In 1973 the AMA (American Medical Association) declared that euthanasia should indeed be practiced but only in a passive way such as withholding treatment from the patient. But in an essay written by James Rachels in 1975 entitled Active and Passive Euthanasia, He argues against the AMA statement about euthanasia claiming that once the decision has been made to allow the patient to die, active euthanasia should be used in place of passive euthanasia. He claims that this method is not only relatively faster but most importantly it is less painful.
Through various examples and hypothetical scenarios, Rachels sets out to show how inaccurate the AMA statement is about euthanasia, how active euthanasia is the appropriate method, and how the present AMA statement could even lead to damaging results.
Rachels opens up his essay with an example and what he calls, "a familiar situation." He begins to tell a story about a man with cancer who is experiencing an immense amount of pain. He states that this man is "certain to die within a few days" and that even with the assistance of modern day medicine, he will die. The family and the patient eventually agree to end his life and the doctor agrees to withhold treatment from the patient, which is what the AMA allows.
Rachels states that even though this passive way is indeed effective, it could actually take longer for the man to die then if more direct actions were taken. Not only does he endorse active euthanasia at this point, but he also uses this example as a strong statement to prove that "once the initial decision not to prolong his agony has been made, active euthanasia is actually preferable to passive euthanasia." Rachels in this statement alone reveals how he feels about the AMA statement on euthanasia which declares that only passive euthanasia is acceptable.
As the essay continues, Rachels begins to try to make an emotional appeal to his audience by bringing up the issue of babies with Down syndrome. Down syndrome, now a day, is quite common and the result of it many times can fatal. Realizing this fact, Rachels decides to use this disease as a way to prove how the AMA statement towards euthanasia is flawed and that, in certain cases, active euthanasia should be practiced. He declares that simply being "allowed the die" can be a relatively slow process and painful process, but on the other hand, take for example lethal injection, is more efficient as well as less painful to the patient.
He argues that babies with Down syndrome who are "allowed to die" should not have to suffer so much pain as their life is literally being sapped out of them. He exclaims that this goes against everything that a doctor is taught, which is to try to save lives. Instead he is forced to sit there and watch a baby slowly dehydrate until he/she is no more. He then attacks the AMA statement by stating that "the doctrine that says that a baby may be allowed to dehydrate and wither….seems so patently cruel."
Rachels appears to make his strongest point when he declares that the "conventional doctrine to decisions concerning life and death" are made on irrelevant grounds." He starts off by continuing on the subject of babies with Down syndrome. He uses a hypothetical scenario of a baby who has an intestinal obstruction that needs to be operated on. But at the same time, the child has Down's syndrome so the parents and the doctors agree that it would be better to let the child die indeed of forcing him to endure all pain that awaits him.
He argues that this thinking is absurd and that if the baby's life is worth saving, then what does it matter if an operation is needed? He then states the opposite view, to show how much the decision of life and death is made on irrelevant grounds, that if it is better for the baby to die, then what difference does it make that he has an intestinal obstruction? He goes on to say that the fact that many decisions on life and death or made on irrelevant grounds is the exact reason why the AMA doctrine should be rejected. They have no idea of what exactly the situation is so therefore their set doctrine or statement about euthanasia is not only flawed, but it could also be quite damaging to a person affected by it.
As the essay progresses, Rachels, realizing his main opposition, begins to focus on the moral aspect of active and passive euthanasia. He starts off by stating the common belief that killing someone is morally worse than letting someone die. At this point, he begins another hypothetical scenario about a man who decides to kill his 6 year old cousin because if he dies, he will gain a large amount of inheritance. While the boy is taking a bath, the man(named Smith), decides to drown the boy. He then carries out his gruesome plan by drowning the kid and then arranging things to make his death look like an accident.
