EUTHANASIA AND AFRICAN CULTURE: A RELIGIOUS-PHILOSOPHICAL APPRAISAL
ABSTRACT
Euthanasia can be defined as well or good death which was intentionally done in order to relieve pain or suffering. This project work is expository, scholars have written in favour of the practice of euthanasia, there are also arguments against euthanasia. Discussions on euthanasia usually revolve around medical legal and moral issues geared at determining the extent to which a physician may, feel obliged to acede to the request of the terminally ill patient to bring to a graceful and his/her pain and suffering by assisting the patient to die. In some jurisdictions physicians are statutorily conceded such rights in spite of the Hippocratic Oath. It is discovered that in Africa (Nigeria) appear favourably disposed to the idea of passive euthanasia, active euthanasia. All these are been explained in this work.  
TABLE OF CONTENT
CHAPTER ONE: GENERAL INTRODUCTION
Background of Study                    
Statement of Problem                    
Clarification of Terms                     
Life                                 
Death                             
Euthanasia                         
Physician Assisted Suicide                 
Ordinary Means of Treatment             
Extraordinary Means of Treatment            
1.4    Aims and Objectives                     
1.5      Scope of Study                        
1.6    Literature Review                    
1.7    Methodology                        
1.8    Division of Work                         
Endnotes                              
CHAPTER TWO: GENERAL CONCEPT, ORIGIN AND VARIOUS STRAINS OF EUTHANASIA
2.1    General Concept of Euthanasia             
2.2    Historical Survey of Euthanasia            
2.3    Classification of the different Distinctions within
the concept of Euthanasia                  
2.3.1    The Active/passive distinction of euthanasia     
2.3.2    The Voluntary/involuntary distinction of
 euthanasia                             
2.4    The Different Strains of Euthanasia        
2.4.1 Active Voluntary Euthanasia                 
2.4.2 Passive Voluntary Euthanasia            
2.4.3 Active Involuntary Euthanasia             
2.4.4 Passive Involuntary Euthanasia            
Endnotes                             
CHAPTER THREE: THE EUTHANASIA DEBATE
3.1    Arguments for Euthanasia                
3.1.1    The Relief from Extreme Pain             
3.1.2    Human Freewill and Autonomy             
3.1.3    Health care Cost Containment             
3.1.4    The Retention of Human dignity             
3.2    Arguments Against Euthanasia
3.2.1    The Imago Dei Theory (Sanckty of Life)        
3.2.2    The Abuse and Misuse of Euthanasia
(Slippery Slope Argument)                
3.2.3    The Utilitarian Appeal of Society            
3.2.4    The Principles of Beneficence and non-magnificence
of the Physician                        
    Endnotes                             
CHAPTER FOUR: GENERAL AFRICAN CONCEPTION OF LIFE, DEATH AND AFTER-LIFE
4.1    The Meaning and Value of Life among the Africans
4.2    Rites of Passage and Their Importance            
4.3    The African Concept of Death            
4.3.1    The African Conception of a good death            
4.3.2    The African Conception of a Bad Death            
4.4    The Relevance of Good Death                
4.5    The African Conception of After-life             
4.6    Euthanasia and the African Culture             
4.6.1    The Literal Level of (A Good Death)             
4.6.2    The Connotative  Level (Mercy Killing)             
    Endnotes                            
CHAPTER FIVE: EVALUATION, RECOMMENDATION AND CONCLUSION
5.1    Evaluation                            
5.2    Recommendations                     
5.3    Conclusion                         
    Endnotes                             
    Bibliography                         
CHAPTER ONE: GENERAL INTRODUCTION
1.1    BACKGROUND OF STUDY
    The concept “Euthanasia” is a not entirely a new one. As Euthanasia has ranged over a long period of time Euthanasia is a “good death” has evoked various questions as relating to the value of human life, the question of the morality of its practice, the legal question of an individuals right to both life and death etc.1
    These questions are more raised about the issue of euthanasia are not new, yet euthanasia has been debated most fiercely in contemporary times, because of the advances made in the fields of medicine and science. However, this debate has ensued mainly from a western perspective and one or two religions standpoints such as Christianity (e.g the Roman Catholic Church).
    The Africans as any other race of the world have beliefs central to their culture and existence. This is especially so, when it pertains to matters of life and death. As the concept “euthanasia” literally means “Good Death” from its Greek translation, what a “good death” connotes must be sufficiently examined from various worldviews as has been done with the West. More specifically, it must be examined, what the African conceptions of a good death is whether the concept of euthanasia as a “good death” concurs with the African understanding of a “good death”.
1.2    STATEMENT OF PROBLEM
    The concept of Euthanasia is known to literally translate as “good death” from the greek words “eu” and “thanasia”. Thus euthanasia has initially been perceived from the western perspective as its earliest recorded origins are like wise western. However, the practice of euthanasia involves human death which cuts across all races of men. Though its debate has began in the west it must not necessarily end there.
    The problem of this study involves appraising the issue of euthanasia from a new light, the African perspective to discover new facts of euthanasia and its ensuring problems.
