LUTHERAN THEOLOGICAL REVIEW - Brock University

6 LUTHERAN THEOLOGICAL REVIEW IX
Mercy killing may be passive or active depending upon whether the
physician allows her to die naturally or whether the physician hastens her
death by using a procedure which overrides the natural process. Regarding
the distinction between passive and active mercy killing, Douglas Walton
has observed that “to allow something to happen [to let her die] is to make it
possible for it to happen when it does in fact happen. By a double negation,
to make it happen [to kill her] is to not allow it [her death] not to happen.” 2
In other words, “to allow her to die” implies that the physician also allows
her to live, however unlikely her continuing to live may be, because socalled
“spontaneous remissions” do occasionally occur. However, in active
mercy killing “to kill her” implies that the physician does not allow her to
live, because the physician’s action closes off every avenue of healing,
including ones that are unfamiliar to medical science.
Unless stated differently, I shall pose the remaining questions only
about Voluntary Active Euthanasia (VAE). The patient is “terminally” ill;
she freely asks her physician to kill her; the physician accedes to her request
by carrying out a procedure which makes it happen that she dies; and the
procedure hastens her death by overriding the natural process of dying. For
example, the physician injects her with curare, a deadly paralysing drug.
2. IS IT IMPOSSIBLE FOR HER ILLNESS TO GO INTO REMISSION
Some ethicists think that the answer to this question is certainly “yes”
for some terminal cases. James Rachaels, for example, says:
it does not follow from the fact that doctors have sometimes been
mistaken that they can never know for sure that any patient is hopeless.
That would be like saying that since some people have sometimes
confused a Rolls Royce with a Mercedes, no one can ever be certain
which is which. In fact, doctors do sometimes know for sure that a
patient cannot recover. 3
It needs to be said straightaway that this is an odd way of speaking.
Physicians with whom I have spoken, one being the director of a palliative
care unit, generally do not talk this way about terminal cases. In my
experience they do not say that a case is “hopeless”, because a meaningful
life can still be lived even if the patient and her physician both believe that
she has no hope of recovery, and they do not claim to know for certain that a
2 Douglas Walton, “Splitting the Difference: Killing and Letting Die”, Dialogue:
Canadian Philosophical Review 20.1 (1981): 76.
3 Tom Regan, ed., Matters of Life and Death, 2 nd ed. (New York: Random House, 1986)
59.