Justifying the practice of euthanasia
Although this book as a whole can be characterized as a discussion of the morality of Dutch euthanasia, in this chapter we want to focus on the ethical analysis of the practice of euthanasia and on the arguments that are commonly provided in the Netherlands to justify the practice. We propose to proceed in three steps.
First, we discuss why exactly the practice of euthanasia is ethically problematic. What aspects of this practice demand specific ethical justification? This first step is about making the right distinctions. Ethical debates on euthanasia are often confounding and ineffective because the various participants in the debate are really talking about different things. For example, proponents of euthanasia may argue that it is wrong to let patients suffer unnecessarily, and if patients want to discontinue life-sustaining treatment they should be able to do so. Opponents may then counter that a physician should never kill patients, even if they are suffering and specifically ask to be killed. The debate between these proponents and opponents of euthanasia is unlikely to get anywhere because they are talking about different things. From an ethical perspective, there are decisive differences between withdrawing treatment that has been refused by a patient, and ending a patient's life at her request. Each can be debated and should be debated carefully, but the two should not be debated at the same time as if they are two examples of the same practice, that is, euthanasia.
Once we have defined euthanasia and laid out the ethically relevant aspects that demand specific ethical justification, we can move to the second step. We will review ethical methods of reasoning that are commonly used by proponents and opponents of euthanasia in the Netherlands and outline