PASSIVE EUTHANASIA

Passive Euthanasia

Passive Euthanasia

Introduction

In our society, the active/passive distinction is the focus of much of the euthanasia debate, but from a libertarian perspective, only the voluntary/involuntary distinction is of any great significance. Many courts have held that the withdrawal of a breathing or feeding tube is letting die (i.e., passive euthanasia) and therefore acceptable. Yet withdrawing treatment is clearly an overt action (the courts have extended the notion of acceptable passive euthanasia to this obviously active act because they do not want people to hesitate to initiate treatment for fear it will be impossible to stop it later). In contrast, some states that allow the withholding and withdrawing of other types of treatment have passed laws prohibiting the withholding and/or withdrawing of nutrition and hydration even if a patient has voluntarily expressed a wish to refuse such treatment. Some states never allow such decisions, and others only allow them of competent patients, but not formerly competent patients (i.e., the state will not accept any form of advance directive as justification for the withholding or withdrawing of nutrition and hydration).

Discussion on Passive Euthanasia

The American Medical Association takes the position that it is inconsistent with a physician's Hippocratic oath for a physician to take a patient's life. The association distinguishes between passive euthanasia and the taking of life in the form of assisted suicide. Still, in addition to Dr. Kevorkian, some in the medical profession believe that there are circumstances under which a physician can and should assist a patient with the cessation of life. This issue came to a head in the case of Washington v. Glucksberg (1997), in which the U.S. Supreme Court held that states may properly prohibit the aiding or causing of a suicide.

Two cases, one from Washington and one from New York, were presented to the Court, appealing the prohibition of physician-assisted suicide as being a violation of the Fourteenth Amendment's Due Process Clause. A unanimous Court stated that there had been no violation of the Fourteenth Amendment, because the history of American jurisprudence evidenced an adherence to the common law practice of punishment or disapproval of both suicide and assisted suicide. The Court further held that the “right” to assistance in committing suicide is not a fundamental liberty interest that can be protected by the U.S. Constitution.

These preferences for passive over active forms of euthanasia are carried over into discussions of voluntary, involuntary, and nonvoluntary euthanasia. Nonvoluntary or even involuntary euthanasia, brought about by treating a patient with large amounts of pain medication in an attempt to relieve suffering (i.e., mercy medication), is allowed in some states. In such cases, the killing is considered passive in the sense that the patient's death is incidental to the physician's attempt to control pain. Conversely, voluntary euthanasia is generally only allowed if passive. The one notable exception is Oregon, where physician-assisted suicide for terminally ill patients is legal.

Given these distinctions, it is logical, based on libertarian first principles of individual liberty and self-determination, that a libertarian society would ...