What does the African conceive as a good death? Is the practice of euthanasia reconcilable with African traditional beliefs? What are the effects of euthanasia in an African society and like wise other societies? These questions basically constitute the problem of this study, euthanasia and African culture, a religions philosophical appraisal.
1.3    CLARIFICATION OF TERMS
    In this study, it is pertinent that certain  terminology be listed and properly explained as they are not only inescapable within the study but quite relevant for better understanding of what is being discussed in the study.
    These distinctive terms include life, death, euthanasia, physician assisted suicide, ordinary means of treatment. Other terminology unique to this study such as the various strains of euthanasia will be duly defined and explained as they appear within this study.
1.3.1    Life
    The Oxford Advanced Learner’s Dictionary of current English defines life as “the ability to breathe, grow, reproduce etc which people, animals and plants have before they die and which objects do not have.2 Clearly life is a form of existence, consciousness or an ability to live. As a form of existence, active existence and passive existence may both be distinguished between.
    Active existence is believed to connote the feature of consciousness which is “the state of being able to use your senses and mental powers to understand what is happening”.3 Passive existence on the other hand is strictly mere existence without notable activity. An example of a passive form of existence in humans is the state of coma one may assume that “life” as referred to in this study is synonymous with “Active Existence”.
    In the case, it remains an accepted fact that humans are capable of exhibiting life.  However, it is necessary that the issue of life not be confused with that of “quality of life”.
1.3.2    Death
    Death is the termination of human physical life.4 It is a natural part of the cycle of life.  However uncertain man may be of his destiny or what life has in store him, he remains certain of one constant and that is death. This unavoidable event death ha several definitions depending upon what perspective it is being discussed from. The question of death’s definition has medical legal, theological and philosophical dimensions.5
    From medical dimensions, physicians initially had a shared option of death. When spontaneous respiration and heartbeat ceased, the person was dead.6 Death was then believed to have occurred. This is now commonly referred to as a clinical definition of death. Due to advances in modern medicine, such a state is now possibly reversible in some cases by resuscitation. There are now more definition of death such as the cardiac – oriented definitions whole brain definition and higher brain oriented definition.
    The more common of these definitions which is the higher brain oriented definition of death states that:   
“Individuals are dead when they have irreversible lost all higher functions of the brain (usually defined as all capacity for consciousness).7
Nevertheless, this is a modern medical definition of death. According to Patricia Mann, author of meanings of death, in different times and different cultures death means different things.
1.3.3    Euthanasia
    Euthanasia is the intentional killing by act or omission of a dependent human being for his or her alleged benefit.8 This definition though common is nevertheless insufficient to explain the various forms, strains and aspect of the act of euthanasia.
    Hence, the definitions of euthanasia are categorized mainly in two ways “euthanasia by consent” and “euthanasia” by means. Euthanasia by consent could be calibrated as voluntary euthanasia and involuntary euthanasia, depending upon the position of the patient. On the other hand, euthanasia by means is calibrated into passive euthanasia or active euthanasia depending upon the role played by the physician.
    When the voluntary involuntary distinction is combined with the active passive distinction four types of euthanasia result.
Active  voluntary euthanasia
Passive voluntary euthanasia
Active involuntary euthanasia
Passive involuntary euthanasia
1.3.4    Physician Assisted Suicide
    Physician assisted suicide is believed to differ from euthanasia among certain people. Thus, the need to state the distinction of physician assisted suicide from euthanasia. In physicians assisted suicide, the physician may provide the patient with the means to end his or her life, but the patient performs the lethal act himself or herself.10 For example, it would be a case of physicians assisted suicide of the patient dies after swallowing an over dose of a lethal drug provided by his/her doctor for the purpose of causing death.
    Physicians assisted suicide need not be distinguished from euthanasia as “the basic issue is still premature patient death, whether physicians assisted or self-inflicted.11
1.3.5    Ordinary Means of Treatment
    Treatment is medical care expected to produce benefits.12 There’s however exists a distinction between what is commonly referred to as an ordinary means of treatment and an extra-ordinary means of treatment.
    Paul Ramsey, a leading theological ethicists says of ordinary means of treatment.
“ordinary means of preserving life are all medicines, treatment and operations, which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain and other inconveniences”.13
    Over a period of time, the connation of what is referred to as ordinary means of treatment has evolved and thus, been misconstrued. The word “ordinary” seems to have been juxtaposed with words such as ‘common or simple’. This is an incorrect assumption as an uncommon mode of treatment may be conceived as an ordinary means of treatment. Ordinary means of treatment simply mean “morally required (treatment) even if the treatment is very unusual and/or high tech.14
    Figuring out how complex or simple a treatment is does not help in determining whether is it morally imperative (thus, an ordinary means of treatment).15 What matters then, in determining whether to provide in treatment to an incompetence patient is not a prior determination that this treatment is likely to provide this patient benefits that are sufficient to make it worth-while to endure the burdens that accompany the treatment.
