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Theories on the value of life
Euthanasia being morally acceptable or not will depend on which view of the value of life is correct and, if relevant to the theory, on the particular type of euthanasia or situation involved.
The Sanctity of life
The conservative, sometimes also called the ‘strong’ sanctity of life view, claims that because God created human life, only God has the right to end it. Humans were created in God’s image, further suggesting that human life is especially valuable
Both conservative Catholics and protestants believe that the strong sanctity of life principle is justified by the Bible. Catholics would also think that Natural Law ethics provides justification for the conservative sanctity of life principle.
The sixth of the ten commandments is “thou shalt not murder”
“Your body is a temple of the holy spirit, who lives in you and was given to you by God. You do not belong to yourself” (1 Corinthians 6:19).
This quote clearly shows there is something sacred about the body such that destroying it would be like destroying a temple. It was given to us by God, implying a gift, and then very straightforwardly and clearly states that we do not belong to ourselves. We essentially do not have the right to take our own life.
“Whoever sheds human blood, by humans shall their blood be shed; for in the image of God has God made mankind.” Genesis 9:6.
This quote shows that the ultimate penalty is deserved for those who take life. The value of life is explained through its link to our being created in God’s image.
The weak sanctity of life view. Proponents of the weak sanctity of life principle criticise the strong version by pointing out that although the sanctity of life is found in the Bible, it is only one of many biblical principles and themes. So, although sanctity of life is important in judging the value of life, there are other principles that should also be included, such as Jesus’ emphasis on compassion. The problem with the strong sanctity of life view is that it allows unnecessary suffering and is uncompassionate, seeming to ignore the demands of compassion. In some cases, then, compassion for the quality of life might outweigh the sanctity of life.
However, although the Bible does have the theme of compassion, that doesn’t mean it can be used to overrule the sanctity of life. The Bible clearly is against killing. There is no exception mentioned for the sake of compassion. Although the Bible says to be compassionate, it doesn’t follow that it is Biblical to go against the sanctity of life when it would be compassionate to do so.
Quality of life
Quality of life refers to how happy or unhappy a life is. Proponents of the quality of life in relation to euthanasia regard it as a valid ethical consideration because they think that life has to be of a certain quality in order for it to count as worth living.
Peter Singer believes the quality of life to be an important factor in euthanasia. He goes as far as recommending non-voluntary euthanasia for babies whose potential quality of life is low, such as due to being born with an incurable condition like spine abifida.
Peter Singer’s criteria for personhood are rationality and self-consciousness. He distinguishes between ‘humans’ (members of our species) and ‘persons’ (rational self-conscious beings). Not all humans are persons. Singer argued that belief in the sanctity of life of members of our species (humans) was based on ‘Christian domination of European thought’, especially belief in an afterlife and that God had ownership of us, his creation. He proposes that since Christian theological tenants are no longer accepted, we should re-evaluate Christian ethical precepts too.
Singer argues that if we think about what we find wrong with killing someone, it is that it deprives them of the life they want to continue live. A consequence is that if euthanasia is voluntarily asked for by a competent adult, then it would not be wrong because they don’t want to continue living their life. In the case of non-voluntary euthanasia for babies or patients in a vegetative state, they have no sense or conception of their life, let alone their life continuing. So, it’s not morally wrong to kill them because it doesn’t deprive them of anything that they are able to have a preference to not be deprived of.
The slippery slope & effect on vulnerable people. Archbishop Anthony Fisher makes the slippery slope argument against the quality-of-life view, arguing that wherever euthanasia is legalised, it is extended to more and more people. He points out that in Holland euthanasia was legalised for the terminally ill but 10 year later was legalised for babies in cases of severe illness.
Fisher further argues that if Euthanasia is allowed for quality of life, then some elderly or otherwise vulnerable people might be tempted to die because they feel like a burden. Western culture values success, self-sufficiency, productivity and beauty. Those who fall short can feel miserable as a result. If we allow euthanasia, such people might feel encouraged to die because they feel like failures.
