Assisted Suicide is a contentious issue in many countries. The question in the debate is this: if a terminally ill person decides that they wish to end their life, is it acceptable for others to assist them? This would normally take the form of a doctor administering a lethal injection, which would end their life painlessly. A clear distinction must be made with involuntary euthanasia, by which someone is ‘put down’ against their wishes, and which is simply murder by another name. Assisted suicide is illegal in most countries around the world. In the United States, Dr Jack Kervorkian – nicknamed ‘Doctor Death’ for his actions beliefs – has campaigned for a change in the law for many years, and assisted in the suicide of at least 45 people. He was found guilty of second degree murder and imprisoned in 1999 after a widely publicized trial. He was released on June 1, 2007, on parole due to good behavior. Those that practice euthanasia continue to risk charges of murder and prison sentences. However, in Oregon and California, state legislation has been passed to allow for euthanasia in special circumstances and within a heavy regulatory framework in which third party ethicists attempt to ensure the appropriateness of assisted-suicide cases. The pros and cons of these types of assisted suicide regimes are framed below.
Every right includes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the right to choose to die is implicit in the right to life.
It is acceptable to take a life in self-defense. It is acceptable to send soldiers into war to die and kill to achieve certain ends. It is acceptable to risk human life in missions into space. And, it is considered acceptable by some (actually many conservatives that oppose euthanasia) to execute criminals. Clearly, life is not inviolable in modern society. It can be violated or risked for certain, highly valuable ends (security, justice, discovery). The question with euthanasia, therefore, is not whether life can be violated for certain ends (it can). The question is whether it can be a justified trade-off, and if so, how to ensure that euthanasia is only performed when it is fully justified under the criteria we set forth.
Allowing the right to die means that opponents can still exercise their rights by choosing not to particpate, whereas refusing this right disenfranchises those who may want to choose the time and manner of their death without harming others. Therefore allowing this right is more democratic.
If we were to assume that euthanasia is wrong, than we would also have to assume that the pleas of the dying for euthanasia are wrong too. Can we disregard these pleas as merely the dying wishes of individuals that have become desperate and irrational? If we disregard these pleas, aren’t we essentially telling the dying that their wishes are wrong and, in fact, immoral? That is, in effect, what opponents of euthanasia are saying to the dying that make these pleas. At a minimum, the state is simply denying individuals their dying wish, angering, and even alienating them. Is this a good way for the state to honor the dying and their lives? No. In this way, denying euthanasia violates the sanctity of the lives of the dying that call for it. Aren’t these the only sanctified lives at hand that matter? Or, is the purpose to walk all over the dying in order to uphold a self-righteous belief among the living about the “sanctity of life”.
Some opponents argue that euthanasia is about permitting doctors and/or families to kill their ill loved ones. This is not the general euthanasia proposal, which is to allow patients with exceptional circumstances to seek euthanasia and receive it if they are eligible. The choice is in the hands of the patient, not the family or doctors, so it cannot be termed “killing”. Rather, its about helping terminal patients die who want to die.
The United States Court of Appeals for the Second Circuit stated in its 1996 Opinion from Quill v. Vacco: – “What concern prompts the state to interfere with a mentally competent patient’s ‘right to define [his] own concept of existence, of meaning, of the universe, and of the mystery of human life,’ [Planned Parenthood v. Casey] when the patient seeks to have drugs prescribed to end life during the final stages of a terminal illness? The greatly reduced interest of the state in preserving life compels the answer to these questions: ‘None’…”
When the freedom of the individual to do what they want is prevented by the state, it must be because a clear, compelling state interest exists. It is not clear that any such interests exists in the case of euthanasia. Certainly, there is no benefit to the state when a dying patient is loudly crying for euthanasia and the state blocks the procedure. The only state interest that could be involved is the notion of the “dignity of life”, but this is highly, highly contested, with great public opposition to the notion that life is inviolable in cases of an excruciating, terminal illness. Does the state have an interest in opposing this public opinion? Where is the interest?
