Euthanasia has been practiced for centuries but up until now, it remains to be a subject of much controversy. It is probably because it deals with something as important as human life and human rights. Euthanasia has different classifications and depending on how euthanasia is classified also affects how it is viewed. History of euthanasia has indicated that there is a lot of conflict of opinion regarding the subject. On the other hand, some forms of euthanasia may somehow be deemed morally acceptable while some may not. Many arguments have been identified that are for and against euthanasia. It was found those that lobby against euthanasia are mostly religious arguments, and although these religious arguments do not bare much ground because it is not supported by facts, euthanasia should not be legalized because it is prone to abuse even as it is illegal. The research has indicated that much of the arguments for the legalization of euthanasia were disproved by proper palliative care and pain management technology. Suffering is no longer an issue with the pain management technology available today.
The Euthanasia Debate
Euthanasia has been a subject of much debate. People point to different arguments to defend their stand and refute the claims of the opposition. The liberals generally point to the legalization of mercy killing, also known as euthanasia, while the conservatives or the religious indicate that euthanasia should never be allowed because life is sacred or that taking life away is against the will of a supreme being. Up until this point, no one has proven the significance of their claims such that euthanasia remains to be a very controversial topic. Generally, arguments that are used to argue against euthanasia are ethical and/or religious arguments while the arguments that support are practical arguments like the right to die and the quality of life which was coined by the liberals who believe that while people have the right to life, they naturally have the right to die. However, religious arguments bear no ground in this form of debate. Only concrete evidence, a factor which the religious arguments lack, is deemed acceptable. Many are also swayed into the pro-euthanasia lobby because of the argument that it is needed to end the suffering of a terminally ill person. Ultimately, euthanasia is made unnecessary because pain management technology has made all forms of pain almost unfelt.
Types of Euthanasia
The term euthanasia was coined from the Greek words “eu” which means good and “thanatos” which means death. Euthanasia has different classifications depending on how it is performed and how if the person being euthanized has acknowledged the act. It is classified as either active or passive and voluntary or involuntary. Active euthanasia is bringing about the death of a person usually using an overdose of sleeping pills. This form of euthanasia has been subject to a lot of criticisms since it has been equated to murder. The inverse of active euthanasia is passive euthanasia which is simply letting nature take its course as the death is not actively caused. It is simply the withdrawal of treatment so that the patient will die naturally (Pregnant Pause). In passive euthanasia, pain medication is still being given to the person so that he will not have to suffer. However, this has also attracted criticisms since it will cause the death of a person to arrive sooner. Nonetheless, it is less controversial compared to active euthanasia. In some cases, it has been argued that passive euthanasia can be worse than active euthanasia.
Voluntary or involuntary euthanasia is another classification of euthanasia. Voluntary euthanasia is when the person requests or at least acknowledged that he/she will be euthanized. On the other hand, involuntary euthanasia is causing the death of a person without him/her consenting. This is usually done when the patient is in a vegetative state and can no longer respond or decide for himself/herself. Only family members or close relatives can decide when the patient can be euthanized but the patient must be in a state wherein he/she can no longer make an informed decision for this to be possible. Usually, law provides that a court order must be present in performing involuntary euthanasia (Pregnant Pause).
Yet, another form of euthanasia is physician-assisted suicide. This form of euthanasia is different because it does not actively or passively kill a person; it is merely providing the patient with a means of killing himself/herself. For example, a doctor may provide a patient with a lethal dose of medication and tells the patient that the drug will cause him to die slowly. The patient takes the drug and dies after a few minutes. This is physician-assisted suicide (Pregnant Pause).
Euthanasia can also be a mix of two forms such as voluntary passive euthanasia and involuntary active euthanasia. There is not much of a problem with voluntary passive euthanasia since the patient has acknowledged it and the death is not caused actively. On the other hand, in involuntary active euthanasia, the patient does not know or does not allow for euthanasia to be performed and the killing is also active. Voluntary passive euthanasia and involuntary active euthanasia are both extremes, the latter being the more controversial one (Pregnant Pause).
Active versus Passive
Within the euthanasia debate, active and passive euthanasia has also been debated. Passive euthanasia is referred to as the “lesser evil” citing the “moral difference between killing and letting die”. Many people think and believe that the withdrawal of treatment is morally acceptable and many believe that deliberately ending the life of a person is murder and therefore a crime. Others reason out that active euthanasia is better since the patient dies quickly and cleanly which would be less painful for him/her. These arguments are better explained under the Doctrine of Acts and Omissions. (BBC) Simon Blackburn explains that:
The doctrine that it makes an ethical difference whether an agent actively intervenes to bring about a result, or omits to act in circumstances in which it is foreseen that as a result of the omission the same result occurs. Thus suppose I wish you dead, if I act to bring about your death I am a murderer, but if I happily discover you in danger of death, and fail to act to save you, I am not acting, and therefore, according to the doctrine, not a murderer. (BBC)
However, this doctrine is not always reliable, James Rachels argues. He cites the case of the murder in the bath. Smith and Jones are in the same situation. They will both get a large sum of money if their cousin would die. Smith advertently drowned his cousin in the bath tub and made it look like an accident. On the other hand, Jones sees his cousin hit his head while in the bath and just watches as the boy drowns. Technically speaking, Smith is guilty of murder while Jones is not but not all would applaud Jones for what he did much more think that what he did is morally acceptable (BBC).
