Over the years, euthanasia has always continued to define the act of ending a patient’s life to relieve them of suffering. Active euthanasia calls for deliberate direct intervention in ending a patient’s life, while passive euthanasia is about the withholding or withdrawal of treatment that is life-sustaining. A debate has risen on whether there exist distinctions within the controversies between active euthanasia and passive euthanasia. Thus, it is a noteworthy course to explore the ethical implications of euthanasia, critically evaluating the justification for distinguishing between active and passive forms of euthanasia.
Although people may claim that there is a valid moral difference between active and passive euthanasia because they involve actions and the latter omission, I contend that such a distinction is not inherently justified. Active euthanasia involves a direct intervention to end life, such as administering lethal medication, whereas passive euthanasia encompasses withholding or withdrawing life-sustaining treatments (Rachels, 2019). Therefore, both forms of euthanasia involve intentional actions that result in the death of a patient and thus should be evaluated on similar ethical grounds.
The consideration of ethical discourses concerning euthanasia invokes the issue that surrounds active versus passive euthanasia; it stands for a difference between doing and not doing. Active euthanasia is administration; it is either an act of killing a patient involving lethal substances or procedures, while passive euthanasia is a case in which life-support measures are withheld or withdrawn; thereby, the result is death (Wiebe & Mullin, 2023). The great proponents of this distinction continue to argue for what they consider to be the bottom line of the difference: that active euthanasia is direct killing and, thus, morally distinct from allowing death to occur as a result of the withdrawal of treatment. However, this turns out to be ethically empty upon critical consideration.
Conceptually, active and passive euthanasia are two arguably different concepts. Actualizing, or the act of active euthanasia, includes the operational administration of agents that will hasten or cause death (Kumar et al., 2021). In contrast, passive euthanasia includes withholding or pulling out from the patient all instances of medical treatment that will get him through a natural death as a result of the disease. However, despite the procedural divergence, the two forms of euthanasia do share a particular standard dimension of importance, namely, the critical conscious decision that primarily involves ending the life of a sufferer (Rachels, 2019). Whether this is done actively or passively does not really matter, for the final intention of such a decision will always be monolithic, that is, the desire to relieve the suffering of the patient by seeking their death (Fernández-Ballesteros et al., 2019). Fundamentally, though the means may be different, the primary issue is the moral one of intending to decide to terminate life, thereby underscoring the moral equivalence between active and passive euthanasia.
Both active and passive forms of euthanasia may be justified using a theoretical framework such as Utilitarianism, a consequentialist moral theory that maximizes general happiness or well-being. It underlines what the results assume when the conduct or the moral actions are likely. Therefore, the use of both active and passive forms of euthanasia may find justification within the Utilitarianism framework as they lower suffering and advance overall well-being (Rachels, 2019). Most of the ethical considerations revolve around the relief of the patient’s suffering and improvement in the quality of life of the patient in both active and passive euthanasia, whether death is brought to realization through some positive action or the neglect of treatment (Dintcho, 2020). From a practical viewpoint, it would not matter anyway by what means death is brought to realization compared to the result following the death, and this would be relief from suffering and increased levels of well-being. Accordingly, ethically speaking, under the premise of utilitarianism, both active and passive euthanasia may be considered to be a justifiable act if and only if they do indeed result in the reduction of suffering and the improvement of the welfare condition of the patient.
Kantian ethics accords overriding importance to moral duties and principles, especially the concept of the categorical imperative in ethics. In Kantian philosophy, an action can be right on moral grounds only if the same applies to all people while maintaining the inherent dignity and independence of the human race. Viewing euthanasia from this school of thought may derive different viewpoints (Audi, 2021). Critics of Kantian ethics then add that through active euthanasia, the categorical imperative ceases to hold; human life takes on a utilitarian nature instead. It is reduced to a means by which objectives are met rather than acknowledging independent human ends. Proponents, on their side, feel that showing respect to what a patient needs and relief of the condition in question can even be underpinned by Kantian thought, regardless of whether the practice is active or passive in euthanasia (Wiebe & Mullin, 2023). In this manner, Kantian ethics may lead to conflicting readings on euthanasia. Still, the fundamental doctrines of universalization and considerations of individual dignity form the center of consideration for the moral permissiveness of active and passive euthanasia.
In conclusion, the supposed difference between active and passive euthanasia, in terms of ethics, is unjustifiable. Both practices include intentional action to bring the lives of visible suffering individuals to an end and, therefore, need to be judged based on their moral consequences. By taking any of the two sides, either in support or against the practice of euthanasia, such a decision requires strict ethical inquiry. Therefore, whether an individual approves or does not approve of euthanasia, there is an absolute need to conduct some ethical severe scrutiny.
Audi, R. (2021). Methodological reflections on Kant’s ethical theory. Synthese, 198(Suppl 13), 3155-3170.
Dintcho, A. D. (2020). Should Active Euthanasia Be Morally and Legally Permissible? Sound Decisions: An Undergraduate Bioethics Journal, 5(1), 1.
Fernández-Ballesteros, R., Sánchez-Izquierdo, M., Olmos, R., & Huici, C. (2019). Paternalism vs. autonomy: Are they alternative types of formal care? Frontiers in Psychology, 10, 458445.
Kumar, A., Mehra, A., & Avasthi, A. (2021). Euthanasia: A Debate—For and Against. Journal of Postgraduate Medicine, Education, and Research, 55(2), 91-96.
Rachels, J. (2019). Active and passive euthanasia. In Death, Dying and the Ending of Life, Volumes I and II (pp. V2_5-V2_7). Routledge.
Wiebe, K., & Mullin, A. (2023). Choosing death in unjust conditions: hope, autonomy, and harm reduction. Journal of Medical Ethics.