Abortion and Euthanasia: Exploring the Ethical Dilemmas

I. Abstract:

Most of people see that human life is priceless and with great importance. Based on that, many constraints and laws prevent people from ending their lives or making decisions about ending another person’s life. There are many perspectives and arguments regarding having the decision to end someone’s life, but this paper will be focused on the ethical concerns about active and passive euthanasia and abortion. This is an abortion and euthanasia essay that discusses the ethical concerns about active and passive euthanasia and abortion. Finally, the writer of this paper discussed what is the arguments that she supports regarding this issue.

Key Words: Active Euthanasia, Passive euthanasia, Abortion, The principle of the doctrine of double effect.

II. Introduction:

The first concept that will be discussed in this paper is euthanasia, which means ending another person’s life with intention based on the explicit request of that person. When some people or some nurses use the concepts of euthanasia and assisted suicide, they think that they talk about the same concept, while there is a difference between them. This difference depends on the culture and the country, where they are using this concept. One of the definitions of assisted suicide means that someone is helping another person in ending his life based on his explicit request. This definition and the definition mentioned above of euthanasia are according to the official Dutch terminology.

The second concept is abortion, which means ending the fetus’s life. This topic is also controversial, and many arguments are aroused on it. One may claim that the fetus has the right to live, and no one should make any decision about this. Another argument might be the claim that the fetus has the right to live only under typical conditions. Based on that, the first argument prevents abortion under any circumstances, but the second one prevents it only under usual circumstances.

The principle of the doctrine of double effect stated that if doing something that is ethically and morally right, but will lead to a harmful side effect, this action will be accepted morally providing the harmful side effect was not intended to have happened. This also will be ethically acceptable even if the doctor sees the high probability of the occurrence of harmful side effects. This principle allows the physician to give a patient, who is suffering from severe pain, a drug that may have a side effect or shorten the life of this patient, or give him a high dose of a drug to relieve his pain, but this is under some circumstances. There are four factors involved in the doctrine of the double effect principle. The first factor stated that the harmful side effect should not be the way to make good things, which means that this principle will not be applied if the drug that given to the patient was only aimed to relieve the patient’s pain by killing him. The second factor stated that the action and its cause should be proportional to each other, which means here that this principle will not be applied if the patient is given a high dose of a drug which will kill him certainly, and not just control his case. The third factor stated that the physician should provide the patient with the right medication for his case, for example, he cannot give him a drug used to treat the pain, but the patient has other symptoms. The last factor stated that this principle would not be applied if the patient, in his terminal condition, is given a fatal dose from a drug that will kill him, and without taking this drug, the patient could have the ability to live.

III. Ethical Arguments about Euthanasia:

Physicians’ morals in their duties are part of their profession. From the physicians’ duties to their patients are that they should respect their life and do not cause any harm to them in addition to preventing them from suffering. The writer of this paper was confused about this role because how they could stop their patients from suffering when they face imminent death, and there is no suitable treatment for them if it is unethical and illegal to kill them or do euthanasia?

Euthanasia has two types: active euthanasia, which is ending someone’s life intentionally, and passive euthanasia, which is stopping the medical treatment of a person at a terminal stage of his life. Euthanasia was subjected to argumentation and controversy for many years. Starting with the ancient philosophers, Plato left to us that Asclepius, healing and medicine’s god, thought that when the expected lifetime of a patient is short, and there is no effective drug that could improve him, the physician could decide to stop curing this person. This is because giving him treatments would not benefit society or the patient himself. On the other hand, Plato was against active euthanasia and believed that people who suicide and end their life should be punished by boriding in a deserted area. He also agreed with passive euthanasia and believed that people who are suffering should not suffer and receive treatment for a long time. Similarly, Hippocrates, who is known as the father of medicine, favored passive euthanasia rather than active euthanasia. He said that the physician should not continue to provide the patient with a drug if this patient has an incurable disease. On the other hand, Pythagorean philosophers believed that the soul is a holy thing, so no surgical operations are allowed to be conducted on any patient, and they saw that no one has the right to end someone’s life.

Everything in human life is valuable, and what humans do has meaning. Based on that, moral theology and medical ethics are the opposite to euthanasia. On the other hand, in bioethics, two principles agree to the human’s right to decide his life, the principle of dignity, and the principle of autonomy. The principle of autonomy means that every person has the right to make his own decisions about what he would do with his life, while the principle of dignity means that a human is not a satisfying thing to any other interests such as health care and commercial interests. One might think that when he decides to end his own life, this is self-love because he prevents himself from facing long-term suffering in the future. The question here, is could we put this self-love as a universal law of nature? If this becomes a universal law of nature, then nature would be controversial with itself because it will lead to the destruction of life through the same feeling, which aims to value life.

The principle of the doctrine of double effect is used to forbid euthanasia, but there are three arguments which are against forbidding of this principle to euthanasia. The first argument stated that benefits to the patients in the medicine are the results of harmful actions. For example, the doctor does surgery to the patient and harms him by making a cut in his abdomen to remove a tumor for example, but this surgery will benefit the patient when the tumor would have removed from his body. The second argument is that doctrine is not applied when the patient decided to remove part of his physical body, even if this part is healthy, to save his life. This can be shown when a patient decided to remove part of his trapped healthy limb from the fallen masonry to save his life. Similarly, this happens when some women, who are genetically predisposed with breast cancer, to remove their breasts to save their lives. Based on that, one may ask why this principle is applied when the patients decide to make mutilations because they see that this will benefit them, and is not applied when the patient sees that euthanasia will be a benefit for him? The last argument stated that there is no moral difference between giving a patient a drug that is known to be the only way to relieve his pain, but it killed him after one hour and killing the patient directly to relieve his pain.

