EUTHANASIA KANTIAN RESPONSE Kant was totally opposed to taking the consequences of an action into account. The end does not in any way justify the means according to his deontological (duty-based) theory. On these grounds, euthanasia cannot be undertaken because of the benefits it will create. Any good consequences from a moral act, for Kant, had to be purely incidental to the moral action and ought to have no place in the decision regarding what action to take. In other words, if euthanasia is to take place the issue will be whether it is simply the right thing to do irrespective of any consequences for good or ill.
decisions based on utility (hypothetical imperatives) are not moral
‘Man cannot have the power to dispose of his life’
C. I. ‘Preserve life at all costs’
Principle of Double Effect is an example of the Good Will
To be well informed a Kantian must consider the nature of Personhood
Human beings are ends in themselves
● Kant would not agree with euthanasia if the decision to grant a request was solely concerned with hypothetical imperatives: that is, with the assessment of the benefit of the action to the patient and his/her family. In other words, the granting of euthanasia to a terminally ill patient because of pain or poor quality of life has no merit to a Kantian since these are consequential concerns. Any action undertaken with the sole intention of killing a patient because they are a burden on their family or on NHS resources would go against Kantian principles – especially the principle of the good will.
● With regard to human life Kant stated: ‘Man cannot have the power to dispose of his life’. Kant came to this conclusion because he saw a relationship between freedom and rationality. We can go even further and say that, for Kant, freedom and rationality coincide (are the same). Put simply, Kant believed that it would be irrational for a human being to use his freedom to dispose of his freedom. In other words, to use life to dispose of life was, in Kant’s eyes, a contradiction: it is the most ‘un-human’ (‘inhuman’) act possible. Therefore, a request for euthanasia is an assault on reason itself which is, according to Kant, the foundation of the moral life (and the foundation of humanity). It is clear that Kant would argue against any act of ‘active’ or ‘direct’ euthanasia that sought after, or allowed, the deliberate death of a patient. This is why Kant and Mill come to different conclusions with regard to the use of human freedom. Freedom, according to Mill, is a property right (‘over himself, over his own body and mind, the individual is sovereign’); and because it is a human possession then it can be disposed of. The mentality here is, ‘It’s mine, so I can do with it what I like!’ In this way, the disposal of freedom (life) can be seen as a distinctive mark of humanity! By contrast, freedom, for Kant, is a duty to uphold at all times, and therefore it would be a contradiction to dispose of one’s freedom through a deliberate act of euthanasia. (In this way, the refusal of ‘active’ or ‘direct’ euthanasia can be seen as a distinctive mark of humanity!)
● It is absolutely clear from the above discussion that Kant has a high regard for human freedom (autonomy), but that a person’s right to exercise freedom over one’s own body must take second place to a person’s duty to be rational. To be rational, in the euthanasia debate, means that a Kantian has a duty to be well informed about the issue so that they can make decisions based on universal principles and not succumb to decisions based on selfish desire or self-interest. Each decision must, in other words, be an example of the Good Will. Secondly, a Kantian must investigate such concepts as personhood in order to help them make rational decisions regarding patients who are perhaps in a permanent coma or PVS. Why personhood? Because, according to Kant, the capacity for rationality defines what it means to be a human person. Both these aspects, (i) the good will and (ii) personhood, will be considered below.
● Consider the categorical imperative, ‘Preserve life at all costs’ Making this a universal rule would make euthanasia wrong without exception, since it appears to fit the three tests of a universal: (1) ‘What if everyone did that?’ (2) ‘Is it logically (not actually) possible for everyone to do it?’ (3) ‘Do you rationally want everyone to do it?’ No one would be killed, but also no one would be allowed to die. A human being would only die because of their underlying condition e.g. their terminal illness no direct intervention would be acceptable; it may even be argued by strict Kantians that morphine should not be used because of its effect in shortening life. Furthermore, those who are deemed to be alive only at the biological level – only respiration and circulation – would have to be kept alive by all means irrespective of any improvement since all that matters is following the imperative. Yet this imperative cannot be a truly universal categorical imperative, because it fails to take into account two things: (i). an action must be an example of the Good Will. This means that the reason why something is done is, for Kant, as important as what is done. In other words, like the Church, Kant is concerned with the intention (will) of an action; he’s interested in why we do things. (ii). secondly, ‘preserve life at all costs’ fails to take into account one’s duty to be rational. How do these two ideas relate to the issue of euthanasia?
- the good will – The Principle of Double Effect is an example of the Good Will - the point of the ‘good will’, for Kant, is that people should do the right thing with the right intention. So Kantians would be against any act of euthanasia which may bring benefit to the patient’s relatives or to the NHS in terms of the saving of scarce resources because these would be seen as examples of self-interest. However, if you act with the right intention (not out of selfish desire or self-interest) then Kantians will recognise the distinction between ‘killing’ and ‘letting die’ as something morally significant. So in agreement with the Christian Church and against utilitarianism, Kant would recognise that there is a valid distinction between deliberately bringing about death and allowing death. For example, if the deliberate intention is to ease pain and death comes about as a foreseen but unintended consequence then a Kantian will accept this since they see it as acting with the right intention. Some may say that this is an example of ‘passive euthanasia’, but a Kantian would say, in agreement with the R.C. Church and C of E that it is an example of the Principle of Double Effect. This creates a more appropriate Categorical Imperative: ‘a good agent must never directly intendthe death of an innocent person’.
- duty to be rational – To be Well Informed a Kantian must consider the nature of Personhood. By ‘duty to be rational’ Kant means that an action should be completely objective – decisions should be informed by the use of reason alone, and not be subjective - influenced by selfish desire or self-interest (i.e. an example of the ‘good will’). In practice this will mean that there ought to be an investigation into the personhood of the patient that is not influenced by the personal (subjective) motives of family members or doctors. In cases like permanent coma and PVS judging a patient’s capacity for rationality is central because, according to Kantians, rationality is the measure of personhood. In the case of a permanent comatose or PVS patient a Kantian would consider that the human being who is kept alive by artificial nutrition is not a person, since their life has only one dimension, that of biological life – the major characteristics of personhood are absent. Consequently, a Kantian would agree that a patient in such circumstances be allowed to die. Kantians may also agree to ‘active euthanasia’ – the administration of a lethal injection – because such patients who are in permanent comas or PVS lack true humanity because they lack rationality. Such action would not contradict the Categorical Imperative: ‘a good agent must never directly intend the death of an innocent person’, because the patient is not a person.
● human beings are ends in themselves. It would be wrong, according to Kant, to treat a terminally ill patient as a means only. So any act of euthanasia done with the sole intention of removing the drain on NHS resources or to end the agony of relatives would be wrong. A patient would be treated as an end-in-themselves if it was decided to allow them to die in order to avoid disproportionate or burdensome treatment. While this would be a means of saving NHS resources and relieving the agony of relatives, the patient is primarily being treated as an end because the deliberate intention of the withdrawal of treatment is to avoid unnecessary suffering. Yet a Kantian may, in good conscience, treat a permanently comatose or PVS patient as a means to an end alone if it is believed they are on longer rational (truly human), because to those who ‘are not self-conscious we have no direct duties’. (See notes on the Kantian Perspective on Abortion for quotation.)