2. Continuing to treat someone suffering from a terminal illness will cause him/her more suffering than would be caused by giving him/her a fatal injection.
Therefore, in case of terminal illness, persons have a right to be given a fatal injection if they request one.

22. Do we have the right to die?
Some limits of a right to control what happens in and to our body.
Persons have a right to be given a fatal injection if they request one?
Do we have the right to die?

23. Against the right to die
(1)Suppose all persons have the right to die and should be allowed to end their lives to avoid suffering they regard as unbearable.
(2)If a person has the right to K, then he/she is morally permitted to exercise it and we must allow him/her to exercise it even when we consider his/her choice to do so unwise.
(3)If a person has the right to die, then he/she is morally permitted to exercise it and we must allow him/her to choose to die even when we consider his/her choice to do so unwise.
(4) If all persons have the right to die, then not only when they have fatal illness or suffer unbearable pain they choose to die, even before they experience any suffering and even when their death is not imminent they choose to die.
(5)But that is absurd.
Therefore, persons do not have a right to die and should not be allowed to terminate their lives to avoid suffering they regard as unbearable.

24. Against the right to die
Right to freedom does not include the right to giving up freedom;
Right to life does not include the right to abandoning life.

25. Against the right to die
A person’s right goes with another person’s duty.
If we have the right to die, then others have the corresponding duty to kill.
Moral duty to preserve and save life, no moral duty to kill.

26. For Euthanasia
1. We make decisions about our lives for ourselves according to our own conception of a good life.
2. Personal autonomy permits people to form and live in accordance with their own conception of a good life.
3. Human dignity lies in people’s capacity to determine and direct their lives in their own ways.
4. If burdens or pains of a patient’s life are so great that make life no longer worth living, then she can decide to forgo life-sustaining treatment or to seek active euthanasia.
5. It is exercising of her self-determination, maintaining the quality of her life, avoiding great suffering, and maintaining her dignity.
Therefore, the patient ought to be allowed to end her life when she chooses as an expression of her autonomy and her choice should be respected.

27. 1) Under depression or psychologically not stable,
Objections
1) Under depression or psychologically not stable,
appropriate to make decision about life and death?

28. Objections
2) Condemn slavery—exercising freedom to give up freedom forever.
One exercises autonomy to give up autonomy?

29. Objections
3) For Kant, autonomy means ‘making a law for yourself to follow’.
Killing yourself or killing a person on his/her request, cannot be universal moral law.

30. Objections
Autonomy does not include the right to kill, or the right to be killed.
Nor it includes the right to act against other good, like human dignity.

31. 4)Human life is indeed a good, and the fundamental good,
Objections
4)Human life is indeed a good, and the fundamental good,
since it is the source of all human dignity and well-being.

32. Autonomy cannot be exercised to abandon it,
Objections
Autonomy cannot be exercised to abandon it,
the same goes for human dignity itself.

33. Objections
5) Human dignity lies in a person’s capacity to control and direct her life according to her own conception of good life or values.

34. Objections
But losing control of our body means losing human dignity?
--Stephen Hawking case.

35. Objections
Nothing undignified in living with disability or even total incapacity.
Indignity lies in the contempt or discrimination with which some people regard others.

36. Objections
6) Not a private matter, not self-regarding act, but other-regarding act or social act.
Doctors are involved in euthanasia.

37. For Euthanasia 1. We have a duty to prevent unnecessary suffering.
2. In case of terminal illness, it is morally permissible to withhold medical treatment in order to allow the person to die of natural causes.
3. Allowing someone to die of natural causes will result in more suffering for that person than would result from giving that person a fatal injection.
4. There is no morally relevant difference between intentionally killing someone and intentionally letting them die.
Therefore, in case of terminal illness, it would be morally permissible to give a person a lethal injection.

38. Objection
Yes, we have moral duty to prevent or alleviate someone’s suffering.
But not by killing him/her.

39. No moral difference between active & passive?
Joe and Doe both stand to gain a lot of money when their five-year old cousin Boe dies.
They plan, separately, to kill Boe.
Here are the two cases.

