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Euthanasia and assisted dying: the illusion of autonomy—an essay by Ole Hartling

Read our coverage of the assisted dying debate.

• Related content
• Peer review
• Ole Hartling , former chairman
• Danish Council of Ethics, Denmark
• hartling{at}dadlnet.dk

As a medical doctor I have, with some worry, followed the assisted dying debate that regularly hits headlines in many parts of the world. The main arguments for legalisation are respecting self-determination and alleviating suffering. Since those arguments appear self-evident, my book Euthanasia and the Ethics of a Doctor’s Decisions—An Argument Against Assisted Dying 1 aimed to contribute to the international debate on this matter.

I found it worthwhile to look into the arguments for legalisation more closely, with the hope of sowing a little doubt in the minds of those who exhibit absolute certainty in the matter. This essay focuses on one point: the concept of “autonomy.”

(While there are several definitions of voluntary, involuntary, and non-voluntary euthanasia as well as assisted dying, assisted suicide, and physician assisted suicide, for the purposes of brevity in this essay, I use “assisted dying” throughout.)

Currently, in richer countries, arguments for legalising assisted dying frequently refer to the right to self-determination—or autonomy and free will. Our ability to self-determine seems to be unlimited and our right to it inviolable. The public’s response to opinion poll questions on voluntary euthanasia show that people can scarcely imagine not being able to make up their own minds, nor can they imagine not having the choice. Moreover, a healthy person answering a poll may have difficulty imagining being in a predicament where they simply would not wish to be given the choice.

I question whether self-determination is genuinely possible when choosing your own death. In my book, I explain that the choice will always be made in the context of a non-autonomous assessment of your quality of life—that is, an assessment outside your control. 1

All essential decisions that we make are made in relation to other people. Our decisions are affected by other people, and …

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The Ethics of Euthanasia

Malleeka Suy | SQ Blogger | SQ Online (2021-2022)

Picture t his: It is the year 3020, and the Martian soil you have been drilling into has finally worked out. Colonizing Mars is taking shape, and soon your family can permanently live on this rusty, rocky planet. However, the effects of progress don’t go unnoticed; every time you move, your skin screams in pain. Everything you once loved doing has lost its appeal. Would you take death in your own hands or live until a painful end?

This moral dilemma seems straight out of a science-fiction novel for most, but euthanasia is a legitimate deliberation for patients with terminal and mental illnesses who deem their lives too painful to live on. It is a practice that is still heavily debated in modern bioethics. Among many definitions, the American Medical Association defines euthanasia as the administration of a lethal agent by a medical professional to a patient to relieve their intolerable or incurable suffering.

Although euthanasia is not a new scientific process, as it has been practiced since the time of the ancient Greeks more than three thousand years ago, it wasn’t generally accepted by Western medicine until recently. The Netherlands was the first country to allow legal euthanasia and assisted suicide in 2002, totaling 1.7-2.8% of total deaths. Euthanasia is generally illegal in the United States, but in a nationwide 2017 American poll , 73% of the public were in favor of euthanasia, and 57% said euthanasia is morally acceptable. These numbers are nearly double the initial poll in 1947. If I had to guess why, it may be partly because of progressive exposure to mental health and its effects. This may have allowed people to understand and empathize with the circumstances and support what euthanasia stands for: a release from an unbearable life.

Euthanasia is especially controversial among general society and the bioethical community. One main argument for the support of euthanasia is grounded in personal autonomy–our ability to act independently– since living life is about minimizing physical pain and maximizing dignity and control . This idea is rooted in ancient times when physicians considered dying with peace and dignity a human right. An article from Stanford’s Encyclopedia of Philosophy regards autonomy as self-determination, so choices about how and when people die is them taking responsibility for their lives. Terminally ill patients in Oregon mentioned how they chose euthanasia because their condition stripped them of their independence and ability to engage in activities that gave their life meaning. After all, what is the meaning of life if we cannot live it?

Another article by the Linacre Quarterly highlights how the ethics of compassion justify the use of euthanasia. From a humanitarian standpoint, we can show compassion by suffering and sympathizing with patients and respecting their wishes of euthanasia as their “remedy.” Kenneth L. Vaux, a consultant in medical ethics, notes in his article that physicians would give a lethal dose to their loved ones out of love if they were dying and suffering, so he finds it “strange and hypocritical” that doctors cannot legally do so for their patients. He claims that “we have lost empathy, sympathy, and the covenant of care with those who have entrusted their lives to us because they believe we embody those very qualities.” Vaux also asks: “Having barred the door to Death, are we not then obliged at some point to open it?” He suggests that since doctors bring life into the world every day, consensually ending a patient’s life for their benefit should be no different.

Despite popular social support, there are many arguments against euthanasia as well–the most popular being religion. Several faiths, such as Christianity, see euthanasia as a form of murder and find it to be morally unacceptable because it may weaken society’s respect for the sanctity of life. Religious groups actively argue against euthanasia, and for this reason, euthanasia became a debate of preservation and purity of life.

Even though medicine is rooted in science, some physicians also use religion as justification against practicing euthanasia. Contrary to public British opinion, studies show that most UK doctors do not support legislation permitting euthanasia due to their religiosity or faith, and less than a quarter of doctors would be willing to practice euthanasia if it became legal.

Physicians also have a professional obligation to fulfill that becomes morally blurred with euthanasia. For more than 2,500 years, doctors have taken the Hippocratic Oath to do no harm and treat those under their care. Does bringing death by euthanasia violate the Hippocratic Oath, or is it in line with a doctor’s mission? Would acting under Hippocrates then make a doctor a hypocrite?

Because of this subjectivity, doctors sometimes feel uncertain about administering euthanasia. Even if a patient is under a lot of pain and medication, how can doctors be sure that their decision was made rationally? In a Dutch article , an experienced psychiatrist dealing with a patient’s invisible suffering made him uncertain about assessing how deeply rooted their suffering really was, and therefore how moral it would be to allow euthanasia to happen. The fickle nature of the human mind makes many physicians and ethicists question whether or not euthanasia should be a normal practice.

Physicians often have their own reservations about euthanasia and how they cope with patients who wish for it. They frequently feel pressured by the patient or the patient’s relatives to perform euthanasia. A 2011 survey among Dutch physicians also found that 86% of physicians dread the emotional burden of performing euthanasia. One physician recounts how a patient told them, “If you won’t perform euthanasia, I might go to a railway line or climb a high building.” This form of blackmail can lead to dangerous expectations, where future normativity of the practice is anticipated or even praised.

Instead of placing the burden on doctors, what if the government or even robots could control euthanasia? Although this faceless jurisdiction seems like a good solution, critics argue that euthanasia would be normalized and twisted for eugenic purposes, adding to the nightmare of AI domination and impeding the sanctity and preciousness of life. These speculations seem inconceivable, but history has unfortunately seen it happen, such as in Hitler’s Germany, where Aktion T4, a Euthanasia Program systematically murdered patients with disabilities to restore the “integrity” of the German nation, thrived. Perhaps then a grimmer alternative to the use of euthanasia is the elimination of incurable, disabled, or elderly patients. Mechanization of euthanasia would also impact the patient and the medical profession, both in what it means to be human and obeying the Hippocratic Oath. Routinization of the practice could also increase the desires of people’s wishes to end their lives, whether individually justified or not.

References:

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• Open access
• Published: 15 January 2014

Should assisted dying be legalised?

• Thomas D G Frost 1 ,
• Devan Sinha 2 &
• Barnabas J Gilbert 3  

Philosophy, Ethics, and Humanities in Medicine volume  9 , Article number:  3 ( 2014 ) Cite this article

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When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.

Introduction

Over the past two centuries, the United Kingdom has experienced rapid population growth associated with a substantial decline in mortality from acute infectious diseases and poor nutrition [ 1 ]. As the average life expectancy has increased, so too have the rates of debilitating chronic illness – particularly coronary artery disease and cancers [ 2 ]. These diseases require years of treatment instead of the mere days to weeks that medicine once operated within [ 2 ]. Although healthcare systems have sought to adapt to such changes, aiming to prevent and treat such disease wherever possible, debate has arisen regarding those patients in the latter stages of chronic, incurable, terminal conditions [ 3 , 4 ]. Moreover, there is increasing recognition that the patient must be at the centre of health care decision-making, such that outcomes must be tailored to their individual needs and views. By extension, assisted dying might seem a logical step to help achieve these goals within the realm of end-of-life decision making [ 5 ]. Several jurisdictions, notably Oregon (1997) and the Netherlands (2001) have already legalised assisted dying in some form. These factors have contributed to ongoing legislative discussions within Parliaments for almost a decade, with current opinion polling suggesting a majority of medical practitioners and the public in favour of physician-assisted suicide [ 6 ].

Viability of assisted dying in practice

In the UK, a model for assisted dying has been developed from the legal structure found within the Assisted Dying Bill introduced by Lord Falconer in the House of Lords in 2013 [ 7 ]. Assisted dying could only be considered under circumstances in which a patient of legal age is diagnosed with a progressive disease that is irreversible by treatment and is “reasonably expected to die within six months” [ 7 ]. Registered medical practitioners would make such decisions for patients with terminal illnesses. Addressing the technicalities of ‘assisted dying’ requires distinction between ‘physician-assisted suicide’ (offering patients medical actions or cessation of actions by which they can end their own life) and ‘euthanasia’ (whereby the medical practitioner actively induces death). In light of the strong hostility of the medical profession towards active euthanasia, this proposed model, as with previous attempts to legalise assisted dying, permitted only the former [ 8 – 10 ].

However, there is concern that such distinction may be unrealistic in practice because medical practitioners could find themselves with a patient who had failed to successfully end their own life and was subsequently left in a state of greater suffering. Were such a patient no longer able to give consent, a heavy burden would then be placed on the physician regarding how to proceed. Moreover, the practice of physician-assisted suicide might be deemed discriminatory, for example by giving only patients with good mobility control over their own method of death.

The Assisted Dying Bill 2013 included the provision that any terminal prognosis must be confirmed and attested by a second registered practitioner. The strictness of such criteria has parallels to a similar double-physician requirement when procuring a legal abortion under the 1967 Abortion Act. The stated aims of the provision in both cases are as follows: first, to check the accuracy of the prognosis upon which the decision was being made; second, to ensure that the situation meets the required criteria; and third, to check that such a decision was taken by the patient after full consideration of all available options [ 11 , 12 ]. By having a second independent doctor, the legislation ensures that all three checks are met without prejudice or mistake.

Problematic for any protocol for assisted dying is the fact that estimates of life expectancy in terminal prognoses are erroneous in 80.3% of cases [ 13 ]. Furthermore, the accuracy of such prognoses deteriorates with increased length of clinical predicted survival. Forecasts of survival times are based largely on past clinical experience, and the inherent variability between patients makes this more of an art than a science. This brings to concern both the accuracy of any prognosis meeting the six-month threshold and the validity of requests for assisted dying based partly or wholly on predicted survival times. Whilst the majority of errors in life expectancy forecasts are a matter of over-optimism and hence would not affect either of those two concerns, many cases remain unaccounted for. Overly pessimistic forecasts occur in 17.3% of prognoses; hence we must decide whether the one in six patients making a decision based on an inaccurate prognosis is too high a cost to justify the use of this system. Patients requesting an assisted death often cite future expectations of dependency, loss of dignity, or pain [ 14 ]. If the hypothetical point at which the progression of their illness means they would consider life to be not worth living is not, as informed, mere weeks away but in fact many more months, then this information would have resulted in a different decision outcome and potentiated unnecessary loss of life.

Whilst the presence of a second doctor would be expected to mitigate such forecasting errors, the anchoring bias of the initial prediction may be enough to similarly reduce the accuracy of the second estimate. It is prudent to question the true independence of a second medical practitioner, and whether this second consultation could become more of a formality, as has now become the case with abortion [ 15 ].

Another challenge for an assisted dying system would be to recognise whether patients requesting death were legally competent to make that decision. Consider that any request for suicide from a patient with clinical depression is generally categorised as a manifestation of that mental disorder, thereby lacking capacity. It is arguably impossible to separate out the natural reactions to terminal illness and clinical depression. Indeed, there is evidence that major depressive disorders afflict between 25% and 77% of patients with terminal illness [ 16 , 17 ]. Any protocol for assisted dying must first determine what qualifies as a ‘fit mental state’ for a terminal patient.

The need for assisted dying

It could be argued that a doctor’s fundamental duty is to alleviate forms of suffering in the best interests of the patient. The avoidance of physical pain, as an obvious manifestation of suffering, might explain why assisted dying would be both necessary and within the duties of a doctor to provide. The evolving principle in common law known as the ‘Doctrine of Double Effect’ offers a solution to this problem [ 18 ]. This legal judgement stated that “[a doctor] is entitled to do all that is proper and necessary to relieve pain even if the measures he takes may incidentally shorten life”. This entails that a protocol already exists for patients searching for an escape from chronic pain. Furthermore, numerous retrospective studies have revealed very little correlation between opioid dose and mean survival times: one study of over 700 opioid-treated patients found that the variation in survival time from high-dose opioid treatment is less than 10% [ 19 – 21 ]. It can therefore be said that pain alone, if appropriately managed, should never be cause for considering assisted dying as an alternative.

