Bioethics in Faith and Practice, Volume 3, Number 1

Bioethics in Faith and Practice ⦁ 2017 ⦁ Volume 3 ⦁ Number 1 25 While acknowledging Bangladesh is a Muslim-majority country that will defer to Islamic doctrine when pertinent to the development of public law and policy, nonetheless this in and of itself does not lead to the conclusion that public deliberation is thereby foreclosed. On the contrary, as B.A. Manninen argues, “It is a rather disturbing trend when the general public fails to take the time to educate itself about a certain controversial issue before criticizing or condemning it. This does a disservice to all by conveying a faulty view of the actual issue, thereby precluding the possibility of discussing its ethical implications intelligently or accurately.” 15 The point applies also to Bangladesh in present case. Accordingly, the issue is engaged here to contribute to public deliberation in Bangladesh on an important ethical question, precisely because there is at present no public law or public policy that provides guidance in the matter of either passive or active euthanasia, whether voluntary, involuntary, or non-voluntary. In the following discussion moral assessment concerns professional norms of practice, deontological ethical reasoning on the issue of euthanasia, and specifically Islamic jurisprudential reasoning pertinent to moral assessment. Issues of Moral Assessment A. Professional Norms and the Slippery Slope Despite current religiously based prohibition of euthanasia in Bangladesh, albeit not explicit in public law but only generally understood to be prohibited by Islamic doctrine as such, there remains the question about the morality of (1) a request that amounts to non-voluntary active euthanasia and involuntary active euthanasia and (2) whether a governmental permission would be morally justified. How does one assess such a request, recognizing that a utilitarian 16 might indeed permit such an act while a Kantian deontologist 17 may not? To answer these questions, we shall consider first some notable classical discussions and then some recent discussions in relation to slippery slope type consequences. Thereafter we will briefly consider the matter with reference to Islamic ethics. A classical argument presented by Gerald Dworkin holds that, “under certain circumstances, it is morally permissible, and ought to be legally permissible, for physicians to provide the knowledge and/or the means by which a patient can take her own life.” 18 A physician, in short, facilitates a patient’s death. The rationale in the case of permissible assisted dying concerns the patient’s interests specifically (in contrast to what may be identified as professional duties of a physician): (1) removing an individual from continued pain and suffering, and (2) responding to a patient’s sense of dignity, both in the case of established “terminal illness” or “an intractable, incurable medical condition that the patient experiences as incompatible with her fundamental values.” 19 In both cases (1) and (2) the operative assumption is that the patient makes the request directly, being capable and competent to do so. The Bangladesh case is clearly different, since the two sons and grandson do not themselves make this request; nor is it clear that they have been consulted so as to consider their views or to assure their consent has been given, consistent with the usual appeals to individual autonomy (even while acknowledging that this may not be fully applicable in the case of the younger son and grandson due to their age). In this case, consistent with customary patriarchy in a Muslim family, it is the father’s judgment that is assumed to be determining and, both de facto and de jure , the sole source of the request. And, indeed, one can argue here, as Leon Kass might argue, that it is not an appeal to autonomy that is pertinent to the decision here; but, instead, “the miserable and pitiable condition” of the dystrophied bodies of these three individuals that, so the father argues, “justifies” the physician’s intervention to assist their deaths, in the absence of the father’s financial ability to provide treatment and lack of committed and sustained governmental medical treatment . 20 Kass makes a pertinent distinction here that is relevant to determining the motivation for action involved here; i.e., the father does not deliberate or decide with reference to any question about his sons’ autonomy, but instead focuses only