Adding to Fisher’s argument, In 2022 in Canada there was a controversy over two high profile cases of people with medical conditions for which they received insufficient financial support applying for euthanasia. One called Denise saying they have applied for euthanasia “because of abject poverty”.
The valid ethical approach would be changing our society, not allowing euthanasia. Those who advocate for euthanasia think they stand for compassion, not realising they are the unwitting executioners for our merciless success-driven society.
Singer responds that people who receive euthanasia in Oregon are disproportionately white, educated and not particularly elderly, so euthanasia does not especially target vulnerable people.
Singer adds that there is no creep of euthanasia becoming more widespread. He points out how in Oregon only one in three thousand deaths are by euthanasia. Genetic screening allowing mothers to know if their baby has a condition before its born and aborting it meant the post-birth non-voluntary euthanasia numbers dropped from 15 in 2005 to 2 in 2010.
We can conclude that Fisher’s points are not criticisms of euthanasia per se. They highlight the problem with allowing euthanasia in a society which lacks proper support for those who need it. Arguably it at most suggests that euthanasia must be combined with proper support for the vulnerable, not that euthanasia cannot be justified.
Autonomy
Autonomy is the freedom of people to make their own choices. This isn’t directly a view on the value of life, but it is the view that the decision about whether a life is valuable ought morally to be up to the individual whose life it is. There are two approaches to autonomy: deontological and consequentialist.
The deontological (absolutist) view of autonomy. Nozick is a libertarian, meaning he thinks people have an absolute right to do whatever they want, so long as they are not harming others, no matter the situation. He argued for the principle of ‘self-ownership’, meaning we essentially have property rights over our own lives and bodies. This results in a deontological view of autonomy regarding euthanasia. If a person wants to die and receive help from others (making it euthanasia) then that is their right.
However, Nozick’s approach seems to have enormous downsides. People will choose euthanasia for short-sighted reasons such as when in the temporary grip of negative emotion. Singer takes a more consequentialist view of the value of autonomy. He’s not an absolutist about autonomy as he says he doesn’t want to make it easy for people to end their lives when they have a treatable condition or when they might easily recover. He gives the example of a young person wanting euthanasia due to depression over relationship issues. Singer argues we can ‘safely predict’ that they will come to view their life as worth living again and the value of that ‘overrides’ the temporary violation of their autonomy when denying them euthanasia.
The consequentialist view of autonomy. Singer’s consequentialist approach to autonomy was influenced by Mill. Mill did not comment on euthanasia directly, but his philosophy formed the basis for justifying the autonomy principle. Mill developed political liberalism. Before the enlightenment, religion told people what to do. Mill thought that people would be happier if granted individual freedom. Individual people are in the best position to judge what is best for them and have the greatest motivation to ensure they live the best lives possible. This shows that euthanasia should be left to the autonomy of a competent adult.
The slippery slope vs consequentialist autonomy. Archbishop Anthony Fisher argues that allowing euthanasia for the reason of autonomy is vulnerable to the slippery slope issue. There is no logically coherent way to restrict the principle of “freedom to die” to the cases where it seems most applicable. If we grant that people have the autonomous freedom to die, how can we then avoid extending it to all cases where someone wishes to die, no matter how short-sighted their reason?
Fisher is arguing that it’s not logically consistent to take a consequentialist approach to autonomy. It’s only possible to coherently believe in absolute autonomy like Nozick. Since that has such morally terrible downsides, it’s better to not adopt autonomy as a principle at all regarding euthanasia.
However, there is a way to coherently adopt a consequentialist view of autonomy, which is to pair it with rationality.
Following Singer and Mill’s arguments, the individual who is in the best position to judge what is best for them and whether the potential value of their future life is of sufficient worth to make continuing to live the best choice for them. However, sometimes people can make irrational choices, not taking their actual long term self-interest into account.
To ensure that autonomy avoids ethical issues, we can therefore add the condition of rationality. The young love-sick person is clearly not making a rational calculation, for example. This position is not susceptible to the slippery slope argument. It would not allow euthanasia for short-sighted unthinking reasons since that would not be rational. This is a logically coherent way of avoiding extending autonomy absolutely.
