A Utilitarian Viewpoint Concerning Euthanasia: Burn Victim Thought Experiment

 In an ambulance approaching the emergency room lays an older male, apparently in his sixties, charred and lifeless. The burn team is called and rushes in to meet the man. The man has significant burns over 70 percent of his body. He will have to go through endless skin graphing and painful therapies; that is if he can even overcome the likelihood that he will die from infection. A few days later the patient is sufficiently conscious enough to moan in agony from the burns. A few days later, the man begins to psychologically and neurologically wither away. He has brain function, but the patient’s neurologist can not even begin to predict when, if ever, the man would regain anything remotely close to “normal consciousness.” The patient is in a comatose state. The older man, having no family or friends, can only lie in his hospital bed. The physician believes that the patient should just continue to undergo care. The nurses and other physicians believe that they should “let him go in peace” (Veatch, 342-343). The million dollar question now is: What should be done?

The debate of euthanasia has been controversial from the get go. Comatose patients, i.e. those who cannot speak for themselves, rely on us when it comes to the issue of euthanasia. Such patients as the older man in the above case are incapable of giving any responses as to whether or not they wish to continue treatment or to ultimately end their lives. According to John Behnke and Sissela Bok, “the great majority of dying patients…have not had the opportunity to affect the end of their lives. Efforts to make the end of their lives as good as possible must, therefore, come from the outside; from all those who are involved in their care” (Behnke and Bok, 20-21). This, I believe, is why this issue of controversy is so important.

In the above case, I believe that the man should ultimately be euthanized. In such a case, the man experiences only severe pain, will most likely not regain consciousness, and will most likely not live a day without the excruciating pain since he will most likely have to have skin graphs for the rest of his life. Some philosophers such as J. Gay-Williams might attack such a statement by saying that such an action would “leave no room for the ‘miraculous’ recoveries that frequently occur” (Olen, Van Camp, Barry, 195).

According to Gay-Williams, euthanasia is wrong and can never be morally justified. A view like Gay-Williams is a deontological approach to the euthanasia debate since it is wrong in the name of a moral law. At all times, euthanasia is wrong. From a viewpoint such as Gay-Williams’, euthanasia is an act against God, nature, self-interest, and the future treatment of terminally-ill patients.

“Man as trustee of his body acts against God, its rightful possessor, when he takes his own life. He also violates the commandment to hold life sacred and never to take it without just and compelling cause,” states Gay-Williams (Olen, Van Camp, Barry, 194). With this notion, one could argue that the burn victim should not be euthanized for the sake of his “afterlife.” This argument he later ignores since it is not the case that everyone believes in God and therefore not everyone believes that He is the rightful possessor of our bodies or lives. In other words, if the burn victim happens to be an atheist then the above argument concerning God is utterly useless. Our bodies combat diseases, fight off infections, and heal themselves. This is Gay-Williams argument that euthanasia is an act against nature. Ending one’s life is against all of our body’s natural processes which attempt to ensure our very survival. With this notion, one could argue that the burn victim should not be euthanized because it would be against his natural processes which are for survival.

However, it is clear that his natural processes are seemingly gone in the sense that his chance of recovery is relatively insurmountable.  But just because our bodies are built to survive, does that necessarily mean that we have to listen to it? People go against their biological/natural processes all of the time. One very obvious example is celibacy. Our bodies are naturally built to reproduce. However, those individuals who participate in the religious practice known as celibacy go completely against what their bodies are built for, namely procreation/reproduction.

Medicine in the 21^st century has come a long way. Our medical procedures and practices have incredibly high expectations and accomplishments. However, it is not perfect. Medical professionals can ultimately make wrong diagnoses. It is with this notion that one could argue that we should not euthanize the burn victim because that would completely expel the possibility of a “miraculous” recovery. This then would lead to patients giving in and giving up hope when the odds are against them. This notion, I believe, fails however in the sense that it seems a bit much to ask a patient to stick around (enduring incredible amounts of pain) just for a tiny ounce of “hope.” This seems like a good idea to a nurse or physician, but to a patient I believe that that is just way too much to ask. Some patients might want to fight the terminal illness as long as they possibly can; this is something we can come to respect. But the idea of making them continue on seems a bit too much. Elizabeth Gailey writes of an American who is undergoing chemotherapy and wonders to herself if it is really worth fighting for. Her physicians push her to do more and to think more optimistically, but the women really just wants to legitimately give in (Gailey, 77-78).

Finally, Gay-Williams argues that euthanasia is an act against the future treatment of terminally-ill patients. By allowing doctors to perform active euthanasia, we will end up corrupting the medical institution. The quality of medical care would decline due to the fact that medical professionals will give up faster and easier on terminally-ill patients. With this notion, one could argue that by allowing the physician to euthanize the burn victim, the physician might decide that the next patient might as well die too since he or she is in the same predicament. I believe that this notion already exists to this day. For example, say you have a crowded hospital and all of the beds are filled. On one bed lies a patient with a bullet in his head and will surely die within a few hours. Seconds later, another man come into the hospital with a sliced leg and is bleeding profusely, but can be saved. In almost every situation one would argue that we should euthanize the first patient and make room for the second patient.

The view given by Gay-Williams, when applied to the above case, seems inappropriate at best.  I, however, argue from roughly a utilitarian viewpoint, rather than Gay-Williams deontological viewpoint. By allowing the man to lie in his hospital bed seems ridiculous in the sense that it produces absolutely no goods for anyone. Keeping the burn patient alive costs the hospital money in order to keep him alive via a feeding tube, respirator, etc. Keeping the burn patient alive costs the well-being of the nurses and physicians who must give care to someone who they believe should be allowed to die peacefully rather than simply wither away in his bed. Keeping the burn patient alive, even if he “miraculously” awoke from him comatose state, would just result in the former pain and agony he experienced before passing into the state of coma. However, if the physician euthanized the patient, the patient would die in a very peaceful and quick manner; probably from an overdose of morphine. From this, the hospital would no longer have to spend money or time on the patient, the nurses and physicians could carry on with their careers without the psychological stress put on to them by allowing the patient to live, and the patient would ultimately be free from his painful situation. From a utilitarian standpoint this case looks rather easy when it comes to deciding what action should be performed. The patient will ultimately benefit in the sense that he will be relieved of his pain and the hospital (as well as the nurses and physicians) will benefit in the sense that they will be relieved of their psychological stress.

An argument against this utilitarian approach might be regarding the fact that I cannot, without a doubt, predict what consequences will be best. To such an argument I will admit that I can certainly not guarantee the consequences of any actions, but I can to the best of my abilities (using my common sense and moral intuitions) develop an idea of what would occur by taking a specific course of action. With the utilitarian viewpoint I believe that’s the best one can do.