By contrast, the ‘Doctrine of Double Effect’ might be seen as a subjective interpretation that has been applied unequally due to a lack of specialist training or knowledge [ 22 ]. Despite this, the principle can be easily understood and poor awareness can be remedied by improvements in medical education and standardisation of protocols. Moreover, should we choose to accept arguments for assisted dying that are based upon inadequate administration of pain medication, we set a precedent for conceding shortcomings in palliative care and other end-of-life treatments. Offering hastened death could become an alternative to actively seeking to improve such failings.

Whilst much has been made of the ‘pain argument’ here, the call for assisted dying is rarely this simple. Many patients also suffer a loss of dignity, often due to their lack of mobility – the inability to relieve oneself without help is a potent example. Beyond this are additional fears of further debilitation and the emotional costs of dealing with chronic illness, both for the patient and for their relatives and friends. A study of terminal patients in Oregon showed that these were the most significant reasons behind requests for assisted suicide, the next commonest reason being the perception of themselves as a ‘burden’ [ 14 ]. Clearly, we could seek to provide balanced, compassionate medical care for these patients, and still fail to address these points.

Developments in healthcare and technology may reduce this emotional burden, but remain an imperfect solution.

Rights of patients and limitations of their autonomy

J.S. Mill’s pithy dictum describes autonomy as follows: “over himself, over his own body and mind, the individual is sovereign” [ 23 ]. Not only has the sanctity of bodily autonomy profoundly influenced the development of liberal democracies, it has also provoked a holistic shift in making our healthcare systems more patient-centred – “care that meets and responds to patients’ wants, needs and preferences and where patients are autonomous and able to decide for themselves” [ 5 ]. The ethical principle of controlling the fate of one’s own body is inherently relevant to the debate on assisted dying. It is difficult to reconcile that citizens may have the right to do almost anything to and with their own bodies– from participating in extreme sports to having elective plastic surgery – yet a terminal patient cannot choose to avoid experiencing additional months of discomfort or loss of dignity in their final months of life.

Expectation of individual liberty has been codified in law. The right to bodily autonomy has been interpreted to be included under Article 8 - the right to privacy - of the European Convention on Human Rights (ECHR) and subsequently the Human Rights Act (HRA) [ 24 , 25 ]. Moreover, the ECHR underpins the right of individuals to ‘inherent dignity’ [ 26 ]. Hence, if an individual feels that dignity is unattainable due to the progression of a terminal illness, then taking recourse though assisted dying ought to be a legitimate option.

Conversely, there are two notable oversights in this interpretation of a right to assisted dying as an extension of the principles of bodily autonomy:

First, it would be wrong to view individual liberty as absolute. The HRA allows for exceptions to Article 8 on grounds of ‘health or morals’ [ 25 ]. The principle of autonomy is not inviolable. Governments have limited such privileges for the protection of individuals and society, for example by criminalizing the use of recreational drugs or the selling of one’s own organs. The preservation of life by denying assisted dying could fall within this category.

Second, the right of autonomy is not necessarily intrinsic to human beings but, as Kant argued, is dependent on our ‘rational nature’ [ 27 ]. This concept sees autonomy as an exercise of ‘evaluative choice’ [ 27 ], requiring rationality on the part of individuals to appreciate the nature of options and their consequences. To achieve true autonomy, there must be sufficient information to make those rational decisions; this is the basis of informed consent and why it is a fundamental duty of a doctor to offer a patient an informed series of treatment options [ 28 ]. The logistical issue is that doctors are unable to advise patients regarding the point at which their situation becomes less preferable to being dead. No doctor (or individual) has any knowledge or experience of what ‘death’ may be like. Hence, in this case, the idea of exercising true autonomy through informed consent might be considered meaningless.

Legalising assisted dying by attempting to establish an absolute right to bodily autonomy may undermine other individual and group rights. Vulnerable patients may feel pressured into assisted dying because of social, emotional, or financial strains placed on family and/or friends. This is exemplified by the trend showing that the proportion of patients stating ‘relief of burden’ on others as the reason for requesting assisted dying has risen from 17% to 25% in Oregon since legalisation [ 29 ]. One could even consider the risk of assisted dying becoming an expected choice rather than a free one. Thus, assisted dying may erode the elemental right to life of terminal patients as the value of their life becomes tied to relative costs to society and to those around them.

Moreover, by creating one class of individuals for whom life is expendable, that particular view may be extended by society to all groups possessing such attributes (e.g. the permanently disabled). There would be a definite risk to the rights of these vulnerable groups in the form of society being less willing to provide for their health and social care.

It is often raised that the limited legalisation of assisted dying would inevitably become extended in scope, but this is not necessarily a flaw. Even if the right to determine the manner of death were later extended to a wider group of people, posterity may reflect positively on such a change, just as extending the franchise to women ultimately led to legislation demanding equal pay.

Effect on health professionals and their role

‘To act in the best interest of the patient’ is often cited as a central duty of the doctor [ 28 ]. This concept of ‘best interest’ guiding the doctor’s action has seen the development of two important ethical principles: beneficence and non-maleficence. Beneficence mandates that the actions of the doctor must be aimed to bring about benefit (clinical improvement) for the patient, usually measured in terms of reduced morbidity or mortality; non-maleficence requires that the doctor not carry out treatment that is likely to cause overall harm the patient [ 30 ]. These traditional ethical imperatives on a doctor both conflict with intentionally hastening the death of a patient, and a resolution of this tension would require redefining what constitutes ‘acting in the best interest’.

A further dimension is the potential reluctance of health professionals to engage in a practice that contravenes their own ethical beliefs, particularly as this would affect doctors who never entered training in the knowledge that assisting patients to die would be an expected duty. This is certainly no argument against the introduction of assisted dying; indeed, a recent survey of a cohort of NHS doctors found that 46% would seriously consider requests from patients to undertake steps to hasten death [ 31 ]. It merely expresses the point that any early model would have to account for the fact that an initial 54% of the doctors in the NHS would be required to advise qualifying patients of assisted dying as a legitimate option, despite disagreeing with it in principle.

Furthermore, doctors who agree ethically with this practice may find themselves facing conflicts of interest. It is expensive to treat chronically ill patients, particularly in the final months of life [ 32 ]. Moreover, it would be difficult for commissioners to ignore the fact that the sustained treatment of one individual could deprive many others from access to surgery or access to novel drugs. Such an argument does not suggest that doctors or any other hospital staff would treat this practice without appropriate respect or care; rather it acknowledges the need for appropriate rationing of care and questions the intentions of service providers. The perception of an ulterior motive could negatively impact patient trust. One survey showed that a reasonable minority of patients (27%) – and particularly particularly the elderly – believe that legalising assisted dying would lessen their trust in their personal physician [ 33 ]. The costs of weakened trust in the doctor-patient relationship could far outweigh the benefits of assisted dying, particularly given the importance of trust when treating a chronic patient for an extended period of time.

There is no doubt that assisted dying would empower some patients to maximise control over the timing and manner of their own death. Such expression of autonomy would surely solidify moves towards a patient-centred approach to healthcare. However, the capacity for such consensual requests remains in doubt. Clinically, the patient’s state of mind and the reliability of diagnostic predictions are of issue; philosophically, the idea of informed consent for death is contradictory. The implications for patients, physicians and society have been weighed extensively within this article. The central tenet throughout has been the balancing of an individual’s right to escape a circumstance that they find intolerable, alongside the consequential changes to their other rights, and the rights and responsibilities of third parties. Ultimately, the challenge is for us as a society to decide where this balance lies.

About the debate

The Varsity Medical Debate was started in 2008 with the aim of allowing students, professors and members of the polis, to engage in discussion about ethics and policy within healthcare. Utilising the age-old rivalry between the two Universities, the debate encourages medical students from both Oxford and Cambridge to consider and articulate the arguments behind topics that will feature heavily in their future careers.

The debate was judged on the logic, coherence, and evidence in arguments, as well as flair in presentation. Although the debaters may not have necessarily agreed with their allocated side, the debate format required them to acknowledge a particular school of thought and present the key arguments behind it. Oxford, who opposed the motion, was awarded the victory in the debate; however, this does not mean that the judges believe that position ought to become public policy.

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Acknowledgements

For Cambridge University: Hilmi Bayri (Trinity), Alistair Bolger (Jesus), Casey Swerner (St Johns).

For Oxford University: Devan Sinha (Brasenose), Thomas Frost (Lincoln), Collis Tahzib (Lincoln).

Martin Farrell (Cambridge).

Baroness Finlay: Professor of Palliative Care Medicine and former President of the Royal Society of Medicine.

Dr. Roger Armour: Vascular Surgeon and Inventor of the Lens Free Ophthalmoscope.

Mr. Robert Preston: Director of Living and Dying Well.

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Thomas D G Frost

Brasenose College, Oxford, OX1 4AJ, UK

Devan Sinha

Green Templeton College, Woodstock Road, Oxford, OX2 6HG, UK

Barnabas J Gilbert

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Frost, T.D.G., Sinha, D. & Gilbert, B.J. Should assisted dying be legalised?. Philos Ethics Humanit Med 9 , 3 (2014). https://doi.org/10.1186/1747-5341-9-3

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Voluntary Euthanasia

The entry sets out five conditions often said to be necessary for anyone to be a candidate for legalized voluntary euthanasia (and, with appropriate qualifications, physician-assisted suicide), outlines the moral case advanced by those in favor of legalizing voluntary euthanasia, and discusses the five most important objections made by those who deny that voluntary euthanasia is morally permissible and who are, in consequence, opposed to its being legalized.

1. Introduction

2. five conditions often proposed as necessary for candidacy for voluntary euthanasia, 3. a moral case for voluntary euthanasia, 4. five objections to the moral permissibility of voluntary euthanasia, other internet resources, related entries.

When a person performs an act of euthanasia, she brings about the death of another person because she believes the latter’s present existence is so bad that he would be better off dead, or believes that unless she intervenes and ends his life, his life will very soon become so bad that he would be better off dead. Accordingly, the motive of the person who performs an act of euthanasia is to benefit the one whose death is brought about. (This also holds for many instances of physician-assisted suicide, but use of the latter term is usually restricted to forms of assistance which stop short of the physician ‘bringing about the death’ of the patient, for example, those involving means that have to be activated by the patient.)

It is important to emphasize the motive of benefiting the person who is assisted to die because well-being is a key value in relation to the morality of euthanasia (see Section 3 below). Nonetheless, the defensibility of the contention that someone can be better off dead has been the subject of extensive philosophical deliberation. Those who claim that a person can be better off dead believe this to be true when the life that remains in prospect for that person has no positive value for her (a possibility which is discussed by e.g., Foot, 1977; McMahan 2002; Bradley 2009), whereas some of those who hold that a person’s life is inviolable deny that a person can ever be better off dead (e.g., Keown in Jackson and Keown 2012). A Kant-inspired variant on this latter position has been advanced by Velleman (1999). He considers that a person’s well-being can only matter if she is of intrinsic value and so that it is impermissible to violate a person’s rational nature (the source of her intrinsic value) for the sake of her well-being. Accordingly, he holds that it is impermissible to assist someone to die who judges that she would be better off dead and competently requests assistance with dying. The only exception is when a person’s life is so degraded as to call into question her rational nature, albeit he thinks it unlikely that anyone in that position will remain competent to request assistance with dying. This position appears to be at odds with the well-established right of a competent patient to refuse life-prolonging medical treatment, at least when further treatment is refused because she considers that her life no longer has value for her and further treatment will not restore its value to her. (For further reasons to reject arguments for the inviolability of the life of a person, including Velleman’s, see e.g., McMahan 2002; Young 2007; Sumner 2011, 2017.)

Because our concern will be with voluntary euthanasia – that is, with those instances of euthanasia in which a clearly competent person makes a voluntary and enduring request to be helped to die (or, by extension, when an authorised proxy makes a substituted judgment by choosing in the manner the no-longer-competent person would have chosen had he remained competent) – a second key value is the competence of the person requesting assistance with dying. There will be occasion to mention non-voluntary euthanasia – instances of euthanasia where a person lacks the competence at the time when a decision is to be made to request euthanasia and has not previously competently declared a preference for it via an advance directive (see the entry on advance directives ) – only when consideration is given to the claim that permitting voluntary euthanasia will lead via a slippery slope to permitting non-voluntary euthanasia. Nothing will be said here about involuntary euthanasia , where a competent person’s life is brought to an end despite an explicit expression of opposition to euthanasia, beyond saying that, no matter how honorable the perpetrator’s motive, such a death is, and ought to be, unlawful.

