When Is Euthanasia Morally Right?

Disclaimer: This article is intended to be read and understood as a discussion on the moral permissibility of euthanasia. It is not to be understood as an incitement to any action that is contrary to the laws of the jurisdiction in which the reader lives.


When is euthanasia morally permissible? Welcome to part four of our series on the talking of life. In this article, we will examine euthanasia from the perspective of Codist thought, asking if and/or when it is morally justified to euthanize a person. As with the previous parts of this series, we will endeavour to follow wherever the logic leads us without concern for traditional morality or sensitivities. As such, and as this article will be dealing with the killing of the sick and disabled, reader discretion is advised.

To understand this article, the reader must view euthanasia through the lens of the moral neutrality of the act of killing in Codist philosophy. The act of killing either a person or an animal is neither right nor wrong in and of itself. Instead, it is the consequences of acting or not acting that make it morally right or wrong. To this end we use the Moral Decision-Making Framework to examine the likely consequences of each choice, looking to see if the outcomes will be positive, negative or neutral to us and our families (RP1’s), and if the consequences will be harmful to our communities. In each case, a negative outcome for either our families (RP1’s) or our communities is only allowed if it is essential to avoid a worse outcome.


Before we can proceed, we must first define what we mean when we talk of euthanasia. Euthanasia is a Greek word meaning the/a ‘good death’ and has traditionally connotated the killing of a person to ease their suffering. Euthanasia—like other polite terms for killing such as execution, abortion, etc.—is simply means of applying a veneer of obfuscation over the act of killing. This respectable veneer was perhaps necessary as, in traditional morality, the act of killing itself was considered wrong. However, for us, killing is simply killing; thus, euthanasia will be used interchangeably with the term killing in this article. In general, though, it is to be understood that we are talking about killing in official settings and with official sanctions when we talk about euthanasia.


It is important to note that while in the modern ‘right to die’ movement, suicide, assisted suicide and euthanasia have become conflated together. They are quite separate moral issues in Codist thought. Suicide, as we discussed in part 3 of this series, is the act of willfully attempting to kill oneself for whatever reason. Assisted suicide is the active enabling of a suicide attempt, i.e., providing the drugs, building the machine, etc., that will allow an individual to kill themselves. Euthanasia, on the other hand, is the active or passive killing of another person without malice and often with the ostensible aim of ending or preventing their suffering.


Euthanasia and abortion are very similar concepts in Codist thought. In fact, as personhood is held to commence on the formation of the zygote after fertilisation, abortion is essentially the euthanasia of a child. The core difference between the two concepts is that of the ability to provide informed consent. By informed consent, we mean ‘permission granted in full knowledge of the possible consequences’ (WA Health Consent to Treatment Policy , 2016). This means that for an individual to provide informed consent, they must have the mental capacity to comprehend the situation. An unborn child is never able to provide their consent while, in many cases, an older person can. Thus, it is traditional when discussing euthanasia to differentiate between the ability of the individual to provide consent and if they have or have not provided that consent. These different capacities and consent levels are generally termed “voluntary, non-voluntary or involuntary euthanasia” (Euthanasia and Assisted Dying, 2021).


When is Euthanasia Permitted?

Before we discuss the permissibility of euthanasia and the different levels of consent, it is important that we understand what is meant by the phrase ‘harm to family and community’ in this context. This concept will come up again and again in this discussion; therefore, it is vital that it not be misunderstood. When we talk about causing harm to our families or communities, we are talking about harm wholistically. I.e., emotional, physical, financial harm, etc. Thus, when we say that a form of euthanasia is morally permissible if the individual’s death would cause the same or less harm to their families or community, what we are saying is that when all the factors are considered by the deciding individual or individuals, in their judgement, the negative impact on the individual’s family and community of their immediate death will be less than the negative impact on their family and community of their continued life or later death.


Many people I have discussed this horrible calculus with have declared that they would always judge the continuation of a loved one’s life to be positive. They claim that no matter the emotional, financial or physical costs, they would judge the continued existence of a loved one to be less harmful to their family and community than their death. Others have admitted that there are situations they can imagine where they would choose to kill a loved one to end their suffering. Or even that there are situations where the emotional, physical and financial costs of prolonging life would outweigh any conceivable benefits from continuation.