The United States Court of Appeals for the Second Circuit stated in its 1996 Opinion from Quill v. Vacco: – “…It seems clear that New York does not treat similarly circumstanced persons alike: those in the final stages of terminal illness who are on life-support systems are allowed to hasten their deaths by directing the removal of such systems; but those who are similarly situated, except for the previous attachment of life-sustaining equipment, are not allowed to hasten death by self-administering prescribed drugs…”
“[…]A thing (as opposed to a state or property) can be valuable in one of two ways (keeping in mind the above distinctions): First, it might be valuable as a vehicle or carrier of what is per se valuable. If human beings were valuable in that way, then they would not be per se valuable, but only the states or properties that they bore or carried would be of per se value. Or, secondly, a thing might be valuable because it is per se valuable, that is, it is valuable for its own sake, and not as a means toward what it enables to be instantiated. But, human beings must be valuable in the second way rather than in the first way. For if they were valuable only as mere vehicles for what is per se valuable, then it would always be morally right to kill one child, provided one agreed to replace him with two others. No human beings would have more than replaceable value. None would have the kind of value that almost all of us recognize that at least some human beings do have. So, human beings are intrinsically valuable, that is, valuable per se. This means that they themselves are valuable, not just as vehicles for what is valuable.
So, since what I am is a living bodily entity, and the thing which I am is intrinsically valuable, it follows that this bodily entity itself is intrinsically valuable. To deny that is to denigrate one’s bodily life, to demean one’s bodily person. Suicide and euthanasia necessarily involve a denigration of the very thing which you and I are, our bodily lives. The choice of suicide or euthanasia unavoidably involves a denial of the intrinsic dignity of the human person.”
The dignity and inviolability of life is an absolute principle. It does not matter if a dying person does not appreciate that dignity and desires to be euthanized; the dignity of their life and life in general still must be protected.
“3. Should people be forced to stay alive? No. And neither the law nor medical ethics requires that “everything be done” to keep a person alive. Insistence, against the patient’s wishes, that death be postponed by every means available is contrary to law and practice. It would also be cruel and inhumane. There comes a time when continued attempts to cure are not compassionate, wise, or medically sound. That’s where hospice, including in-home hospice care, can be of such help. That is the time when all efforts should be placed on making the patient’s remaining time comfortable. Then, all interventions should be directed to alleviating pain and other symptoms as well as to the provision of emotional and spiritual support for both the patient and the patient’s loved ones.”
When you choose to remain silent, for instance, you may change your mind at a later date; when you choose to die, you have no such second chance. Similarly, participating in someone’s death is also to participate in depriving them of all choices they might make in the future. That euthanasia is irrevocable in this way is the problem.
Nobody has the authority to take the life of another individual. Nor do they have the authority to euthanize an individual. And, if a doctor or family merely provides the poison, they can, nevertheless, be seen like accomplices to a crime.
It is justified to take another life in self-defense. But, this is very different than euthanasia; it is out of self-defense. Euthanasia, in contrast, involves taking an innocent life.
If someone is threatening to kill themselves it is your moral duty to try to stop them. You would not, for example, simply ignore a man standing on a ledge and threatening to jump simply because it is his or her choice; and you would definitely not assist in his suicide by pushing him. In the same way, you should try to help a person with a terminal illness, not help them to die.
Those who are in the late stages of a terminal disease have a horrific future ahead of them: the gradual decline of their body, the failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to ‘control’ their pain will often leave them in a delirious and incapable state. Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and die with dignity.
Chantal Sebire, a 52- year-old Dijon schoolteacher, suffering from a rare disease that has left her disfigured by facial tumors, said in 2008 to Time magazine: “I no longer accept this enduring pain, and this protruding eye that nothing can be done about. I want to go out celebrating, surrounded by my children, friends, and doctors before I’m put to sleep definitively at dawn.” From the Time article, “Making a Case for Euthanasia”. Mar. 15, 2008, “Sebire and her backers retort that preventing her from getting medical assistance to end her life swiftly and painlessly ensures months or years of additional torment from pain. Her death will come, they say, after a long coma that will reduce her to being nothing but an inanimate burden on her family.”
