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To Die or Not to Die: A Kantian Perspective on Euthanasia

Abstract

The paper attempts to explore the implications of Kant's moral criticism of suicide in the case of euthanasia. The paper argues that since Kant's criticism of suicide is essentially directed towards rational beings who are in full control of their rational faculty. It would hence not be applicable in case of individuals who are suffering from dementia and who have expressed a prior desire to be euthanized in such a scenario.

Introduction

Euthanasia as defined under the AMA website means “the administration of a lethal agent by another person to a patient for the purpose of relieving the patient’s intolerable and incurable suffering”.Footnote 1 In common parlance, euthanasia denotes the practice of deliberately terminating the life of a patient to relieve her of incurable suffering.Footnote 2 Depending on the agency, whose action brings about the death of the patient, euthanasia can be both voluntary and non-voluntary.Footnote 3 It is voluntary when the patient expressly makes a desire to die. It can be in the form of an advanced directive, in which case the patient—while still in possession of her full mental faculties—expresses her desire to terminate her life should she become incapable of doing it herself.Footnote 4 It can also be done when the patient expresses a desire to die to relieve herself of pain and incurable suffering; or because of a justified belief that she may lose her rationality and become incapable of doing it herself. In both cases, the patient should be suffering from an incurable medical condition.Footnote 5 Euthanasia is non-voluntary when a patient is euthanized in the absence of her directive or consent. The patient in such cases is generally an infant or someone who by reason of her age or medical condition cannot give consent.Footnote 6 The consent in such cases is given by the attending physician or the relatives or family members of the patient. It is imperative to point out that in all cases of euthanasia death should be caused for the welfare of the patient: to relieve her from her pain and incurable suffering.

Throughout history, people have debated the moral permissibility of suicide from different perspectives.Footnote 7 Some have condemned it as an act of cowardice, while appealing to the sanctity of life as a reason for avoiding it.Footnote 8 Others have condoned the act, for instance, to protect one’s honor or to avoid the possibility of living with a “diminishing capacity”.Footnote 9 A central concern in all these debates have been the search for some fundamental values of human existence to undergird the morality of suicide. These debates in turn have defined human existence not as an isolated event of living and dying, but as an interplay of various attributes working together to make existence meaningful for men. These attributes, due in part to their intrinsic value as components of rational existence, or by reason of their unique capacity to distinguish human from other animals is often used as eulogizing tools for the moral and legal sanctity of human life.

The moral philosophy of Immanuel Kant provides one of the most insightful—albeit controversial—contribution to this field of study. In essence, Kant gave a pivotal role to both dignity and autonomy in matters concerning one’s own life and death. As would be discussed later, Kant had a unique conceptualization of personal autonomy—and in conjunction with dignity—he articulated a strong moral opposition to suicide. The present article is an effort to understand Kant’s moral position on suicide and to extrapolate his insights to build a moral justification for euthanasia. The paper also seeks to understand Kantian notions of the duty to die and whether it could be applied in the case of patients anticipating dementia.

What Does It Mean for Kant to Have Dignity?

Kant himself never defined the term dignity, but its meaning over the years has been understood in conjunction with other related terms like “humanity”, “autonomy”, “personality” and the “capacity of rational beings to set ends according to reason”. In Kantian terms, dignity reflects rational beings’ ability to legislate the moral law for themselves without relying on external factors.Footnote 10At the core of Kant’s ethics is the idea that the only thing good without any qualification is a “good will” (G4:393). The idea introduce us to the basic premise of Kantian philosophy that what is good in a person is a will that acts only on the basis of a moral law.Footnote 11 It is in this context that Kant introduces the concept of autonomy, which he defines as the “property of the will by which it is a law to itself” (G4:440).

