Bonnie Steinbock, “The Intentional Termination of Life,” in Larry May and others, Applied Ethics: A Multicultural Approach, Prentice Hall, 2011, 5th ed., pp. 489-494.
Steinbock challenges Rachels’ defense of active euthanasia. Rachels has argued that the American Medical Association (AMA) accepts passive euthanasia but rejects active euthanasia. Rachels then goes on to argue that active euthanasia is more humane under some circumstances and should be practiced in place of passive euthanasia.
Steinbock replies that the AMA rejects all forms of euthanasia but accepts withholding treatment when the patient has given consent. The consent of the patient, Steinbock contends, removes the action of withholding treatment from the category of euthanasia.
Steinbock contends that the withholding of medical treatment sometimes does not involve an intention to terminate life. She considers a situation with a dying cancer patient whose treatment causes more distress than the cancer. The withholding of treatment in this case is not intended to terminate the patient’s life but to relieve suffering. Steinbock regards such treatment as extraordinary. The physician does not have the option to treat when the patient has requested not to receive extraordinary treatment.
Steinbock claims that the intention is of moral significance in the withholding of life-prolonging treatment. She interprets the AMA statement as assigning moral weight to physicians’ intentions when it distinguishes between ordinary and extraordinary treatment. To fail to give extraordinary treatment is not punishable, but to fail to give ordinary treatment is neglect or even homicide. The AMA statement dealing with life-prolonging treatment rests on a distinction between ordinary and extraordinary treatment, Steinbock maintains, not on a distinction between active and passive euthanasia.