French President Nicholas Sarkozy said in a 2007 campaign speech, “when I hear debates on euthanasia, I tell myself that while I respect the principles, the convictions, at the bottom of my heart I still say there are limits to the suffering that can be imposed on a human.”
The most sacred element of a person is their identity as individual and a soul. Once this is lost, much of the sanctity and fulfillment in life is lost. While this is not a full justification for euthanasia, it is a salient factor.
The future which lies ahead for the terminally ill is of course terrifying, but society’s role is to help them live their lives as well as they can. This can take place through counselling, helping patients to come to terms with their condition.
Supporters of euthanasia sometimes argue that the ill are no longer the person they were, and therefore that their lives have no more meaning, and that euthanasia can relieve any suffering that this causes. But, human identity must be defined as connected with the continued existence of the body, even if mental capacities are entirely diminished. Even if a personality is gone, the continued dignity of the bodily identity must be respected.
Euthanasia is typically proposed only for the terminally ill; those who are not expected to live beyond six months. But, six months is not a very long time. Isn’t it reasonable to expect the terminally ill to live out these six months or less until their death, especially when modern medicine can reduce any pain and make the process tolerable?
Modern palliative care is immensely flexible and effective, and helps to preserve quality of life as far as is possible. There is no need for terminally ill patients ever to be in excruciating pain, even at the very end of the course of their illness. There are some difficulties with using pain medicines that are regulated substances. Many doctors recommend that, at a minimum, the first step before considering euthanasia is to loosen the regulations on these substances so that terminally ill, pained patients can be more fully relieved of their pains.
Euthanasia advocates, having built a case largely on the pain of the terminally ill, respond to the notion of advanced pain treatment by arguing that it is undignified for individuals to be in a “drugged state”. Yet, a “drugged state” can hardly be cited as a sufficient reason for euthanasia. As long as there is no unbearable pain, there is not much of a case for euthanasia.
“While some people refer to the liberty interest implicated in right-to-die cases as a liberty interest in committing suicide, we do not describe it that way. We use the broader and more accurate terms, ‘the right to die,’ ‘determining the time and manner of one’s death,’ and ‘hastening one’s death’ for an important reason. The liberty interest we examine encompasses a whole range of acts that are generally not considered to constitute ‘suicide.’ Included within the liberty interest we examine, is for example, the act of refusing or terminating unwanted medical treatment…
Casey and Cruzan provide persuasive evidence that the Constitution encompasses a due process liberty interest in controlling the time and manner of one’s death — that there is, in short, a constitutionally recognized ‘right to die.'”
The Terri Shiavo case is illustrative of the situation created by the illegality of euthanasia. A choice was made that Terri Shiavo’s death was imminent and that should should be allowed to die. Without the option of euthanasia, her feeding tubes were removed, and she was starved to death. How is that more moral than euthanasia? Forcing patients to starve to death or go into cardiac arrest, simply because the option of euthanasia does not exist, is a cruel alternative.
Doctors are allowed to make non-treatment decisions in special cases in order to shorten the life of a patient and end their suffering. This is a roundabout form of “euthanasia” that causes patients far more harm than a real euthanasia would. Doctors should be allowed to use euthanasia to avoid having to make these Non-Treatment decisions.
Life can be kept “alive” for longer and longer periods with modern technologies and techniques. Is this natural? No. Is it excessive? It certainly can be. When keeping life “alive” becomes an excessive exercise in medicine and technology, a cut-off point become necessary. That cut-off point is euthanasia. This argument will become increasingly relevant into the future, as human-beings are kept alive with dozens of test tubes and transplants.
Opponents of euthanasia talk about the importance of allowing nature to run its course with human life, and for humans to die a natural death (or as God intended), as opposed to induced by euthanasia. Yet, if “natural-death” is the criteria for right kind of death, then hospitalization, IVs, medication, and all other sorts life-support would be wrong. And, yet, this is precisely what is used to the extreme to keep alive, artificially, many individuals that would otherwise die a “natural” death. In this way, an “unnatural” life is often the only alternative to an “unnatural” death through euthanasia. Since neither alternative is “natural” or as “God intended”, we must decide if euthanasia is appropriate on other criteria. Since this “natural death” argument is central to the opposition to euthanasia, we will find that the remaining case against euthanasia is dramatically weakened.