Kant argues that the concept of autonomy is key to understanding the authority which moral laws have over us. According to Kant, the moral laws have an authoritative hold on us because these laws are our own creation, by which he means it has its sources in the autonomy of the will (G5:33). The will as a fundamental source of causality is autonomous, insofar as it acts in accordance with the moral laws. Kant also refers to the autonomy of the will in a negative sense; that is, its causality is not determined by external sources or natural inclinations. On the contrary, Kant argues, a person with a free will acts on the basis of laws which one has given to oneself (G 4:431).Footnote 12

Kant observes that moral requirements are requirements of practical reason.Footnote 13 To act morally would imply acting under certain directions that are unconditional. These directions that constitute the fundamental principles of all our moral duties are referred to as the Categorical Imperatives.Footnote 14 A major part of Kant’s work is devoted to developing justification for the grounds of categorical imperative. Indeed, a common theme throughout Kant’s treatment of the categorical imperative is that if moral requirements are unconditional, then it must be based on an end whose value is absolute and which does not derive its worth from being an object of our desire; an end, in other words, which is of unconditional worth or value (G 4:228). Such an end would not only be and end in itself but would also be deserving of some specific treatment.Footnote 15 Writing on this point, Kant observes that “rational nature exists as an end in itself” (G 4:228). It is in the concept of rational nature, that Kant also identifies an unconditional and intrinsic value which he refers to as “dignity”.Footnote 16 It is dignity, Kant observes, that underpins the supreme principle of morality and all the moral requirements that are derivable from the principle.Footnote 17 Hence, he regards dignity as consisting of the inherent worth of human beings, which grounds a duty to treat people as ends in themselves.Footnote 18

Latent to the idea that people are ends in themselves is the fundamental Kantian postulate that dignity is inherently associated with autonomy.Footnote 19 Kant observes that “Autonomy is… the ground of dignity of human nature and of every rational nature” (G 4:436/85). Accordingly, Kant implies that to “treat people with dignity is to treat them as autonomous individuals able to choose their destiny”.Footnote 20 Kant also believes that possessing dignity has certain consequences that finds its manifestation in an individual’s relationship with other persons: that he ought be respected by them and at the same time he ought to be able to value himself equally to them.Footnote 21

Kantian Ethics and The Mind Body Connect

Kant sees a close connection between the mind and the body and this constitutes a major force in his opposition to suicide.Footnote 22 Kant values the existence of the body, if not much for its biological importance, then as a conduit for the true realization of rational existence. The body, as it were, shares a conditional relationship with the mind, and it is only in the presence of the body that the true capacities of the mind can be realized. Therefore, it is imperative for Kant that the body remains in the best of conditions as to facilitate the proper exercise of rational faculties including the autonomy of the will. To understand the mind–body paradigm, as Kant understood it, we need to first understand Kant’s aversion towards an “undisciplined body”. Kant is aware that the body has a tendency to give in to its own desires, thus impacting the way the rational mind is required to function. Indeed, in Kantian terms any action that are influenced by bodily desires would go against the tenets of the moral law. It would amount to heteronomy and would tantamount to acting under a hypothetical imperative.Footnote 23

It isn’t surprising, therefore, that Kant is against the idea of suicide. He argues that under no circumstances—while labouring under an “excruciating pain” or “irremediable suffering”—a man is entitled to take his own life.Footnote 24 Kant is opposed to the idea of suicide not because of the harm done to the body. For Kant, the body is a mere object and only shares a conditional relationship with the mind. And if it were possible, Kant argues, to “slip out of one body and enter another, like a country”, then the body wouldn’t have the same value as it has now.Footnote 25 Kant values the body for being the condition of the mind. In a close-knit moral universe, which Kant’s moral philosophy indeed is, the proper exercise of all rational faculties is conditional on the existence of a well-functioning body.

