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This paper tries to set the issue of voluntary euthanasia in a philosophical framework by showing how some of the main philosophical theories about morality would deal with the topic. Philosophers have not discussed euthanasia as such until recently, although it is now a popular topic. What has always been discussed, however, is suicide, which raises much the same moral problems as voluntary euthanasia. The moral similarity between voluntary euthanasia and suicide enables us to make a reasonable guess about what some of the great philosophers would say about voluntary euthanasia.
In this country patients have a legal right to refuse treatment even if death will be the result, though doctors may make it difficult for them to exercise this right. But it is illegal for a doctor actively to bring about the death of his patient at the patient's request, in the way that is now decriminalised in the Netherlands. In this paper I shall concentrate on the controversial issues: whether it is morally permissible for a doctor actively to bring about the death of his patient at the patient's request and whether the law should be altered to permit this.
My title mentions "death with dignity". But dignity is a very complex concept. I shall not attempt to give a definition of dignity here. Instead I shall list aspects of dignity which seem to be important when death with dignity is discussed, recognising that some of these aspects will be more important to some people, others to others. Dignity involves: not being dependent on other people or on things; self-control and autonomy; privacy; the maintenance of one's own standards, of all kinds; self-esteem. A death with dignity is a death which enables the dying person to retain the elements of dignity which he or she values.
Consequentialism & Utilitarianism
Traditional philosophical theories about morality have often aimed to find a criterion of morally right action. We can divide such theories into two groups: those which hold that the right action is always that which produces the best consequences, and those which hold that the right action is not always that which produces the best consequences. Theories of the first kind are called Consequentialist theories; theories of the second kind are called Deontological theories, from the Greek words 'deonto' meaning 'to do with obligation' and 'logos' meaning roughly 'body of knowledge'. Consequentialist theories can be further subdivided: into Egoistic theories, those which see the consequences which matter morally as including only consequences for the doer of the action, the agent, and Universalistic theories, those which see them as including consequences for all those affected. I shall return to Egoism at the end of my paper. I shall begin with Universalistic Consequentialism, because this view (which still has many philosophical adherents) may strike one at first as the obvious common-sense, rational, secular approach to moral questions.
The first question that arises about Universal Consequentialism is: what counts as good consequences? One popular answer is the one given by John Stuart Mill in his famous essay, Utilitarianism good consequences are simply happiness, and happiness is pleasure and freedom from pain - not only physical pain but also distress of other kinds. According to this view, then, the right action is that which produces the most pleasure and least pain for all those affected. Another kind of answer is also found in the works of Mill, notably in his Essay on Liberty but also in Utilitarianism: the view that good consequences depend not only on the quantity of pleasure but also on the quality of the experiences which produce it and of the human being which is developed by them. According to this second...