To look at the issue in another perspective, active euthanasia may be better than passive euthanasia because it may be the lesser evil since passive euthanasia will lead to more suffering for the patient whereas active will end it immediately with minimal suffering (BBC).
History of Euthanasia
The murders perpetrated by the Nazi changed how people view euthanasia. The Nazi used euthanasia as an excuse to murder people. Nazi doctors killed thousands of sick people on the order of the government saying that these people are “useless eaters”. This led to the coining of the “slippery slope” argument that “any action to end a person’s life in any situation might lead to many more deaths”. On the other hand, supporters of euthanasia believe that regulation, legislation, and due process will eliminate the cases wherein it can be abused. A long time ago, several parts of the world has already practiced euthanasia owing to the fact that medical technology then was not as good as today’s. India, Israel, Sparta and Greece have all practiced a form of mercy killing. Obviously, the Jewish Society has always been against a practice such as euthanasia. Pythagoras held the same testaments as well as the Roman people. Judaism, just like Christianity also blatantly opposed the practice of euthanasia (The Life Information Charitable Trust).
Within the 15th century, two people made their mark in the euthanasia debate. Sir Thomas More (1478-1535), a Christian, approved of euthanasia in his book entitled Utopia. He told the terminally ill that they can opt for euthanasia and that it should only be done when the patient has given consent. On the other hand, Francis Bacon (1561-1621), an English philosopher, pointed to life prolongation as the new aim of medical science. He said that doctors should acquire skills so that the ill can pass away easily and quietly. Rather than advocating for euthanasia, he advocates for better palliative care (The Life Information Charitable Trust).
In 1828, the first law in America that outlaws euthanasia and assisted suicide was signed into legislation. Up until the end of the 19th century, euthanasia was generally regarded as a peaceful death and many supported it. Carl Marx, a medical graduate stated that dying is a personal choice and the physicians can judge when there is no hope of cure. He said that “death either occurs as a sudden accident or in stages, with mental incapacity preceding the physical”. In the latter part of the 19th century, Darwin, with his theory of evolution, challenged the existence of a supreme being which affected the euthanasia debate since the arguments against euthanasia were mostly associated with religion. The first popular advocate of active euthanasia also appeared in 19th century. It was Samuel Williams and he lobbied for “medicalized” euthanasia (The Life Information Charitable Trust). He opined:
In all cases it should be the duty of the medical attendant, whenever so desired by the patient, to administer chloroform, or any other such anaesthetics as may by and by supersede chloroform, so as to destroy consciousness at once, and put the sufferer at once to a quick and painless death; precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish beyond any possibility of doubt or question, that the remedy was applied at the express wish of the patient. (The Life Information Charitable Trust)
As time passed, the euthanasia debate grabbed more attention and more scholars have been looking into it. Some countries have totally banned euthanasia while some countries have approved of euthanasia or some forms of euthanasia. On several instances, some doctors abused it and euthanized their patients (The Life Information Charitable Trust).
Much of the opposition in the euthanasia debate makes use of religious arguments but ethical and practical arguments also exist. However, even as religion is a major argument against euthanasia, there is significant difference among religious stands on the anti-legalization lobby. A great difference in rates of liberalization has also been observed especially on the side of the conservative Protestants (Moulton, Hill & Burdette, p.249).
However, even as these arguments compose of much of the anti-euthanasia movement, they bear no ground as people have different religions while some do not even abide by a religion. The only credible arguments are ones that are supported by factual data and not what is said on some religious scripture. Religious arguments mostly say that euthanasia is against the will of god, it gives humans the right to play god, or it weakens the sanctity of life. Some may say that suffering has its value because it is the will of a supreme being. Also, it is argued that voluntary euthanasia may eventually lead to the slippery slope (BBC).
Arguments based on ethical and moral principles are more credible compared to religious arguments. These arguments are mostly based on a perception of right and wrong and because of this, people may still present varying opinions but common ethical arguments are that life is too sacred to be thrown away whereas other people believe that it is ethical to let a person die when that person wants to die (BBC).