Suicide and Kant

Kant’s reluctance to allow for a wilful termination of one’s own life flows from his conceptualisation of humanity.Footnote 26 Kant regards humanity as the foundation of all the rational and autonomous faculties inherent in human beings. He believes that it is in virtue of humanity that one is able to exercise one’s freedom; and it is in freedom, that he locates the duty of self-preservation.Footnote 27 In humanity, therefore, Kant sees an incentive for protecting the body, and he considers all such acts that destroys humanity as “the supreme violation of duties to oneself”..Footnote 28 Kant believes that the act of taking one’s own life is immoral, not the least because it terminates one’s life forces, but because it also terminates the humanity in oneself. For Kant, the immoral nature of the act flows not only from its propensity to terminate humanity but from a wrongful exercise of one’s autonomy. Kant’s concern, as it were, relates to how disregard for humanity lowers the status of an individual to a “thing”, eschewing in the process any respect that was due to him.Footnote 29 At the same time, it also reflects Kant’s concern for the harm done to dignity which stems from the loss of humanity.Footnote 30

Kantian Exceptions to Suicide

Kant does not expressly propose any exception for suicide. Yet in answer to the question whether an individual is justified in taking his life because he is not happy, Kant answers, “there is no need to live and be happy… but it is important to live honourably… Suffering does not give a man the right to take his/her own life.”Footnote 31 These are no doubt harsh words, but it also brings home the point that given some higher values a person is justified in sacrificing his life. So, what are these higher values? Kant observes that a man “who has inner worth will rather sacrifice his life, than commit a disreputable act”.Footnote 32 In the same passage he observes that such a man would rather put “the worth of his personhood above the worth of his life”.Footnote 33 Thus, Kant believes that if a situation so requires that a man has to choose between death and continue living his life dishonourably, he should choose the former. The stress on honour is important because for Kant there is nothing more honourable than to live one’s life according to the fundamental principles of morality.

It should be noted that Kant’s commitment to honour in the face of sure, but dishonourable existence reinforces the conditional value he puts on the biological life. In Kantian terms, life is worth living only if it can be lived in accordance with the fundamental principles of morality. Kant observes that if the continuation of life is only possible by disreputable conduct, virtue absolves one from the duty of preserving it.Footnote 34 And while Kant puts a high value on dignified existence, he also believes that our lives are not priceless. Dignified existence for Kant is reflective of an attitude in which an individual values moral freedom more than his life. It is also an attitude that puts a high premium on dignified existence that sacrificing one’s life would appear a viable alternative if faced with the possibility of living an undignified life. Thus despite his deep commitment to the core values of self-preservation, he still proposes that,

…It is better to sacrifice life than to forfeit our morality. It is not necessary to live, but it is necessary that, for as long as we live, we do so honorably; but, one who can no longer live honorably is no longer worth of living. Living dishonorably extends our biological life at the cost of our ‘moral life’.Footnote 35

Kant equates dishonourable existence with animal existence. In either situations, he argues, moral existence becomes subordinate to instinctual needs and humanity (rational faculty and autonomy) becomes mere conduits for survival. In similar fashion, when a person ends his life not being able to tolerate his existence anymore, he uses his humanity to serve his bodily inclinations, using it merely as a means to reduce his pain. While in the former case humanity exists merely as an instrument to serve his desire, in the latter case it is annihilated altogether.

Kant and Euthanasia

According to Kant, dignity signifies the inner worth of a person who has the capacity to exercise her rational faculties according to the moral laws. This articulation of dignity allows us to build two distinct moral perspectives on euthanasia.

Firstly: Since dignity has an absolute value—and as rational beings we have a duty to respect the dignity inherent in us—it follows that no amount of pain or suffering can morally legitimize any act which leads to the termination of dignity. Therefore, euthanasia to the extent it entails killing of oneself to ease one’s own pain and suffering would be, in Kantian terms, an immoral act. Secondly: individuals who do not have the capacity to exercise their rational functions lack dignity (in the sense Kant understood it).Footnote 36 Life in such cases becomes a mere biological unit lacking any rational or moral capacity. Since such individuals can no longer be regarded as persons (in Kantian terms), it could be argued, that Kantian prohibition against suicide would not apply to such individuals. By extension, it could also be argued, that the prohibition would not apply to such cases where an individual commits suicide on a justified likelihood that she would lose control of her rational faculty.