This article is not aimed at suggesting that one viewpoint is correct and the other is wrong. Instead, it seeks to explore and set the barriers of moral permissibility. Fundamentally, as with all ethical and moral choices, the maxims can only ever be guides. Each individual must use their own intellect and reason to apply and interpret them. Thus, both those who would choose to euthanize a loved one and those who would not, provided they are motivated by the long-term welfare of their families, may be right at the same time. In the end, it is a matter of judgement.


This is indeed a horrible calculus to consider and is an inestimably terrible choice to be forced to make. However, it is necessary that we examine it lest we allow greater evils to occur through our intellectual cowardice and moral uncertainty. As Arthur Schopenhauer said, one of the main requirements for philosophy is “to have the courage not to keep any questions back” (Schopenhauer, 1890). So, we must push on to the uncomfortable consideration of when euthanasia is acceptable.


Voluntary Euthanasia

Voluntary euthanasia is when an individual who is competent to provide informed consent agrees to be killed. This is essentially suicide, and thus, its moral permissibility rests on if the circumstances conform to one of the four situations listed below (discussed in greater detail in part 3), where it is morally permissible to kill yourself:

1. Where you can be confident that to die then would result in the same or less harm to your family than dying later, and if the contiguity with death is immediate and definite. I.e., you will definitely die in a short period of time (<1 year) with or without your interference.

2. Where you suffer from a permanent disability that requires full-time care for the remainder of your life and your death will result in the same or less harm to your family.

3. When it is the only way to protect your children, i.e., those with a higher priority to yourself.

4. When your death is certain and near, but by sacrificing yourself, you can minimise the harm to others in your family or community.

In each case, suicide is only permissible when it is essential to avoid greater harm to yourself and others. It is not permissible simply to avoid personal suffering. But rather is a tool of last resort, able to be utilised only in extremis to support the achievement of the purpose, namely by allowing you to kill yourself to prevent additional harm from befalling your family or community. This process can be seen on the moral decision-making framework flow chart below:


Figure 1: MDM Flow Chart Voluntary Euthanasia and Suicide

Non-Voluntary Euthanasia

Non-voluntary euthanasia is the killing of a person who is unable to either provide or withhold consent. This could be the case if the individual is in a coma, is too young to provide consent or is suffering from a cognitive impairment sufficient to render them incapable. This form of euthanasia is synonymous with abortion in that both are carried out without regard to the desire of the individual involved, but rather with reference to the welfare of their family and community. Thus, as with abortion, non-voluntary euthanasia is only morally permissible:


1. When the individual’s death is certain and near. Their immediate death would result in the same or less harm to their family than dying, and their death can save another individual. An example of this is the case of an unborn child, where the mother and the babe will die if no action is taken. However, by killing the child, the mother could be saved. Or in the case of conjoined twins where both will die; however, by killing one, the other’s life could be saved. Or perhaps even in the case where the individual could save multiple lives through immediate organ donation.


2. Or if the individual is severely disabled and cannot positively contribute to their family or community, and their continued existence constitutes a severe and persistent burden on their family and community with little or no chance of recovery. I.e., their continued existence would result in greater harm to their family and community than their death.


In situations where an individual can’t provide their consent, this decision must be made by their next of kin or guardian(s). As the decision is being made without the consent of the individual involved and the consequences are permanent, extreme care must be taken to ensure that the decision is indeed necessary for the long-term welfare of their family and community. The moral decision-making framework for this process is illustrated below:

Figure 2: MDM Flow Chart Non-Voluntary Euthanasia

Involuntary Euthanasia

The final level of consent regarding euthanasia is involuntary euthanasia. This is defined as: “When euthanasia is performed on a person who would be able to provide informed consent, but does not, either because they do not want to die, or because they were not asked” (Medical News Today, 2018). Involuntary euthanasia is generally considered murder as it is done against the expressed wishes of the individual (Holm, 2010). For us, though, there is little moral difference between the killing of a person who is held to be unable to express their consent but who may wish to live, and the killing of a person who is held to be able to express their consent but does not want to die.


