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Active Euthanasia: Moral Responsibility Rather Than Killing

İlayda Arık

The most important thing a human has, the right to live, and ethical dilemmas about life are among the biggest concerns of ethical discussions. Maybe one of the most popular ethical questions about life would be whether euthanasia is ethical or not. Some philosophers wrote impactful papers about this issue that are still being discussed. One of them was written by James Rachels and is called Active and Passive Euthanasia. The distinction between active and passive euthanasia can be explained by the distinction between killing someone and letting someone die. Active euthanasia happens when one kills a patient by using euthanasia, and passive euthanasia happens when one does not do anything to make the patient’s condition better while a patient has a severe illness. Rachels himself questions whether active euthanasia is worse than passive euthanasia and concludes that active euthanasia is not worse than passive euthanasia (1975). Another philosopher, Thomas D. Sullivan, writes a criticism to Rachels’ paper. Sullivan thinks that if there is the death of a person at the end, then it does not morally differ whether one lets that person die or kills that person (2009). This paper will argue that euthanasia is not killing and, therefore, not a crime but just relieving pain by using the example of a doctor who used euthanasia on a patient who asked for it and got prisoned by the laws. It will also be argued that we are morally responsible for ending a patient’s suffering. One of Sullivan’s examples against Rachels will be disproved, and possible criticisms of the views presented in this paper will be answered.

The argued views will be argued according to the following scenario. There is a seriously ill patient who stays in a hospital. His doctor gives him pain killers every day, but since he cannot be on pain killers twenty-four-seven, he goes through unbearable pain every time the pain killers lose their effect. He screams in pain and asks for his doctor, who gives him pain killers to kill him using euthanasia. The doctor says he cannot use euthanasia because it is illegal in their country. Also, the patient’s family does not want doctors to euthanize the patient and say that he cannot think properly due to the pain he experiences, and this is why he asks for euthanasia. After some time, the doctor realizes that the patient’s condition is not getting any better, and he does not see any hope. He sees his patient begging him to use euthanasia on him every time he sees his patient. One day the doctor decides to hear his patient’s pleas and uses euthanasia on the patient. Since he did something illegal, the doctor gets prisoned, and they take his right to work at hospitals. In such a case, even though the doctor was judged and found guilty by the laws, he cannot be found morally guilty. The doctor did not kill the patient; he solved his patient’s suffering. One of the euthanasia doctors in Belgium talks about euthanasia, “I do not call that killing a patient, I shorten his agony, his suffering.” (BBC Stories, 2019). The doctor is not using euthanasia to kill his patient; he uses euthanasia to end his patient’s suffering. In this sense, the doctor is not doing something that should be found morally guilty.

There are two options for the doctor: he either chooses to use active euthanasia on the patient or sees the patient suffer. In both options, there is a moral responsibility. How one acknowledges the moral responsibility by exercising active euthanasia is clear. By exercising active euthanasia, one directly ends a patient’s suffering and takes the moral responsibility to save the patient from their sufferings. At the same time, by doing nothing to prevent a person’s pain, one does something. The act of doing nothing affects what is going to happen to that patient. Since doing nothing can make the suffering of that patient longer, doing nothing cannot lead to zero moral responsibility. The doctor is morally responsible for ending the suffering of their patients, and therefore euthanasia is the moral responsibility of a doctor rather than a crime one commits.

Sullivan makes the following criticism to Rachels, “It is possible to foresee that something will come about as a result of one’s conduct without intending the consequence or side effect. If I drive downtown, I can foresee that I will wear out my tires a little, but I do not drive downtown with the intention of wearing out my tires” (Sullivan, 214). If we put the case about euthanasia in Sullivan’s example, we can see that the argument Sullivan tries to make simply does not work. Against Sullivan’s example about tires, we will say, “If I use euthanasia, I can foresee the death of a patient, but I do not use euthanasia with the intention of killing my patient.” When we turn the example about tires into an example about euthanasia, we can see that the action does not have to define the intention. Doctors do not kill to kill. Doctors solve the suffering, and its consequence is death. In the example about the doctor who used euthanasia and got prisoned, the doctor does not use euthanasia to kill his patient. The patient asks the doctor to end his suffering, and the doctor just ends his pain.

One may criticize the points I made by saying that even though we accept euthanasia as our moral responsibility and not murder, one can still misuse euthanasia and exercise unethical acts with it. However, this does not change anything since anything can be misused, especially in a medical place, if we think about it. That euthanasia can be misused in some cases does not change our moral responsibility to use euthanasia on patients when they need it. Instead of saying that misuse should be the reason why euthanasia should not be moral, we can decide under which circumstances euthanasia should be accepted as moral to reduce the possibility of misuse. For example, in Belgium, euthanasia is legal, but there are some conditions one should fulfill to ask for euthanasia. A euthanasia doctor in Belgium explains why his patient fits the circumstances to use euthanasia, “He meets the required conditions as he made a written request. He has a serious illness that cannot be cured, and his suffering cannot be relieved. He meets the three basic conditions to request euthanasia.” (BBC Stories, 2019). We can decide on the conditions that make euthanasia morally valid, which should solve the problem of the misuse of euthanasia.

Overall, whether euthanasia can be morally accepted or not has been argued based on the articles of Rachels and Sullivan. An example of a doctor who used euthanasia on his patient because the patient asked for the doctor to end his suffering was given to demonstrate why euthanasia should be accepted as stopping the suffering of patients instead of being accepted as killing. It was said that the doctor has two options, namely active euthanasia and passive euthanasia. The doctor should choose to use active euthanasia since this is the way to end his patient’s suffering. Doing nothing cannot lead to zero moral responsibility because doing nothing also affects the patient’s condition. This is why it is the moral responsibility of a doctor to use active euthanasia. Sullivan’s criticism and example of tires against Rachels have been argued and replaced with an example about euthanasia to show that the intention of the use of euthanasia is not killing, but saving the patients from their sufferings. The paper was concluded with criticism about the possible misuse of euthanasia and answered by saying that we can set parameters in which the possibility of misuse can be brought down to the bottom. Euthanasia is still an important topic for moral discussion, and I hope to shed light on this subject matter.


BBC Stories. (2019, June 14). Euthanasia doctor: ‘I don’t call it killing.’ [Video]. Youtube.

Cahn, S. M. (Ed.). (2009). Exploring ethics: an introductory anthology. Oxford University Press.

About the Author

İlayda Arık

She was born in Istanbul in 2001. She continues her studies in the philosophy department and minors in sociology at Middle East Technical University. She is interested in ethics and ancient philosophy.



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