this Death be
or a "Merciful Death"?
FOUR DIFFERENCES BETWEEN MERCY-KILLING
The advent of medical technology that can keep a
for months or even years after
the person is no longer
necessitates some new thinking and new terminology
for the process of deciding to end the life of another individual
who can no longer decide for himself or herself
and who might now have become a former person.
This essay proposes to define and distinguish
that might seem to be synonymous: mercy-killing
and merciful death.
The same four distinctions can be used to distinguish
irrational suicide from voluntary death.
SEPARATING MERCY-KILLING FROM MERCIFUL DEATH
1. Will this death be harmful or helpful
to the patient?
B. PRACTICAL WAYS TO
SEPARATE MERCY-KILLING FROM MERCIFUL DEATH
2. Will this death be irrational
3. Will this death be capricious
4. Will this death be regrettable
SHOULD REMAIN A CRIME;
MERCIFUL DEATH SHOULD BE PERMITTED AND
Will this Death be
a "Merciful Death"?
by James Leonard Park
A. SEPARATING MERCY-KILLING
FROM MERCIFUL DEATH
1. Will this death be harmful
or helpful to the patient?
Mercy-killing is a well-known phenomenon in almost
It happens when someone causes death in another individual
based on the belief that death would be good for the victim.
But when the facts come to light, almost everyone agrees
that death was not
the best option under those circumstances.
For example, spouses sometimes kill their loved ones
under what turns out to be the false belief that they had cancer.
When the body was autopsied by the medical examiner,
sometimes no cancer was found.
When such mistakes are made by well-meaning spouses,
in retrospect even they agree that the death was a harm
to the victim.
Such cases are correctly called "mercy-killings".
On the other hand, there are situations in which the
really was suffering an incurable and painful disease.
And when all the facts became known,
even people who were initially against a chosen death
agreed that death was a better option than meaningless
Increasingly, due to modern life-support systems,
the patient is unconscious or otherwise unable to make medical
Then the proxies must collect all of the relevant information
and explore all the remaining medical options,
possibly concluding that death would be the best course of action
for this person or former person.
When the facts and opinions point to death as
the best choice,
then this death might be called a "merciful death".
This is parallel to a voluntary death
which could have been chosen by the patient himself or herself
if he or she was still able to make medical decisions.
And often the proxies will have asked themselves:
What would this individual have chosen
if he or she knew everything that we know?
If the patient would have chosen a voluntary death,
then the proxies are justified in calling it a merciful death
when they must make
the life-ending decisions for the patient.
Laws should be re-written wherever necessary
so that proxies do in fact have the same powers to choose death
for a patient who has now lost decision-making capacity.
None of us should lose the right-to-die
merely because we can no longer authorize
the necessary actions (or withholding-of-actions) ourselves.
2. Will this death be irrational or
When other people examine a mercy-killing after the
death has occurred,
they determine that the reasons for death were insufficient.
The person who committed the mercy-killing
probably believed at the time that it was best for the
But when cooler heads examine all of the facts,
they decide that it was really an irrational response
to a situation that was perhaps misunderstood.
Often the relative of someone who is suffering
has a limited understanding of medical matters.
This can lead to false ideas about what is likely to happen.
And such mistaken beliefs can lead to a mercy-killing.
However, if the duly-appointed proxies
for someone who has ceased
to function as a full person
have examined all the medical facts and recommendations,
then if they make a wise choice for death,
it might be called a "merciful death"—not a "mercy-killing".
And there should be no punishment for that life-ending decision.
Just as the patient could have reached the same conclusion
if he or she were still able to weigh medical facts and opinions
and reach a wise decision about how to proceed,
so the proxies for the patient have thought long and hard
about all the possible courses of action
and have reluctantly decided that death is the
There can always be disagreements about just what is
but at least the principle
can be applied to each specific situation.
When the patient can no longer decide,
what is the wisest course of action for the proxies to take?
If the patient makes a foolish choice for death,
that is called "committing irrational suicide".
If someone else make a foolish choice for death, that is called
This is the same irrational/rational distinction
that separates irrational
suicide from voluntary
(See the companion on-line essay:
Will this Death be an "Irrational Suicide" or a "Voluntary Death"?
Will this death be capricious or well-planned?
