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least, cannot be guaranteed without stepping over the fine line
between active and passive euthanasia. (Lorber's opponents
have claimed that the untreated infants under his care all die
because they are given sedatives and fed only on demand. Sleepy
babies do not have healthy appetites.) An Australian clinic following
Lorber's approach to spina bifida found that of seventynine
untreated infants, five survived for more than two years.
For both the infants, and their families, this must be a longdrawn
out ordeal. It is also (although in a society with a reasonable
level of affluence this should not be the primary consideration)
a considerable burden on the hospital staff and the
community's medical resources.
Consider, to take another example, infants born with Down's
syndrome and a blockage in the digestive system which, if not
removed, will make it impossible for the baby to eat. Like 'Baby
Doe', these infants may be allowed to die. Yet the blockage can
be removed and has nothing to do with the degree of intellectual
disability the child will have. Moreover, the death resulting from
the failure to operate in these circumstances is, though sure,
neither swift nor painless. The infant dies from dehydration or
hunger. Baby Doe took about five days to die, and in other
recorded instances of this practice, it has taken up to two weeks
for death to come.
It is interesting, in this context, to think again of our earlier
argument that membership of the species Homo sapiens does
not entitle a being to better treatment than a being at a similar
mental level who is a member of a different species. We could
also have said - except that it seemed too obvious to need saying
- that membership of the species Homo sapiens is not a reason
212
I,
I
I
Taking Life: Humans
for giving a being worse treatment than a member of a different
species. Yet in respect of euthanasia, this needs to be said. We
do not doubt that it is right to shoot badly injured or sick animals
if they are in pain and their chances of recovery are negligible.
To 'allow nature to take its course', withholding treatment but
refusing to kill, would obviously be wrong. It is only our misplaced
respect for the doctrine of the sanctity of human life that
prevents us from seeing that what it is obviously wrong to do
to a horse, it is equally wrong to do to a disabled infant.
To summarise: passive ways of ending life result in a drawnout
death. They introduce irrelevant factors (a blockage in the
intestine, or an easily curable infection) into the selection of
those who shall die. If we are able to admit that our objective
is a swift and painless death we should not leave it up to chance
to determine whether this objective is achieved. Having chosen
death we should ensure that it comes in the best possible way.
THE SLIPPERY SLOPE: FROM EUTHANASIA
TO GENO~IDE?
Before we leave this topic we must consider an objection that
looms so large in the anti-euthanasia literature that it merits a
section to itself. It is, for instance, the reason why John Lorber
rejects active euthanasia. Lorber has written:
I wholly disagree with euthanasia. Though it is fully logical, and
in expert and conscientious hands it could be the most humane
way of dealing with such a situation, legalizing euthanasia would
be a most dangerous weapon in the hands of the State or ignorant
or unscrupulous individuals. One does not have to go far back
in history to know what crimes can be committed if euthanasia
were legalized.
Would euthanasia be the first step down a slippery slope? In
the absence of prominent moral footholds to check our descent,
would we slide all the way down into the abyss of state terror
and mass murder? The experience of Nazism, to which Lorber
213
Practical Ethics
no doubt is referring, has often been used as an illustration of
what could follow acceptance of euthanasia. Here is a more
specific example, from an article by another doctor, Leo
Alexander:
Whatever proportions [Nazi) crimes finally assumed, it became
evident to all who investigated them that they had started from
small beginnings. The beginnings at first were merely a subtle
shift in emphasis in the basic attitude of the physicians. It started
with the acceptance of the attitude, basic in the euthanasia movement,
that there is such a thing as life not worthy to be lived.
This attitude in its early stages concerned itself merely with the
severely and chronically sick. Gradually the sphere of those to
be included in the category was enlarged to encompass the socially
unproductive, the ideologically unwanted, the racially unwanted
and finally all non-Germans. But it is important to realize
that the infinitely small wedged-in lever from which this entire
trend of mind received its impetus was the attitude toward the
nonrehabilitable sick.
Alexander singles out the Nazis' so-called euthanasia program
as the root of all the horrendous crimes the Nazis later committed,
because that program implied 'that there is such a thing
as life not worthy to be lived'. Lorber could hardly agree with
Alexander on this, since his recommended procedure of not
treating selected infants is based on exactly this judgment. Although
people sometimes talk as if we should never judge a
human life to be not worth living, there are times when such
a judgment is obviously correct. A life of physical suffering,
unredeemed by any form of pleasure or by a minimal level of
self-consciousness, is not worth living. Surveys undertaken by
health care economists in which people are asked how much
they value being alive in certain states of health, regularly find