The medical profession has attempted to draw an ethical distinction between "passive" and "active" euthanasia. The argument being that, although giving a patient a drug, or in some other way causing or hastening their death is entirely unethical, allowing a patient to die by withholding treatment and/or nutrition is morally acceptable. The criteria by which the determination is made to bring about a patient's death appears to mostly be age related, using the "quality of life" argument that at their age, treatment would only prolong what, in the doctor's opinion, would be a few more years of...well, of being old, I guess. I am still unable to see the distinction. Given that the goal (to bring about the untimely death of the patient) is identical in both cases, it becomes merely a matter of the means to bring about that ultimate end. Out on a walk I find a person in a life or death situation, let's say hanging off a cliff, for instance. That person is barely holding on and certain to fall if I don't attempt to help him. I have three options in this situation; 1: I can do all I can to save them.
2: I can ignore them, sentencing them to certain death, or 3: I can give them a shove or step on their fingers, sending them to the same certain death, only faster. All three options entail making a conscious decision, the latter two leading to the same end. Obviously, there is only one ethical course of action, and that is to do everything possible to save that person.
Now if I happen to know the person in trouble and am of the opinion that they, or some age/ethnic/economic section of society I associate them with, is a drain on our system, or lives what I believe to be an inferior lifestyle, does that alter in any way, the three options? Does option one now get dropped from the list and the moral dilemma become one of deciding which of the remaining two options is the most "ethical"? Does my opinion of this person's lifestyle/quality of life/economic situation give me the moral right to decide they should not be saved? What if I know this person and believe that they, or the segment of society they are representative of, are a benefit to society...does that opinion somehow change morality? Are numbers two and three off the table and I now have a moral imperative to do everything I can to save the person? Is it ethical to justify my actions/lack of action based on my opinion of this person's "quality of life"?
The quality of life argument is inherently flawed. Exactly what a quality life entails is subjective...each and every person on Earth has a slightly different definition of "quality of life". Not only do individuals differ in their interpretation of the term, but our personal vision of a quality life is in a constant state of flux, dependent on our age, economic situation, physical conditions, etc. It is a transient concept, one which not only changes over long periods of time, but can change from day to day, or even hour to hour. I can think back to days working in the woods when the weather was perfect, I was dead fit, the ground easy; when the mountains would rise up, bold and snowcapped, all around, and the smell of spring in the air when, if asked about my quality of life, I could say in all honesty and with enthusiasm, that I lived the most perfect of lives. Other days, the endless winter days of howling winds, torrential sideways rain mixed with snow, steep, muddy and brushy ground; days so miserable that early in my "career" would cause me to contemplate sticking an arm or leg between two logs and breaking it just to get off that miserable mountain (which I could never bring myself to do, being averse to pain and knowing I would feel more guilt than I could be comfortable with)...THOSE days would have elicited an entirely different, very negative response. There are those too, undoubtedly, who have something important enough in their lives that they want to live and attain/see/experience, in spite of a degradation of their "quality of life". Perhaps grandchildren they want to watch grow, or some task they committed themselves to.
What kind of quality of life is enjoyed by the sick, the addicted, the imprisoned, the mentally ill, the deformed, the obese, the mentally challenged, and who is qualified to make that determination besides themselves? When will society decide that it has a moral imperative to "save" these people from their "unhappy lives" and will the arbitrary age/other criteria used to justify euthanizing patients be lowered to fit economic/population situations/densities at some future time? Is there an economic wrinkle...too many old and aging Americans, struggling Social Security/Medicare programs and a bankrupt nation?
The Declaration of Independence famously declared that we Americans were owed the right to "Life, liberty and the pursuit of happiness". The inclusion of the word "pursuit" implies NOT the "right" to happiness, but the right to chase that dream, to attempt to make it a reality. The right to life is pretty self-explanatory. Taking a human life, whatever the age/health/economic situation, denies that person the right to seek happiness...and "liberty" is a meaningless concept to the dead.