Kantian ethics are often used to resolve medical dilemmas, Both J, David Velleman and Judith Thomson attempt to use Kantian ethics to assess the legality of physician-assisted suicide. Velleman takes the position that it is immoral to offer suicide as a protected option guaranteed by law and Thomson claims that it would be immoral not to. While both authors bring up good points, ultimately Thomson is right and physician-assisted suicide should be officially legalized in all its forms. Deciding what is moral in Kantian ethics centers on the categorical imperative, and for this discussion its second form, the formula for humanity Kant defines this as acting in a way “that you use humanity, in your own person as well as in the person of any other, always at the same time as an end, never merely as a means”.
In other words under the formula for humanity, any action that deprives anyone, including oneself, of their autonomy is immoral, For example, under Kant stealing is wrong because by taking that action you are using another person as an end, in this case to acquire a stolen good, and thus depriving them of their autonomy. While, both Velleman and Thomson agree with Kant‘s formula, they disagree on its application especially what actions deprive someone of their autonomy Velleman’s opposition to physician-assisted suicide is based on the assertion that not all options are good and having an option is sometimes detrimental, even if one does not exercise it. He gives numerous examples of why being given an option can be bad, and asserts that many of these reasons apply to the option of euthanasia.
However, Velleman specifically focuses on how physician-assisted suicide as a protected option deprives patients of their ability to stay alive by default. He writes that “once a person is given the choice between life and death, he will rightly be perceived as the agent of his own survival“. This means that when a patient is formally given the choice to live or die, he is automatically seen as being responsible for that decision and as a result he is expected to justify whatever decision he makes. The burden of justification becomes a problem when the patient can notjustify his choice to live because there is a modern cultural bias that detests dependence, and without justification the patient appears irrational.
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Being irrational, Velleman asserts, results in “being cutoff from meaningful intercourse with others, which is life’s only remaining consolation”. This is because in the context where euthanasia is being offered, presumably, the patient has lost independent movement and may be suffering from intense pain, if he is deemed irrational and not worth interacting with he loses his only remaining reason to live. Thus, through the offering of euthanasia as a protected option we disrupt the status quo forcing the patient into a situation where the best option is worse than the status quo that was disrupted We would in effect be harming patients by giving them the option of euthanasia. This would take away their autonomy, something immoral under Kantian ethics. Only a greater infringement of autonomy could warrant protecting the option of euthanasia.
Consequently, Velleman concedes that while his arguments apply to the option to refuse or ask to be disconnected from life support, it is protected on the grounds that without consent it is assault. However, he concludes that any other practice that results in physician-assisted death is not assault and should not be protected, Thomson, in contrast, argues that physician-assisted suicide should be protected in all its forms, in particular, lethal injections at the request of the patient and the providence of lethal pillsr She takes this stance based on her assertion that “placing restrictions on what can be done for patients who are terminally ill and wish to be helped is a serious infringement of liberty”. That is to say Thomson assumes by default the more options one has the better and depriving patients of the option of euthanasia infringes upon their autonomy.
If opponents wish to keep the option to refuse life support protected they must, successfully come up with an argument that allows for the morality of the life support, but forbids the practice for the other types of euthanasia. Using this criteria Velleman’s argument is invalid as he relies on protection from assault to protect the life support cases. Thomson expressly states “that that reason for legalizing disconnecting and non-connecting cannot be brought to bear in support of legalizing drug-providing and drug-injecting is no reason at all for keeping drug-providing and drug- injecting illegal”. Thus, because Velleman uses assault as an addendum to protect the life support options Thomson would not agree with his conclusion that euthanasia should not be protected option, Of course, Velleman does not agree with Thomson’s criteria and is not bound by them.
Yet, Thomson position is still correct because Velleman’s argument, that physician-assisted suicide is generally harmful enough to warrant not providing it as an option, is at its core paternalistic, While Velleman seeks to disprove this claim by stating that protecting the option of euthanasia is guaranteed to cause harm even if the patients are infallible and always choose the correct choice, he fails to take into account the patient’s ability to judge the value of that harm. This can be best seen by looking at an example. Say that Tom comes home to his house on fire, the police and firemen are already there, but his family is trapped and it is too dangerous for the firemen to enter. The firemen know that there is a small chance that Tom can go into the house and save his family.
If the firemen do not tell him about this chance, he would be better off because he is guaranteed not to die in a rescue attempt and is not forced into the decision of risking his life or watching his family burn while he knew that he could do something. Naturally, if Tom found out later that the firemen withheld this information, in effect not providing the option of saving his family, he would be furious. The firemen, by deciding to not give Tom the option of saving his family, would be paternalistically prioritizing the harm Tom would incur by being given that option over Tom’s right to choose what he would like to do Similarly, Velleman paternalistically decides that the harm caused by the option of euthanasia trumps the patient‘s desires.
This creates a contradiction as it is impossible to deprive someone of his autonomy in the name of protecting his autonomy. Velleman might respond by arguing that most patients, unlike Tom in the above example, would want the status quo and giving them the option of euthanasia deprives them of the option of maintaining it. Assuming this is true, it would appear that all other things being equal euthanasia should not be protected because either way there will be a deprivation of choice and the option of euthanasia would also have the negative effects Velleman describes However, this conclusion falsely equates keeping the status quo as an option with importance to autonomy.
If a businessman receives a lucrative job offer in a country far away the status quo of being completely satisfied with his job has effectively been destroyed. Even if he were to turn down the offer and keep his job he would not be as satisfied before the job offer. Yet, in general, no one would accuse the company that offered him a new job as taking away his ability to maintain the status quo In contrast, if the businessman’s boss intercepted the job offer and destroyed it, that action would be decried as taking away the businessman right to choose. The action would still be immoral even if the manager knew that the businessman would never leave the company and wanted to allow the businessman to maintain the status quo.
This shows clearly that the option of keeping the status quo is not a real option in regards to autonomy. Velleman‘s argument is well»intentioned, but like many well-intentioned ideas falls into the trap of treating rational adults paternalisticallyi While always offering the option of euthanasia may result in the negative effects he outlines, not doing so infringes upon patients’ autonomy. There is always a cost [0 having options, and it is dangerous for any person or group to restrict options that do not violate others autonomy based on their arguments that it would be beneficial to do so. Thomson is right that all forms of euthanasia should be a protected option because inherently choices are good especially those related to life and death.