There isn’t much to be said about the first perspective except that there is a strong moral support for euthanasia outside the moral universe of Kant; hence it would not be taken up for any further discussion. As regards the second situation, and despite the relative simplicity of the perspective we have generated, there are inherent difficulties that borders on issues of complex moral concerns like the duty to die and matters of capacity and consent. While some of the issues can be subjected to a philosophical extrapolation, for example moral issues like the debate on “dying with dignity”, there are others that cannot be answered without subjecting it to a full empirical treatment.Footnote 37

Existing literature on euthanasia suggests that a Kantian prohibition on suicide can be eschewed in respect of persons suffering from dementia.Footnote 38 Since dementia involves the loss of cognitive functioning—a key feature of the Kantian notion of humanity—it is argued that individuals in such state exist simply as physical beings.Footnote 39 The emphasis on physical beings, serves as a deliberate contrast to the idea of a moral being, as someone who still has control of her rational faculties. It also reinforces a key concept of the mind–body paradigm: that the body’s moral status is conditional to serving as a conduit for rational functions.Footnote 40 Under such circumstances, it is argued, Kant cannot have a moral objection to euthanasia.

Taking this hypothesis as a starting point, Cooley observes that “in the case of those who will be demented, it is a rational duty to die physically before dying morally” adding further that this is a duty which the individual “owes to herself as a moral agent”.Footnote 41 Cooley grounds the duty to die from his reading of Kant’s duty of self-preservation, which as explained by Kant could be eschewed only in the face of higher moral duties. Cooley extrapolates this argument to suggest that an individual who is anticipating dementia has a moral duty to commit suicide before dementia set roots and deprives her of her rational capacity. Thus, Cooley argues that in the face of a certain possibility that one may be deprived of one’s rational faculties (as in the case of dementia), it is better to commit suicide and preserve one’s moral and rational agency, than settle for a less moral existence.

It is noteworthy that Cooley does not extend the same duty to those already in a state of dementia. He observes that the loss of rational agency, which comes with dementia, deprives a person of her moral status and dignity, thereby rendering her incapable of any duty.Footnote 42 This point is taken further by Sharpe, who argues that patients suffering from dementia are like objects, hence, they should be treated in a manner that is ethically best suited to the interest of others.Footnote 43 Arguing from a Kantian perspective of beneficence, Sharp argues that a demented person is a burden—both financially and emotionally—to all those near him; hence it would be in the best interest of others to euthanize her.Footnote 44 For most part, while Sharp disagrees with Cooley’s interpretation of the Kantian duty to die—and by extension with the claim that person anticipating dementia has a duty to die—he agrees with Cooley that a person suffering from dementia has no dignity. Unlike Cooley however, he argues that if such persons do not commit suicide before the onset of dementia, the onus would fall on others to do it for her once dementia sets in.

Critics have questioned whether a Kantian duty to die could be applied to patients suffering from dementia. While Sharp shares Cooley’s premise that a demented person lacks dignity, he is doubtful whether the same premise could be used to justify a duty to die on the part of patients anticipating dementia. Sharp also argues that Cooley’s reliance on the Kantian analogy of the madman wouldn’t do much to further his claim as both apply to different situations. He observes that Kant’s justification for suicide by the madman are based on considerations that are unique to the madman’s own position—for example he may pose a danger to others or his own person—which may not be compatible to the position that demented patients find themselves.Footnote 45 Cooley’s work has also been criticised as being based on an incorrect interpretation of Kantian ethics. Cholbi, for example, argues that Kantian ethics allows no scope for a duty to die, at least in respect of situations that are unique to individuals anticipating dementia.Footnote 46 Cholbi observes that Cooley’s reference to a Kantian duty to die applies only to those situations where an individual has to choose between surrendering his dignity and living an undignified life or sacrificing himself and saving his honour in the process.Footnote 47 Cholbi is sceptical that a soon-to-be demented person warrants the same consideration regarding dignity as someone staring at a life full of indignity. In the former case, he argues, the question of indignity would never arise because a demented person being a “non-person” is neither capable of dignity nor indignity.Footnote 48 Moreover, Cholbi believes that Cooley completely misunderstands the different “threats to moral agency” that necessitates suicide in both the cases.Footnote 49 In the case of a person staring at a life full of servitude, suicide is necessary so that his moral agency is not misused for immoral purposes, whereas in the case of person avoiding dementia suicide is an option so that he does not lose that agency.Footnote 50