It is justifiable for a person to refuse treatment. This respects the individual’s right to not be touched or affected by other individuals. But, euthanasia is different in the sense that it involves other individuals in the process of the death of the individual.
This means that withdrawing life-support should never be equivalent in intent to euthanasia. That is, it should never have the explicit purpose of ending a life. In Terri Shiavo’s case, for instance, the explicit purpose of withdrawing life-support was to end her life. This was wrong, and is the reason why it was so widely opposed. Instead, withdrawing life support or denying it from the beginning must be about a broader desire to, for instance, live life naturally and without artificial support, spend as much time as possible with family without the interruption of life-support, or to live life naturally without the interruptions, discomfort or pain of life support. And, of course, withdrawing or denying life-support can also include death as the end result, but that death should never be the central purpose of the act.
The “natural death” alternative to euthanasia is not keeping someone alive via life support until they die on life support. That would, indeed, be unnatural. The natural alternative is, instead, to allow them to die off of life support.
It is important that man not attempt to play God or nature in subjecting another individual to euthanasia. Rather, patients should be allowed to live and die naturally. God or nature intended man to die in a certain way (ie. “naturally”). By euthanizing the individual, a person is deprived of this natural human experience and its diverted from the intentions of the Maker.
It is false to claim that the state or doctors are choosing to euthanize individuals. Doctors and the state make no choice at all, accept to permit and empower individuals to make their own choice to die or not. Any argument against euthanasia that is premised on the notion that it is wrong for one individual to kill or harm another misses this critical point; euthanasia only involves governments and doctors allowing patients to harm/kill themselves. It is a case of of the state and doctors allowing individuals to exercise their own liberties, rather than of the state or doctors taking any liberties away from the patient.
Margaret Battin, Ph.D. Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, Division of Medical Ethics, University of Utah. “Is a Physician Ever Obligated to Help a Patient Die?,” Regulating How We Die. 1998: “Suicide assisted by a humane physician spares the patient the pain and suffering that may be part of the dying process, and grants the patient a ‘mercifully’ easy death.”
A good doctor will form close bonds with their patients, and will want to give them the best quality of life they can. However, when a patient has lost or is losing their ability to live with dignity and expresses a strong desire to die, they are legally unable to help. To say that modern medicine can totally eradicate pain is a tragic over-simplification of suffering. While physical pain may be alleviated, the emotional pain of a slow and lingering death, of the loss of the ability to live a meaningful life, can be horrific. A doctor’s duty is to address his or her patient’s suffering, be it physical or emotional. As a result, doctors will in fact already help their patients to die – although it is not legal, assisted suicide does take place. It would be far better to recognise this, and bring the process into the open, where it can be regulated. True abuses of the doctor-patient relationship, and incidents of involuntary euthanasia, would then be far easier to limit.
There is no necessity to force any given doctor into performing euthanasia. If a doctor strongly opposes euthanasia, it’s OK, another doctor can be found to perform the procedure.
The relevant portion of the Hippocratic oath reads, “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death.” This oath is the center piece of medical practice and ethics. How can euthanasia be practiced in the medical profession when it so clearly violates its principal ethical code.
The physician has always acted as healer. Euthanasia contradicts this basic role.
Some suggest that physicians have an obligation to end the suffering of patients by subjecting them to euthanasia. Yet, physicians may have strong beliefs against the practice, particularly on the basis that human life should never be intentionally ended under any circumstance. Who is to say that they are wrong? Furthermore, physicians never signed any piece of paper that states an obligation to euthanize patients in circumstances of extreme suffering. Finally, the Hippocratic oath, the main oath taken by physicians, directly forbids physicians from performing euthanasia. Certainly, it is a stretch any physician would be obligated to perform the procedure.
a physician must not be involved in deliberately harming their patient. Without this principle, the medical profession would lose a great deal of trust; and admitting that killing is an acceptable part of a doctor’s role would likely increase the danger of involuntary euthanasia, not reduce it.
