2. Voluntary vs. Nonvoluntary Euthanasia
Voluntary Euthanasia: Euthanasia with the patient’s consent.
Active voluntary: Directly causing the patient’s death with their consent.
Passive voluntary: Withholding or withdrawing life-sustaining treatment with the patient’s
consent.
Nonvoluntary Euthanasia: Euthanasia without the patient’s consent.
Active nonvoluntary: Directly causing the patient’s death without their consent.
Passive nonvoluntary: Withholding or withdrawing life-sustaining treatment without the
patient’s consent.
Remember: For any of these to be euthanasia, they must be done for the patient’s benefit.
3. Brock Thesis
Voluntary active euthanasia is morally
permissible and should be legal. It is supported
by two values - autonomy (individual self-
determination) and individual well-being - that
also support a patient’s right to decide about
life-sustaining treatment.
4. We value autonomy (individual self-determination) because we
think that a person should make important decisions about how
their life goes.
• Must have a certain amount of competence to make these decisions.
• Brock says that the value of self-determination extends to the time and
manner of one’s death, since we are concerned about when and how we
die.
We value individual well-being.
• Brock says that sometimes continued life is a burden for someone, not a
benefit.
5. Two Kinds of Arguments Against
Voluntary Active Euthanasia:
1) Moral Arguments
2) Public Policy Arguments
6. Moral Arguments Against
Voluntary Active Euthanasia
Moral arguments against voluntary active euthanasia agree with
Brock that autonomy and individual well-being sometimes
support voluntary active euthanasia.
- But they claim that other moral considerations outweigh
those values, making voluntary active euthanasia morally
wrong.
- Brock’s goal is to say that those arguments are flawed.
7. A Specific Moral Argument Against
Voluntary Active Euthanasia
Voluntary active euthanasia is morally wrong because it is the deliberate
killing of an innocent person. Withdrawing life-sustaining treatment is
morally permissible because it is just allowing to die.
Brock’s Response has two parts:
1) Withdrawing life-sustaining treatment IS the deliberate killing of an innocent person.
Analogy: the greedy son who removes his mother from a respirator kills his mother.
2) Because withdrawing life-sustaining treatment for humane reasons is deliberate killing
and NOT morally wrong, we cannot conclude that voluntary active euthanasia is morally
wrong just because it is deliberate killing.
8. Is killing worse than letting die?
• Like Rachels, Brock says no.
Brock’s example:
Gravely ill patient rushed to emergency room and begins to develop respiratory
failure.
Version 1: Family alert doctors to patient’s wish not to placed on a respirator.
Version 2: Family arrives late, respirator is removed, patient dies.
According to Brock, Version 1 is letting die and Version 2 is killing,
and there is no moral difference between these versions.
9. Potential Problem
Potential Problem with Brock’s Responses:
One could argue, contrary to Brock, that BOTH
failing to give life-sustaining treatment
(Version 1) AND withdrawing life-sustaining
treatment (Version 2) are cases of letting die,
and that letting die is less morally bad than
killing.
10. What makes killing wrong?
What makes killing wrong is that it “deprives a person of
a valued future.” (p. 673)
Note the connection to Marquis!
But voluntary active euthanasia does not deprive a
person of a valued future, and so it is not wrongful
killing.
11. Policy Arguments FOR
Voluntary Active Euthanasia
Respects self-determination of competent patients who want it.
Is reassuring for everyone else, that they won’t have to endure a
protracted dying process if they don’t want to.
Relieves physical pain and suffering.
A quick death is more psychologically humane than a slow one.
12. Policy Arguments AGAINST
Voluntary Active Euthanasia
1) It’s incompatible with physicians’ fundamental role as healers.
Brock’s Response: That role should be guided by the values of patient self-
determination and well-being.
2) It weakens society’s commitment to care for dying patients.
Brock’s Response: There is no strong evidence for this claim. The right to forego life-
sustaining treatment hasn’t affected society’s commitment to care for dying patients.
3) It threatens the current consensus in favor of allowing patients to refuse
treatment.
Brock’s Response: There is no strong evidence for this claim, and the current consensus
is strong.
13. Policy Arguments AGAINST
Voluntary Active Euthanasia
4) The option of voluntary active euthanasia may pressure more people to
take it.
One of Brock’s Responses: This concern would also apply to the option of withdrawing
life-sustaining treatment, but there is no evidence that having this option is harmful in
that case.
5) It might weaken the legal prohibition of homicide.
Brock’s Response: It won’t because the patient chooses it.
6) There’s a slippery slope from the fully voluntary/permissible cases to the
impermissible ones.
14. Slippery-slope Argument
Slippery-slope argument: arguing that some action is wrong because doing it will lead
to a chain of events and actions that will result in a disastrous outcome.
Sometimes slippery-slope arguments work. When they don’t, they are fallacies.
Slippery-Slope Fallacy: FALSELY arguing that some action is wrong because doing it will
lead to a chain of events and actions that will result in a disastrous outcome.
A slippery-slope fallacy occurs when the evidence for the alleged chain reaction is
lacking.
15. Brock responds by proposing safeguards
to stop the slippery slope:
1. Provide patient with all relevant information about
condition, prognosis, and alternative treatments.
2. Ensure that the request for euthanasia is stable and
enduring (waiting period) and fully voluntary.
3. Explore all reasonable alternatives.
4. Psychiatric evaluation.
16. Nonvoluntary Active Euthanasia
The values of autonomy and individual well-being can support some
cases of nonvoluntary active euthanasia as well – e.g., when the
patient is incompetent and a surrogate makes the choice.
This is just like how these values can support cases of nonvoluntary
withdrawal of life-sustaining treatment.
Brock: The important moral divide is not between active and passive
euthanasia but between voluntary and nonvoluntary performances of
either.
