Bioethics in Faith and Practice, Volume 3, Number 1

Bioethics in Faith and Practice ⦁ 2017 ⦁ Volume 3 ⦁ Number 1 29 death is a better option.” Mr. Hossain’s argument is clearly utilitarian, accounting for his lack of the financial means to provide requisite treatment for his two sons and grandson, even as he accounts for the severity of their physical condition that for him requires relief through active euthanasia. But, Kant is not a consequentialist in his attention to categorical duties, in which case Mr. Hossain’s rationale in his request has no standing in a Kantian assessment. One may reasonably distinguish between the body and the mind and account an individual a person in view of his rational nature rather than his physical nature, such that the above argument is made that cognitive impairment entails loss of personhood. But this premise, in and of itself, is insufficient to conclude that the fact of cognitive impairment due to pathological causes means death is a better option than continued life. At issue here instead is whether Mr. Hossain would violate the universal practical imperative not to treat his two sons and grandson merely as a means to his own end (in this case, removing his burden and personal distress in caring for them as their DMD promises their continued physical deterioration; which is to be distinguished from a clear benevolence and compassion that, accounting for the interests proper to the two sons and grandson, intends a genuine act of mercy, hence a mercy -killing). One must, then, distinguish between what is merely convenient to Mr. Hossain as head of household (i.e., what is a matter of his inclination to act according to perceived need or desire) and what his duty is (consistent with the personhood of the sons and grandson). This is so even if and when one reasonably anticipates loss of moral agency in the case of the elder son (contrasted here to lack of moral agency in the youngest son and grandson due to their age, which nonetheless is not sufficient reason for non-voluntary active euthanasia). If Mr. Hossain’s principal motive is self-interested, appealing to his own present inclinations and his projection of a highly probable growing burden and distress under the morally relevant circumstances, then the universal practical imperative central to deontology would be violated. Involuntary active euthanasia in the case of Abdus Saber would, thereby, be morally impermissible. And, furthermore, given the normal expectation that government authority has responsibility for the public welfare and public health, on grounds of benevolence (i.e., manifestation of a “good will” consistent with moral duty), then it would be morally irresponsible of the Bangladesh government authorities to grant Mr. Hossain his request, even if the extant public law or policy is silent on the question, as at present time. C. Learning from the Groningen Protocol Given that the present case also concerns non-voluntary active euthanasia in the case of the younger son and grandson, it behooves us to consider how a given protocol may assist in decision. The Netherlands some time ago was forced to public debate, and to consider guidelines proposed by the Groningen Academic Hospital on the question of euthanasia of terminally ill infants—a clear case of non-voluntary active euthanasia. 34 The protocol accounted for morally relevant circumstances that included several assurances be given: 1. The suffering must be so severe that the infant has no prospects for a future. 2. There is no possibility that the infant can be cured or alleviated of her affliction with medication or surgery. 3. The parents must give their consent. 4. A second opinion must be provided by an independent doctor who has not been involved with the child’s treatment. 5. The deliberate ending of life must be meticulously carried out with the emphasis on aftercare. If one were to apply such a protocol to decision in the Bangladeshi case, it is clear neither the two sons nor the grandson is in a state of suffering so severe that any one has no prospects for a future. They have a future, albeit one of limited mobility with continuing degeneration with life expectancy to