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  • Writer's pictureSociety of Bioethics and Medicine

Euthanasia: To What Extent is it Ethical?

Written by Angel Joseph

Edited by Rayyan Bhuiyan



Deriving from Greek roots eu (good) and thanatos (death), peaceful death, medically known as euthanasia, has well evolved its definition over the years (Kalal, 2018). Professionals believe that the original motive of euthanasia was to make the medical act of death painless (Malik, 2019). Today, there are four different levels of practicing euthanasia, and the boundary between “mercy killing” and withholding treatment is blurred. The original definition has evolved to the extent that medical professionals are petitioning to modify it to fit the needs of the modern medical community. Furthermore, this “evolved” definition is still not adapted in countries in a similar manner, which makes it even more of a topic to comprehend. 


The medical community has changed the terminology of euthanasia and has categorized it into four levels: active euthanasia, passive euthanasia, assisted suicide, and physician-assisted suicide (Kalal, 2018). Active euthanasia is the intentional cause of death of the patient. Passive euthanasia is when the physician withholds treatment after seeing that the patient is suffering from his/her condition. Assisted suicide is the patient, themselves, ending their life and physician-assisted suicide is the doctor facilitating the patient’s death (Malik, 2019). When did “peaceful death” turn into different levels? Why do physicians feel the need to withdraw treatment to their own liking? According to the American Medical Association (AMA), mercy killing is condemned, however, they support the cessation of extraordinary means to prolong life when biological death is imminent” (Malik, 2019). The researcher of the study “Analysis of euthanasia from the cluster of concepts to precise definition”, Mohammed Manzoor Malik, proposed a new definition for euthanasia: “intentionally causing a terminally ill person’s death by performing an action by a physician” (Malik, 2019). Nurses have also shown their perspectives on this issue, by stating that the primary goal of nurses is to care for and display acts of compassion toward the patients. Their goals are to improve patient quality (Pesut, 2020). Where is the boundary between what is considered euthanasia and what is not? 


Administering euthanasia is both supported and critiqued by different groups of people from various backgrounds and beliefs (Deguma, 2020). From a religious standpoint, Christian and Jewish beliefs do not support the practice of euthanasia because the faith promotes the value of human life at all costs (Deguma, 2020). Christianity seeks to motivate the concept of salvation and that it is the “redemptive characteristic of the value of suffering.” In Hindu cultures, karma is practiced. This means that the suffering one endures is his or her fate from the universe since it is fair and just. Buddhists and Taoists see life as “dukha,” meaning that life isn’t a struggle without interactions with pain and loss. Similarly, “enduring” life is even taken from a philosophical perspective. Philosophers, such as John Stuart Mill, claimed that one of the beauties of life is to endure pain. “Thus part of that which brought pain and suffering will help a person in finding the real value of life which is the greatest happiness a person could ever achieve” (Deguma, 2020). Victor E. Frankl, an Austrian psychiatrist, and Philip Yancey, an American author, both deem pain and suffering as inevitable aspects of life. They both claim that pain a value to the growth of life: “... a conversion of mere experience of suffering to a purposeful avenue to appreciate life itself” (Frankl, 1959), “...it has a value that becomes clearest in its absence” (Yancey, 1993). 


Now that the levels of euthanasia are in place, how are different locations implementing the modernized practice? In 2014, legislation passed in Belgium stated that euthanasia can be administered to minors who want to end their lives. The physicians believe that this “life or death” is decided by the patients who are conscience and legally permitted to make an independent medical choice. Belgium has been the first country to pass such legislation and there have been more than 1,000 registered cases of euthanasia every year, in Belgium, since 2015. In the Netherlands, euthanasia is only seen as an option when there are no alternatives left. The government took years to enforce this policy because they needed to ensure that the physicians were able to accurately grant the wishes of the patient on certain terms and conditions (voluntary and consciously-made decisions). Eleven states in the U.S. have legalized euthanasia with 15 states, currently, considering the legality of this legislation. On the other hand, countries like Australia have made euthanasia entirely illegal. In India, passive euthanasia is preferred over the other levels and is only administered to patients in a vegetative state (Kalal, 2018). From a philosophical standpoint, euthanasia should be legal with necessary limitations and who, when, and how it should be implemented (Boichenko, 2023). This way, patients have the autonomy to decide for themselves, and physicians truly have a chance to care for their patients until they cannot anymore (Dugdale, 2019). Euthanasia, should it be legal? If so, to what extent?


References:

Boichenko, N M, and N A Fialko. “Legitimation of Euthanasia Decisions: A Philosophical Assessment of the Assisted Life Termination.” Anthropological Measurements of Philosophical Research, no. 24, 29 Dec. 2023, pp. 18–26, https://doi.org/10.15802/ampr.v0i24.295295. Accessed 8 Feb. 2024.


Brand, Paul, and Philip Yancey. Pain: The Gift Nobody Wants. New York, NY Harper Collins Zondervan, 1993.


Deguma, Jabin J., et al. “Why Is It Better to Suffer and Not to Die through Euthanasia? A Multi-Perspective Analysis.” Journal of Social and Political Sciences, vol. 3, no. 2, 30 June 2020, https://doi.org/10.31014/aior.1991.03.02.178.


Dugdale, Lydia, et al. “Pros and Cons of Physician Aid in Dying.” YALE JOURNAL of BIOLOGY and MEDICINE, vol. 92, 2019, pp. 747–750, www.ncbi.nlm.nih.gov/pmc/articles/PMC6913818/pdf/yjbm_92_4_747.pdf.


Frankl, Victor E. Man’s Searching for Meaning. Beacon Press, 1959.


Malik, M., 2019. “Analysis of euthanasia from the cluster of concepts to precise definition”. Eubios Journal of Asian and International Bioethics, 29 (2), 2350-3106. https://philpapers.org/archive/MALAOE.pdf


Nipin Kalal. 2018. “Euthanasia: Right to live & right to die”, International Journal of Current Research, 10, (11), 75543-75546


Pesut, Barbara, et al. “Nursing and Euthanasia: A Narrative Review of the Nursing Ethics Literature.” Nursing Ethics, vol. 27, no. 1, 21 May 2019, p. 096973301984512, journals.sagepub.com/doi/pdf/10.1177/0969733019845127, https://doi.org/10.1177/0969733019845127.



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