Let's begin with two examples, one fictional and the other real:
A. At a mine cave-in, Joe's friend Seth Pruitt stands over the body of a man he admits to having euthanized. The man was mortally injured, in agony, and begging to be put out of his misery. Seth swears Joe to secrecy, leaving Joe to struggle with his conscience, and decide if it's right to keep the secret. "The Quality of Mercy," Bonanza (Season 5 Episode 9).
B. Years ago I read about a father and sons who were horribly burned when the garage that were working in exploded. They weren't killed instantly. They were mortally burned and die hours later at the hospital. That's not a case of euthanasia, but for those who support euthanasia, it's a good candidate to illustrate the issues.
1. On the one hand there are ethicists, generally Christian, who think euthanasia is intrinsically wrong. For convenience, let's call it the deontologist position.
One apparent advantage of the deontologist position is that it seems to be simpler to apply. It forbids mercy killing under any circumstances. I'll revisit the question of whether it avoids the complications and imponderables of the alternative position momentarily.
2. In addition to the argument from principle, the deontologist is concerned that once you open the door a crack for mercy killing under any circumstances, that becomes a wedge issue or wedge tactic which will be exploited. And, indeed, that's a legitimate and very realistic concern. Once euthanasia is permitted, there are those who continually extent and expand the scope of candidates for euthanasia. A mania for killing ensues. This has been documented by Wesley J. Smith: https://www.discovery.org/c/human-exceptionalism/
3. On the other hand are ethicists who think euthanasia is permissible in certain situations. Some ethicists are very conservative about the permissibility of euthanasia, limiting it to "extreme" cases. Others are far more lenient. For convenience, let's call it the euthanasist position.
These labels are simplistic. On the one hand it's possible for a deontologist to consider mercy killing justifiable under very exceptional circumstances. On the other hand, euthanasist is an indiscriminate term. Proponents of euthanasia can range along a continuum from highly restrictive to open-ended. But labels are necessary to identify and distinguish the respective positions, so with those caveats in place, they will suffice for discussion purposes.
4. A challenge for the euthansist position is where to draw the line.
i) That raises the thorny old issue of the sorites paradox. However, the sorites paradox doesn't necessarily disqualify the euthanasist position. The sorites paradox isn't confined to ethics. There are many situations in human experience susceptible to soritical paradox, yet we disregard it and go right on drawing moral or practical distinctions, even if we can't solve the paradox.
ii) In addition, we're often confronted with forced options where we have no choice but to draw a line, even if the cutoff is arbitrary. If, moreover, you can't avoid stipulating an arbitrary threshold, then a degree of arbitrariness is blameless.
iii) That's said, some arbitrary distinctions are more reasonable than others. While there are borderline cases, some distinctions approximate clear boundary conditions.
5. For its own part, the deontologist position doesn't escape the sorites paradox. Even hardline opponents of euthanasia typically concede that there are moral limits on our duty to keep people alive. Take a terminal cancer patient with stage 4 cancer. Desperate medical intervention may prolong the patient's life, but the treatment itself is increasingly destructive to the patient, with ever diminishing returns.
If, however, the obligation to keep people alive is less than absolute, then that concession creates gray areas. In a sense, then, both the deontologist and euthanasist are in the same boat, although one may occupy the stem while the other occupies the stern.
6. Regarding the Bonanza dilemma, there are two additional issues:
i) On the one hand, Seth has no right to obligate Joe to keep Seth's action a secret. He lacks the moral authority to unilaterally make that decision for Joe. At best, Joe must enter into that voluntarily.
ii) On the other hand, even if we conclude that Seth's action was morally unjustified, that doesn't automatically mean Joe has a duty to report him to the authorities. This is the flip side of (i). Just as Seth can't make Joe share responsibility in the deed, since it's Seth's deed, not Joe's, Joe is not responsible for what Seth did.
To put it another way, even if Seth had a duty to turn himself in to the authorities, it doesn't follow that a second party has a duty to turn Seth in to the authorities. A second party isn't directly responsible for Seth's actions.
iii) Of course, that doesn't mean there's never an obligation to report a wrongdoing to the authorities. But that's not a universal duty. It depends on the nature of the wrongdoing.
iv) Moreover, even if we conclude that Seth's action is morally unjustifiable, there are extenuating circumstances that mitigate the guilt and distinguish it from murder. The intent is different.
v) Likewise, we should often judge people more leniently who had to make a snap decision under duress compared to a premeditated action.
7. There is, however, a difference between the actions of random individuals and a social policy. For instance, if my younger teenage brother loses his temper and smacks me in the face, I'm not going to call the cops, have him arrested and charged with assault. But making personal exceptions for close relatives doesn't mean we should decriminalize assault and battery.
8. Finally, I doubt that all moral dilemmas are soluble in principle. It's easy to dream of hypothetical predicaments with no licit options. There won't always be a handy formula. I think we ultimately depend, not on having the right answers for every conceivable situation, but on divine providence not to put us in morally compromising situations.