The daily decisions made in order to preserve life can be difficult enough; to require them to also carry the immense moral responsibility of deciding who can and cannot die, and the further responsibility of actually killing patients, is unacceptable. This is why the vast majority of medical professionals oppose the legalisation of assisted suicide: ending the life of a patient goes against all they stand for. Many doctors that have performed euthanasia are traumatized or deeply, negatively affected by the experience.
As was mentioned above, euthanasia is an immediate and painless way to end a life that is too painful. Many families don’t want to see their loved ones suffer and the patient doesn’t want them to suffer either. Euthanasia provides an option to end a life before it even enters the terminal “death-bed” stage of suffering, or it allows families to choose to end a “death bed” existence with dignity and peace instead of simply pulling the plugs to, in some case, starve their loved one to death.
Charlie Crist, former Attorney General of Florida and current governor, was quoted in an April 20, 2006 article in the AZ Republican, entitled “Attorney General Says Bush Had Schiavo Case Wrong” – “I am pro-life and I respect life.. There are some decisions that ought to be left to God and family… Had I been governor, I would not have done the same thing [as Jeb Bush]… These kinds of end-of-life matters do not belong in government.”
Some advocates of euthanasia note that those that have come out of a “bed-side” death very frequently become advocates of euthanasia. In the same vein, they argue that those making decisions against euthanasia have not been in the same “bed-side” situation, and if they had been, they would probably change their position.
Where euthanasia is currently illegal, it is a lonely, desperate act, carried out in secrecy and often as a cry for help. The impact on the family who remain can be catastrophic. By legalizing assisted suicide, the process can be brought out into the open. In some cases, families might have been unaware of the true feelings of their loved one; being forced to confront the issue of their illness may do great good, perhaps even allowing them to persuade the patient not to end their life. In other cases, it makes them part of the process: they can understand the reasons behind their decision without feelings of guilt and recrimination, and the terminally ill patient can speak openly to them about their feelings before their death.
Families often have a direct interest in seeing an ill family member die. First, they may not have the money to support the costs of keeping the patient alive. Second, they may not want to go through the burden of supporting and comforting a loved one in a long downward spiral toward their death. These are strong incentives for family members to pressure their ill family member into euthanasia, even if the individual does not want it. Legalizing euthanasia would open the door to this kind of pressure. Even the most well regulated system would have no real way to ensure that this does not happen.
Many may resent a loved one’s decision to die, and would be either emotionally scared or estranged by the prospect of being in any way involved with their death.
The dying have a profound sense of shame and guilt, being in the condition that they are, and causing their family substantial burdens and strains. If euthanasia is available, they may choose it simply out of this sense of guilt, which would be wrong. No regulations can prevent this from occurring, particularly because the patient would give the appearance of choosing euthanasia completely voluntarily. And, it would be voluntary, but in the context of guilt, rather than self-interest.
R.G. Frey, D.Phil, Professor of Philosophy, Bowling Green State University. “The Fear of a Slippery Slope,” Euthanasia and Physician-Assisted Suicide: For and Against. 1998 – “Especially with regard to taking life, slippery slope arguments have long been a feature of the ethical landscape, used to question the moral permissibility of all kinds of acts… The situation is not unlike that of a doomsday cult that predicts time and again the end of the world, only for followers to discover the next day that things are pretty much as they were…
We not only can distinguish between [voluntary and non-voluntary] cases [of euthanasia] but do… We need the evidence that shows that horrible slope consequences are likely to occur. The mere possibility that such consequences might occur, as noted earlier, does not constitute such evidence.”
It is common when a practice is criminalized that it is taken into the shadows and performed without regulation and, subsequently, abusively. This is no less the case with euthanasia.
The criteria involved in the proposals to legalize euthanasia are very detailed and would be enforced very strictly. Breaking from these criteria even minutely would be very difficult, which means that the potential of a slippery slope to forced euthanasias, murders, and other abuses is virtually impossible. While minor infractions of the criteria are possible, the gloomy “slippery slope” scenarios argued by opponents of euthanasia are virtually impossible.
