An Introduction to the Problem of Euthanasia

The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those in the shadows of life, the sick, the needy and the handicapped.

― Senator Hubert Humphrey.1


Euthanasia: Here We Go Again!

You have to hand it to liberals.  When they develop a strategy that works, they stick with it.  Margaret Sanger and her peers strongly emphasized the “hard cases” in their relentless agitation for the legalization of birth control.  First, contraception was legalized for heart-rending, heavily-publicized (and rare) exceptions, and then for more and more cases, until it was legalized by decree of the United States Supreme Court in 1968.  Of course, these methods of birth control failed millions of times every year, leading to a demand for the legalization of abortion — again, only for the emotional “hard cases.”  These exceptions expanded until the complete legalization of abortion in 1973.

As we know, both contraception and abortion strongly contribute to the breakup of families by enabling sexual promiscuity among both married and unmarried people.  Meanwhile, the social demotion of the “traditional” family as the norm has been greatly accelerated by the availability of widespread divorce, pornography and pretend homosexual “marriage.”

This means that many sick and older parents are abandoned by their children, who are themselves struggling with fractured families and resultant poverty.  The elders are often shuttled off to a “retirement facility” by their children, where they slowly begin to believe that life might not have very much purpose.

old man sad and alone

Under the guise of caring for those who are suffering and lonely, many Americans are now demanding “physician-assisted suicide.”  The most liberal states — Washington, Oregon, California and Vermont — have already legalized the practice, but just for the “hard cases,” of course.  Across the Atlantic, we can see the future of euthanasia — there are almost no limits on the practice in the most liberal European nations of the Netherlands, Belgium and Switzerland.

As with both contraception and abortion, we are now hearing louder and louder calls for courts to resolve the “patchwork quilt of laws” across the states and to legalize euthanasia nationwide — but only for the “hard cases,” of course.  Pro-euthanasia groups are also portraying the current state requirements of three requests for euthanasia as “burdensome,” and there is much agitation to jettison all such prerequisites and establish “euthanasia on demand.”

The Definitions and Types of Euthanasia

The term “euthanasia” means any action committed or omitted for the purpose of causing or hastening the death of a human being after birth, usually for the alleged purpose of ending the person’s suffering.  The word is derived from two Greek words:  “Eu,” meaning “easy,” and “thanos,” which means “death.”

The Vatican’s Declaration on Euthanasia states, “By euthanasia is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated” [¶II].

All of the elements of the Culture of Death — from contraception to abortion to homosexual rights — have made their advances primarily by emphasizing the “hard cases,” which usually make up from one to three percent of all of those affected.

The pro‑euthanasia lobby has learned this lesson well.  It has accomplished many of its goals by using scare tactics involving dramatic anecdotes of people in severe, unrelieved pain, who are being “kept alive by machines” with forests of tubes and beeping devices surrounding them, interfering with their peace and, above all, the vaguely-defined term “quality of life.”  Pro‑euthanasia groups have also confused lawmakers and the public by intentionally blurring the lines between direct and indirect euthanasia and a natural death.  Pro‑abortionists use precisely the same tactic when they lump contraceptives, abortifacients and abortion together.

Types of Euthanasia

The critical differences between active/passive and voluntary/non-voluntary/involuntary euthanasia and natural death must be defined precisely before any intelligent discussion on the various “shades” of euthanasia may proceed.

Anti‑euthanasia activists must be intimately familiar with the terms relating to euthanasia, or they will be confused and ineffective in their efforts to save lives. These are the basic types of euthanasia:

  • Active (positive, direct) euthanasia is action taken for the purpose of causing or hastening death.  These measures may include a lethal injection or an overdose committed by a physician or other person.
  • Passive (negative, indirect) euthanasia is action withheld for the purpose of causing or hastening death.  These measures include the withholding or withdrawal of non-heroic measures, including food, hydration (water), and oxygenation.  Examples of this type of euthanasia are the many infanticides committed each year in the United States by withholding food and water from handicapped newborn babies who would otherwise have lived.  Another example of passive euthanasia is the withholding of food and water from a person in a so-called “persistent vegetative state,” or from someone whose health is not improving rapidly enough in the opinions of the attending health care workers.
  • Voluntary euthanasia is committed with the willing and autonomous cooperation of the subject. This means that the subject is free from direct or indirect pressure from others.
  • Non-Voluntary euthanasia is committed when the subject is unconscious or otherwise cannot give consent.  Permission may be granted by a court or by family members, or euthanasia may be performed at the discretion of the attending health care professional or caretaker.
  • Involuntary euthanasia is committed on a subject against his expressed wishes.

active euthanasia, cutting off medication, types of euthanasia

This means that there are six general types of euthanasia:  (1) Active voluntary, (2) Passive voluntary, (3) Active non-voluntary, (4) Passive non-voluntary, (5) Active involuntary, and (6) Passive involuntary.