According to Cholbi, Cooley follows a line of reasoning that does not logically justify the conclusion he is seeking to achieve. Cholbi, for example, points out that the reasoning Cooley’s argument goes like this: that if the moral standing of a person is by reason of her possessing a certain property, which also requires her to preserve it, then it follows that if the property is lost (or will be lost) she should kill herself. Cholbi argues that this conclusion is logically flawed, in that, it does not follow from the premise Cooley has adopted. By way of an analogy Cholbi explains that if an object has certain value because of a certain property it possesses which also requires it to be preserved, it does not follow that the loss of the property (or possible loss of the property) entails the destruction of the object. All that follows, observes Cholbi, is that “I do not have a duty to preserve it”.Footnote 51

But Can a Kantian duty of self-preservation, which basically is a duty to oneself, be exercised on behalf of the duty-holder? Sharp, for example, suggests that if the patient is no longer capable of ending her life (prior to full onset of dementia), then someone must do it for her.Footnote 52 It is doubtful, given the personal nature of the duties to the self, whether this suggestion can hold ground.Footnote 53 It should be noted that what Kant envisages as duties to the self consists of some exclusive category of duties, which by their very nature could only be performed by the duty-holder. Since these duties are aimed at the moral perfection of individuals, its full worth can only be realised if the duty-holder performs the task herself. Hence, Cholbi argues that Sharp’s proposal of euthanizing a demented patient is based on an incorrect reading of Kantian philosophy.

Sharp also, it seems, mistakenly conflates two distinct ethical systems and uses the precepts of one ethical system to justify a claim made under the other. For example, his position on the moral status of demented persons (and the consequent need to euthanize them) follows unequivocally from the Kantian notions of dignity and personhood. Yet he is equally considerate of the emotional and financial consequences of keeping a demented person alive, something he uses as a justification for euthanizing a demented person. These are at best utilitarian considerations, something which Kant himself would never have approved. While Sharp could still argue that as non-moral entities, patients of dementia are not amenable to Kant’s ethical precepts since it applies only to rational persons. But such a stance only begs the question whether Kantian ethics are inapplicable to non-rational persons? As Cholbi points out in his work, it would be a fallacy to presume that Kantian ethics are not applicable to demented individuals. For one, Cholbi observes “we may have indirect duties to others concerning the demented’, which in this case would involve not causing unnecessary pain to the families and friends of the demented person by our actions.Footnote 54

Is Cooley justified in assuming that there is a Kantian duty to die? While Kant believes that it is morally permissible for a person to sacrifice herself if it could preserve her honour, it is not clear whether he considers it morally obligatory as well. Cholbi himself claims that such a conclusion is not possible from Kant’s own example in this regard.Footnote 55 Yet there are aspects of Cholbi’s criticism against Cooley that needs to be reconsidered in the light of Kantian notion of “honour”. The argument here is not to create a Kantian duty to die but to understand whether “honour” in the sense that Kant understood it could be reconciled with Cholbi’s suggestion that it is not dishonourable to be demented.