Of course, for the family member who must make the decision, their loved one expressing their wish to live would likely be very persuasive. However, we must be clear that the default position of all living beings is the desire to continue to live. Just because an individual may be unconscious, in a persistent vegetative state (coma), mentally disabled, in the womb, very young, or otherwise unable to provide their consent, it does not mean that they are not more likely to want to live rather than to die.

Therefore, from a moral permissibility standard, if it is right to kill a person who is unresponsive, it is equally right to kill a conscious person who wishes to live. The standard we have set for the killing of any being is that their death will either result in a positive or neutral outcome to the killer’s family and community, i.e., for the killing of any being (human or animal), their death is morally right only if it does not result in harm to the killer’s family or community. In the case of euthanasia, this is the case only when the individual’s continued existence is actively harmful to the long-term welfare of their family and community. Or if, with their death being certain and imminent, less harm would be caused to their family and community if they died sooner rather than later.


Excepting the possible emotional harm caused to the family members who choose to euthanise a conscious relative who is asking to live, there can be no substantive difference in the horrible calculus of euthanasia between when the person is able to provide consent but withholds it or if they cannot provide consent. In both cases (as horrible as it is to contemplate), if their death is the least bad option, i.e., inflicts the least harm to their family and community, it is morally correct. Therefore, involuntary euthanasia is morally permissible when non-voluntary euthanasia is, i.e.:

1. When the individual’s death is certain and near. Their immediate death would result in the same or less harm to their family than dying, and their death can save another individual. An example of this is the case of an unborn child, where the mother and the babe will die if no action is taken. However, by killing the child, the mother could be saved. Or in the case of conjoined twins where both will die; however, by killing one, the other’s life could be saved. Or perhaps even in the case where the individual could save multiple lives through immediate organ donation.


2. Or if the individual is severely disabled and cannot positively contribute to their family or community, and their continued existence constitutes a severe and persistent burden on their family and community with little or no chance of recovery. I.e., their continued existence would result in greater harm to their family and community than their death.


As with the case of non-voluntary euthanasia, the individual next of kin or guardians would need to provide the authority to euthanise the affected individual. As this individual would be killed without or against their expressed wishes, it would be essential that strong safeguards were enforced to ensure that only where it was truly and absolutely necessary for the long-term welfare of the individual’s family and community was a person killed against their will. The moral decision-making framework for this process can be found below:

Figure 3: MDM Flow Chart Involuntary Euthanasia

When is Euthanasia Not Permitted?

Accordingly, euthanasia is permitted only when the death of the individual would have a neutral or positive outcome, i.e., less bad impact than their continued existence. It is morally permissible only when the following conditions are met:

The individual provides consent and:

1. They can be confident that to die then would result in the same or less harm to their family than dying later, and if the contiguity with death is immediate and definite. I.e., they will definitely die in a short while with or without interference.


2. Where they suffer from a permanent disability that requires full-time care for the remainder of their lives and their death will result in the same or less harm to their family.


3. When it is the only way to protect their children, i.e., those with a higher priority to themselves.


4. When their death is certain and near but by sacrificing themselves, they can minimise the harm to others in their family or community.

Or if they cannot or will not provide consent only if:

1. The individual’s death is certain and near. Their immediate death would result in the same or less harm to their family than dying, and their death can save another individual. An example of this is the case of an unborn child, where the mother and the babe will die if no action is taken. However, by killing the child, the mother could be saved.


2. Or if the individual is severely disabled and is unable to positively contribute to their family or community, and their continued existence constitutes a severe and persistent burden on its family and community with little or no chance of recovery. I.e., their continued existence would result in greater harm to their family and community than their death.

In all other circumstances, and especially those where the impetus to take a life is motivated by personal gain rather than an honest assessment of the impact of the individual’s death, euthanasia is not morally permissible. No matter how old or sick they are, the death of any person is always harmful to their family and community. It robs them of that person’s knowledge, experience, and most importantly, whatever they could be and do in the future.


Each being has the same inherent right to life and value as an individual as any other. Even where it is permissible morally and essential to kill them, care should be taken to do the least harm as possible by showing kindness and compassion. Remember also what is right for you is also right for others. Perhaps today you will be called to judge another’s fate—but remember, tomorrow someone else may judge yours.


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