Usually what we later call a mercy-killing was
basically a capricious act,
taken on the spur of the moment, not carefully planned and
The man who wants to shoot his wife to end her suffering
does not share this plan
with anyone else
because he fears on some level that others will not agree with him
and will take action to prevent
him from shooting his wife.
And if he is delayed by other people or circumstances,
he probably will have had second thoughts about killing his wife.
Good medical information might have assured him
that death today is
not the wisest course of action.
In contrast, when the proxies are planning the death
of their patient,
they will complete an exhaustive search for the best medical treatments
before they conclude that no
cure is possible.
They might consult a variety of medical people
before they move toward a "merciful death".
The process of planing for a merciful death could take up to one year
—especially in cases of complex
diseases with several
Just as a person who is considering his or her own
will pursue all meaningful options before deciding to accept death,
so the proxies for someone who has lost decision-making capacity
will analyze all the facts and collect all relevant medical opinions
before possibly deciding that death is the best option available.
And as each of us retains the power to choose a voluntary death
while we still have all our wits about us,
so our proxies should be duly authorized to choose death for us
after we have lost consciousness permanently
or otherwise become unable to make medical decisions.
As a voluntary death
can be well planned by the patient,
so a merciful death
can be well planned by the proxies
for the patient.
4. Will this death be regrettable
When a distraught relative has committed a
everyone who knows about this tragedy regrets that result.
We wonder what we could have done to prevent this needless death.
And some premature deaths have
when others learned of a foolish plan to commit mercy-killing.
These evaluations often must be made after the death
But if we know of any plans to kill a vulnerable person,
we can take the necessary steps to prevent such a regrettable crime.
However, if a mercy-killing has already taken place,
we should let the justice system examine the case.
On the other hand, when a merciful death is planned,
no crime will be committed and the justice system will not become
It is a wise and admirable plan to draw this life to a close
at the best time—not
too soon and not too
If the patient had been able to participate in the decision for death,
he or she would have agreed that death is the wisest course.
Then if others must carry forward the plans for death,
it will be called a wise, merciful death.
Again, the proxies should have the same full powers to decide
as held by a patient with full capacity to make medical decisions.
and medical practice will have to change in some degree
to make this distinction between mercy-killing and merciful death
effective in the real world.
But the basic tests can be understood by anyone
who knows the differences between:
(1) harming or helping;
(2) being irrational or rational;
(3) acting capriciously or cautiously; &
(4) a death we regret or a death we admire.
Mercy-killings will still take place.
And they will have to be dealt with by law enforcement:
the police, the prosecutors, the courts, & the prisons.
But the new concept of
merciful death can be put into practice
under the supervision of the medical
They can recommend a life-ending decision to the proxies
when the facts of the case suggest
that death is the best choice for this patient.
Often the death will come about
as the result of disconnecting life-support systems,
which has long been recognized
as a valid and reasonable way to draw life to a close.
When other methods are needed to shorten the process of dying,
these measures can be called "merciful death".
B. PRACTICAL WAYS TO SEPARATE MERCY-KILLING
FROM MERCIFUL DEATH
Having outlined the philosophical and
between the familiar phenomenon of mercy-killing
and the less common practice of merciful
we can ask for some practical
methods by which to separate these two.
Here are ten definite steps that anyone can take
which will help to tell whether a proposed death
would be a mercy-killing
or a merciful death:
1. Advance Directive
from the Patient.
Consultant Certifies that the Patient is Competent to Decide.
Summary of Condition and Prognosis.
Doctor Confirms the Condition and Prognosis.
Others Agree with the Life-Ending Decision.
of the Clergy Approves the Life-Ending Decision.
Reviews the Life-Ending Decision.
and Civil Penalties for Causing Premature Death.
Periods for Reflection.
Reporting of all Material Facts.
As might be obvious from these ten safeguards,
they can be used for all
forms of life-ending decisions:
(1) while the patient is still capable of making the decision,
(2) after the decision-making power has passed to the proxies,
(3) in either case when considering withdrawing life-support systems,
(4) when considering more active means of drawing life to a close.
In cases of proposed merciful death,
the prior record of choices when the patient was still capable
of making decisions should still be honored.
We should not
lose our right-to-die when we become unconscious.
