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Introduction
The ethics of human relationships is the object of many philosophical teachings and doctrines. At the same time, specific issues and topics are controversial and acute since they are difficult to discuss within the framework of one particular theory due to distinctive views on causes and effects. As such a controversial topic related to biomedical ethics, the issue of assisted euthanasia will be addressed. The evaluation of this phenomenon from different perspectives may help draw conclusions about individual philosophers interpretations regarding the admissibility of this issue and the factors that explain attitudes to it. The doctrines of utilitarianism, deontology, and virtue ethics will be drawn upon, and the provisions of Mills, Kants, and Aristotles theories will be reviewed, respectively. The analysis of assisted euthanasia from the standpoint of one specific concept is impossible due to distinctive views on this phenomenon and unique philosophical ideas that interpret this ethical issue.
Issue of Assisted Euthanasia
Assisted euthanasia is a controversial ethical issue that is debated at various levels and concerns many stakeholders, including patients, the medical community, and legislators. Banovi et al. (2017) consider euthanasia from the perspective of two possible options active and passive. In the first case, a medical employee assists in interrupting the life of a hopelessly ill patient, and in the second one, no resuscitation actions are taken intentionally. The topic of this work is to analyze the first phenomenon implying the direct involvement of healthcare workers when the interruption of a patients life occurs by mutual consent of both parties. The assessment of this phenomenon from the standpoint of individual philosophical doctrines can help provide appropriate arguments to justify or, conversely, condemn the application of such an ethically ambiguous procedure in modern society.
Utilitarian Approach
Utilitarianism is a concept that implies evaluating a specific behavior or idea from the standpoint of its usefulness. Colosi (2020) cites the position of Mill, one of the most famous philosophers to develop this doctrine. According to Mill, the concept of utilitarianism is explained by a situation when not one person but all people benefit from a particular solution (Colosi, 2020). In other words, a specific action cannot be regarded as objective if it is intended to satisfy the needs of one human and, at the same time, creates discomfort or difficulties for others. Results are valued above the very essence of an action, which is the basis of this concept.
In relation to the ethical issue under consideration, utilitarianism allows euthanasia as an act aimed to reduce the suffering not only of an individual person but also of other stakeholders. According to Colosi (2020), Mills thoughts about people form the idea that a human being has a variable worth that depends on specific circumstances. Therefore, regarding the act of interrupting ones life, a patients desire is of importance as a factor that allows satisfying both individual needs and bring relief to other interested parties, including relatives and medical staff.
In relation to assisted euthanasia as a procedure for attracting aid from healthcare workers, the doctrine of utilitarianism also does not contradict this approach. As Dintcho (2020) states, within the framework of this philosophical teaching, observing someones painful death from the outside is no better than helping to alleviate suffering. Moreover, the involvement of professional medical personnel in such a procedure reduces the risks of failure. One of the key ethical dilemmas that arise when discussing assisted euthanasia is patient consent and his or her understanding of consequences. However, the framework is limited: either an individual is conscious and asks to interrupt ones life voluntarily, or relatives or guardians make this decision due to a patients incapacity. In any of the situations, the concept of utilitarianism assumes the relief of suffering as the most objective and correct outcome. Therefore, this doctrine allows assisted euthanasia as a tool to meet different stakeholders needs.
Deontological Approach
As a concept that opposes utilitarianism, one can consider the deontological philosophical doctrine. Kroneisen and Steghaus (2020) note that Kant was one of its founders and devoted much time to the development of treatises and theories concerning the foundations of human relationships. As the most recognized ideas, Doyle (2018) cites Kants Categorical Imperative as a concept that represents the doctrine of the highest degree of moral relationships. This concept largely forms the essence of deontology, which, in turn, defines morality and ethics as the main criteria of human behavior. The Categorical Imperative does not allow any violations of existing values for the benefit of one person or a group of people. In other words, doing the right thing regardless of individual beliefs is a key tenet of deontology. Regarding assisted euthanasia as a procedure involving crucial ethical contradictions, deontology and Kants specific concepts make it possible to give an unambiguous assessment.