Types of Suicide

Suicide is the act of deliberately ending one’s life.  Pro-euthanasia activists often speak approvingly of rational suicide, which means that a person has carefully contemplated his actions, as opposed to a person who acts impulsively, under duress, or under severe psychological or emotional stress.

Assisted suicide is the act of providing means (drugs, a gun, a rope, a plastic bag with an elastic opening, a rusty Volkswagen van, or whatever else is needed) in order to help a person take his or her own life.  Physician-assisted suicide simply means that a doctor provides the means for a person to end their life.  Specifically, this means that the physician provides a prescription or other means for a person to commit suicide; the patient, not the doctor, actually performs the lethal act.  Pro-euthanasia activists sometimes refer to this as physician aid-in-dying or self-delivery.

Condition of the Subject

Coma is an abnormal deep stupor occurring in illness in which the patient cannot be aroused by external stimuli.  Comas are sometimes induced in order to help a patient heal from a severe injury or to help him avoid an extreme degree of pain for a temporary period.

side view of senior man in coma on bed in hospital

Persistent Vegetative State, or PVS, is a term sometimes used synonymously with “brain death,” but the terms actually differ greatly in meaning.  The American Academy of Neurology defines PVS as “a form of eyes-open permanent unconsciousness in which the patient has periods of wakefulness and physiological sleep/wake cycles, but at no time is the patient aware of him- or herself or the environment.”

Many people refer to a person who lapses into an extended coma as one who has entered a “persistent vegetative state.”  This is an inaccurate and demeaning term.  To begin with, more than half of all patients in PVS eventually regain consciousness, as we will see.

Perhaps even more important, we should avoid the term “persistent vegetative state” because it is dehumanizing.  People are never “vegetables” at any time from fertilization to natural death, so we should not refer to them as such.  We must recognize that all human beings must be afforded dignity and care as basic rights, regardless of the seriousness of their condition.

A more dignified term would be simply “comatose.”

Finally, the term “persistent vegetative state” is a very imprecise catch‑all term, and its meaning can vary substantially depending upon the outlook and the intent of the person using the term.  Because it is so open to abuse, the term should be avoided altogether.

Brain Death, or the exact instant of death in a human being, has been precisely defined by medical professionals.  Blakiston’s Pocket Medical Dictionary provides measurable criteria with which to determine if brain death has actually occurred:

Cessation of neurologic functioning by the criteria of deep unconsciousness without response to painful stimuli, absence of spontaneous breathing, fixed pupils, spontaneous marked hypothermia, absent reflexes except rarely tendon reflexes, and an isoelectric electroencephalogram showing no electrical activity over 2 microvolts at maximum gain even with stimulation by sound, pain, or pressure, recorded for 30 minutes or longer at 24‑hour intervals.  Excluded are patients under profound central nervous system depressants or hypothermia.

This exacting definition leaves little doubt that a person suffering “brain death” has little or no hope of recovery.2

We have covered the definitions of the varieties of euthanasia (active and passive, voluntary, non-voluntary and involuntary), the types of suicide, and the scientific definition of death.  It is important to know terms relating to the natural end of a human life, and we should also be familiar with the soothing and deceptive terms often used by pro-euthanasia groups.

Natural death means allowing a person to die in comfort and peace by withholding excessive or heroic treatment that would only cause pain and lengthen the person’s lifespan by a modest or insignificant amount.  Note that if medical professionals withheld the same treatment from a person in the same circumstances whose lifespan would be significantly lengthened by it, they would be instead committing passive euthanasia.  Food, water and oxygen must be provided during the person’s progression to natural death, because they are the right of every human being.

Photo from the top of nurse holding older sick man's hand who lies in hospital bed

Letting a person die a natural death is not passive euthanasia.  As Bishop Rene Gracida has defined it, “if the removal of a life-sustaining procedure is intended to avoid an unreasonable burden of the procedure, so that a quicker death is only an unintended side-effect of the decision, it is not a case of euthanasia.”3

An associated term is palliative care, which is treatment provided in order to alleviate pain and other discomfort that accompany a terminal illness without treating the illness itself, because such treatment is considered to be futile and not in the best interests of the patient.