Situation ethics on Euthansia
Fletcher’s rejection of legalism in the Bible including the sanctity of life. Fletcher’s liberal view of the Bible. Fletcher argued that the Bible is not a legalistic ‘rules book’ but an ‘editorial collection of scattered sayings’ which at most offers us ‘some paradigms or suggestions’. We can’t take the Bible literally, nor can we figure out which interpretation is correct. The best approach is to follow the general themes of the Bible, the most important of which is agape. This approach allows Fletcher to reject the sanctity of life principle.
Application to euthanasia. Situation ethics would judge that euthanasia can be morally good, in situation where it maximises agape. In situations where it would maximise agape to avoid euthanasia, it would be wrong, however. For example, if someone has a very low quality of life and an autonomous wish to die, it seems that Fletcher would accept euthanasia. However if someone is pressured into euthanasia by their family who are greedy for inheritance or by society making them feel like a failure or a burden, or if they have a short-term issue like Singer’s example of a lovesick teenager, Fletcher would think it wrong to allow euthanasia in such cases.
The issue that love is subjective applied to euthanasia
Situation ethics claims that love is the basis for ethical judgement. However, what counts as loving is subjective, meaning a matter of opinion. The Nazis had a forced euthanasia program against terminally ill patients and also babies they deemed disabled. Love is too subjective a thing to provide a stable basis for ethics.
Defence of Fletcher: love might be subjective, but agape is not. Agape is more than just love – it involves selfless love of your neighbour; loving your neighbour as yourself. A person would not want to be pressured into euthanasia themselves, so it cannot be agape to pressure your neighbour into it.
Optional further evaluation: However, what if someone genuinely thought that they would actually want to be euthanised if they were in the circumstance their neighbour was in. Many Nazis would probably genuinely feel like they would hope someone would have euthanised them If they were born with what the deemed to be a disability. So in a grotesque sense they would technically be ‘loving their neighbour as themselves’. The problem with loving your neighbour as yourself is that it depends on whether you love yourself in an ethical way.
W. Barclay’s criticism applied to euthanasia
People are not perfectly loving so if given the power to judge what is good or bad, people will do selfish or even cruel things. People’s loving nature can be corrupted by power. Someone might find it loving to manipulate/pressure someone into or out of euthanasia, perhaps if they will get inheritance to pay for their children’s food or something. Some might find it loving to end their life because they feel like a burden.
Fletcher and Robinson argue (influenced by Bonhoeffer) that humanity has ‘come of age’, however. This means that humanity has become more mature. In medieval and ancient time, when humanity had not come of age, people in general were less educated and less self-controlling. This meant that they needed fixed ridged clear rules to follow, because they could not be trusted to understand and act on the nuances and complexities in how a rule could justifiably be bent or broken if the situation called for it. However, now people are more civilised, to the point that granting them more autonomy will increase love without risking the stability of society.
Barclay disagrees however, and thinks that although people might appear improved, if granted the freedom (and thus power) to do what they want, they won’t choose the loving thing they will choose the selfish or even the cruel thing. This is essentially the classic argument that power corrupts. It also echoes the debate about the extent to which human nature is corrupt, such as by original sin. Also relevant is psychology like the Stanford prison experiment and literature like lord of the flies. It is a well-known feature of human psychology that power is corrupting. The freedom to decide what is good or bad without external supervision of legalistic laws grants humans more power and thereby corrupts them.
Natural law and the Catholic church on Euthanasia
Natural law ethics claims that we should follow the Bible teachings, which Aquinas calls the ‘divine law’. It claims there is also another law, the ‘natural law’ which also comes from God. God has given reason to human nature and designed it to be able to intuitively know the primary precepts of natural law.
Application to Euthanasia. Euthanasia violates the primary precept to protect and preserve human life.
Violating the sanctity of life, such as by allowing euthanasia, also violates the primary precept of maintaining an orderly society. Natural law is the idea that God designed all things, including humans, with the potential to be in harmony if they follow God’s natural law, such as the preservation of human life. Failure to follow this will therefore cause disharmony. Our society will break down because living contrary to God’s design is unnatural and thus leads to immorality and social disorder.
