shalt not steal”). Positive ethics considers active
benevolence and charity necessary to individual and
social virtue (e.g., “Love thy neighbor as thyself”).
These two (positive ethics in classical and religious
ethics; negative ethics in Lockean liberalism) often
conflict. An emphasis on respecting rights, leaving
others alone, and diversity is most common in nega-
tive ethics; a concern with others’ moral well-being is
characteristic of positive ethics.
Further Reading
Sheldon, G. W. The History of Political Theory.New York: Peter
Lang Publishing, 1988.
euthanasia
Euthanasia describes an act of causing a person’s death
painlessly to end his or her suffering. There are two
categories of euthanasia to be considered—active
euthanasia and passive euthanasia. Active euthanasia
requires the deliberate killing of a person, using med-
ical skills and knowledge as the instrument of death.
Passive euthanasia refers to the practice of ceasing
medical treatment so as to allow death. In addition to
these categories, we distinguish between voluntary and
nonvoluntary euthanasia. The former occurs when a
patient chooses and so consents to die. The latter
occurs when an act of euthanasia is carried out on a
patient who is unable to decide, usually because the
patient is incompetent and so cannot consent.
These categories and distinctions enable us to iden-
tify four types of euthanasia:
- Passive voluntary euthanasia
- Passive nonvoluntary euthanasia
- Active voluntary euthanasia
- Active nonvoluntary euthanasia
Acts of euthanasia raise moral and political issues:
first, whether respect for individual autonomy should
allow patients to decide life-and-death issues for them-
selves; second, whether medical practitioners should
use their skills and available technology to end life
rather than to preserve it; and third, whether others
(and which others) should decide life-and-death issues
for patients who are incompetent. The most prominent
issue in recent times has been the controversy of cases
of doctor-assisted suicide, where a physician provides
medication and instruction to individuals so that they
may take their own lives. In nearly all countries, active
euthanasia, including doctor-assisted suicide, is out-
lawed. The most notable exception is Holland, where
active voluntary euthanasia is, in some circumstances,
permitted.
There are a number of common arguments against
euthanasia. First, it is argued that there are moral and
practical grounds for a general rule or practice that
universally prohibits the killing of others and respect-
ing the sanctity of life. To allow euthanasia is to chal-
lenge and thereby weaken an absolute prohibition on
killing. This is the position held by the Catholic
Church and others. The utility of maintaining this rule
outweighs the benefit to those whose suffering is
ended by acts of euthanasia. Second, it is argued that
errors in diagnosis and in determining the prognosis
for recovery of a patient are possible; thus, patients
who would otherwise live are needlessly killed by
euthanasia. Finally, a patient may be beyond current
medical help now but within its scope in the future. A
sanctioned practice of euthanasia, too, readily sup-
poses that medicine can no longer help.
These arguments are opposed by those who claim
that what should be preserved is not life but rather a
minimum quality of life. Death then is sometimes a
benefit rather than a harm to the person who dies.
Also, voluntary euthanasia respects the autonomy and
self-determination of patients: It allows individuals to
make their own choice in the most crucial question
instead of being subject to the decisions of third par-
ties.
In cases of nonvoluntary euthanasia where a
patient is unable to render a competent decision, the
difficulty is in determining who makes the choice to
end life-preserving treatment and on what grounds. In
practice, passive nonvoluntary euthanasia is usually a
joint decision between family and doctors. There are
several grounds for ending life-preserving treatment:
First, the existence of a “living will,” or advance direc-
tive, that directs others to treat its author according to
his or her wishes should the author become incompe-
tent; second, by “substituted judgment,” where others
decide according to how they think he or she would
have decided for herself; finally, by basing a decision
on what others take to be in the patient’s best interests.
There are a number of deep controversies on the
topic of euthanasia other than whether its practice, in
any form, is morally and politically acceptable. It is
common in practice to draw a very sharp distinction
between active and passive euthanasia. The former is
most often legally forbidden; the latter is permitted.
James Rachels has argued that the distinction fails to98 euthanasia