Cases of Abuse
Several incidents of abuse have already happened even as euthanasia remains illegal in most parts of the world. Dr. Jack Kevorkian is one doctor who has performed active euthanasia on his patients. He has helped a total of more than 100 people commit suicide which earned him the title of “Dr. Death”. He even created a machine that would help people commit suicide. The person need only push a button and a lethal dose of medication will be administered to him leading to a quick and painless death (Hassan). Later, Kevorkian was sentenced to 10 to 25 years in prison after he was found guilty of second degree murder. Kevorkian euthanized his 52-year old patient Thomas Youk while recording it on video. Additionally, he was sentenced for 3 to 7 years in prison for administering a controlled substance (CNN).
During World War II, the Nazis also abused euthanasia and over 100,000 people were killed. Another incident in 1990 at a Dutch Hospital resulted in the death of a lot of people; 22,500 were killed through the withdrawal of life support, 14,175 were denied medical treatment without proper consensus, and 1,701 were euthanized without consent even as they were still mentally competent. This particular incident resulted in the defeat of the euthanasia legalization lobby in the United States (Hassan).
In another case, Ellen Haug euthanized her own mother by giving her an overdose of sleeping pills ending her mother’s misery because of an illness. She defended herself by saying that she would not know what would happen to her mother if something happened to her. Her reasoning was considered vain and selfish (Hassan).
Much of the pro-euthanasia lobby is focused on the argument that euthanasia is a choice and that it is necessary so that the suffering of a person who is terminally ill may be ended. However, the suffering argument may no longer be valid because of proper palliative care. Proper palliative care with good pain management makes physical pain unfelt. In fact, there is are a lot of painkillers available on the market and depending on the level and the cause of the pain, different painkillers are prescribed. Aspirin and acetaminophen are used for mid pains as well as indomethacin, ibuprofen, naproxen and sulindac. A stronger pain-reliever is codeine but doctors rarely prescribe this because it has an opiate derivative. For intense pains that could not be handled by mild analgesics, doctors can always prescribe morphine (Connoly, p.502).
However, pain management can only take care of the physical pain; other forms of pain such as emotional, social and spiritual pain are to be addressed separately (Connoly, p500-501). Family members and relatives must always be there to support the patient to ease these kinds of pain. If the person is religious, it would help that a pastor or religious leader talks with him/her.
Without pain management, the terminally ill will suffer greatly. In humanitarian terms, anyone who is ill and is in need of pain management should receive it but there are certain barriers that need to be overcome. Receiving pain management is related to the health care issue as many people do not have the capacity to pay for medical attention and the price of receiving health care has increased exponentially. This problem can be cushioned by more donations from the private sector and fund-raising movements to help the terminally ill (Connoly, p.507). In the long run, the government must address this problem and provide every citizen with the basic medical attention that he/she deserves.
Euthanasia has been under a lot of fire. It has existed and has been practiced for a long time but people remain divided on the issue. Arguments against euthanasia rely on religion and ethics while arguments for euthanasia may be practical or ethical arguments. Religious arguments are however not reliable and much of the arguments that argue for the legalization of euthanasia have been made irrelevant by pain management technology. The strongest argument which is the prevention of the suffering of the terminally ill is no longer valid with proper palliative care. Additionally, euthanasia should not be legalized because it is prone to abuse especially if the death of a person will have extreme financial consequences. It has been abused in the past even as it is illegal. It will be abused more if it is legalized since there is no clear way of how it will be regulated.
British Broadcasting Corporation. “Active and Passive Euthanasia”. 8 February 2005. Accessed November 12, 2008, from http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_print.html
British Broadcasting Corporation. “Arguments Against Euthanasia”. 8 February 2005. Accessed November 12, 2008, from http://www.bbc.co.uk/ethics/euthanasia/against/against_print.html
Cable News Network. “Kevorkian gets 10 to 25 years in prison”. 13 April 1999. Accessed November 13, 2008, from http://www.cnn.com/US/9904/13/kevorkian.03/
Connolly, Matthew E. “Alternative to Euthanasia: Pain Management”. Issues in Law and Medicine 4 (4). (1989):500-507.
Hassan, Mahjabeen. “Euthanasia: Should humans be given the right to play God?”. 4 January 2008. Accessed November 13, 2008, from http://serendip.brynmawr.edu/exchange/node/1715
Moulton, Benjamin E., Hill, Terrence D., & Burdette, Amy. “Religion and Trends in Attitudes among US Adults, 1977-2004”. Sociological Forum 21 (2). (2006):249
Pregnant Pause. “Types of euthanasia”. 20 November 2001. Accessed November 12, 2008, from http://www.pregnantpause.org/euth/types.htm
The Life Information Charitable Trust. “General History of Euthanasia”. 2007. Accessed November 12, 2008, from http://www.euthanasia.org.nz/about-euthanasia/history-global/1/