Since, according to deontology, any decision made should be an act of morality, interrupting a patients life, even at his or her request, is unacceptable. Applying the provisions of the Categorical Imperative to this ethical issue clearly states that there is no justification for assisting in euthanasia. Despite a patients deliberate desire, according to Kants theory, a choice is submission to duty, which also refers to life (Doyle, 2018). On this basis, one can assume that, in a situation of moral choice between life and its intentional interruption, Kants ethics prescribes life. In addition, assisted euthanasia is regarded as facilitation and is unacceptable due to the violation of the moral right to protect patient interests. Even if a person insists that euthanasia can help him or her get rid of suffering, deontology regards this desire as reasonable but not instinctive since the preservation of life is a natural property of human nature. Thus, assisted euthanasia is an unacceptable phenomenon under Kants Categorical Imperative.
Virtue Ethics Approach
Virtue ethics is one of the widely known philosophical approaches that interpret human relationships within the framework of specific norms. This doctrine has been developed over many centuries, and Aristotle, the ancient Greek philosopher, is considered one of its founders. Van Zyl (2019) describes this concept as an approach that emphasizes virtue and moral character as opposed to doctrines that highlight the importance of duties and rules, in particular, deontology. Aristotles ideas related to the development of virtues of mind and character when a person acquired wisdom through learning and, at the same time, developed habits and preferences through social interaction (Van Zyl, 2019). The ethical issue of euthanasia, which is considered within the framework of this doctrine, is a phenomenon that it is desirable to avoid. Nevertheless, if no other outcomes can save a person from suffering, the assisted interruption of a patients life is possible. This approach characterizes virtue ethics as a concept that considers the problem from different perspectives and makes it possible to find a compromise.
One of the key tenets of virtue ethics proposed by Aristotle is that a person should seek an answer but not rely on dogmas and rules. As Jacobs (2016) argues, the philosopher sought to find arguments to support that generally accepted benefactors could help achieve goals and answer complex questions about human existence. Thus, assisted euthanasia may be viewed as a consequence of accumulated medical experience proving that treatment cannot be effective, and the further existence of a person will not bring him or her anything but suffering. As a result, the voluntary interruption of life is seen as a compromise, which is that a physician does not stay idle and, at the same time, does not make senseless efforts. If a patient, in turn, views assisted euthanasia as a tool to relieve suffering, no one has the right to prevent this. Thus, Aristotles virtue ethics is built on the principle of humanity supported by existing knowledge and experience.
Conclusion
Assisted euthanasia is an ethical issue that is controversial among adherents of different views, and the use of specific philosophical concepts to analyze this phenomenon can help determine the interpretation of the problem. The approaches of utilitarianism, deontology, and virtue ethics are reviewed in relation to assisted euthanasia, and the ideas of Mill, Kant, and Aristotle are assessed. The deontological doctrine prohibits medical assistance in interrupting a patients life, while two other concepts allow it, and utilitarianism even welcomes such a solution to the dilemma in question.
References
Banovi, B., Turanjanin, V., & Miloradovi, A. (2017). An ethical review of euthanasia and physician-assisted suicide. Iranian Journal of Public Health, 46(2), 173-179.
Colosi, P. J. (2020). Christian personalism versus utilitarianism: An analysis of their approaches to love and suffering. The Linacre Quarterly, 87(4), 425-437. Web.
Dintcho, A. D. (2020). Should active euthanasia be morally and legally permissible? Sound Decisions: An Undergraduate Bioethics Journal, 5(1), 1-8.
Doyle, D. J. (2018). Lies, deception, and therapeutic privilege in clinical ethics: A critique of the Kantian perspective. Ethics in Biology, Engineering and Medicine: An International Journal, 9(1), 21-34. Web.
Jacobs, N. (2016). On the viability of a virtue ethics approach to bioethics [Unpublished masters thesis]. Utrecht University.
Kroneisen, M., & Steghaus, S. (2020). The influence of decision time on sensitivity for consequences, moral norms, and preferences for inaction: Time, moral judgments, and the CNI model. Journal of Behavioral Decision Making, 1-14. Web.
Van Zyl, L. (2019). Virtue ethics: A contemporary introduction. Routledge.
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