Debate about the morality and legality of voluntary euthanasia has been, for the most part, a phenomenon of the second half of the twentieth century and the beginning of the twenty first century. Certainly, the ancient Greeks and Romans did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide when no relief could be offered to a dying person or, in the case of the Stoics and Epicureans, when a person no longer cared for his life. In the sixteenth century, Thomas More, in describing a utopian community, envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of ‘torturing and lingering pain’. But it has only been in the last hundred years that there have been concerted efforts to make legal provision for voluntary euthanasia. Until quite recently there had been no success in obtaining such legal provision (though assisted suicide, including, but not limited to, physician-assisted suicide, has been legally tolerated in Switzerland for a number of decades). However, the outlook changed dramatically in the 1970s and 80s because of a series of court cases in the Netherlands which culminated in an agreement between the legal and medical authorities to ensure that no physician would be prosecuted for assisting a patient to die as long as certain guidelines were strictly adhered to (see Griffiths, et al., 1998). In brief, the guidelines were established to permit physicians to practise voluntary euthanasia in those instances in which a competent patient had made a voluntary and informed request to be helped to die, the patient’s suffering was unbearable, there was no way of making that suffering bearable that was acceptable to the patient, and the physician’s judgements as to diagnosis and prognosis were confirmed after consultation with another physician.

The first legislative approval for voluntary euthanasia was achieved with the passage in the parliament of Australia’s Northern Territory of a bill enabling physicians to practise voluntary euthanasia. Subsequent to the Act’s proclamation in 1996, it faced a series of legal challenges from opponents of voluntary euthanasia. In 1997 the challenges culminated in the Australian National Parliament overturning the legislation when it prohibited Australian territories from enacting legislation to permit voluntary euthanasia on constitutional grounds. Australia is a federation consisting of six states and two territories. Unlike the territories, the states do have the constitutional right to enact such legislation and in 2017 the state of Victoria did just that. The legislation came into effect in 2019. In 2019, a second state, Western Australia, enacted legislation to enable voluntary medically assisted death. The legislation became effective in 2021. In 2021 three further states, Tasmania, South Australia and Queensland enacted legislation to enable voluntary medically assisted death which came into force in 2022 for the first two, and 2023 for the third. Finally, in 2022 NSW enacted legislation which came into force in 2023 resulting in voluntary medically assisted death being available in each of the states. Attempts are currently being made in both the Australian Capital Territory and the Northern Territory to introduce legislation in favor of voluntary medically assisted death that will avoid being vetoed by the federal parliament.

In November 2000, the Netherlands passed legislation to legalize the practice of voluntary euthanasia. The legislation passed through all the parliamentary stages early in 2001. The Belgian parliament passed similar legislation in 2002 and Luxembourg followed suit in 2009. (For a very helpful comparative study of relevant legislation see Lewis 2007. See also Griffiths, et al. 2008.)

In Oregon in the United States, legislation was introduced in 1997 to permit physician-assisted suicide after a referendum strongly endorsed the proposed legislation. Later in 1997 the Supreme Court of the United States ruled that there is no constitutional right to physician-assisted suicide; however, the Court did not preclude individual states from legislating in favor of physician-assisted suicide (so the Oregon legislation was unaffected). Since that time the Oregon legislation has been successfully utilised by a significant number of people and similar legislation has been passed in the state of Washington in 2009, in Vermont in 2013, and more recently still in California, Colorado, Florida, Hawaii, Iowa, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico and the District of Columbia. A series of judicial decisions in the state of Montana in 2008 and 2009 established that the state could not prohibit physician-assisted suicide but legislation has not yet been introduced to codify the legal situation. A number of the remaining states are currently considering physician-assisted suicide bills.

A similar legal position to that in Montana obtained in the nation of Colombia from the late 1990s as a result of a majority ruling by its Constitutional Court in favor of the legality of physician-assisted suicide but legislative provision was finally made only quite recently. In 2021, Spain legalized voluntary euthanasia. In Austria and Germany courts have authorised physician-assisted suicide but no legislative backing for the practice has been introduced, while in Italy legislation for voluntary medically assisted death has been passed in one house of the bicameral parliament. In Portugal legislation for physician-assisted suicide was passed but was subsequently rejected by the Constitutional Court.

In Canada, the province of Quebec introduced legislation permitting medical aid in dying in 2014. The legislation came into effect in 2016 at around the same time that the Canadian National Parliament passed legislation permitting both physician-assisted suicide and voluntary euthanasia throughout all of the Canadian federation. (For a brief account of events leading up to the enactment of the various pieces of legislation in Canada see Downie and Schuklenk 2021.)

New Zealand held a referendum in 2019 which resulted in approval for the introduction of legislation for voluntary medically assisted death. The legislation came into effect late in 2021.

In the following countries legislative proposals for voluntary medically assisted death are presently under review: the Czech Republic, France, Ireland, the Isle of Man, Japan, Jersey, South Korea, the Philippines, Slovenia and the United Kingdom.

With that brief sketch of the historical background in place, we will proceed first to consider the conditions that those who have advocated making voluntary medically assisted death legally permissible have typically insisted should be satisfied. Consideration of the proposed conditions will establish a framework for the moral interrogation that will follow in Sections 3 and 4. Section 3 will outline the positive moral case put forward by those who want voluntary euthanasia and physician-assisted suicide to be legally permissible. Section 4 will be devoted to scrutinising the most important of the objections that have been levelled against that case by those opposed to the legalization of voluntary euthanasia and physician-assisted suicide.

Advocates of voluntary euthanasia typically contend that if a person

• is suffering from a terminal illness;
• is unlikely to benefit from the discovery of a cure for that illness during what remains of her life expectancy;
• is, as a direct result of the illness, either suffering intolerable pain, or only has available a life that is unacceptably burdensome (e.g., because the illness has to be treated in ways that lead to her being unacceptably dependent on others or on technological means of life support);
• has an enduring, voluntary and competent wish to die (or has, prior to losing the competence to do so, expressed a wish to be assisted to die in the event that conditions (a)-(c) are satisfied); and
• is unable without assistance to end her life,

there should be legal and medical provision to facilitate her being allowed to die or assisted to die.

It should be acknowledged that these conditions are quite restrictive, indeed more restrictive than many think appropriate. In particular, the first condition restricts access to voluntary euthanasia to those who are terminally ill . While that expression is not free of all ambiguity, for present purposes it can be agreed that it does not include those who are rendered quadriplegic as a result of accidents, or sufferers from chronic diseases, or individuals who succumb to forms of dementia like Alzheimer’s Disease, to say nothing of those afflicted by ‘existential suffering’. Those who consider that cases like these show the first condition to be too restrictive (e.g., Varelius 2014, Braun, 2023) may, nonetheless, agree that including them as candidates for legalized voluntary euthanasia is likely to make it far harder in many jurisdictions to gain sufficient support for legalization (and so to make it harder to help those terminally ill persons who wish to die). Even so, they believe that voluntary euthanasia should be permitted for those who consider their lives no longer worth living, not just for for the terminally ill. Whether those who judge that their lives are no longer worth living, and so believe their lives are in that sense ‘complete’, should be afforded medical assistance with dying, has recently become a pressing concern in Belgium and the Netherlands. Several court cases have affirmed that such assistance may sometimes be provided for individuals in the former category even though the question remains as to whether it is properly a medical responsibility to render assistance with dying to someone who believes her life is complete despite her not suffering from a terminal medical condition (see, e.g., Young 2017). Relatedly, the issues of whether those suffering from a disability which will not reasonably foreseeably lead to death and those suffering because of a mental illness should be able to access medical assistance with dying have recently been the subject of intense debate in Canada. The debate culminated in disabled individuals, whose conditions are the cause of enduring, intolerable and irremediable suffering, being given access to medical assistance with dying as long as they are capable of making a competent request for that assistance. An intention to make a similar arrangement for those whose sole underlying condition is a mental illness was flagged for introduction in 2024, but has been temporarily shelved until further research has been conducted on the issue. It seems likely that the changes that have been made, or mooted, in these jurisdictions to the eligibility conditions for medical assistance with dying will lead to an expansion of the eligibility conditions for voluntary medically assisted death in other jurisdictions.

The fifth condition further restricts access to voluntary euthanasia by excluding those capable of ending their own lives, and so may be thought unduly restrictive by those who would wish to discourage terminally ill patients from attempting suicide. There will be yet others who consider this condition to be too restrictive because competent patients can always refuse nutrition and hydration (see, e.g., Bernat, et al. 1993; Savulescu 2014). Though this is true, many competent dying persons still wish to have access to legalized medically assisted death, rather than having to rely on refusing nutrition and hydration, so that they may retain control over the timing of their deaths and avoid needlessly prolonging the process of dying.

The second condition is intended simply to reflect the fact that it is normally possible to say when someone’s health status is incurable. So-called ‘miracle’ cures may be proclaimed by sensationalist journalists, but progress toward medical breakthroughs is typically painstaking. If there are miracles wrought by God that will be quite another matter entirely, but it is at least clear that not everyone’s death is thus to be staved off.

The third condition recognises what many who oppose the legalization of voluntary euthanasia do not, namely, that it is not only a desire to be released from pain that leads people to request help with dying. In the Netherlands, for example, pain has been found to be a less significant reason for requesting assistance with dying than other forms of suffering like frustration over loss of independence (see e.g., Marquet, et al. 2003; Onwuteaka-Philipsen, et al. 2012; Emanuel, et al. 2016). Sufferers from some terminal conditions may have their pain relieved but have to endure side effects that, for them, make life unbearable. Others may not have to cope with pain but, instead, with having to rely on forms of life support that simultaneously rob their lives of quality (as with, e.g., motor neurone disease). Yet others struggle with psychological distress and various psychiatric conditions and believe these conditions ought to be counted among the forms of suffering that qualify competent individuals to access medical assistance with dying. There has been greater recognition of, and support for, this position in those jurisdictions that make the role of unbearable suffering central to the determination of the eligibility of competent individuals for medical assistance with dying (see the discussion above of the first condition). Even so, inclusion of these forms of suffering highlights legitimate issues to do with the competence of at least some of those who suffer from them. (For a helpful recent study of the handling of requests for assistance with dying by psychiatric patients in the Netherlands see Kim, et al. 2016.)

A final preliminary point is that the fourth condition requires that the choice to die not only be uncoerced and competent but that it be enduring. The choice is one that will require time for reflection, and, almost certainly, discussion with others, so should not be settled in a moment. Nonetheless, as with other decisions affecting matters of importance, adults are presumed to choose voluntarily and to be competent unless the presence of defeating considerations can be established. (See the entry on decision-making capacity .) The burden of proof of establishing lack of voluntariness, or lack of competence, is on those who refuse to accept an adult person’s choice. There is no need to deny that this burden can sometimes be met (e.g., by pointing to the person’s being in a state of clinical depression). The claim is only that the onus falls on those who assert that an adult’s choice is not competent. (There are different issues to be faced when the competence of at least some older children and adolescents is at issue. In the Netherlands, for example, those aged twelve and older have sometimes been found to be competent to make end-of-life decisions for themselves. However, the topic will not be pursued further here because the focus of the entry is on competent adults.)

Clearly the five conditions set out above are likely to require some refinement if complete agreement is to be reached but there is sufficient agreement for us to proceed without further ado to consideration of the cases for and against legalization of voluntary euthanasia. (However, for a fuller discussion of issues concerning the definition of ‘euthanasia’ see, e.g., Beauchamp and Davidson 1979.)

One central ethical contention in support of voluntary euthanasia is that respect for persons demands respect for their autonomous choices as long as those choices do not result in harm to others. Respect for people’s autonomous choices is directly connected with the requirement for competence because autonomy presupposes competence (cf., Brock 1992). People have an interest in making important decisions about their lives in accordance with their own conception of how they want to live. In exercising autonomy, or self-determination, individuals take responsibility for their lives; since dying is a part of life, choices about the manner of their dying and the timing of their death are, for many people, part of what is involved in taking responsibility for their lives. Many are concerned about what the last phase of their lives will be like, not merely because of fears that their dying might involve them in great suffering, but also because of the desire to retain their dignity, and as much control over their lives as possible, during this phase. A second contention in support of voluntary euthanasia was mentioned at the beginning of this entry, namely the importance of promoting the well-being of persons. When someone is suffering intolerable pain or only has available a life that is unacceptably burdensome (see the third condition above), and he competently requests medical assistance with dying, his well-being may best be promoted by affording him that assistance. When harnessed together, the value to individuals of making autonomous choices, and the value to those individuals who make such choices of promoting their own well-being, provide the moral foundation for requests for voluntary euthanasia. Each consideration is necessary for moral justification of the practice, but taken in isolation neither suffices (see, e.g., Young 2007, 2017; Sumner 2011, 2017).

The technological interventions of modern medicine have had the effect of stretching out the time it takes for many people to die. Sometimes the added life this brings is an occasion for rejoicing; sometimes it drags out the period of significant physical and intellectual decline that a person undergoes with the result that life becomes no longer worth living. Many believe there is no single, objectively correct answer as to when, if at all, a person’s life becomes a burden and hence unwanted. If they are right, that simply points up the importance of individuals being able to decide autonomously for themselves whether their own lives retain sufficient quality and dignity to make life worth living. Others maintain that individuals can be in error about whether their lives continue to be worth living (cf., Foot 1977). The conditions outlined above in Section 2 are intended by those who propose them to serve, among other purposes, to safeguard against such error. But it is worth adding that in the event that a person who considers that she satisfies those conditions is judged by her medical attendants to be in error about whether it would be worth her continuing to live, the likely outcome is that those attendants will refuse to provide medical assistance with dying. (Evidence that will be mentioned below shows that this happens more frequently than might be predicted in jurisdictions in which medically assisted dying has been legalized. (There are discussions of the principles at stake in such matters in Young 2007; Wicclair 2011; Sumner 2020.) Unless a patient is able to be transferred to the care of other medical professionals who accept her assessment, she will have to rely on her own resources (e.g., by refusing nutrition and hydration). Even so, other things being equal, as long as a critically ill person is competent, her own judgement of whether continued life is a benefit to her ought to carry the greatest weight in any end-of-life decision making regardless of whether she is in a severely compromised and debilitated state. The idea that a competent individual’s autonomous judgment of the value to her of continued life should trump an assessment by others of her well-being should not be thought surprising because precisely the same happens when a competent patient refuses life-prolonging treatment.

