Involuntary euthanasia

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Involuntary euthanasia occurs when euthanasia is performed on a person who is able to provide informed consent, but does not, either because they do not choose to die, or because they were not asked.^[1] It is typically, but not always, murder.^[2] For example:

“

A soldier has their stomach blown open by a shell burst. They are in great pain and screaming in agony. They beg the army doctor to save their life. The doctor knows that they will die in ten minutes whatever happens. As he has no painkilling drugs with him he decides to spare the soldier further pain and shoots them dead.[2]

”

Involuntary euthanasia is contrasted with voluntary euthanasia (euthanasia performed with the patient's consent) and non-voluntary euthanasia (where the patient is unable to give their informed consent, for example when a patient is comatose or a child). Involuntary euthanasia is widely opposed and is regarded as a crime in legal jurisdictions, and is sometimes used as a reason for not changing laws relating to other forms of euthanasia.^[3][4]

Historically, involuntary euthanasia has received some support from parts of the eugenics and pro-euthanasia movements.^[5] During the Second World War, the Nazis ran an involuntary "Euthanasia Programme", later called Action T4,^[6] which was supposed to grant "mercy deaths" to incurable patients. In practice it was used to exterminate "lives unworthy of life" as part of their "racial hygiene" concept and, as a result, at least 200,000 physically or mentally handicapped people were killed by medication, starvation, or in the chambers between 1939 and 1945.^[7][8] Although some authors have identified fundamental similarities between Action T4 and euthanasia, (for example, Leo Alexander noted that both the euthanasia movement at the time and Action T4 emerged from the same basic principles),^[9] it has been argued that the Action T4 program did not constitute euthanasia, in spite of the use of the term, in part because it was not intended to be in the interests of the subject. Instead it is argued that the use of the word "euthanasia" was as a "camouflage word for manslaughter and murder of innocent subgroups of the population on the grounds of disabilities, religious beliefs, and discordant individual values".^[10] Whether or not it can be defined as euthanasia, Action T4 is employed within the euthanasia debate as an example of where legalising euthanasia can potentially lead.^[11]

More recently, Brad Hooker noted that "we can distinguish between killing innocent people against their wishes but for their own good, and killing them for some other reason", although he also stated that such a distinction is not very useful and would be likely to scare people away from medical experts, and that he "cannot imagine how allowing involuntary euthanasia could generate benefits large enough to begin to offset this loss".^[12] Philosopher Peter Singer, in his book Practical Ethics, after arguing in favour of voluntary and non-voluntary euthanasia also speaks of conceivable cases of justifiable involuntary euthanasia, but rejects the latter as "fortunately, more encountered in fiction than in reality."^[13]

References

1. ^ Jackson, Jennifer (2006). Ethics in medicine. Polity. p. 137. ISBN 074562569X. 
2. ^ ^{a b} Voluntary and involuntary euthanasia BBC Accessed July 26, 2011.
3. ^ Harris, NM. (Oct 2001). "The euthanasia debate.". J R Army Med Corps 147 (3): 367–70. PMID 11766225. "It is the occurrence of involuntary euthanasia which forms one of the main arguments against legalisation." 
4. ^ Chapple, A.; Ziebland, S.; McPherson, A.; Herxheimer, A. (Dec 2006). "What people close to death say about euthanasia and assisted suicide: a qualitative study". J Med Ethics 32 (12): 706–10. doi:10.1136/jme.2006.015883. PMC 2563356. PMID 17145910. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2563356. 
5. ^ Dowbiggin, Ian (2003). A Merciful End: The Euthanasia Movement in Modern America. New York: Oxford University Press. 
6. ^ Peter Sandner: Die "Euthanasie" Akten im Bundesarchiv. Zur Geschichte eines lange verschollenen Bestandes p. 385, Note 2 (see PDF version p. 66). The authors state the term was first used in trials against the doctors and used later in the historiography
7. ^ Lifton, p.102
8. ^ Horst von Buttlar:Forscher öffnen Inventar des Schreckens at Spiegel Online (2003-10-1) (German)
9. ^ Alexander Leo, Medical Science Under Dictatorship, The New England Journal of Medicine, 1949, No.241, pages 39-47
10. ^ Michalsen, Andrej; Reinhart, Konrad (2006). ""Euthanasia": a confusing term, abused under the Nazi regime and misused in present end-of-life debate". Intensive Care Medicine 32 (32): 1308–1309. doi:10.1007/s00134-006-0256-9. PMID 16826394. 
11. ^ Humphries, Mark (July 2010). "The Abuse of History: The Use of the Nazi Analogy in Contemporary Euthanasia Debate". Australian Policy & History. http://www.aph.org.au/files/articles/theAbuse.htm. Retrieved 26 May 2011. 
12. ^ LaFollette, Hugh (2002). Ethics in practice: an anthology. Oxford: Blackwell. p. 27. ISBN 0-631-22834-9. http://books.google.com/books?id=o5peQpgSTTIC&pg=RA1-PA3-IA3. 
13. ^ Singer, Peter (1993). Practical ethics. Cambridge, UK: Cambridge University Press. p. 201. ISBN 0-521-43971-X. http://books.google.com/books?id=OZOmSTWZNdcC&pg=PA201.