Mother Theresa summed up this kind of argument well during her speech upon receiving the noble peace prize. She claimed “the greatest threat to world peace is abortion. If a mother can kill her own child in her own womb, what is left to stop us from killing one another?”
It is dangerous for human beings to give themselves the right to judge when it is ok to kill people. We are unworthy of that power because we would be corrupted by it. If we stop believing life is sacred, we reduce the value our society places on life and thus will treat it as less valuable. That will endanger the order of society. No human is good enough to wield that power responsibly.
The Catholic Church on euthanasia & the sanctity of life
The Catholic Church uses the double effect to claim that sometimes doctors can stop or withdraw treatment (passive euthanasia) or even administer pain medication which could speed up death. So long as the intention is not to kill, the double effect would suggest such actions can be morally acceptable.
The Catechism of the Catholic Church on euthanasia:
‘Direct’ (active) euthanasia is never justified, but passive euthanasia, whether voluntary or non-voluntary, can be justified through the double effect.
“Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable … Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate … Here one does not will to cause death; one’s inability to impede it is merely accepted.” – Catechism of the catholic church.
Interestingly, the Catechism does allow for administering high doses of pain killers even if it risks killing them, so long as death is foreseen but besides the intention:
“The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable.” – Catechism of the catholic church.
Peter Singer criticises the way that the sanctity of life principle is applied by the Catholic Church – claiming that “they do not really act as if they believe it”. He points out that the Catholic Church allows for passive euthanasia – the withdrawal of life support machines from patients who are in a coma or vegetative state. The Church claim that this is because they have no obligation to provide “burdsonsome or disproportionate treatment”. However, there are cases of patients in comas who the Church have allowed passive euthanasia for (e.g. Karen Ann Quinlan). Singer points out that since such patients are in a coma, it’s impossible to see how keeping them alive on life-support machines could have imposed a ‘burden’, since unconscious people cannot experience burden. Singer concludes that the only logical way to think it good to remove treatment is if you believe that life must have some “positive quality” in order to be valuable, i.e. the quality of life view.
Whether Natural law ethics and the sanctity of life is outdated
Weakness: Aquinas’ Natural law ethics and the sanctity of life principle are increasingly seen as outdated. Sociologically, we could claim these ethical principles were created to be useful in the socio-economic conditions of their time. Ancient and Medieval society was more chaotic, strict rules were important to hold society together and because people were not educated nor civilised enough to be trusted with the freedom to interpret their application. It made sense to create strict absolutist ethical principles to prevent society from falling apart. This would explain the primary precepts. They served a useful function in medieval society.
Applied to euthanasia, we can argue it was useful to simply ban all killing in medieval times, because violence and killing was much more common and therefore needed to be strongly restricted. People were less self-controlling and less educated, so they needed clear simple rules to follow.
The issue clearly is that all of these socio-economic conditions have changed. So, the primary precepts are no longer useful. They were designed for a different time and are now increasingly outdated. Society can now afford to gradually relax the inflexibility of its rules and think about how they might be reinterpreted to better fit modern society.
Evaluation: Aquinas could be defended that this doesn’t actually make his theory wrong. The fact that mainstream culture has moved on from natural law ethics doesn’t mean it was right to. If Hitler had won WW2 and enslaved humanity, then democracy might have been viewed as ‘outdated’, but that wouldn’t make it wrong. Calling an ethical theory outdated is not an argument against its actual truth.
Counter-evaluation: A better version of the ‘outdated’ critique is to argue that Aquinas’ theory was actually a reaction to his socio-economic context and since that has changed, Natural law is no longer relevant.
Aquinas thought that he discovered the primary precepts through human reason, as God designed. However, arguably it’s a simpler explanation that Aquinas was simply intuiting what was good for people in his socio-economic condition. The idea that the resulting principles actually came from God was only in his imagination.
The great strength of religion as a form of social organisation is also its greatest weakness. By telling people that its ethical precepts (such as the primary precepts or sanctity of life) come from God it creates a strong motivation to follow them. Yet, because those precepts are imagined to come from an eternal being, they become inflexible and painstakingly difficult to progress. This makes them increasingly outdated.