Suppose, for the sake of argument, that it is agreed that we should respect a person’s competent request for medical assistance with dying (e.g., so as to enable her to achieve her autonomously chosen goal of an easeful death). It might be thought that in such an eventuality different moral concerns will be introduced from those that arise in connection with competent refusals. After all, while competent patients are entitled to refuse any form of medical treatment, they are not entitled to insist on the administration of forms of medical treatment that have no prospect of conferring a medical benefit or are not being provided because of a scarcity of medical resources or their affordability. While each of these points is sound, it remains the case that medical personnel have a duty to relieve suffering when that is within their capacity. Accordingly, doctors who regard medical assistance with dying as an element of appropriate medical care will consider it morally permissible to agree to a request for assistance with dying by a competent dying patient who wishes to avoid unbearable suffering. The reason for claiming only that this is morally permissible rather than morally obligatory will be explained in a subsequent paragraph. (For further reflections on the issue of responses to requests for medical assistance see, for instance, Dworkin 1998; Sumner 2011, 2017, 2020; Young 2007, 2017.)

Notwithstanding this response, as was seen earlier, at least some proponents of voluntary medically assisted dying wish to question why medical assistance with dying should be restricted to those covered by, in particular, the first three conditions set out above in Section 2. If people’s competent requests for medically assisted death should be respected why impose any restrictions at all on who may have access to medically assisted death? Why, for example, should those suffering from depression, or forms of dementia, not be eligible for medically assisted dying? Most proponents of voluntary medically assisted dying hold that there are at least two reasons for restricting access to it to those who satisfy the conditions set out earlier (or, a modified set that takes account of the concerns canvassed in the discussion of those proposed conditions). First, they contend that there are political grounds for doing so, namely, that because legalizing medically assisted dying for competent individuals is politically contested, the best hope for its legalization lies in focusing on those forms of suffering most likely to effect law reform. That is why some proponents deny the eligibility even of sufferers from conditions like ‘locked-in’ syndrome, motor neurone disease, and multiple sclerosis for voluntary medically assisted dying since, strictly, they are not terminally ill, and reliance has to be placed in consequence on their claim to be suffering unbearably. Second, and relatedly, most proponents of the legalization of medical assistance with dying have been cautious about supporting medically assisted death for those suffering from, for example, depression and dementia, because not only are they not terminally ill, but their competence to request assistance with dying is apt to be called into question, particularly in instances where they have given no prior indication of their preference for such assistance. Restricting access to medical assistance with dying to those whose suffering is less likely to be disputed avoids becoming embroiled in controversy. As was noted earlier, some critics of the restrictive approach (e.g., Varelius 2014) take a harder line and claim that it should not even be necessary for a person to be suffering from a medical condition to be eligible for medical assistance with dying; it should be enough to be ‘tired of life’. Only in a few jurisdictions, viz., Switzerland, the Netherlands and Belgium, has this issue been seriously broached. Regardless of what may happen in those jurisdictions, those seeking the legal provision of medical assistance with dying in other jurisdictions seem likely to maintain that if such assistance is to be seen as a legitimate form of medical care it has to be provided in response to a medical condition (rather than because someone is ‘tired of life’), and, indeed, restricted to those who satisfy the conditions outlined earlier in Section 2 (or some similar set of conditions). In short, these latter hold that making an autonomous request for assistance with dying is necessary, but should not be sufficient, for triggering such assistance.

There is one final matter of relevance to the moral case for voluntary medically assisted death on which comment must be made. The comment concerns a point foreshadowed in a previous paragraph, but it is also linked with the remark just made about the insufficiency of an autonomous request for assistance with dying to trigger that assistance. It is important to make the point that respect has to be shown not only for the dying person’s autonomy but also for the professional autonomy of any medical personnel asked to lend assistance with dying. The value (or, as some would prefer, the right) of self-determination does not entitle a patient to try to compel medical professionals to act contrary to their own moral or professional values. Hence, if voluntary euthanasia is to be legally permitted, it must be against a backdrop of respect for professional autonomy. Similarly, if a doctor’s view of her moral or professional responsibilities is at odds with her patient’s competent request for euthanasia, she should make provision, where it is feasible to do so, for the transfer of the patient to the care of a doctor who faces no such conflict. Given that, to date, those who contend that no scope should be permitted for conscientious objection within medical practice have garnered very little support for that view, making use of referrals and transfers remains the most effective means of resolving such disagreements.

Opponents of voluntary euthanasia have endeavored in a variety of ways to counter the very straightforward moral case that has been laid out above for its legalization (see, for example, Keown 2002; Foley, et al. 2002; Biggar 2004; Gorsuch 2006). Some of the counter-arguments are concerned only with whether the moral case warrants making the practice of voluntary euthanasia legal, whereas others are concerned with trying to undermine the moral case itself. In what follows, consideration will be given to the five most important counter-arguments. (For more comprehensive discussions of the morality and legality of medically assisted death see Biggar 2004; Gorsuch 2006; Young 2007; Sumner 2011, 2017; Keown 2018).

4.1 Objection 1

It is sometimes said (e.g., Emanuel 1999; Keown in Jackson and Keown 2012) that it is not necessary nowadays for people to die while suffering from intolerable or overwhelming pain because the provision of effective palliative care has improved steadily, and hospice care is more widely available. Some have urged, in consequence, that voluntary euthanasia is unnecessary.

There are several flaws in this contention. First, while both good palliative care and hospice care make important contributions to the care of the dying, neither is a panacea. To get the best palliative care for an individual involves trial and error, with some consequent suffering in the process; moreover, even the best care fails to relieve all pain and suffering. Perhaps even more importantly, high quality palliative care commonly exacts a price in the form of side-effects such as nausea, incontinence, loss of awareness because of semi-permanent drowsiness, and so on. A rosy picture is often painted as to how palliative care can transform the plight of the dying. Such a picture is misleading according to those who have closely observed the effect of extended courses of treatment with drugs like morphine. For these reasons many skilled palliative care specialists acknowledge that palliative care does not enable an easeful death for every patient. Second, even though the sort of care provided through hospices is to be applauded, it is care that is available to only a small proportion of the terminally ill and then usually only in the very last stages of the illness (typically a matter of a few weeks). Notwithstanding that only relatively few of the dying have access to hospice care it is worth drawing attention to the fact that in, Oregon, to cite one example, a high proportion of those who have sought physician-assisted suicide were in hospice care. Third, and of greatest significance for present purposes, not everyone wishes to avail themselves of palliative or hospice care. For those who prefer to die on their own terms and in their own time, neither option may be attractive. As previously mentioned, a major source of distress for many dying patients is the frustration that comes with being unable to satisfy their autonomous wishes. Fourth, as also indicated earlier, the suffering that occasions a desire to end life is not always traceable to pain caused by illness. For some, what is intolerable is their forced dependence on others or on life-supporting machinery; for these patients, the availability of effective pain control is not the primary concern. (In relation to the preceding matters see Rietjens, et al. 2009 and Onwuteaka-Philipsen et al. 2012 for findings for the Netherlands; and, for Oregon, Ganzini, et al. 2009.)

4.2 Objection 2

A second, related objection to the moral and legal permissibility of voluntary euthanasia turns on the claim that we can never have sufficient evidence to be justified in believing that a dying person’s request to be helped to die is competent, enduring and genuinely voluntary.

It is certainly true that a request to die may not reflect an enduring desire to die (just as some attempts to commit suicide may reflect only temporary despair). That is why advocates of the legalization of voluntary euthanasia have argued that a cooling off period should normally be required before euthanasia is permitted to ensure that the request is enduring. That having been said, to claim that we can never be justified in believing that someone’s request to die reflects a settled preference for death is to go too far. If a competent person discusses the issue with others on different occasions over time, and remains steady in her resolve, or privately reflects on the issue for an extended period and does not waver in her conviction, her wish to die surely must be counted as enduring.

But, it might be asked, what if a person is racked with pain, or mentally confused because of the measures taken to relieve her pain, and is, in consequence, unable to think clearly and rationally about the alternatives? It has to be agreed that a person in those circumstances who wants to die should not be assumed to have a truly voluntary and enduring desire to die. However, there are at least two important points to make about those in such circumstances. First, they do not account for all of the terminally ill, so even if it is acknowledged that such people are incapable of agreeing to voluntary euthanasia that does not show that no one can ever voluntarily request help to die. Second, it is possible in at least some jurisdictions for a person to indicate, in advance of losing the capacity to give competent consent, how she would wish to be treated should she become terminally ill and suffer either intolerable pain or an unacceptable loss of control over her life (cf., for instance, Dworkin 1993). ‘Living wills’ or ‘advance directives’ are legal instruments for giving voice to people’s wishes while they are capable of giving competent, enduring and voluntary consent, including to their wanting help to die. As long as they are easily revocable in the event of a change of mind (just as civil wills are), they should be respected as evidence of a well thought-out conviction. (For more detailed consideration of these instruments see the entry on advance directives .)

Perhaps, though, what is really at issue in this objection is whether anyone can ever form a competent, enduring and voluntary judgement about being better off dead, rather than continuing to suffer from an illness, prior to suffering such an illness (cf., Keown in Jackson and Keown 2012). If this is what underlies the objection it is surely too paternalistic to be acceptable. Why is it not possible for a person to have sufficient inductive evidence (e.g., based on the experience of the deaths of friends or family) to know her own mind, and act accordingly, without having had direct experience of such suffering?

4.3 Objection 3

According to the traditional interpretation of the ‘doctrine of double effect’ it is permissible to act in a way which it is foreseen will have a bad effect, provided only that

• the bad effect occurs as a side-effect (i.e., indirectly) to the achievement of the act that is directly aimed at;
• the act directly aimed at is itself morally good or, at least, morally neutral;
• the good effect is not achieved by way of the bad, that is, the bad must not be a means to the good; and
• the bad effect must not be so serious as to outweigh the good effect.

Hence, it is permissible, according to the doctrine of double effect, to, for example, alleviate pain (a good effect) by administering a drug, knowing that doing so will shorten life, but impermissible to administer the same drug with the direct intention of terminating a patient’s life (a bad effect). This latter claim is said to apply regardless of whether the drug is given at the person’s request.

This is not the appropriate forum for a full consideration of the doctrine, for which see the entry on the doctrine of double effect . However, there is one very important criticism to be made of the application of the doctrine that has direct relevance to the issue of voluntary euthanasia.

On the most plausible reading, the doctrine of double effect can be relevant to the permissibility of voluntary euthanasia only when a person’s death is bad for her or, to put it another way, a harm to her. Sometimes the notion of ‘harm’ is understood simply as damage to a person’s interests whether consented to or not. At other times, it is understood, more strictly, as damage that has been wrongfully inflicted. On either understanding of harm, there can be instances in which death for a person does not constitute a harm for her because it will either render her better off, or, as some would insist, no worse off, when compared with remaining alive. Accordingly, in those instances, the doctrine of double effect can have no relevance to the debate about the permissibility of voluntary euthanasia. (For extended discussions of the doctrine of double effect and its bearing on the moral permissibility of voluntary euthanasia see, e.g., McIntyre 2001; Woodward 2001; Cavanaugh 2006; Young 2007; Sumner 2011, 2017.)

4.4 Objection 4

As was noted earlier in Section 3, there is a widespread belief that so-called passive (voluntary) euthanasia, wherein life-sustaining or life-prolonging measures are withdrawn or withheld in response to a competent patient’s request, is morally permissible. The reason why passive (voluntary) euthanasia is said to be morally permissible is that the patient is simply allowed to die because steps are not taken to preserve or prolong life. This happens, for example, when a dying patient requests the withdrawal or the withholding of measures whose administration would be medically futile, or unacceptably burdensome. By contrast, active (voluntary) euthanasia is said to be morally impermissible because it is claimed to require an unjustifiable intentional act of killing to satisfy the patient’s request (cf., for example, Finnis, 1995; Keown in Jackson and Keown 2012; Keown 2018).

Despite its popularity and widespread use, the distinction between passive and active euthanasia is neither particularly clear nor morally helpful. (For a fuller discussion, see McMahan 2002.) Whether behavior is described in terms of acts or omissions (a distinction which underpins the alleged difference between active and passive voluntary euthanasia and that between killing a person and letting her die), is often a matter of pragmatics rather than anything of deeper moral importance. Consider, for instance, the practice (once common in hospitals) of deliberately proceeding slowly to a ward in response to a request to provide assistance for a patient who has been assigned a ‘not for resuscitation’ code. Or, consider ‘pulling the plug’ on a respirator keeping an otherwise dying patient alive, as against not replacing the oxygen supply when it runs out. Are these acts or omissions? If the answers turn on merely pragmatic considerations the supposed distinction between passive euthanasia and active euthanasia will be hard to sustain.