1.3.6    Extraordinary Means of Treatment
    Extraordinary means are all medicines treatments and operations which cannot be obtained or used without excessive expense, pain or other inconvenience, or which if used would not offer a reasonable hope of benefit.17 In other words, this kind of treatment is referred to as extraordinary not because it is special or different rather because it has little or no impact on it’s attempt t alleviate suffering or pain. It however, may prolong the event of death for a limited period of time.18
    Thus, extraordinary means of treatment connotes,  “morally expendable , even if it is very common and/or technologically simple extraordinary means of treatment are expected to produce benefits that are less than harms or no greater than harms.20
1.4    AIMS AND OBJECTIVES
    The aims and objectives of this study are clear out and precise. They are duly outlined as follows;
To present the concept of euthanasia as both a theory and practice in  a distinctively  clear fashion without bias.
To discover what is the generally accepted African conception of a good death (i.e euthanasia).
Thus, bringing forth the African contribution to this age old yet important debate of euthanasia which globally affects man and his existence.
To critically examine euthanasia as it is modernly perceived with  the back light of African traditional beliefs and cultures
Lastly, to assert, if euthanasia as a practice is reconcilable with African culture and if not proffer reasons behind this impasse while suggesting practicable recommendations.
1.5    SCOPE OF STUDY
    In this study, Euthanasia and African culture, A religious philosophical appraisal” it is imperative to outline what exactly its scope is as the issue of euthanasia is both broad and inexhaustible. Certain areas will therefore be focused upon to prevent this study from being rendered in adequate.
    This study will include a basic appraisal of what is generally conceived as “euthanasia, its generally conceived as “euthanasia, its history practice and implications from diverse dimensions such as the medical legal, religions and socio-economic dimensions. This shall be done following the clarifications of relevant terminology to the study. Most importantly, this study shall further examine euthanasia as the “good death” out from the much needed perspective of the African and their cultural backlight.
    The African concept of a “good death” shall be outlined and properly explained thus putting “euthanasia” in a new light. The African concepts of life, death, afterlife and good death shall be adequately explicated to truly present a philosophical appraisal of euthanasia in relation to African culture.
1.6    LIMITATIONS OF STUDY
    In an effort to present this work from being rendered redundant, its limitations are thus outlined. This study shall not include case studies of instances where euthanasia in any of its forms has been practiced also, in this philosophical appraisal of euthanasia, and existing distinctions between euthanasia and physician assisted suicide, shall be diminished “for purposes of understanding the moral vision and values at stake in the euthanasia debate.21
    In highlighting the African account of related issues to a “good death” such as that of life and death, the general beliefs or opinions shared by Africans shall be divulged. Singular African cultures the common and general features reflected by the majority of African cultures shall be outlined.
1.7    METHODOLOGY
    This study, “euthanasia and African culture, a religion philosophical appraisal” shall employ an electric form of methodology that will consist of the methods of conception clarification, historical analysis and critical analysis. The tools of both archival and internet research shall also be applied.
    Conceptual clarification shall be applied in the definition of relevant terms of the study such as that of life, death physician assisted suicide, euthanasia and its various forms as well as strains (eg active voluntary euthanasia, passive voluntary euthanasia, active involuntary euthanasia and passive involuntary euthanasia). The application of history analysis is particularly apt for the presentation of a historical survey of euthanasia, its origin and evolution through the ages.
    Finally, after presentation of facts of African cultural beliefs as relating to the study euthanasia and its major arguments, both for and against its practice, the method of critical analysis will be engaged to examine and evaluate if there exist any contrast between the western and African conceptions of a “good death” (i.e euthanasia) and if the practice of euthanasia can be reconciled with African culture and their traditional beliefs.
1.8    DIVISION OF WORK
    This study entails five chapters within which specific areas have been set to impact certain knowledge. The first chapter naturally is a general introduction inclusive of a statement of problem, clarification of all relevant terminology, scope and limitation of study, aims and objectives of study and the study methodology.
    The chapter two will be presentation of the shared beliefs of Africans on issues of life, death (i.e a good and bad death), afterlife, rites of passage from birth to death etc. All these shall be duly elaborated upon.
    The concept of euthanasia, its historical origin and evolution over the years, its major distinctions and various strains will be delivered into in the third chapter of this study.  
    Chapter four shall mainly be an outline of the euthanasia debate, arguments that have been put forth both in support and against its practice. These arguments are reflections of medical, legal, religious and socio-economic systems of thought.
    The fifth chapter though the final is in no case the lease relevant of the listed chapters. In essence it shall entail an evaluation of the study, recommendations as well as a conclusion of the study.
 ENDNOTES
J.k. Mason, G.T. Laurie and M. Aziz, “Mason and McCall Smiths law and Medical Ethics “Seventh Edition, (New York: Oxford University Press, 2006), p. 598.
A.S. Hornty, “Oxford Advanced Learner’s Dictionary of Current English Sixth Edition, (New York: Oxford University Press, 2002), p. 683.
Ibid, p. 242.
P. De Vries, R. Veatech and L. Newton, “Ethics Applied” (Boston: Pearson Education, 2000), p. 285.
J.B. Nelson and J.S. Rohricth, “Human Medicine Ethical   perspective on today’s medical issues”, (Minneapolis: Augsturg Publishing House, 1984), p.145.
Ibid.
P. De Vries, R. Veatech L. Newton, “Ethics Applied”,   p. 285.