“Rights Talk” and Euthanasia

The Culture of Death has found that it can make great progress by emphasizing the “hard cases” and by framing all of its initiatives in terms of “human rights.”  It is irrelevant whether or not such “rights” are moral or immoral, beneficial or terribly destructive, legal or illegal, or even if they exist; liberals believe that saying something makes it so, and they see all individuals as bundles of rights that must possess the maximum possible degree of freedom in order to be happy and fulfilled.

Of course, this is a very effective way to advance their own agendas, whether or not they are in the best interests of the people.

The Right to Die does not actually exist, according to either the laws of God or the laws of man.

Pro‑euthanasia activists cleverly fabricated a “right to die” in order to appeal to people who have become conditioned into unthinkingly accepting new and dangerous “rights.”  The “rights” formulated under the umbrella “right to privacy” include contraception, abortion, direct and indirect infanticide, various homosexual activities, pornography and euthanasia.  Courts have used the so‑called “right to privacy” repeatedly to legitimize behavior that many people find abhorrent or immoral ― quite simply because there is no possible legitimate justification for them.

Fundamentally, the “right to die” is not a right ― it is the forfeiture of all possible rights, and, as in the Netherlands, Belgium and the People’s Republic of China, will inevitably become for many people the duty to die.  As former Colorado Governor Richard Lamm asserted, “We have a duty to die.  It’s like leaves falling off a tree forming the humus for the other plants to grow out.  We’ve got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life.”4

senior couple walking

Other pro-euthanasiasts have gone so far as to allege that living a long and healthy life is actually an immoral act!  John Hardwaig, Professor of Medical Ethics and Social Philosophy at East Tennessee State University, has claimed:

There may be a fairly common responsibility to end one’s life in the absence of any terminal illness….There can be a duty to die even when one would prefer to live.  To have reached the age of, say, 75 or 80 years without being ready to die is itself a moral failing, the sign of a life out of touch with life’s basic realities.5

Death with Dignity is a difficult term to address, because it is so slippery and hard to define.  This failing, of course, makes it a perfect tool for the euthanasia pushers.

All people, whether they support or oppose euthanasia, desire a dignified death for themselves and for their loved ones.  But the primary conflict arises over the definition of “dignity.”

  • Pro‑euthanasia activists perceive a loss of physical or intellectual dignity when a person becomes incontinent, incoherent and confused, suffers intractable pain, or feels that he has lost control of his destiny.
  • Anti‑euthanasia activists perceive a loss of spiritual dignity when a person loses his focus on God and instead desires only a release from an existence that he or others may find pointless and wasteful.

The terminally ill person’s state of mind highlights the difference in viewpoints.

When a person’s fear of death is exceeded only by his fear of pain or loss of control, he is in a state of mortal terror and may see death as only a blessed release from his current situation.  He may indeed fear what happens after death, but primarily focuses only on his present circumstances.  Such a person necessarily defines his degree of dignity by purely physical or emotional criteria.

However, when a person overcomes his fear of both death and pain, and accepts and transcends them with a deep peace at the end of his life, he realizes that purely physical measures of “dignity” are inappropriate because they are incomplete.  True compassion demands that all of us love and support one another regardless of our functional capacity or appearance, and prepare the dying for their ultimate meeting with God.  This is the true definition of living with dignity, even when in the last stages of dying.

Mercy Killing is an act of direct euthanasia usually committed for the alleged purpose of ending the suffering of an unproductive or terminally ill person.  In reality, healthy people usually commit “mercy killings” in order to relieve themselves of the inconvenience and expense of caring for those who have (or will) become an emotional or financial burden on them.  “Mercy killing” usually takes place without the express request of the victim, and is carried out in the belief that it is the most compassionate course of action.

Over the past few decades, society has defined two classes of born human beings who are not suffering, but who are nonetheless candidates for “mercy killings” ― handicapped newborns who could otherwise live long lives, and people in an extended comatose state.  Pro‑euthanasia groups are now attempting to extend this lethal “privilege” to terminal patients and nursing home residents, regardless of their emotional state or level of pain.  It is inevitable that the number of people eligible for “mercy killings” will expand rapidly and uncontrollably, just as it did in Nazi Germany, and just as it is doing in the Netherlands, Switzerland and Belgium today.

“Mercy killing” of both infants and adults is a logical extension of the practice of elective abortion committed to eliminate handicapped preborn babies.  If healthy preborn babies can be killed up until the moment of birth because the mother perceives her health or well‑being is threatened, then why can they not be killed shortly after birth, especially if they have a serious chromosomal defect such as Down’s Syndrome?