Our advance directives and any other documents created by others
should still have legal and ethical force
unless there is some substantial change in the patient's condition
that would render the prior decisions invalid or irrelevant.
Anyone who goes to the trouble of fulfilling these
should be assumed to be acting in good faith,
watching out for the best interests of the patient.
For example, someone who has an urge to commit a mercy-killing
is not going to consult the ethics committee of the hospital.
Proxies who do ask
for input from others
about the wisdom of death now
rather than death later
are much more likely to be planning
what will be called (after the fact) a merciful death.
The safeguards named above (and a few others)
are explained in further detail in another on-line essay:
for Life-Ending Decisions
This essay is linked
to an even more comprehensive
list of safeguards.
SHOULD REMAIN A CRIME;
MERCIFUL DEATH SHOULD BE PERMITTED AND
Mercy-killing is different from other forms of murder
because the perpetrator believed the victim was already dying.
Thus it should be prosecuted as a new form of homicide.
This new law should also include the possible crime
of prematurely disconnecting life-support systems
—another means of killing people
that our forefathers never imagined.
Here is a draft of such a law, called Causing
This draft embodies 26 safeguards.
If substantially all of the safeguards are fulfilled, no crime was
And the death will be a voluntary
death if chosen by
The death will be a merciful
death if chosen by
Each state or country will have to modify its own
But looking ahead by 100 years,
we can be confident that such changes will be common
and that irrational mercy-killings
will continue to be prosecuted
whereas wise merciful deaths
will be permitted and supported.
Created October 30, 2005; revised
several times, including: 11-13-2008; 6-5-2009;
11-4-2011; 12-31-2011; 1-22-2012; 2-1-2012; 2-22-2012; 3-30-2012;
7-11-2012; 9-13-2012; 10-17-2012;
James Park is an independent existential philosopher
with deep interest in medical ethics,
especially the many issues surrounding the end of life.
Medical Ethics and Death are two of the seven doors
to his website called "An Existential Philosopher's Museum":
The above four ways
to separate mercy-killing from merciful death
is also Chapter 20 of How to Die:
Safeguards for Life-Ending Decisions:
Will this Death be a
"Mercy-Killing" or a "Merciful Death"?
you like to join a world-wide cyber-seminar
is discussing this book-in-progress?
the complete description for this seminar:
our Facebook Group called:
for Life-Ending Decisions:
Here is the summary of Part Two of
How to Die:
Safeguards for Life-Ending Decisions.
Clicking the chapter numbers will take you to each chapter on the
of Part Two
Use of Language will Advance the Right-to-Die
Advocates of the right-to-die have developed a set
of conventional terms
they use in discussing the end-of-life options with one another.
But for historical reasons that are not obvious,
most of the traditional terms have developed very negative connotations.
Thus, it is time for a deep revision
of the language used by supporters of the right-to-die.
What advantage would be achieved by continuing to use
"suicide" and "euthanasia" when we want to convince people in the middle
to support wise end-of-life medical choices?
Each chapter in this section addresses one term,
of referring to "assisted suicide" and "committing suicide",
we could speak of "physician assisted dying", "voluntary death",
"aid in dying", or "managed dying".
of the traditional term "euthanasia",
we could refer to "gentle death", "good death", "chosen death", etc.
Then opponents would tie themselves in knots
when they say that they oppose all forms of good death or gentle death.
"Hastening death" has not been much examined as a term of art.
But we really do not advocate exiting from life as soon as possible.
Rather, we want to choose reasonable and "timely" deaths.
We seek the best time for death to come, not too soon and not too late.
because the first law used this expression,
"medication" has been the word for gentle poison
to be taken to achieve a painless and peaceful death.
What about calling them "life-ending chemicals"?
It would probably be better if we avoided any possible confusion
with drugs used for treating disease or alleviating symptoms.
right-to-die movement should never be confused with a suicide cult.
At every opportunity, we should say that we do not advocate
people foolishly throwing their lives away.
With careful and consistent use, we might be able to establish
"voluntary death" by clearly distinguishing it from "irrational
Likewise, we should no longer seem to advocate "mercy-killing".
Rather, would it be possible to define and describe "merciful death"
as an end-of-life choice that is helpful, rational, well-planned, &
Here are a few related on-line essays also by James