Behind the supporters and opponents of euthanasia, what is at stake are opposing anthropological visions.
Is life something "sacred" that no one can freely dispose of, or is human life nothing more than the life of an animal like any other, albeit more evolved? What prescriptive ethical value does the biblical commandment "Thou shalt not kill" have in today's culture?
Joaquín Díaz Atienza
What I present below in a way that is accessible to any reader are the basic concepts about what is called euthanasia or a peaceful or gentle death, which is ultimately what euthanasia means and no dignified death, as their supporters try to rename what is, ultimately, killing a person.
TYPES OF EUTHANASIA
This presentation is based on what the professor argues. Peter singer1 , el utilitarian consequentialist which all current laws regulating euthanasia have used.
According to this author There are no fundamental differences between human beings and any other animal.That would only differentiate us, and not always. self-awareness with temporal continuity. Therefore, for him it does not have the same ontogenetic value a newborn (has no self-awareness) than a adult Therefore, they do not possess the same moral value either.
He distinguishes between voluntary euthanasia, involuntary euthanasia, and non-voluntary euthanasia.
-
Voluntary euthanasia
There are no differences between what is understood as Assisted suicide and voluntary euthanasiaUltimately, it is killing a person who has previously requested it, either directly or through advance directives with full awareness of the action and freely.
In this situation, those who kill the individual are merely carrying out what the patient voluntarily requests, with full awareness of what he demands and in the exercise of his autonomy.
-
Involuntary euthanasia
For Singer, killing someone who has chosen to continue living is not the same as killing someone who has not given their consent, but, he says, "had we asked them, they would have given their consent." Although he gives reasons to support this claim, in my opinion, it remains a subjective decision for the person who decides to kill, where their values come into play. We can never be absolutely certain that the patient would have decided what we, "in their place," would have decided.
-
Non-voluntary euthanasia
Here he describes those situations in which the patient is unable to distinguish between what it means to continue living or to die.. He describes different situations: The incurably ill, newborns with serious disabilities, and those who have lost the ability to decide and had not expressed their wishes in advance.
What does Singer mean by "Human Person"?. For bioethicists who follow the utilitarian and/or consequentialist school of thought, only those individuals capable of reasoning, possessing self-awareness over time, and autonomous in making decisions can be considered human persons. Therefore, a newborn is not considered a human person in the fullest sense, as it lacks self-awareness, reasoning, and autonomy.
These arguments lead the author to defend infanticideSince there are no significant differences between an animal and a newborn, Singer questions why it would be less reprehensible to kill a suffering pet to prevent its suffering than to kill a newborn for identical reasons.
To justify infanticide, he adds one more argument: that of replaceability. Parents who choose to terminate a newborn with severe abnormalities that will affect their life, both physically and in terms of quality of life, have the opportunity to replace that loss with another child born healthy. In this way, we avoid the moral, physical, and economic sacrifice, as well as the reduced quality of life, that a child with severe abnormalities entails, allowing us to dedicate our efforts to raising a healthy child. Examples include children with anencephaly, Down syndrome, and others.
He also questions the differences between pre-implantation genetic selection and letting a newborn die or killing it. For him, there are no objective differences, since he tells us that life "morally significant" It begins when the subject becomes aware of himself in time.
IS VOLUNTARY EUTHANASIA JUSTIFIED?
Singer explains that some of the following arguments should be taken into account: for the classical utilitarianism If an individual has the capacity to decide about their own death, killing them would have worse effects than respecting their capacity to decide. preference utilitarianism He argues that the patient's desire to continue living is a sufficient reason not to kill. The theory of rights, It argues that to have rights, one must have the capacity to desire what one is entitled to. If the patient lacks this capacity, euthanasia would be justified. And finally, the autonomy: We must respect the patient's decision, provided they have the autonomous capacity.
Therefore, voluntary euthanasia would be justified, although it recommends a series of requirements to be able to carry it out and in order to avoid the slippery slope, as well as the abuses that would inevitably lead to a practice that would violate the rights of the patient.
We literally quote what Singer proposes:
- It must be performed by a doctor.
- The patient has explicitly requested euthanasia.
- The patient is well informed, their decision is free and lasting.
- The patient suffers from an irreversible health condition that causes unbearable physical or mental suffering.
- There is no reasonable alternative (from the patient's point of view) that would alleviate their suffering. (I have underlined this point because it calls into question the allocation of healthcare resources so that any patient can freely choose between euthanasia and palliative care. That is why offering euthanasia as an alternative without providing the opportunity for palliative care is considered a clearly unjust measure.) quality palliative care).
- The doctor has consulted with another independent professional.
Later we present some reflections on patient safety and the application of these principles in light of the results that these measures are producing in countries that have recognized euthanasia.
ACTIVE AND PASSIVE EUTHANASIA. ORDINARY AND EXTRAORDINARY TREATMENTS.
For Singer, there are a number of bioethical concepts that morally lack intrinsic justification. He asks, Why is killing wrong and letting die not? For him, it's exactly the same because the ends are the same. The procedure itself isn't what makes an act that produces the same effect good or bad. He argues that this distinction between active euthanasia (the patient is killed) y passive euthanasia (letting die), ethically presents no differences and is based more on "religious concepts about life" than on objective arguments about it. He also believes that the double effect theoryIn the case of euthanasia, it is also an artificial moral construct.
Finally, it also does not consider that what we understand by ordinary and extraordinary treatments, taking into account that nowadays there is no tendency towards obstinacy or therapeutic cruelty.
SOME OBSERVATIONS.
- Our stance on the legalization of euthanasia depends on the value we place on life, on our beliefs and anthropological perspective. For example, if we believe the commandment "Thou shalt not kill" has absolute value, we cannot support it in any of its forms. It's important to note that even the Catholic Church has not respected this commandment throughout history. Saint Thomas Aquinas argues that the death penalty is justified in certain cases. Numerous examples could be given.
- As has been reported in countries like the Netherlands and Belgium, euthanasia is not always carried out in accordance with the regulations governing it. Therefore, what empirically appears to guarantee the patient's rights is not guaranteed with absolute certainty in the practical application of the law.
- Regarding the slippery slope issue, it's a proven fact: it began as a right for terminally ill patients who voluntarily requested it; it continued with a reinterpretation of their voluntariness by family members and doctors; it started with adults and has spread to childrenIt was legislated for terminally ill patients and is currently applied as assisted suicide; not necessarily in a terminal state or with serious illnesses; the latter, in the Netherlands, any "ailment" typical of old age can be a reason to request euthanasia.
- It is not fair to offer euthanasia without first establishing quality and universal palliative care, which leads us to think of a prevailing economic view of the measures, not a humanitarian and compassionate one as they want to present it to us.