To start with, Cholbi is correct in assuming that suicide necessitated by the threat to one’s rational agency cannot be compared with suicide necessitated by the fear of losing one’s rational agency. The stress on killing however is overemphasised. It should be the consequences of being alive that should guide our discussion on this matter rather than the act of killing oneself. For Kant, suicide is morally permissible only when staying alive would lead to the moral agency being used in contradiction to the objectives of rational existence. Cholbi refers to such situation as the “misuse” of rational agency. But what does misuse mean in this context? Cholbi refers to misuse in a Kantian sense of the term, which in the context of autonomy implies using our rational agency for purposes that are not warranted by the moral law. In a state of perpetual slavery, a person is governed not by the action she wills in accordance with the moral law, but by the dictates of her master. Slavery, in this sense is dishonourable for Kant because it effectively curbs the capacity to exercise one’s rational faculties in accordance with the autonomy of the will.

Is it dishonourable to be demented? Cholbi answers in the negative; and going by the literal meaning of the word, there is indeed nothing dishonourable about being demented. However, in Kantian terms dishonoured existence has implications that are deeply rooted in one’s capacity to live a moral life. It implies a condition in which an individual is no longer in a position to honour the dignity of her autonomy. Rachel Bayefsky points to a Kantian quality called the “love of honour”, which, she suggests, implies an attitude to live up to the “dictates of autonomous reason, and not on the opinion of others”.Footnote 56 She further claims that “honour for Kant, then, is not simply an external appendage or an inimical passion, but can actually play a role in discharging a duty to respect the dignity of humanity”.Footnote 57 If honourable existence means an attitude to live up to the dictates of autonomous reason, then it follows that only a person who possesses the faculty of rational agency can live with that attitude. Dementia impairs all those faculties that Kant considered necessary for moral existence; thus, taking it beyond the scope of the demented individual to honour her dignity. Based on this perspective, there is no reason to doubt that it is indeed dishonourable to be demented. Of course, not being able to exercise one’s rational faculties by reason of some medical condition is one thing, and wrongfully exercising it under coercion is another thing. But the goal here is not to compare the reasons why an individual is incapable of exercising her rational agencies. The inquiry, instead, should concern with the consequences that ensue if a person does not kill herself even in the likelihood of losing her rational agency. In other words, it is the likelihood of being in a position which compromises her ability to lead a moral life that justifies suicide and not the reason why she is in that situation. Based on the above points it seems that under a Kantian ethical framework it would be morally permissible for a person anticipating dementia to euthanize herself.

Conclusion

Overall this article has highlighted certain aspects of Kant’s thought on dignity and autonomy and how they can both be used to build a viable justification for euthanasia. However, while a Kantian support for euthanasia can be conceptualised in respect of patients anticipating dementia, it seems euthanasia solely for the purpose of or relieving a patient of her pain and suffering is outside the purview of Kant’s moral philosophy.

Notes

  1. https://www.ama-assn.org/delivering-care/ethics/euthanasia visited on 08/04/20.

  2. Marina Budic, ‘Suicide Euthanasia and the Duty to Die: A Kantian Approach to Euthanasia’, (2017) Philosophy and Society 29, 89. Also see generally, Hazel Biggs, Death with Dignity and the Law, (Hart Publishing 2001), Michael Cholbi (ed), Euthanasia and Assisted Suicide: Global Views on Choosing to End Life (Praeger, 2017), Helga Kushe, Udo Schuklenk and others (ed), Bioethics an Anthology (3rd ed, Wiley Blackwell, 2016); Ora O’Neil, Autonomy and Trust in Bioethics, (CUP, 2002).

  3. Ibid90.

  4. Ibid90.

  5. Robert Young, Voluntary Euthanasia, Stanford Encyclopaedia of Philosophy (Spring 2020 Edition) Edward N Zalta (ed) at https://plato.stanford.edu/archives/spr2020/entries/voluntary/ visited on 08/04/20.

  6. cf Budic (note 2) 90.

