Active and passive euthanasia.

Abstract

Recently the Canadian Medical Association has indicated its approval, under certain conditions, of some kinds of instances of what is called euthanasia. The need for some kind of ruling in this direction is made urgent by very pressing, widespread problems introduced by recent developments in medical technology. A characteristic instance would be the case of a terminally ill patient, who is in great pain and who is known to be about to die with overwhelming probability in a few days or a few hours, and shows symptoms of immediately imminent death (cessation of respiration, cardiac functions, and so forth). Active emergency methods of resuscitation are available (violent electrical shock, heart massage, and associated techniques)-a unit for this purpose is now customarily in readiness. But it is known that activation of these emergency measures will, at best, prolong the patient's life for a short and excruciatingly painful time. Moreover, as one can well imagine, repeated application of emergency resuscitation procedures in aggravated cases, where the patient could be described more as a mass of fibers than as a person, could constitute extreme cruelty. What is the physician to do? It has seemed to many that heroic measures should, under certain conditions, be waived. But does not such a waiver constitute killing the patient? On the other side, is not a too-strenuous interference in the course of nature equally morally abhorrent, cruel, and inhumane? The latter course may not seem to serve the interests of the patient, if unthinkingly or automatically always applied. A possible basis for resolving these problems is said to be an often cited distinction between and euthanasia.' The former entails active interference in the course of natural events, the taking of steps through positive action. Passive euthanasia carries with it no such requirement but only failure to institute positive action, letting nature take its course, so to speak. Thus it is sometimes felt that passive euthanasia is morally acceptable, under certain conditions, but that active euthanasia is never morally acceptable under any conditions. Recently, however, a contravening sentiment has made itself felt: that there