Even supposing that the distinction between acts and omissions, and the associated distinction between killing and letting die, can be satisfactorily clarified (on which see the entry doing v. allowing harm ), there remains the issue of whether these distinctions have moral significance in every circumstance. Consider a case of a patient suffering from motor neurone disease who is completely respirator dependent, finds her condition intolerable, and competently and persistently requests to be removed from the respirator so that she may die. Even the Catholic Church in recent times has been prepared to agree that it is permissible, in a case like this, to turn off the respirator. No doubt this has been because the Catholic Church considers such a patient is only being allowed to die. Even were it to be agreed, for the sake of argument, that such a death should be regarded as an instance of letting die, this concession would not show that it would have been morally worse had the patient been killed at her request (active voluntary euthanasia) rather than being allowed to die (passive voluntary euthanasia). Indeed, supporters of voluntary medically assisted death maintain that since death is beneficial in such an instance (or, at the very least, leaves the dying person no worse off), actively bringing about the death is morally to be preferred to just allowing it to happen because the desired benefit is achieved sooner and thus with less suffering.

Opponents of voluntary euthanasia claim, however, that the difference between active and passive euthanasia is to be found in the agent’s intention: if someone’s life is intentionally terminated she has been killed, whereas if she is just no longer being aggressively treated, her death should be attributed to the underlying disease. Many physicians would say that their intention in withholding or withdrawing life-sustaining medical treatment in such circumstances is simply to respect the patient’s wishes. This is plausible in those instances where the patient competently requests that aggressive treatment no longer be given (or, the patient’s proxy makes such a request). But it will often be implausible. In many cases the most plausible interpretation of a physician’s intention in withholding or withdrawing life-sustaining measures is that it is to end the patient’s life. Consider the palliative care practice of ‘terminally sedating’ a patient after a decision has been made to cease aggressive treatment. Suppose (as sometimes happens) that this is then followed by withholding artificially supplied nutrition. In these latter instances the best explanation of the physician’s behavior is that the physician intends thereby to end the life of the patient. What could be the point of the action, the goal aimed at, the intended outcome, if not to end the patient’s life? (Cf. Winkler 1995.) No sense can be made of the action as being intended to palliate the patient’s diseased condition, or to keep the patient comfortable. Nor is it appropriate to claim that what kills the patient is the underlying disease. What kills the patient is the act of depriving her of nutrition (i.e., of starving her to death). The point can be generalized to cover many more instances involving either the withdrawal or the withholding of life-sustaining medical treatment. In short, there is no good reason to think that whereas so-called passive voluntary euthanasia is morally acceptable active voluntary euthanasia never can be.

But we can go further. Giving titrated doses of morphine that reach levels beyond those needed to control pain, or removing a respirator from a sufferer from motor neurone disease, seem to many of us to amount to intentionally bringing about the death of the person being cared for. To be sure, as was acknowledged above, there are circumstances in which doctors can truthfully say that the actions they perform, or omissions they make, will bring about the deaths of their patients even though it was not their intention that those patients would die. So, for instance, if a patient refuses life-prolonging medical treatment because she considers it futile, it can be reasonable to say that her doctor’s intention in complying with the request was simply to respect her wishes. Nevertheless, as we have seen, there are other circumstances in which it is highly stilted to claim, as some doctors continue to do, that they had no intention of bringing about death.

These considerations should settle matters but do not do so for those who maintain that killing, in medical contexts, is always morally unjustified – a premise that underwrites much of the debate surrounding this fourth objection. But this underlying assumption is open to challenge and has been challenged by, for instance, Rachels 1986 and McMahan 2002. One of the reasons the challengers have given is that there are cases in which killing a competent dying person when she requests assistance with dying, is morally preferable to allowing her to die, namely, when taking the latter option would serve only to prolong her suffering against her wishes. Further, despite the longstanding legal doctrine that no one can justifiably consent to be killed (on which more later), it surely is relevant to the justification of an act of killing that the person killed has autonomously decided that she would be better off dead and so asks to be helped to die.

4.5 Objection 5

It is sometimes said that if society allows voluntary euthanasia to be legalized, we will then have set foot on a slippery slope that will lead us eventually to support other forms of euthanasia, including, in particular, non-voluntary euthanasia. Whereas it was once the common refrain that that was precisely what happened in Hitler’s Germany, in recent decades the tendency has been to claim that experience with legalized euthanasia in the Netherlands and Belgium, in particular, has confirmed the reality of the slippery slope.

Slippery slope arguments come in various versions. One (but not the only) way of classifying them has been to refer to logical, psychological and arbitrary line versions. The common feature of the different forms is the contention that once the first step is taken on a slippery slope the subsequent steps follow inexorably, whether for logical reasons, psychological reasons, or to avoid arbitrariness in ‘drawing a line’ between a person’s actions. (For further discussion see, e.g., Rachels 1986; Brock 1992; Walton 1992.)

We need first to consider whether, at the theoretical level, any of these forms of argument is powerful enough to refute the case for the legalization of voluntary euthanasia. We will then be in a position to comment on the alleged empirical support from the experiences of Hitler’s Germany and, more recently, of legalized euthanasia in the Netherlands and elsewhere, for the existence of a slippery slope that supposedly comes into being with the legalization of voluntary euthanasia.

To begin with, there is nothing logically inconsistent in supporting voluntary euthanasia while maintaining the moral inappropriateness of non-voluntary euthanasia. (However, for an attempt to press the charge that there is such an inconsistency see, e.g., Keown 2022.) Undoubtedly, some advocates of voluntary euthanasia wish also to lend their support to some acts of non-voluntary euthanasia, for example, for those in persistent vegetative states who have never indicated their wishes about being helped to die, or for certain severely disabled infants for whom the outlook is hopeless. (See, e.g., Kuhse and Singer 1985; Singer 1994; Stingl 2010; Sumner 2017.) Others believe that the consent of the patient is strictly required if euthanasia is appropriately to be legalized. The difference is not a matter of logical acumen; it is to be explained by reference to the importance placed on key values by the respective supporters. Thus, for example, those who insist on the necessity for a competent request by a patient for medical assistance with dying typically believe that such a request is the paramount consideration in end-of-life decision making (even when it is harnessed to the value of individual well-being), whereas those who consider a person’s best interests to be the paramount consideration are more likely to believe in the justifiability of instances of non-voluntary euthanasia like those mentioned above.

Next, it is hard to see why moving from voluntary to non-voluntary euthanasia is supposed to be psychologically inevitable. Why should those who support the legalization of voluntary euthanasia, because they value the autonomy of the individual, find it psychologically easier, in consequence, to endorse the killing of those who are not able competently to request assistance with dying? What reason is there to believe that they will, as a result of their support for voluntary euthanasia, be psychologically driven to endorse a practice of non-voluntary euthanasia?

Finally, since there is nothing arbitrary about distinguishing voluntary euthanasia from non-voluntary euthanasia (because the line between them is based on clear principles), there can be no substance to the charge that only by arbitrarily drawing a line between them could non-voluntary euthanasia be avoided were voluntary euthanasia to be legalized.

What, though, of Hitler’s Germany and the recent experience of legalized voluntary euthanasia in the Netherlands and elsewhere? The former is easily dismissed as an indication of an inevitable descent from voluntary euthanasia to non-voluntary. There never was a policy in favor of, or a legal practice of, voluntary euthanasia in Germany in the 1920s to the 1940s (see, for example, Burleigh 1994). There was, prior to Hitler coming to power, a clear practice of killing some disabled persons. But it was never suggested that their being killed was justified by reference to their best interests; rather, it was said that society would be benefited. Hitler’s later revival of the practice and its widening to take in other groups such as Jews and gypsies was part of a program of eugenics , not euthanasia.

Since the publication of the Remmelink Report in 1991 into the medical practice of euthanasia in the Netherlands, it has frequently been said that the Dutch experience shows that legally protecting voluntary euthanasia is impossible without also affording shelter to the non-voluntary euthanasia that will follow in its train (see, e.g., Keown 2018). In the period since that report there have been regular national studies of the practice of euthanasia in the Netherlands (see, e.g., Rietjens, et al. 2009; Onwuteaka-Philipsen, et al. 2012; van der Heide, et al. 2017). The findings from these national studies have consistently shown that there is no evidence for the existence of such a slippery slope. Among the specific findings the following are worth mentioning: of those terminally ill persons who have been assisted to die about sixty per cent have clearly been cases of voluntary euthanasia as it has been characterised in this entry; of the remainder, the vast majority of cases were of patients who at the time of their medically assisted deaths were no longer competent. It might be thought that these deaths ought to be regarded as instances of non-voluntary euthanasia. But, in fact, it would be inappropriate to regard them as such. Here is why. For the overwhelming majority of these cases, the decisions to end life were taken only after consultation between the attending doctor(s) and close family members, and so can legitimately be thought of as involving substituted judgements. Moreover, according to the researchers, the overwhelming majority of these cases fit within either of two common practices that occur in countries where voluntary euthanasia has not been legalized, namely, that of terminal sedation of dying patients, and that of giving large doses of opioids to relieve pain while foreseeing that this will also end life. In a very few cases, there was no consultation with relatives, though in those cases there were consultations with other medical personnel. The researchers contend that these instances are best explained by the fact that families in the Netherlands strictly have no final legal authority to act as surrogate decision-makers for incompetent persons. For these reasons the researchers maintain that non-voluntary euthanasia is not widely practised in the Netherlands.

That there have only been a handful of prosecutions of Dutch doctors for failing to follow agreed procedures (Griffiths, et al. 1998; Asscher and van de Vathorst 2020), that none of the doctors prosecuted has had a significant penalty imposed, that a significant proportion of requests for medical assistance with dying are rejected as unjustifiable, and that the Dutch public have regularly reaffirmed their support for the agreed procedures suggests that, contrary to the claims of some critics, the legalization of voluntary euthanasia has not increased the incidence of non-voluntary euthanasia. A similar picture to the one in the Netherlands has emerged from studies of the operation of the law concerning physician-assisted suicide in Oregon. Indeed, in a recent wide-ranging study of attitudes and practices of voluntary euthanasia and physician-assisted suicide covering two continents, a prominent critic of these practices has concluded (in agreement with his co-authors) that little evidence exists of abuse, particularly of the vulnerable (see Emanuel, et al., 2016). Unfortunately, insufficient time has elapsed for appropriate studies to be conducted in the other jurisdictions that have legalized either voluntary euthanasia or physician-assisted suicide (but for some relevant evidence see e.g., White, et al. 2022). Finally, some commentators have pointed out that there may, in reality, be more danger of the line between voluntary and non-voluntary euthanasia being blurred if euthanasia is practised in the absence of legal recognition, since there will, in those circumstances, be neither transparency nor monitoring (which cannot be said of the Netherlands, Belgium, Oregon and so on).

None of this is to suggest that it is not necessary to ensure the presence of safeguards against potential abuse of legally protected voluntary euthanasia. This is particularly important for the protection of those who have become incompetent by the time decisions need to be taken about whether to assist them to die. Furthermore, it is, of course, possible that the reform of any law may have unintended effects. However, if the arguments outlined above are sound (and the experience in the Netherlands, Belgium and Luxembourg, along with the more limited experience in several states in the United States and in Canada, is, for the present, not only the best evidence we have that they are sound, but the only relevant evidence), that does not seem very likely.

It is now well-established in many jurisdictions that competent patients are entitled to make their own decisions about life-sustaining medical treatment. That is why they can refuse such treatment even when doing so is tantamount to deciding to end their life. It is plausible to think that the fundamental basis of the right to decide about life-sustaining treatment – respect for a person’s autonomy and her assessment of what will best serve her well-being – has direct relevance to the legalization of voluntary euthanasia (see, e.g., Dworkin 1998; Young 2007, 2017; Sumner 2011, 2017). In consequence, extending the right of self-determination to cover cases of voluntary euthanasia does not require a dramatic shift in legal policy. Nor do any novel legal values or principles need to be invoked. Indeed, the fact that suicide and attempted suicide are no longer criminal offences in many jurisdictions indicates that the central importance of individual self-determination in a closely analogous context has been accepted. The fact that voluntary euthanasia and physician-assisted suicide have not been more widely decriminalized is perhaps best explained along a similar line to the one that has frequently been offered for excluding the consent of the victim as a justification for an act of killing, namely the difficulties thought to exist in establishing the genuineness of the consent. But, the establishment of suitable procedures for giving consent to voluntary euthanasia and physician-assisted suicide is surely no harder than establishing procedures for competently refusing burdensome or otherwise unwanted medical treatment. The latter has already been accomplished in many jurisdictions, so the former should be achievable as well.

