In “Elements of a Practical Morality,” John Mackie attempts to “sketch out a general outline of a first order moral system” without appealing to any objective moral claims or in Mackie’s words, “without appeal to any mythical objective values or requirements or obligations or transcendental necessities.” Mackie approaches moral claims from a practical perspective asking the Aristotelian question, “What is the ‘good’ life for man?” Then, he discusses ethical issues and potential resolutions from a practical perspective one issue being and still heavily debated today, the ‘right to life.’ From here I will consider what Mackie has to say on this issue particularly on the right to end one’s life.
Mackie contends “the right to end one’s life…is not absolute,” where “there is no difficulty describing circumstances in which suicide would be permissible.” Further, Mackie believes that it is morally permissible for someone to voluntarily commit suicide by euthanasia. He states, “nor can there be anything morally wrong in assisting a genuinely voluntary suicide.” It seems Mackie’s logic would also allow advance directives (living wills which tell what a medical professional should do in case of certain medical conditions, which discontinue or hinders one’s ability to communicate with that medical professional) with nothing being immoral for a medical professional, lawyers, etc. to assist someone in making a living will (advance directives). His argument may be outlined as follows:
 If I am experiencing pain and suffering it should be stopped.
 Pain and suffering can be eliminated by ending my life.
 Therefore, I should (if I so choose to) end my life.
From a practical perspective this may be valid and many would support such an argument. However, upon further investigationt, one may find it immoral, even from a practical perspective such as Mackie’s, to support voluntary euthanasia and advance directives. It is my objective to elucidate why this may be the case.
If many people (myself included) were experiencing a tremendous amount of pain due to some medical condition, he/she would want to be “taken out of their misery.” This seems logical, however, research on attitudes towards euthanasia among patients with life threatening illnesses tells a different story. Owen et al. found that among cancer patients, the ones with potential curative treatments had the most positive outlook on euthanasia while patients who were in a terminal phase had a negative outlook on euthanasia. That is, cancer patients who potentially may be cured had a stronger interest in euthanasia, while terminal patients were less interested. In regards to advance directives, Danis et al. found that as a surveyed population of volunteers remained in stable health condition, their desire for future medical intervention and treatment remained low (they also had a more positive outlook on euthanasia). However, as some of the participants surveyed had to hospitalized for various reasons, their desire for future medical intervention and treatment increased (and desire for euthanasia decreased). The conclusion reached by Ryan (2000) is, “both studies suggest that having had an episode of serious illness or a deterioration of an existing illness may make people more likely to want more intervention,” and their outlook on euthanasia decreases. As a result the assumption that Mackie may have, that as people become sicker they are more likely to desire euthanasia, is critically challenged.
This may not immediately challenge Mackie’s argument. Mackie might simply respond that just because one may grossly underestimate one’s desire to live, one can still give the medical professional the approval of euthanasia or not. For instance, a person may be in the terminal phase of cancer and still have a desire for euthanasia. Further, even if this person continued to live without any ability to communicate after expressing a desire to be euthanized, Mackie may argue that it is not immoral to euthanize the person due to it being the person’s last wishes where there person understood that death will soon occur anyway. Those particular scenarios may not challenge Mackie’s contention critically, but I’ll elucidate one that can:
Imagine a young man, in his twenties, for some reason or another creates a Living Will. In his Will he explicitly expresses a desire to be euthanized if he is involved in any traumatic injury (or experiences any other serious medical ailment) and has lost the ability to communicate with medical professionals. Soon this young man is involved in a serious car accident and is in a serious state of coma from traumatic injuries. Mackie does bring a similar issue up of whether medical professionals should terminate life support, however this is different from my example as the young man in my example is alive (without the use of machinery) and has lost the ability to communicate with medical professionals. The doctors may find themselves in an uncertain predicament in my example given that the young man has already explicitly stated to be euthanized if he lost the ability to communicate with medical professionals.
If we adopt Mackie’s logic then there is no moral obligation to allow him to live as he expressed an earnest desire to be euthanized if he cannot communicate with medical professionals. Thus, euthanizing him is not only practical but also morally acceptable. Given the research mentioned, which is that people who are relatively healthy and young are more likely to underestimate their desire to live, should euthanizing the young man still be morally acceptable as well as practical? If the answer one gives is yes, I find it unconvincing and potentially dangerous. Why should the research cited not be taken seriously? In fact, it could be argued that euthanizing the young man may be immoral as well as impracticable. Further, the moral imperative to not euthanize the young man would not fall into an objective value, which Mackie may criticize. Rather, not euthanizing the young man may be a practical moral obligation as it takes into account the significant miscalculation of young, healthy peoples’ desire to live.
In conclusion, my argument may not refute Mackie’s, but to some degree, it critically challenges his notion of a practical morality (in regards to euthanasia), where he states, “there [cannot] be anything morally wrong in assisting a genuinely voluntary suicide,” and also, “…there is no difficulty describing circumstances in which suicide would be permissible.” My elucidation of the research cited by Ryan (2000), Owen et. al., and Danis et. al. show that it could be extremely difficult to decide when voluntary suicide would be permissible where even a practical morality such as Mackie’s may not seem so ‘practical.’ Mackie does seem to present a similar issue to mine, but his rests on the notion that medical professionals were deciding whether to terminate life support or not; this, although common in hospitals today, is different from my example, which is also common in hospitals today. Perhaps further consideration on this particular issue would entice Mackie’s supporters to develop a more thorough argument on the practice of euthanasia (understanding that Mackie himself could not do this because he is no longer alive); one, which takes into account, the research cited.
Much of the thoughts in my argument comes from Ryan, C.J (2000). “Betting Your Life: an argument against certain advance directives.” In Journal of Medical Ethics, 1996, 22: 95-9.
Research collected comes from Danis M, Garrett, J, Harris, R, Patrick DL. “Stability of choices about life-sustaining treatments.” Annals of Internal Medicine, 1994, 120: 567-73
Owen C, Tennant C, Levis J, Jones M. Suicide and euthanasia: patient attitudes in the context of cancer. Psycho-Oncology, 1992, 1: 79-80
 It would be worthy to note here that there was a statistically significant difference between the two views (p<0.05).
 There is more research on the matter, however due to length purposes, I will not dwell on any other research.