Euthanasia IV

If we accept that the intentions of a terminal patient in great pain who wants to deliberately shorten their life would not be much different from a patient in a similar position who does not think of or is not in a position to kill themselves (and this is what I posited as a possibility yesterday), what about the care-giver who decides to end the life of such a patient? What would their intentions and thus their vipaka, be? Now the kin of a terminal patient could have plainly negative reasons in wanting such a patient euthanatized – to limit the hospital bills, to end their own grief and distress or perhaps just ‘to get it over and done with.’ But let's say the care-giver has had a long, close and loving relationship with the patient and they have bee been asked by their loved one to end their life. I honestly cannot see how they would have anything but compassion and fellow-feelings for their loved one in agreeing to and carrying out their request. Surely, in acquiescing to their loved one's request they would be doing what the Buddha said we should try to do, putting themselves in the place of the other (attanam upamam katva, Dhp.129), feeling for them, feeling with them, and acting out of compassion. I cannot see in what way this would be, as Archishop Chia called it, ‘false compassion’ other than that it contradicted some dogma. In the past, before the rise of our litigatious society, this is exactly what doctors did. Their years of experience told them when the kindest thing to do was to withhold treatment or even administer a lethal does of medicine. It was not taught, it was never talked about, but it was widely done and it no doubt prevented untold pointless suffering. A doctor's reason for not doing this now is the fear of being sued, hardly a positive or noble reason in allowing a patient to end their days in unendurable pain.
Just to sum up the main points I made or tried to make -
From the perspective of Buddhism, what gives any behavior its ethical quality is primarily the intention (cetana) behind it and also the effect it will have on oneself and the other.
Under most circumstances, killing is morally wrong because it requires strongly negative intentions on the part of the killer and it goes so much against the victim most cherished desires, thus causing great terror, distress, etc. and such suffering is intrinsically evil.
Killing oneself in order to save the lives of others could be motivated by compassion and thus not have negative vipaka.
If killing oneself could be done out of positive intentions it is conceivable that killing another (at their request and to save them from great pain) could be done with the same or similar intentions.
This last point is reinforced by the universalizability principle – applying to others one’s own wishes. I would not like to spend my last days suffering great pain so I will (when requested to do so) relieve the pain of someone in that position.

The theistic faiths’ objection to any type of euthanasia is based on the myth of a life-giving, life-taking deity. Speaking with Buddhists on this issue, it seems that their objections to it (when they do object to it and by no means all do) are derived from the idea that killing is wrong because it is wrong in itself, it is intrinsically wrong. But my understanding is that this is not what the Buddha taught. For example to unintentionally and unknowingly kill something has no kammic consequences (vipaka) because it is not intentional. It is intention that makes an act moral or immoral. It is this point that needs to be kept in mind when thinking about euthanasia. I am undecided on the pros and cons of euthanasia but I do think the issue is much more complex and nuanced that the usual ‘it’s wrong’ stance. What do you think?