Suppose that the moral case for legalizing voluntary euthanasia and physician-assisted suicide does come to be judged more widely as stronger than the case against legalization, and they are made legally permissible in more jurisdictions than at present. Should doctors take part in the practice? Should only doctors perform voluntary euthanasia? These questions ought to be answered in light of the best understanding of what it is to provide medical care. The proper administration of medical care should promote the welfare of patients while respecting their individual self-determination. It is these twin values that should guide medical care, not the preservation of life at all costs, or the preservation of life without regard to whether patients want their lives prolonged should they judge that life is no longer of benefit or value to them. Many doctors in those jurisdictions where medically assisted death has been legalized and, to judge from available survey evidence, in other liberal democracies as well, see the practice of voluntary euthanasia and physician-assisted suicide as not only compatible with their professional commitments but also with their conception of the best medical care for the dying. That being so, doctors of the same conviction in jurisdictions in which voluntary medically assisted death is currently illegal should no longer be prohibited by law from lending their professional assistance to competent terminally ill persons who request assistance with dying because of irremediable suffering or because their lives no longer have value for them.

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How to cite this entry . Preview the PDF version of this entry at the Friends of the SEP Society . Look up topics and thinkers related to this entry at the Internet Philosophy Ontology Project (InPhO). Enhanced bibliography for this entry at PhilPapers , with links to its database.

• Medically Assisted Dying , an annotated bibliography authored by Robert Young (La Trobe University)
• Eight Reasons Not to Legalize Physician Assisted Suicide , by David Albert Jones, online resource at the Anscombe Bioethics Centre website.

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The Ethical and Legal Implications of Euthanasia

Generally, the topic of euthanasia has resulted in hot debates among all stakeholders, including healthcare professionals and legal experts, due to the ethical and legal issues associated with the topic. It affects both patients and their healthcare providers. Over the years, the debate on euthanasia has focused on suffering patients with terminal illnesses. However, the topic has extended to include even patients with mental illnesses like depression. Therefore, it is appropriate to look at the controversy surrounding euthanasia in a recent case study. Euthanasia is a controversial topic that requires further inquiry to fully understand different opinions offered by the opposing sides and the ethical implications associated with it.

Recent Case Study

The case published in the Catholic Herald involves a 29-year-old woman who underwent euthanasia following a series of mental illnesses. According to the author, despite being physically fit, the woman was given a lethal injection, having been granted her wish to die by the court after eight years of legal battles. In her argument, the woman claimed she had experienced extreme bouts of depression that had made her life intolerable. The case raised concerns among various stakeholders, including politicians who lamented how dangerous euthanasia could be.

Ethical Issues Involved in the Case Study

Generally, the case study raises various ethical dilemmas related to euthanasia, including when it is justifiable to end one’s life. In addition, the topic also opens up a whole discussion on the limitations of patients’ autonomy and the ethical responsibilities of healthcare professionals, as highlighted in the bioethical principles of beneficence and maleficence. Concerning autonomy, questions are raised regarding the patient’s capability to understand the decision that she was making. With superior knowledge and training, the physician is best positioned to help make an ethical decision that is in the patient’s best interest to protect patients from irresponsible choices. For patients to make an autonomous decision, they should be mentally capable of comprehending the information of the decision. In the case study, the patient has a mental health condition. Hence, her ability to make rational decisions is in question.

The Context of Euthanasia

The case study highlights euthanasia, particularly among patients with mental conditions such as depression. Historically, numerous attempts have been made to legalize euthanasia, but minimal success has occurred. The euthanasia discussion in psychiatry was awakened after the Nazi Holocaust when thousands of psychiatric patients were gassed or poisoned to death under the ‘euthanasia program’. According to Felder, the Nazi euthanasia program was used by scientists, mainly physicians, to conduct medical experiments. It is out of the scientific experiments of the Nazi physicians that ‘The Nuremberg Code’ was established to guide future experiments on human subjects.

Additionally, politicians have had their hand in the matter by sponsoring bills to legalize the act, with some opposing such attempts and publicly making their views known. From a social perspective, euthanasia has continued to be controversial, with many societies coming up to air their opinion. In the traditional Christian context and culture, euthanasia is viewed as morally unacceptable due to human life’s sacred nature. However, other social groups support euthanasia with the thought of extending dignity to death, such as the Voluntary Euthanasia Society. As such, there is no single available societal perspective regarding the issue of euthanasia. Hence, it is important to society as it touches on the critical matters of life and death.

The Differing Perspectives on Euthanasia

The individuals and societies in support of euthanasia have always centered their opinion on patient suffering. They argue that patients in the terminal stages of illness experience excruciating pain and have poor wound healing, poor social interactions, and many other aspects of physical suffering. According to the proponents, euthanasia is a more merciful response to relieve this suffering, especially where the quality of life is jeopardized. Among the patients with mental illnesses, the proponents argue that some mental conditions, including severe depression, induce intense suffering and are unresponsive to treatment. Additionally, the proponents note that since the patients request most cases of euthanasia, it is a way for physicians to show respect for personal autonomy. Thus, to the proponents, euthanasia relieves undue suffering and is in harmony with respect for autonomy and the individual’s right to a dignified death.

Contrary to the proponents’ arguments, the opponents base their argument on the intrinsic wrongness of killing, professional integrity, and the possibility of potential abuse. According to Naga and Mrayyan, willingly ending one’s life is inconsistent with human rights, and alternatives should be sought to relieve the patient’s suffering and improve their quality of life. Furthermore, Naga and Mrayyan note that administering lethal substances by physicians to end life is unethical according to guiding medical ethical practices, especially the Hippocratic Oath that restricts physicians from administering such substances to their patients or aiding their patients to die. They also note that legalizing euthanasia could lead to its potential abuse and a slippery slope where individuals will use it to escape chronic but manageable medical conditions.

Evaluation of the Arguments and Their Ethical Implications

The arguments presented by both the proponents and the opponents seem to be entirely influenced by one’s culture, moral philosophy, and personal experiences. Those opposed to euthanasia seem to be influenced by their religious cultures. Specifically, Christian teachings view life as sacred and state it should not be terminated prematurely at any cost. On the other hand, the proponents seem to subscribe to the Stoic philosophy that has always defended suicide as a reasonable departure from life, especially when intense suffering is involved. Anecdotal evidence also suggests that personal life experiences with suffering may make one choose to end one’s life. For example, seeing a cancer patient suffer may make individuals consider euthanasia if diagnosed with a similar terminal disease, as they will not want to experience the same ordeal.

While both the proponents and those opposed to euthanasia have valid arguments, myriads of ethical issues surround each side’s perspective. It is indeed true that certain illnesses, including mental conditions, lead to severe suffering and reduced quality of life. However, ethical issues arise regarding the ability of the patients requesting euthanasia to make autonomous decisions. For example, Appelbaum notes that it is common for depressed patients to reject treatment and even request death, yet change their decision once the depression is resolved. Accordingly, this raises the ethical question concerning the impact of the mental illness itself on the patient’s decision-making. It has also been observed that most patients are only resistant to one form of treatment and that other options should be tried to relieve their suffering.

Furthermore, it is noted that the right to autonomy is not always absolute and that physicians have the legal and ethical responsibility to override the patient’s decisions and continue pursuing alternative treatment in response to the patient’s symptoms and request a dignified death. Thus, the argument regarding patients’ autonomy to end their lives is weak. On the other hand, the opponents’ unethical medical practice mainly touches on physicians’ ethical responsibilities to act in good faith and protect their patients from harm. In line with non-maleficence and beneficence principles, physicians cannot administer lethal dosages to their patients as it causes more harm than good. Additionally, the claim of potential abuse if euthanasia is legalized, holds grounds owing to several reported cases, including ones with mental illnesses, where euthanasia has been performed without following due process in countries where it is legalized. Thus, the ethical questions raised by those opposed to euthanasia regarding non-maleficence, benevolence, and potential abuse are strongly supported by evidence.

Personal Perspective on Euthanasia

The issue of euthanasia among depressed patients will continue to dominate medical discussions. Subjectively, the opponents of euthanasia seem to offer a strong argument. Notably, depression can be treated just like other mental conditions, and symptoms can be controlled where treatment is impossible. Patient autonomy among psychiatric patients is in question. Mental illnesses tend to affect one’s way of thinking, and suicidal ideations are common phenomena among depressed patients. I have dealt with patients who have changed their stance on ‘mercy killing’ after a series of professional counseling sessions and continued treatment. Thinking about these experiences concerning my patients and the ethical dilemmas related to euthanasia makes me view it as an undesirable event in medical practice that I will not want to engage in.

The topic of euthanasia is controversial based on the numerous arguments aired by those in its support and those who are against it. The case study published in the Catholic Herald offers a good scenario through which the effects of euthanasia can be accessed and its ethical implications reviewed. While the Pro-euthanasia argument is based on the need to relieve undue suffering, respect autonomy, and grant the right to a dignified death, the opponents have emphasized the intrinsic wrongness of killing, professional integrity, and the possibility of a “slippery slope”. Overall, the ethical issues addressed autonomy, beneficence, and non-maleficence. Subjectively, the ethical questions touching upon professional integrity, especially the need to observe non-maleficence and doing good, are strong enough to make me offer my support against euthanasia.

📎 References:

1. Appelbaum, P. S. (2017). Should mental disorders be a basis for physician-assisted death? Law & Psychiatry, 68(4), 315-317. https://doi.org/10.1176/appi.ps.201700013 2. Beauchamp, T. L. (2016) Principlism in bioethics. In P. Serna & J. A. Seoane (Eds.), Bioethical decision making and argumentation (pp. 1-16). New York, NY: Springer. 3. Caldwell, S. (2018, February 1). Dutch doctors euthanize a 29-year old woman with depression. Catholic Herald. 4. Felder, B. M. (2013). “Euthanasia,” human experiments, and psychiatry in Nazi-occupied Lithuania, 1941-1944. Holocaust and Genocide Studies, 27(2), 242-275. https://doi.org/10.1093/hgs/dct025 5. Kim, S. Y., De Vries, R. G., & Peteet, J. R. (2016). Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands 2011 to 2014. JAMA Psychiatry, 73(4), 362-368. https://doi.org/10.1001/jamapsychiatry.2015.2887 6. Naga, B. S. B., & Mrayyan, M. T. (2013). Legal and ethical issues of euthanasia: Argumentative essay. Middle East Journal of Nursing, 7(5), 31-39. https://doi.org/10.5742/MEJN.2013.75330 7. Nunes R., & Rego, G. (2016.) Euthanasia: A challenge to medical ethics. Journal of Clinical Research & Bioethics, 7(4), 1-5. https://doi.org/10.4172/2155-9627.1000282 8. Tomasini, F. (2014). Stoic defence of physician-assisted suicide. Acta Bioethica, 20(1), 99-108. Retrieved from https://scielo.conicyt.cl/pdf/abioeth/v20n1/art11.pdf

Table of content

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The Ethics of Euthanasia Essay

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Statement of Issue

Research plan, overview of claims.

Euthanasia should be viewed as not simply a medical procedure carried out based on the principles of healthcare ethics (i.e., terminating the suffering of the patient), but also as an irrefutable right of a person to die.

It is required to identify the key arguments against and in favor of euthanasia. Moreover, it is necessary to nail down the reasons for people to approve of euthanasia or to dismiss it. In order to carry out the analysis of the existing opinions, several ways of viewing the issue must be provided, including ethical, medical and legal ones. It will also be required to consider the recent researches on euthanasia, as well as case studies and court cases. After a thorough literature review is carried out, the discussion of the existing arguments will commence. In the analysis of the claims in favor and against euthanasia, the cause and effect relationships between the factors affecting the choice of euthanasia should be established.

Main topic: Euthanasia must be accepted as the procedure that allows for the compliance with one of the basic human rights, i.e., the right to die. Despite the fact that euthanasia is currently prohibited in all states of the USA, it should be noted that self-assisted dying is legal in Washington and several other states (Montana, Oregon, New Mexico and Vermont). While involuntary euthanasia is not to be allowed, euthanasia as the method of terminating the suffering of a patient must be practiced in the U.S. healthcare institutions.

Claim 1:.The right to die is one of the basic human rights that must be appreciated and complied with by the state governmental bodies. Therefore, people should be provided with an opportunity to terminate their suffering in case when medical assistance is impossible.

Type of argument: inductive (Wood, 2015)

Support (use at least one outside source): Lachman, V. (2010). Physician-assisted suicide: Compassionate liberatio or murder? MEDSURG Nursing, 19 (2), 121–125.

Claim 2: Though healthcare ethics presupposes that the healthcare specialist must not carry out any actions that will do the patient any harm, it could be argued that in case of a terminal and painful disease the inaction is even more harmful than action; therefore, euthanasia as the action aimed at relieving the patient of their pain can be considered the only ethical step possible.

Type of argument: deductive

Support (use at least one outside source): ANA Center for Ethics and Human Rights. (2013). Position statements: Euthanasia, Assisted suicide and aid in dying . Washington, DC: American Nurses Association.

Claim 3: By claiming that euthanasia should be banned, people care not about the person, who may be suffering more than (s)he can handle, but themselves, i.e., their concept of ethics and the compliance with the existing moral code, not to mention the threats of legal issues that the introduction of the law may entail. Therefore, when considering the argument, one may dismiss the ethical concerns of the opponents as invalid.