Types of euthanasia which the theories on the value of life will have judgements on:
Terminal illness
Terminal illness is the most common reason for euthanasia as the person is going to die anyway often after a period of suffering.
Incurable physical illness
incurable physical illness such as cluster headaches are simply extremely painful and have no cure, reducing quality of life. Other incurable physical illness such as locked in syndrome almost completely paralyse a person which make them incapable of committing suicide even if they wanted to.
Incurable mental illness
incurable mental illness raises the issue of whether there is a kind and degree of mental illness which sufficiently impinges on the mind such that a rational choice to die cannot be made. Someone might be suffering considerable from an incurable mental illness, but if their ability to make informed rational choices is undermined by their illness, pro-autonomists would argue they shouldn’t be given euthanasia, while quality of life advocates might decide they should be.
In Belgium euthanasia is legal for people who don’t have a terminal illness but have an incurable and severe mental illness. Even young people in their 20s have been euthanized for this reason. If they have tried everything including every medication available, euthanasia is seen as a last resort.
Active & passive
Active euthanasia is when the person is killed by some positive action such as lethal injection, usually by a Doctor. Passive euthanasia is when no one performs an action which results in the death of the person but they are left to die by natural means, either by the result of their illness if they have one or simply by removing life-support machine equipment or even stopping giving them food. The death takes longer and unless they are unconscious in a coma or braindead, is more painful. However, the moral difference is that no one performed an action of killing them.
Situation ethics would likely regard active euthanasia as morally better than passive euthanasia, since it is quicker which can mean less suffering, which seems the more loving option.
The sanctity of life view would regard active and passive euthanasia as equally wrong since all life is sacred and must therefore be preserved.
The Catholic Church’s use of Natural law regards passive euthanasia as being potentially justifiable in certain circumstances under the double effect, so long as the intention is to accept ‘one’s inability to impede’ death.
Voluntary & non-voluntary
Voluntary euthanasia is when a person has the mental capacity to choose euthanasia.
Non-voluntary euthanasia is when someone does not have the mental capacity to choose euthanasia. If they are in a coma for example, or a persistant vegitative state,
This also applies to the euthanasia of babies. When a baby is born with a terrible terminal condition that will cause them significant pain before killing them in a few months anyway, many argue that non-voluntary euthanasia would be justified.
Case study: Alfie Evans. A particularly difficult case because the (apparently religious) parents wanted medical treatment to continue but the High Court of the UK ruled that the decision should be taken away from them as continued treatment of Alfie would be unkind and inhumane, due to it pointlessly delaying inevitable death and causing pain to Alfie in the process. It’s tempting to think that the parents should have the right to decide in cases like this, but what about the rights of the child not to suffer unnecessarily?
Possible exam questions for Euthanasia
Easy
Assess whether natural law is helpful for dealing with the issue of euthanasia
Assess whether situation ethics is helpful for dealing with the issue of euthanasia
‘euthanasia can be the loving choice in some situations’ – Discuss.
‘euthanasia goes against God’ – How far do you agree?
Can euthanasia ever be justified?
To what extent is euthanasia morally good?
Medium
Should a person have complete autonomy to choose euthanasia?
Is quality of life a basis on which euthanasia might be justified?
‘Life should never be ended because it is sacred’ – Discuss.
Hard
‘The religious concept of sanctity of life has no meaning in twenty-first century medical ethics’ – How far do you agree?
Critically compare sanctity of life with autonomy as principles for judging the issue of euthanasia
Is there a moral difference between active and passive euthanasia?
Critically compare the morality of voluntary with non-voluntary euthanasia
Quick links
Year 12 ethics topics:
Natural Law. Situation ethics. Kantian ethics. Utilitarianism.
Euthanasia. Business ethics.
Year 13 ethics topics:
Meta-ethics. Conscience. Sexual ethics.
OCR Philosophy
OCR Christianity
OCR essay structure
OCR list of possible exam questions