40. No moral difference between active & passive?
Joe gets to Boe first while Boe is in the bath and
holds Boe’s head under the water until Boe dies.

41. No moral difference between active & passive?
Doe gets to Boe but before Doe can drown Boe,
Boe slips, bangs his head and falls, unconscious, with his head under the water.
Doe waits, ready to hold his head under the water if Boe recovers, but this proves unnecessary.

42. No moral difference between active & passive?
Joe drowns Boe; or Joe kills Boe.
Doe lets Boe drown when Doe could have saved Boe.
Joe and Doe are murderers, both are equally morally culpable.

43. No moral difference between active & passive?
Both Joe & Doe have intention to kill Boe.
No matter euthanasia is active or passive,
the doctor has intention to end the patient’s life.

44. No moral difference between active & passive?
The consequence of Joe’s action and Doe’s inaction is the same—Boe’s death.
Active or passive, the consequence is the same—patient’s death.

45. No moral difference between active & passive?
If the decision of ending the patient’s life is made, why active or passive makes a moral difference?
Patient suffers less in active than in passive, why not active?

46. No moral difference between active & passive?
In passive euthanasia,
the doctor is not doing nothing, he/she has done something—let the patient die.

47. No moral difference between active & passive?
Down’s Syndrome babies with intestinal blockage.
Not to remove the blockage—babies starved and dehydrated to death.
Life or death—not the small problem of intestinal blockage, but Down’s Syndrome.

48. Against euthanasia
1. A person’s right to life is an inalienable right.
2. An inalienable right is a right that cannot be taken away nor given away.
3. Voluntary euthanasia is an abandonment of right to life.
Therefore, voluntary euthanasia is morally impermissible.

49. Against euthanasia
Right to life is inalienable
If a person gives up his right to life, he gives up every thing.

50. Against euthanasia Compare with property right?
Property right to particular item is alienable,
but not the right in general.

51. Against euthanasia
1. There are some events which human beings should not seek to control nor should we control even when we have the power to do so.
2. Among such events are the onset and ending of a person’s life. The place, time and circumstances of our birth and death should remain out of our control.
3. Euthanasia is intentionally ending a person’s life. It intends to control the place, time and circumstances of a person’s death.
Therefore, voluntary euthanasia is not morally permissible.

52. Other reasons against euthanasia
Doctor should not be a healer as well as a killer.
*Permitting euthanasia is incompatible with a doctor’s duty as a healer to care for patients, save and protect life.
*Patients thus lose trust in doctors or medical service.

53. Other reasons against euthanasia
2.Humans are fallible and doctors could make mistakes in diagnosis and prognosis.
*Advancement and development of medical technology and medicine could make ‘incurable’ illness curable.

54. Other reasons against euthanasia
3. Permitting voluntary active euthanasia could be a ‘slippery slope’
—from voluntary to non-voluntary,
--from non-voluntary to involuntary,
--from adults to children,
--from terminally ill to chronically ill,
--from unbearable suffering to dissatisfaction with our life.

55. Fallacy of slippery slope
Same sex marriages should never be licensed by the Hong Kong government. If these arrangements are licensed, they will become an attractive alternative to heterosexual marriage. Married couples will start abandoning their spouses and link up with same-sex partners. Before long, everyone will adopt this lifestyle, and no one will have any kids. The extinction of the human race will follow soon thereafter.

56. Other reasons against euthanasia
4.Hospice services (hospital for people with incurable illness) or
--palliative care (to lessen the unpleasant effects of illness, dying, suffering without removing the cause)

57. Other reasons against euthanasia
Hospice services provide alternatives to euthanasia.
These services relieve pain and anxiety, prepare the patient for dying.

58. Other reasons against euthanasia
Doctors, nurses and family members work together to help the patient to live with a disability,
to cope with dying, and to live the last days of a human life.

59. Case study
David Hill left his parents and led a wretched and miserable life since his teens. He went into a coma after a traffic accident on his 35th birthday. His parents decided with a doctor, to give David a lethal injection to terminate his life for the reasons that a wretched and miserable life is worthless, and a comatose life is not a human life.

60. THE END