Type of argument:deductive

Support (use at least one outside source): Ebrahimi, N. (2012). The ethics of euthanasia. Australia Medical Student Kournal, 3 (1), 73–75.

With the integration of personal and professional responsibility into the U.S. healthcare, as well as the reconsideration of some of the current legislation principles from the perspective of basic human rights (the right to die in particular), one must admit the necessity to consider euthanasia a legal procedure.

ANA Center for Ethics and Human Rights. (2013). Position statements: Euthanasia, assisted suicide and aid in dying . Washington, DC: American Nurses Association.

Ebrahimi, N. (2012). The ethics of euthanasia. Australia Medical Student Kournal, 3 (1), 73–75.

Lachman, V. (2010). Physician-assisted suicide: Compassionate liberation or murder? MEDSURG Nursing, 19 (2), 121–125.

Wood, N. (2015). Perspectives on argument (8th ed.). London, UK: Longman.

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• Health Fraud: HIV/AIDS and Sexual Enhancement Scams
• Confronting Physician-Assisted Suicide and Euthanasia
• "The Triumph of Autonomy in American Bioethics" by Wolpe
• Vitro Fertilization Ethical Issues
• Chicago (A-D)
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IvyPanda. (2021, March 28). The Ethics of Euthanasia. https://ivypanda.com/essays/the-ethics-of-euthanasia/

"The Ethics of Euthanasia." IvyPanda , 28 Mar. 2021, ivypanda.com/essays/the-ethics-of-euthanasia/.

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IvyPanda . 2021. "The Ethics of Euthanasia." March 28, 2021. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

1. IvyPanda . "The Ethics of Euthanasia." March 28, 2021. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

Bibliography

IvyPanda . "The Ethics of Euthanasia." March 28, 2021. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

• DOI: 10.1016/j.ajp.2024.104146
• Corpus ID: 271016752

Euthanasia for Psychiatric Disorders: Considerations and Trepidations

• Rahul Mathur , Gayatri Bhatia , +1 author Sneha Garg
• Published in Asian Journal of Psychiatry 1 July 2024
• Psychology, Medicine

8 References

Assisted suicide and euthanasia in mental disorders: ethical positions in the debate between proportionality, dignity, and the right to die, physician assisted death for psychiatric suffering: experiences in the netherlands, euthanasia and assisted suicide in psychiatric patients: a systematic review of the literature., euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of dutch psychiatrists, death on demand an analysis of physician-administered euthanasia in the netherlands, can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living, long-term outcome of major depressive disorder in psychiatric patients is variable., competing paradigms of response to assisted suicide requests in oregon., related papers.

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Euthanasia: agreeing to disagree?

Søren holm.

1 Centre for Social Ethics and Policy, School of Law, Williamson Building, University of Manchester, Manchester, M13 9PL UK

2 Section for Medical Ethics, University of Oslo, Oslo, Norway

In discussions about the legalisation of active, voluntary euthanasia it is sometimes claimed that what should happen in a liberal society is that the two sides in the debate “agree to disagree”. This paper explores what is entailed by agreeing to disagree and shows that this is considerably more complicated than what is usually believed to be the case. Agreeing to disagree is philosophically problematic and will often lead to an unstable compromise.

In discussions about the legalisation of active, voluntary euthanasia performed by medical doctors 1 it is sometimes claimed that what should happen in a liberal society is (merely?) that the two sides in the debate “agree to disagree” or “split the difference” (Huxtable 2007 ); and the Netherlands is taken as an example of this kind of accommodation. Agreeing to disagree will allow persons to pursue their own idea of the good life and the good death both as patients and as health care professionals, it will calm the often vociferous and unnecessarily antagonistic public debate, it will exhibit state impartiality and it will lead to a resolution that is the right one in an area where significant liberty interests of patients are at stake.

The underlying idea is that even if we cannot agree on whether euthanasia is ethically acceptable we can reach a societal accommodation that allows those who can find a willing doctor to end their life by euthanasia without fear of criminal prosecution.

The present paper will problematise this account of the virtues and effects of “agreeing to disagree” through an analysis of what that type of societal accommodation actually entails in the context of euthanasia.

The first part of the paper will briefly rehearse some philosophical arguments against compromise or accommodation as a viable option in a context of deep value conflict about an important ethical issue.

The second part will then more concretely analyse (1) what the pro-euthanasia side wants to achieve by the legalisation of euthanasia and (2) what the anti-euthanasia side is worried about in relation to legalisation.

The third part will then show that “agreeing to disagree” is significantly more complicated and fraught with problems than is sometimes assumed.

Throughout the paper no position will be taken as to whether euthanasia is in general, or in specific instances ethically justifiable. The analysis will primarily be drawing on resources from political philosophy and political science and not from moral philosophy.

The paper will also not try to provide a final answer to the question of whether “agreeing to disagree” is a philosophically coherent position to advocate given the strong underlying views on both sides of the debate. But it is worth noting that for someone, such as Dame Mary Warnock believes that doctors who refuse euthanasia requests are ‘Genuinely wicked’ it would be strange to agree to disagree and difficult to see what the agreement could be about (News Letter 2009 ).

Agreeing to disagree and deep value conflict

Within a modern liberal society it is arguable that the best way of resolving policy differences is through some form of deliberative democracy. The parties sit down, trash out their differences and try to argue their way to an outcome that is either accepted or at least acceptable to all participants in the process (Guttman and Thompson 1990 ; Guttman 1993 ; Habermas 1992 ; Habermas 1995 ; Rawls 1996 ; Holm 2006 ).

At both the theoretical and the practical level this kind of process is likely to work best when the different views of the parties stem only from the fact that they have different interests. Such differences can be mediated through reflection and/or compromise.

If, however the differences are differences in values it may be more difficult to achieve a resolution or a compromise. Values are often more intimately connected with the participant’s ultimate world view than interests are and they more often involve metaphysical commitments (McCarthy 1996 ). 2 This is, for instance quite obvious in the abortion debate where one of the issues at stake is the metaphysics of persons and of personal identity.

There are circumstances where disagreements about values are likely to generate irresolvable standoffs. This is especially likely to happen if one or both of the positions involve what John Woods calls:

“Philosophy’s Most Difficult Problem . Let A  = <{ P 1,…., Pn }, C > be a valid argument, a sequence in which C is a logical consequence of proceeding steps. Philosophy’s Most Difficult Problem is that of adjudicating in a principled way the conflict between supposing that A is a sound demonstration of a counterintuitive truth, as opposed to seeing it as a counterexample of its premises.” (Woods 2000 , p. 205).

Discussions about euthanasia often involve exactly this kind of problem. It is, for instance well known that the personhood approaches to moral status involved in many pro-euthanasia arguments generate highly counterintuitive results in relation to beginning of life and end of life issues and that these very results are often seen as a reductio of such approaches by their opponents.

If, furthermore the values on both sides are firmly entrenched we may reach a standoff that excludes negotiability, where the mere suggestion that there is a possible compromise is seen as grotesque and improper.

What is the legalisation of euthanasia supposed to achieve?

Let us, despite the philosophical problems raised above move on and ask what proponents of euthanasia want to achieve through the legalisation of the activity.

The most minimal legalisation of euthanasia would simply involve the decriminalisation of the activity, but supporters of euthanasia understandably want more, because mere decriminalisation will not in itself entail that euthanasia is available.

Decriminalisation is, for instance, compatible with strong professional condemnation and disciplinary action and even with expulsion from the profession of those who perform the acts. The UK regulator of medical doctors the General Medical Council (GMC) does, for instance, oblige doctors to observe duties that they are not legally obliged to observe (e.g. acting as good Samaritans) and it requires them to abstain from acts that are not illegal (e.g. looking at legal internet pornography on work computers). Doctors who breach GMC guidance in these areas may lose their license to practice, even if they have done nothing that could remotely be construed as illegal or criminal. Supporters of euthanasia will therefore not only require that euthanasia is decriminalised but also that it is deemed to be acceptable professional practice and are furthermore likely to require that those who choose to practise euthanasia within the agreed boundaries are not discriminated against in employment decisions.

This is part of a more general feature of the pro-euthanasia position. Those who hold this position view euthanasia as morally justified and therefore also want it to become socially normalised. For them euthanasia is just a normal medical service; and in public health care systems or systems with a large component of third party payment supporters of euthanasia will also want euthanasia to be conceived of as a normal health care service in relation to payment. For instance, if a General Practitioner (GP) attends a patient at home to perform euthanasia the GP should be reimbursed as for any other home visit of similar complexity.

The requirement of normalisation of euthanasia also reaches beyond the health care setting to issues such as death certification, burial and insurance law. For the proponent of euthanasia, death following euthanasia should be treated as a ‘normal death’ and not for instance as a kind of suicide or a potentially illegal killing. 3

What worries does legalisation of euthanasia raise?

Opponents of euthanasia share the concern about the effect of legalisation on the status of health care professionals, but they are likely to focus on the other side of the coin, i.e. the effects in relation to those who do not want to perform euthanasia. Any euthanasia legislation is likely to contain a conscientious objection provision, but this may not be enough to protect doctors and other health care professionals in the long run. After the legalisation of abortion it has become difficult for doctors who do not want to perform abortions to specialise in gynaecology and obstetrics and similar difficulties might occur in some specialties in relation to euthanasia. There has also been a tendency in some jurisdictions to interpret conscientious objection clauses quite narrowly both with regard to the type of health care personnel that is covered and with regard to the kind of involvement that a person can object to participate in. Opponents of euthanasia are therefore likely to require stronger protections than mere conscientious objection.

A related issue is that a right to conscientious objection is often combined with a professional duty to refer the patient to another practitioner willing to perform the act in question. But for someone who thinks that euthanasia is closely akin to murder such a duty is highly problematic.

More generally those who are opposed to euthanasia will also be opposed to the general normalisation of euthanasia as a medical service. They are likely to want it to be kept separate and special, and may be unlikely to be willing to have it included in normal reimbursement mechanisms. This may be combined with an unwillingness to contribute financially through insurance premiums or taxation to a practice seen as morally abhorrent.

In relation to resources in the health care system there may also be a worry about whether introducing euthanasia as an option undermines or weakens claims to have expensive life prolonging treatment provided, or whether in the long run a presumption would be established that choosing euthanasia was the morally right choice in some circumstances of severe resource constraints.

Opponents of euthanasia are also likely to have a distinct worry in relation to whether both sides involved in the societal bargain are willing to let it stand. Is “agreeing to disagree” about active, voluntary euthanasia performed by a medical doctor a stable accommodation or just a staging post to the legalisation of other forms of euthanasia. This is, paradoxically a concern that is at least partially fuelled by the writings of academic bioethicists and legal scholars in relation to end of life decisions and abortion. A typical type of argument in these writings is a consistency argument of the form “society already allows X, therefore it is inconsistent not to allow Y which is currently prohibited”. There are many problems with consistency arguments of this type, but they are never the less often rhetorically powerful (Holm 2003 ). It is obvious that the legalisation of euthanasia will enable a variety of new consistency arguments to be brought forward. What is going to be legalised is, for instance not initially “euthanasia on demand” but euthanasia in cases of terminal disease with significant, irremediable suffering. But the underlying justification for allowing euthanasia only in this specific class of circumstances is inherently unstable because it relies on elements of both respect for autonomy and the relief of suffering.

Why is agreeing to disagree difficult?

From the analysis so far it has become clear that there are several problems with implementing “agreeing to disagree” as a societal accommodation or compromise in relation to euthanasia, even if we believed it made philosophical sense to advocate such a position.

The first problem is that whereas it might be possible to agree to disagree about the very narrow issue of decriminalisation of euthanasia, it is much more difficult to agree to disagree about the normalisation of euthanasia as a type of medical/health care intervention. It is practically difficult to confine the legalisation of euthanasia to mere permission. There will almost always also be an element of acceptance in any legalisation. 4

The second problem is that the situation established by agreeing to disagree is unstable. It satisfies neither side in the debate and there is therefore always a temptation to try to disturb the equilibrium and get a little more; and a possible lingering suspicion that that is exactly what the other side will try to do.

The third problem is that any move from the now prevailing status quo in most countries, i.e. that euthanasia is illegal will be a move that only involves loss seen from the point of view of a strict opponent of euthanasia. For such and opponent there is nothing to be gained in the move itself and the only incentive to agree to disagree is if it is believed that the legal position after agreeing to disagree will be more restrictive than any position that would be reached without agreeing to this form of accommodation.

If the position in the Netherlands can rightly be described as “agreeing to disagree”, and I do not want to claim that this is an accurate or adequate description, then it is a position that has been reached through a long historical development. It has been reached in a specific societal context and there is evidence that what the Dutch have agreed to disagree about has changed over time. It is not obvious that other societies can reach the same kind of accommodation in one single step.