There is very little historical evidence of doctors actually coercing patients into accepting euthanasia against their will. Part of the reason is that it is a major leap from patients having to request euthanasia to doctors forcing it upon them. It reality, it is not a very plausible leap, particularly with the number of checks that would be in place against such abuses, upon legalization.
Wesley Smith, J.D., Consultant to the International Task Force on Euthanasia, writes in his 2000 book Culture of Death: The Assault on Medical Ethics in America. – “Oregon is sliding down the same slippery slope as did the Netherlands. Once killing is redefined from bad to good, the protective guidelines for assisted suicide, which advocates assure us will keep the practice of hastening death corralled, are also quickly redefined, at least in practice, as obstacles to be overcome. Then they are attacked, ignored, or reinterpreted, while potential violations go essentially uninvestigated – to the point where they eventually become irrelevant.”
Richard Fenigsen, “Dutch euthanasia revisited, ” Issues in Law & Medicine, Winter 1997 v13 n3 p301-311 – “Dr. Fenigsen says the Dutch are not on a slippery slope, “Dutch doctors who practice euthanasia are not on a slope. From the very beginning they have been at the bottom.” Dr Fenigsen found “involuntary euthanasia…is rampant. . ..a staggering 62% of all newborns’ and infants’ deaths resulted from ‘medical decisions,'” further to this, in 1995 alone there were 900 lethal injections given to patients who had not requested euthanasia.. It revealed that 189 were fully competent and could have been consulted about their consent but were not. Fenigsen concludes that “those who contend that it is possible to accept and practice ‘voluntary’ euthanasia and not allow involuntary totally disregard the Dutch reality.”
“3. Euthanasia will only be voluntary, they say Emotional and psychological pressures could become overpowering for depressed or dependent people. If the choice of euthanasia is considered as good as a decision to receive care, many people will feel guilty for not choosing death. Financial considerations, added to the concern about “being a burden,” could serve as powerful forces that would lead a person to “choose” euthanasia or assisted suicide.
People for euthanasia say that voluntary euthanasia will not lead to involuntary euthanasia. They look at things as simply black and white. In real life there would be millions of situations each year where cases would not fall clearly into either category. Here are two:Example 1: an elderly person in a nursing home, who can barely understand a breakfast menu, is asked to sign a form consenting to be killed. Is this voluntary or involuntary? Will they be protected by the law? How? Right now the overall prohibition on killing stands in the way. Once one signature can sign away a person’s life, what can be as strong a protection as the current absolute prohibition on direct killing? Answer: nothing.”
Euthanasia will give the impression that it is OK to kill or to commit suicide when faced with a problem. This is a bad example to set.
The argument that the legalization of euthanasia will increase deaths of disabled by euthanasia is premised on the faulty notion that the government and doctors are actually forcing euthanasia on people. Individuals must ask for euthanasia, it can never be forced upon them. Therefore, the only way that euthanasia’s legalization could increase the death of the disabled is if disabled people more frequently asked for euthanasia. There is no evidence that disabled would request the practice any more than other dying and suffering people.
As mentioned before, everyone has a right to end their pain. Right now, suicide is allowed in many countries while euthanasia aren’t. This is a clear discrimination toward the patients who is not able to end their lives without any help of others.
Robert Burgdorf Jr., J.D., The National Council on Disability. “Assisted Suicide: A Disability Perspective”. March 24, 1997 – “Current evidence indicates clearly that the interests of the few people who would benefit from legalizing physician-assisted suicide are heavily outweighed by the probability that any law, procedures, and standards that can be imposed to regulate physician-assisted suicide will be misapplied to unnecessarily end the lives of people with disabilities and entail an intolerable degree of intervention by legal and medical officials in such decisions. On balance, the current illegality of physician-assisted suicide is preferable to the limited benefits to be gained by its legalization. At least until such time as our society provides a comprehensive, fully-funded, and operational system of assistive living services for people with disabilities, this is the only position that the National Council on Disability can, in good conscience, support.”