  7. For example, in India, there were two forms of altruistic suicide- Jauhar and Sati. Jauhar or mass suicide, was practiced by women when their male counterparts were defeated in battle. Suicide in such situation was undertaken to avoid rape, enslavement and other retributions against them. In Sati, the wife would immolate herself on the funeral pyre of her husband. While sati is often justified on religious grounds, there is a possible economic angle to it as well. See generally, Lakshmi Vijay Kumar, “Altruistic Suicide in India’, 2010 Arch Suicide Res 8, 73–80.

  8. The ‘sanctity of life” theory as a prohibition against suicide can be found in the works of classical thinkers like Plato and Socrates. For Plato, the act of suicide represented the act of releasing our soul from our bodies. Suicide under religious heads were regarded as sins. For example, early and medieval Christianity also used religious precepts to prohibit suicide. For, example the often-quoted command from the Old Testament, “Thou shall not kill’, was taken to be forbidding self-destruction. Similar views can be found in Islam, Hinduism and Buddhism. See generally, Michael Cholbi, Suicide, The Stanford Encyclopaedia of Philosophy (Fall 2017 Edition) Edward N Zalta (ed) at https://plato.stanford.edu/artchives/fall2017/entries/suicide/ visited on 08/04/2020.

  9. The Greek philosopher Seneca believed that it was better to kill oneself than to live with failing capacities. For example in one of his works he observed “I will not abandon old age, if old age preserves me intact as regards the better part of myself; but if old age begins to shatter my mind, and to pull its various faculties to pieces, if it leaves me not life, but only the breath of life”. Seneca, “58th Letter to Lucilius,” trans. R. M. Gummere, in T. E. Page et al. (eds.).

  10. Mark Timmons, Moral Theory an Introduction (2nd edn, Rowman and Littlefield Publishers, 2004) 2010.

  11. Young (note 5).

  12. Andrews Reath, Kant’s Conception of the Autonomy of the Will, in Oliver Sensen (eds), Kant on Moral Autonomy (Cambridge 2013) 33.

  13. Ibid.

  14. Ibid.

  15. Timmons (n 10) 207.

  16. Ibid.

  17. Ibid.

  18. The idea that dignity consist of the inherent worth of an individual is also commonly associated with the idea of human rights. All international human rights instruments endorse directly or indirectly the “inherent dignity’ of an individual as the source of human rights. However, for a contrary opinion see Oliver Sensen, who argues that Kantian dignity is based on the concept of dignity by which he means that it is not a distinct metaphysical property, that itself dignity is not a source of rights, and dignity is primarily about duties to oneself. Oliver Sensen, Kant on Human Dignity (2011 Deutsche Nationalbibliothek) 161.

  19. Christopher McCrudden, ‘Human Dignity and Judicial Interpretation of Human Rights’(2008) 19 EJIL 655, 659.

  20. Ibid.

  21. See generally, Rachel Bayefsky, Dignity, Honour, and Human Rights: Kant's Perspective, (2013) 41 Political Theory 809, 816.

  22. Jeniffer. E. Bulcock, ‘How Kant would Chose to Die’ (Master’s Thesis, University of New Hampshire Durham, 2006).

  23. By hypothetical imperative Kant refers to all those external forces of causality that derives its validity as an object of desire, and therefore is of a conditional nature.

  24. Immanuel Kant, Lectures on Ethics, ed. Peter Heath and J.B. Schneewind. (New York: Cambridge University Press, 1997), 148.

  25. Ibid 144.

  26. Kerstein Samuel, Treating Persons as Means’, The Stanford Encyclopedia of Philosophy (Summer 2019 Edition), Edward N. Zalta (ed.), URL =  < https://plato.stanford.edu/archives/sum2019/entries/persons-means/ > . Accessed on 22/09/20.

  27. For example, Kant observes “There is thus lodged in man an unlimited capacity that can be determined to operate in his nature through himself alone, and not through anything else in nature. This is freedom, and through it we may recognize the duty of self-preservation” Lectures (note 24) 144.

