Whose moral significance are you referring to above? The individual doctor's? Medical doctors who would be willing participants likely see euthanasia as essentially a moral or amoral choice. If you're talking about the medical profession as a whole, you can then flip the argument on its head and say that the "inflict no harm" principle is trampled when patients's lives are forcibly prolonged at potentially great agony or pain, physical and/or mental, for that patient.
I guess it would be accurate to say I meant the medical profession as a whole, though the underlying concern is I think a more general one, in that the fact that the person administering the lethal injection would be a doctor isn't per se where the problem lies for me. (For the record, I have similar difficulties arriving at a proper philosophical, 'in principle' stance on capital punishment--despite my rejection of it as practice, since certainty of guilt is often unacceptably lacking--in part because of the necessity for an executioner. But that's a whole other tangent.) I don't know the details of your grandmother's case, but just to be clear, I specified
active euthanasia because I'm
not talking about e.g. taking someone off a respirator whose prognosis is hopeless, who is clearly in the process of dying (let alone brain-dead) such that all you'd be doing otherwise is prolonging suffering in the face of a readily foreseeable outcome. Tony Nicklinson did not have a life-threatening condition...and I feel awful even typing that, because I fully understand he was suffering emotionally, he himself described his life as "pure torture," and believe me I'd be the last person to glibly point to stories of so-and-so who met a comparable fate with inspiring grace and dignity, yadda yadda as the standard one 'ought to' strive for. Nonetheless, it's true that tetraplegia is not a terminal illness, and so a doctor has only the patient's apparent present emotional state to go by in judging whether s/he would in effect merely be facilitating 'death with dignity' by administering a lethal injection. And I get that for many doctors there'd at the very least be powerful emotional incentive to conclude, Yes that's exactly what this is, because I feel the pull of that too, the guilt and the horror of watching someone else suffer. Still I can't quite square that with the fact that you're asking someone else to
kill you, not just to step aside and let fate finish you off rather than wage some hopeless scorched-earth campaign at your expense. To me that's a big difference; I'm troubled by the idea of effectively saying "I agree, better you be dead than live like this, so let me bring that about for you" to someone who isn't already dying, who is confronting not an imminent death but a diminished life. I'm just not certain whether that's ever someone else's place to do, however much it hurts to watch someone suffer. And yes, I realize it isn't always possible to make hard-and-fast pronouncements as to who's in the process of dying and who isn't.
This is one of those topics that I really, strongly believe that people who have not had a close family friend or relative die in prolonged agony will struggle with a lot more than those of us who saw it first hand.
I don't doubt that forever changes the way one looks at it, though my decided impression is that people who
have had such experiences don't at all arrive at the same conclusions about euthanasia. But it's true I haven't (yet, anyway) been through that precisely. I did as you know have the experience of watching my brain-injured mother stumble through the last two years of her life as a mental two-year-old continuously bewildered by and often clearly distressed over what was happening to her, which certainly felt like a sick farce to me, and there's no doubt in my mind the woman who raised me would rather have died than lived that life. But I suppose that has no bearing here, since her inability to meaningfully express herself at the time presumably renders both her feelings and mine morally irrelevant to the present discussion.