Child with down syndrome cuddling with dog

Down’s Syndrome children are among the happiest and most contented human beings in existence, often living well into adulthood and giving great joy to others.  In fact, surveys have shown that people with Down’s are by far the happiest group of people on Earth, with an incredible 99% saying that they are satisfied and happy with their lives.  Yet 90% of them are killed in utero, not because they will suffer, but because their parents perceive that they will suffer.

If a person accepts death on God’s terms, it is a mercy.  However, if others force it on us, or if we strive for it due to the dictates of our misguided consciences, it is a dreadful burden, seemingly acceptable only because it appears to be less terrible than the pain.

It All Comes Down to Intent

Despite the forest of confusing terms, there is one certain way to determine whether an action is licit or illicit — intent.   If the intent of the action or omission is to hasten the death of a person, this is euthanasia and is never morally permissible.  However, if the intention of the action or omission is simply to let nature take its course and not unnecessary prolong the process of dying, then it is permissible to withhold or withdraw a treatment or procedure.

In summary, it is intent, not the consequences of the situation, no matter how dire, that determines the morality of a particular act.6



[1] Remarks at the dedication of the Hubert H. Humphrey Building, November 1, 1977, Congressional Record, November 4, 1977, Volume 123, page 37,287.

[2] Pope St. John Paul II, during his address to the 18th International Congress of the Transplantation Society on August 29, 2000, said:

Acknowledgement of the unique dignity of the human person has a further underlying consequence: vital organs which occur singly in the body can be removed only after death, that is, from the body of someone who is certainly dead.  This requirement is self‑evident, since to act otherwise would mean intentionally to cause the death of the donor in disposing of his organs….When can a person be considered dead with complete certainty?  In this regard, it is helpful to recall that the death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self….Specifically, this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). This is then considered the sign that the individual organism has lost its integrative capacity.…Here it can be said that the criterion…for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.

[3] Bishop Rene H. Gracida, Corpus Christi, Texas.  “A Dissent from the ‘Interim Pastoral Statement on Artificial Nutrition and Hydration’ Issued by the Texas Conference of Catholic Health Facilities and Some of the Bishops of Texas.”  Diocesan Press, May 25, 1990, paragraph 2.

[4] Former Colorado Governor Richard D. Lamm, in a March 27, 1984 address to the Colorado Health Lawyers Association, quoted in the Star Tribune, March 29, 1984, page 13A, and The New York Times, March 29, 1984.

[5] John Hardwaig, Professor of Medical Ethics and Social Philosophy at East Tennessee State University.  “Is There a Duty to Die?”  Hastings Center Report, March/April 1997.

[6] “A Guide to Making Good Decisions for the End of Life:  Living Will and Durable Power of Attorney for Health Care.”  Washington State Catholic Conference, 2006, page 7.


  1. Sally Sullivan on April 23, 2020 at 4:00 PM

    We have seen that silos in pro-life education and advocacy are wholly ineffective and at times such as this misleading and only enable those we fight and the evils they perpetrate. I encourage you, as the scholar that you are, to collaborate with Dr. Elizabeth Wickham of and Dr. Paul Byrne of Life Guardian Foundation.

  2. Heather on April 5, 2021 at 5:56 PM

    I strongly dislike how you used the term, “Liberal”. From “handing it to the liberals, to calling European countries “liberal”, it enables that the two party system is the only way, and we all know that everywhere else that is a first world country is way past the two party system phase. This isn’t about republicans vs liberals, and both sides has its faults. This is about people’s life, that you are presumably trying to advocate for. I, two hundred percent, agree that it all fall down to the intent of the situation, but it is also the patient’s choice as well, no one else, unless if the patient is not in the well being to do so. The amount of bias in this article, very disappointing, especially coming from a scholar.
    The same goes with abortion. I would never get an abortion, nor would promote anyone I know towards the choice of getting an abortion. But, it isn’t our job to play God. The same way we live in a country where “freedom prevails”, people should and have the freedom to make their own choices. The fetus is a part of the mother and cannot survive until it hit has 30 weeks, at the least. to assume what the baby wants, is not our choice. If you can provide ways to better the foster care system, along with the way senior citizens are cared for in the system, then I would be open to change. children need their parents, not to be thrown in a system. The same goes for senior citizens. Pro choice is different than “Pro Abortion”. Everyone should have the freedom to make their own choices.

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