  28. Ibid 124.

  29. Rachel (note 21) 814.

  30. Rachel (note 21) 816–819.

  31. Lectures (n 24) 147.

  32. Ibid 149.

  33. Ibid 149.

  34. Ibid151.

  35. Yost, Benjamin S. “Kant’s Justification of the Death Penalty Reconsidered”, 2020 Kantian Review 15.

  36. Sharp, Robert, “The Dangers of Euthanasia and Dementia: How Kantian Thinking Might be used to Support non-voluntary euthanasia in cases of extreme dementia”, 2012 Bioethics 26, 231–235.

  37. Questions regarding capacity and consent and also those for determining at a what particular stage a person lose the capacity to make decisions for himself are mostly empirical enquiries. Existing laws on mental capacity presumes that a patient has the capacity to make decisions and that decisions taken by him with regard to his treatment (stopping) are taken in full understanding of the consequences. However, existing literature suggests this might not always be the case. See, Colin Gavaghan, Capacity and Assisted Dying in Michael Cholbi (ed), Euthanasia and Assisted Suicide: Global Views on Choosing to End Life (2017 Praeger); S Natalie Banner, “Can Procedural and Substantive Elements of Decision- Making be Reconciled in Assessments of Mental Capacity?”(2013) International Journal of Law in Context 9, 71–86.

  38. Brassington Iain “Killing people: what Kant could have said about suicide and euthanasia but did not”, 2006 Journal of Medical Ethics 32, 571–574.; Dennis Cooley, “A Kantian Moral Duty for the Soon-to-be Demented to Commit Suicide”, (2007) AJOB 7, 37–44; Sharp, Robert, “The dangers of euthanasia and dementia: how Kantian thinking might be used to support non-voluntary euthanasia in cases of extreme dementia”, (Sharp 2012) Bioethics 26, 231– 235.

  39. Dennis Cooley, “A Kantian Moral Duty for the Soon-to-be Demented to Commit Suicide”, (2007) AJOB 7, 37–44.

  40. Sharp (note 50) 232.

  41. Cooley (note 54) 37–44.

  42. Ibid.

  43. Sharp (note 50) 234. For similar claims see Joshua Beckler, ‘Kantian Ethics: A Support for Euthanasia with Extreme Dementia’, 2012 CedarEthics Online 16.

  44. Sharp (note 50) 234. Kant’s duty of beneficence flows from his duty to others regarding their happiness. Kant regards such duties as imperfect duties or duties of commission. It includes the duty to cultivate the virtues of beneficence, gratitude and sympathy.

  45. Ibid 235–245.

  46. Cholbi, Michael (2014), “Kant on Euthanasia and the Duty to Die: Clearing the Air”, Journal of Medical Ethics, 2014 Bioethics 41, 607–610.

  47. Ibid 610.

  48. Ibid 609.

  49. Ibid 610.

  50. Ibid 610.

  51. Ibid 610.

  52. Sharp (note 50) 234.

  53. See Cholbi’s criticism against this line of thought. Cholbi (note 62) 609.

  54. Ibid.

  55. Ibid 607. Cholbi claims (in a footnote) that Cooley’s assumption of Kantian duty to die is also based on an erroneous reading of Kant. He argues that while Kant considers it heroic for someone to sacrifice herself to save her honor, the act still violates her humanity. Thus, disallowing the possibility of a duty to die.

  56. Rachel (note 27) 824, 25.

  57. Ibid.

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Correspondence to Navin Sinha.

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Sinha, N. To Die or Not to Die: A Kantian Perspective on Euthanasia. J. Indian Counc. Philos. Res. 39, 13–24 (2022). https://doi.org/10.1007/s40961-021-00265-3

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Keywords

  • Kantian
  • Euthanisa
  • Dignity
  • Autonomy