For the philosopher the main problem with “agreeing to disagree” as a policy solution is that it requires both sides to suspend judgement on whether the counterintuitive consequences of accepting, for instance a personhood based justification of the permissibility of voluntary, active euthanasia should count as a reductio or should instead be seen as pointing to future goals for policy development. It furthermore requires the philosophical proponents of euthanasia to acquiesce in what they see as illiberal legislation prohibiting euthanasia in circumstances where it should be allowed; and it requires the philosophical opponents of euthanasia to accept that a kind of killing they think is profoundly unethical should be allowed in law. We can see how philosophers on both sides might “agree to disagree” as citizens, but if they continue to believe, as they almost inevitably must do that they have the correct argument on their side, agreeing to disagree will create significant cognitive dissonance and unease.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

1 In the following all unqualified uses of the term “euthanasia” refer to active, voluntary euthanasia performed by a doctor.

2 Let us in passing note that any call for the exclusion of metaphysical commitments from ethical debates about human life and death is potentially highly problematic. First because every participant in the debate has metaphysical commitments that influences their position and second because the exclusion of metaphysical commitments from the debate is likely to be a bigger burden for some participants than for others.

3 This is exactly why the “Dutch solution”, leaving euthanasia as technically illegal but not prosecuted if the criteria are fulfilled is often criticised by proponents of euthanasia.

4 Even mere decriminalisation of euthanasia by medical doctors could be seen as conveying some form of social acceptance by classifying the act as a medical act and thereby lending it some of the lustre (if such lustre exists) of medicine and the medical profession.

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Home — Essay Samples — Social Issues — Human Rights — Euthanasia

Essays About Euthanasia

Euthanasia essay: examples, types of euthanasia essays:.

• Euthanasia Argumentative Essay: This type of essay presents arguments for and against euthanasia and requires the writer to take a position on the issue.
• Euthanasia Persuasive Essay: The purpose of this essay is to persuade the reader to support or reject the idea of euthanasia. The writer needs to use convincing arguments and evidence to support their position.
• Euthanasia Controversy Essay: This type of essay explores the controversies surrounding euthanasia, including ethical, moral, legal, and religious issues. The writer needs to analyze and present different perspectives on the issue.

Euthanasia: Argumentative Essay

• Choose a clear position: Before you start writing, it's important to decide where you stand on the issue of euthanasia. Do you believe that euthanasia should be legalized, or do you think it should remain illegal? Your position will guide your research and the evidence you present.
• Conduct thorough research: Euthanasia is a complex and controversial issue, so it's essential to do your research before starting to write. Look for reliable sources of information, such as academic articles, government reports, and medical journals.
• Develop a strong thesis statement: Your thesis statement should clearly state your position on euthanasia and provide a roadmap for the rest of your essay. It should be clear, concise, and easy to understand.
• Provide evidence to support your arguments: Use evidence to support your arguments, such as statistics, expert opinions, and case studies. Make sure that your evidence is credible and comes from reputable sources.
• Address counterarguments: It's important to address counterarguments to your position to demonstrate that you have considered all perspectives on the issue. Addressing counterarguments will also make your essay more persuasive.
• Use persuasive language: Use persuasive language to make your argument more convincing. Use strong, clear language that emphasizes your point of view.

Euthanasia: Persuasive Essay

• Conduct research: The writer should conduct thorough research on the topic to gather as much information as possible to support their argument.
• Develop a clear thesis statement: The writer should clearly state their position on euthanasia in the thesis statement.
• Present convincing evidence: The writer should use credible and convincing evidence to support their argument, such as statistics, case studies, and expert opinions.
• Address counterarguments: The writer should acknowledge and address counterarguments to their position, and provide strong rebuttals.
• Use persuasive language: The writer should use persuasive language and techniques, such as emotional appeals and rhetorical questions, to convince the reader of their position.

Euthanasia Controversy Essay

• Start with a clear and concise introduction that presents the topic and the main arguments.
• Conduct thorough research on the topic, using credible sources, such as academic journals, government reports, and expert opinions.
• Present a balanced view of the issue by providing arguments for and against euthanasia.
• Use clear and concise language, avoiding emotional language that may detract from the argument.
• Consider the ethical and moral implications of euthanasia, and the different perspectives of stakeholders involved.
• Conclude the essay with a summary of the main arguments and a final thought on the topic.

Tips for Choosing a Topic for Euthanasia Essays:

• Identify your stance: Before choosing a topic, decide on your position on euthanasia. This will help you select a suitable topic for your essay.
• Conduct research: Thoroughly research the topic of euthanasia to gain a better understanding of the subject matter. Use reliable sources such as books, journals, and academic articles.
• Brainstorm: Create a list of potential topics related to euthanasia and narrow down your choices based on your research and personal interest.
• Focus on a specific aspect: Instead of trying to cover the entire topic of euthanasia in your essay, focus on a specific aspect such as the ethical or legal implications.

Hook Examples for Euthanasia Essays

Anecdotal hook.

Meet John, a terminally ill patient who faces excruciating pain every day. His decision to seek euthanasia sparks a controversial debate over the right to die with dignity.

Question Hook

Is it ethical for physicians to assist patients in ending their lives to relieve unbearable suffering? Explore the moral dilemmas surrounding the topic of euthanasia.

Quotation Hook

"Dying is not a crime." — Jack Kevorkian. Investigate the legacy of Dr. Kevorkian, who championed the cause of physician-assisted suicide, and its impact on the euthanasia debate.

Statistical or Factual Hook

Did you know that euthanasia is legal in several countries, while it remains illegal in others? Examine the global landscape of euthanasia laws and the factors that influence these decisions.

Definition Hook

What exactly is euthanasia, and how does it differ from other end-of-life choices? Delve into the definitions, types, and terminology associated with this complex issue.

Rhetorical Question Hook

Should individuals have the autonomy to decide when and how they will end their lives, especially in cases of terminal illness? Analyze the arguments for and against euthanasia's role in preserving personal freedom.

Historical Hook

Travel through history to explore the evolution of euthanasia practices and laws. Discover how societies have grappled with the idea of mercy killing across centuries.

Contrast Hook

Contrast the perspectives of medical professionals who advocate for euthanasia as a compassionate choice with those who argue for preserving the sanctity of life at all costs. Explore the ethical dilemmas inherent in these differing viewpoints.

Narrative Hook

Step into the shoes of a family member faced with the agonizing decision of whether to support a loved one's request for euthanasia. Their personal story sheds light on the emotional complexities involved.

Shocking Statement Hook

Prepare to be shocked by the cases of covert euthanasia that occur outside the boundaries of the law. These stories expose the gray areas and ethical challenges surrounding end-of-life decisions.

Euthanasia, Assisted Dying and The Right to Die

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The Issues Why Physician-assisted Suicide Should not Be Legalized

Physician-assisted suicide (pas), a controversy over the issue of physician assisted suicide, right to die: euthanasia issues, let us write you an essay from scratch.

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My Views on The Issue of Assisted Suicide

Physician-assisted death: advantages and moral matters of right to die, medical and ethical dilemma: euthanasia or right to die, range of moral, ethical and legal perspectives of right to die or euthanasia, get a personalized essay in under 3 hours.

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Discussion on Whether Human Euthanasia Should Be Made Illegal

Natural death and euthanasia: the catholic church’s historical response, the popularity of euthanasia among the american population, a moral interpretation of euthanasia and murder, analysis of physician-assisted suicide (pas) in terms of bioethics, a debate over allowing physician assisted suicide, arguments expressed by proponents of the legalization of physician-assisted suicide (pas), persuasive essay pro euthanasia, why physician-assisted suicide for terminally ill patients should be legalized, the arguments for euthanasia: a critical analysis, advantages and disadvantages of euthanasia, death with dignity act: ethical dilemma regarding euthanasia, the right to die: debating euthanasia in modern society, advocating for legalizing euthanasia, an assisted suicide: roller coasters as tools for euthanasia, euthanasia: examining arguments, ethics, and legalities, voluntary euthanasia persuasive speech, the struggle with physician assisted suicide in the united states, why euthanasia should not be allowed, physician aid in dying: a controversial ethical issue.

Euthanasia is the practice of intentionally ending life to relieve pain and suffering.

Euthanasia is categorized in different ways, which include voluntary (when a person wills to have their life ended), non-voluntary (when a patient's consent is unavailable), or involuntary (.done without asking for consent or against the patient's will)

Jack Kevorkian, Philip Nitschke, Barbara Coombs Lee.

The United States (Washington, Oregon, California, Colorado, Montana, Vermont, Hawaii), Switzerland, Germany, Japan, the Netherlands, Belgium, Luxembourg, Colombia, Canada.

Though euthanasia is still illegal in England, King George V was euthanized. Euthanasia is mostly administered by giving lethal doses of painkiller or other drugs. Despite Euthanasia being generally illegal in India, there is a tradition of forced euthanasia in South India.

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The Rise of Microchip Implants in Humans: Benefits and Concerns

This essay is about the rising trend of microchip implants in humans, exploring their potential benefits and associated concerns. It discusses how these implants can enhance medical care by storing critical health information and monitoring vital signs, as well as improve security and financial transactions by replacing keys and passwords. However, it also addresses significant privacy and security risks, such as data vulnerability and unauthorized tracking, as well as ethical issues related to bodily autonomy and potential societal divides. The essay emphasizes the need for careful consideration of these concerns to balance the advantages of microchip implants with the protection of individual rights and freedoms.

How it works

The concept of implanting microchips in humans, once the domain of science fiction, has become an increasingly discussed reality in recent years. These tiny devices, typically the size of a grain of rice, can be embedded under the skin to perform a variety of functions, from tracking medical information to facilitating financial transactions. The rise of this technology presents a fascinating glimpse into the future, but it also raises important ethical, privacy, and security concerns that need to be addressed.

Microchip implants offer several potential benefits that could significantly enhance our daily lives.

One of the most promising applications is in the medical field. These implants can store a patient’s medical history, including allergies, blood type, and past treatments, providing instant access to crucial information in emergencies. This could improve the efficiency and accuracy of medical care, especially in situations where time is of the essence. Additionally, for individuals with chronic conditions, microchips could be used to monitor vital signs and send real-time data to healthcare providers, enabling more proactive and personalized care.

Beyond healthcare, microchip implants have the potential to revolutionize how we interact with the world around us. In the realm of security, these devices could replace traditional keys and passwords, allowing for secure and convenient access to homes, offices, and even digital devices. By simply scanning their hand, a person could unlock doors, start their car, or log into their computer, reducing the risk of lost keys or forgotten passwords. Financial transactions could also become more seamless, with implanted chips allowing for contactless payments that are faster and potentially more secure than current methods.

Despite these potential benefits, the idea of microchip implants in humans is not without controversy. Privacy is a major concern, as the data stored on these chips could be vulnerable to hacking or unauthorized access. In an age where data breaches are becoming increasingly common, the thought of having personal information accessible through an implant raises significant questions about security. There is also the potential for misuse by employers or governments, who might track individuals’ movements or activities without their consent, leading to a loss of personal autonomy and freedom.

Ethical considerations are equally important when discussing human microchip implants. The notion of having a foreign device permanently embedded in one’s body can be unsettling, raising questions about bodily autonomy and the extent to which technology should be integrated into our lives. There is a risk of creating a societal divide between those who choose to adopt this technology and those who do not, potentially leading to new forms of inequality and discrimination. Furthermore, the long-term health effects of having a microchip implanted are still not fully understood, necessitating further research to ensure that these devices are safe for widespread use.

The potential for microchip implants in humans also intersects with issues of consent and coercion. It is essential to ensure that individuals are fully informed about the implications of receiving an implant and that their decision to do so is entirely voluntary. In some scenarios, there could be pressure to conform, such as in workplaces where employers might encourage or even mandate the use of implants for security or efficiency purposes. Protecting individual rights and freedoms in the face of advancing technology is a critical aspect of this ongoing discussion.

Microchip implants in humans represent a significant technological advancement with the potential to improve various aspects of our lives. However, the adoption of this technology must be approached with caution, taking into consideration the privacy, ethical, and health concerns that accompany it. As we move forward, it is crucial to engage in thoughtful and inclusive discussions about how to balance the benefits of microchip implants with the need to protect individual rights and ensure the responsible use of technology. Only by addressing these concerns can we fully harness the potential of microchip implants while safeguarding the values and freedoms that are fundamental to our society.

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The Rise of Microchip Implants in Humans: Benefits and Concerns. (2024, Jun 28). Retrieved from https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/

"The Rise of Microchip Implants in Humans: Benefits and Concerns." PapersOwl.com , 28 Jun 2024, https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/

PapersOwl.com. (2024). The Rise of Microchip Implants in Humans: Benefits and Concerns . [Online]. Available at: https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/ [Accessed: 13 Jul. 2024]

"The Rise of Microchip Implants in Humans: Benefits and Concerns." PapersOwl.com, Jun 28, 2024. Accessed July 13, 2024. https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/

"The Rise of Microchip Implants in Humans: Benefits and Concerns," PapersOwl.com , 28-Jun-2024. [Online]. Available: https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/. [Accessed: 13-Jul-2024]

PapersOwl.com. (2024). The Rise of Microchip Implants in Humans: Benefits and Concerns . [Online]. Available at: https://papersowl.com/examples/the-rise-of-microchip-implants-in-humans-benefits-and-concerns/ [Accessed: 13-Jul-2024]

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