Africa Focus Debates on Contemporary Contentious Biomedical Issues

Chapter Two

23 Chapter Two Clashing Views on Euthanasia Having paid attention to the concepts “ethics” and “euthanasia” separately, let us examine how and why the morality of the latter is a subject of debate. Arguments for and against euthanasia will therefore be presented in a bid to show how the morality of euthanasia is a contested notion and, why it does need incisive intellectual investigation. Pro- euthanasia Arguments The morality of euthanasia has an understanding which is very porous. There is no consensus amongst those who labour themselves to reflect on the morality of euthanasia. Consequently, two schools of thought have cropped in, making the morality of euthanasia even more complex, obscure and difficult to philosophically unpack. Among versions emanating from the debate on the morality of euthanasia, two intriguing and very different counterweights, which seem fundamentally significant, have taken the toll. One is summed up in the view of Fredrick Stenn, Margaret Battin and Carl Becker. These scholars have defended euthanasia on moral, religions and rational grounds. Generally, their views claim that euthanasia is morally right. It is a fundamental right of anyone wishes to have his or her life terminated, and to deny one who wants his life terminated is inhumane and unjust. Thus, it is out of this simple logic that euthanasia is considered as inherently morally right. One of the prominent advocates of euthanasia, Stenn has employed a principle of autonomy in reinforcing his 24 argument. The word “autonomy” is a legacy from ancient Greece. It is derived from the Greek compound “autos (self) and nomos (rule or law) first combined to refer to selfgovernance in the Greek city- states”1 where citizens were given the mandate to formulate their own laws. The most general idea of personal autonomy in moral philosophy is self –governance; forming one’s own self by adequate knowledge and understanding; free from controlling interference by others, government or personal limitations. The general idea of autonomy is linked in philosophical literature to several allied concepts such as the freedom to choose, the creation of a personal moral position and accepting responsibility for one’s actions. The principle of autonomy, in fact, requires that “we regard others as rightfully self-governing in matters of their choice and action…”2 In other words, the principle of autonomy contends that values and beliefs of the patient should be the primary moral consideration in determining what is to be done to the patient or in deciding the fate of the patient. In the light of this principle, Stenn argues “…man chooses how to live, let him choose how to die. Let man choose when to depart, where and under what circumstances the harsh winds that blow over the terminus of life must be subdued.”3 Stenn’s position shows that the main thrust of his philosophical argument lies in the principles of autonomy. It springs from the assumption that all individuals, whether young or old, are in a position to ascertain their own interests either verbally or otherwise more competently than anyone else. For instance, if an elderly competent patient declares that he wants life support systems to be removed because he does not value prolonged life, then, he should have life supporting systems removed even if family members might object. Expressed differently, the principle of autonomy 25 contends that the patient’s values and values should be the basis for determining what is in his or her best interests. This is to say that, for Stenn, euthanasia is a fundamental moral right of anyone who wishes to have his/her life terminated. In short, Stenn is of the view that it is morally right to terminate the patient’s life if the patient requests this on the moral grounds of autonomy. Margaret Battin has also supported this line of thought. She argues that physician-assisted suicide should be allowed. Battin seems to be considering physician-assisted suicide as a form of euthanasia (despite the distinction between physician-assisted suicide and euthanasia as shown in the preceding paragraphs). Battin thus argues that “various forms of euthanasia are taking root in some cultures, for instance, active euthanasia has been practiced without major difficulties in Netherlands. In Germany assisted suicide is allowed; why not in America?”4 It is against this background that Battin argues that even though passive euthanasia in the form of withdrawal or withholding of treatment is common in United States, still, more forms...