IV. Ethical Arguments about Abortion:

Similar to euthanasia, the principle of the doctrine of double effect forbids abortion. The argument here, is there is a difference between killing the fetus because this benefits the mother by treating her, and killing it as a side effect of doing a good thing? Two arguments are discussing this issue. The first argument argues that the doctor has the right to remove a cancerous uterus that contains the fetus to save the life of his mother. Then, he can say that the fetus was aborted as a result of the hysterectomy. On the other hand, the doctrine principle forbids aborting the fetus and saving the mother, if this mother has the symptoms of eclampsia or hypertension, which leads to her death within hours. Similarly, at ectopic pregnancy cases, the doctrine principle supports performing surgery to remove the fetus but forbids giving the mother methotrexate intramuscular injections to kill him. The second argument stated that there is no difference between an action to cause death as a means, and causing it as a result of side effects when the mother and the fetus are affected similarly by both of them. For example, performing surgery for abortion when the pregnancy is triggering a specific disease inside the mother’s body, is the same as giving the mother a drug that causes abortion.

Two principles have aroused about the ethics of doing an abortion, and they are opposite to one another. The first principle called the value of life principle, which agreed with the beginning of human life at the moment of conception, so this should be valued, and abortion is unethical then. On the other hand, the second principle called the self-determination principle, which agreed with the women’s right to take an abortion decision. The writer of this paper sees that from the beginning of conception till the moment of birth, there is a gradual development in the fetus, which means that he becomes a potential person, and based on that, we cannot make the decision to end his life.

What do doctors do an abortion? What is meant by fetus scientifically? Is the fetus a part of his mother, or he is different? Those questions should be answered clearly to provide the most acceptable argument about abortion. There are two opposite answers to the first question; the first answer stated that the doctor is just removing some tissues inside the mother’s uterus while the second states that abortion is a result of killing a child. Similarly, there are two opposite answers to the second and third questions. The first one stated that the fetus is just a mass of tissues or cells that could be removed like removing cancerous cells. In contrast, the second opinion said that the fetus is a person that is growing day after day and uses his mother’s uterus as an incubator to be able to grow until birth. According to what has been known in embryology, the last opinion also said that there is a genetic difference between the mother and his fetus, so they think that those who are supporting abortion, they are somehow supporting euthanasia because, even if the fetus is just a mass of cells first, but this mass of cells has a soul, it will continue to grow until it becomes a full person.

V. The difference between Euthanasia and Abortion:

There is one question that could be used here to answer this question, which is why euthanasia and abortion have been performed? One argument said that abortion is aiming to cause positive things, while euthanasia will not lead to doing positive things. For example, the doctor performs an abortion to get out the fetus from the uterus to save his mother’s life, while euthanasia will not lead to ending someone’s life for the sake of nothing.

Because Egypt is an Islamic country, in paragraph euthanasia and abortion will be discussed from the Islamic ethical point of view. Before starting to show what Islam said about euthanasia and abortion, Islamic ethics should be defined clearly. Islamic ethics is a combination, or a mixture between principles, rights, duties, and responsibilities, and all of these are derived mainly from the Quran and the Prophet Mohammad Sunnah. For Active euthanasia, Islamic ethics stated that Allah is giving life to people, and he is the only one who has the authority of taking it. For passive euthanasia, there are different opinions in Islamic Fiqh. One argument is against passive euthanasia and is supported by the Prophet's hadith which is Abu Hurayrah narrates: The Prophet said: “There is no disease that Allah has created, except that He has also created its treatment”. On the other hand, the other argument supports passive euthanasia. They stated that the patient has the right to take a medication or not in some cases. For example, the patient has the right to refuse to do surgery or take a drug to remove cancer which took hold of all his body because this will increase his pain and will not be beneficial for him. For abortion, Islamic ethics stated that there is a religious imperative of protecting human lives to build a strong community for the sake of worshipping God. For Islam, the action of doing an abortion, or euthanasia is considered interfering with Allah’s Role as the decider of life and death.

VI. Conclusion:

Euthanasia and abortion are supported by many and rejected by others. In this paper, a lot of opponent arguments from the old and modern eras have been discussed. Abortion is more wide-spreading in many countries than euthanasia, although they seem to have the same result of killing other people. In these countries, they think that the mother has the right to kill his fetus before his birth, but has no right to kill herself. Although ethics could be discussed away from religions, the preferable argument from the ones mentioned above is that includes the Islamic ethics about abortion and active and passive euthanasia. Based on that, the writer’s point of view is that abortion and euthanasia actions should not be committed, because no one has the right to take a soul except God as he is its creator. Also, if the writer’s opinion should be away from religion and only be given from an ethical stance, her opinion will also be against euthanasia and abortion. For abortion, she thinks that no one has the right to decide the life of the fetus, even if this person is his mother. The same for active euthanasia as no one has the right to end his life, but for passive euthanasia, she thinks that every patient has the right to be given medications and treatment, even if he was in his terminal stages, this is because no one can see the future, as Allah can make a miracle and strengthen the life of this patient.