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Euthanasia Research Paper

Profile image of Pablo Alexis Domínguez Grau

The issue of euthanasia has been controversial for a long time, and different situations regarding its legalization are presented in this research paper. The problem with euthanasia is its own approval by law in the countries around the globe. Because its violations of ethics, morals, values, and human rights, euthanasia should not be legal, though oppositions to this do exist. To correctly determine the influence it has, a religious point of view from some of the main religions like Christianity, Islam, and Buddhism, has been evaluated. Also, the point of view of trustworthy professionals has been taken into consideration. In general, euthanasia is proven to be unaccepted by religion, inefficient and immoral to a great number of doctors and professionals, and by law definition, it should still be illegal. Even though, the clear majority of opposition that does not want to maintain this unlawful practice forbidden, believes that dignity is self-sufficient to endorse its approval. As euthanasia is emerging all over the world as a possible solution to terminally ill people, these results may change through time, just as every controversial topic one day comes to an end.

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  • Ann Med Surg (Lond)
  • v.75; 2022 Mar

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Euthanasia and assisted suicide: An in-depth review of relevant historical aspects

Yelson alejandro picón-jaimes.

a Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia

Ivan David Lozada-Martinez

b Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia

Javier Esteban Orozco-Chinome

c Department of Medicine, RedSalud, Santiago de Chile, Chile

Lina María Montaña-Gómez

d Department of Medicine, Keralty Salud, Bogotá, Colombia

María Paz Bolaño-Romero

Luis rafael moscote-salazar.

e Colombian Clinical Research Group in Neurocritical Care, Latin American Council of Neurocritical Care, Bogotá, Colombia

Tariq Janjua

f Department of Intensive Care, Regions Hospital, Minnesota, USA

Sabrina Rahman

g Independent University, Dhaka, Bangladesh

End-of-life care is an increasingly relevant topic due to advances in biomedical research and the establishment of new disciplines in evidence-based medicine and bioethics. Euthanasia and assisted suicide are two terms widely discussed in medicine, which cause displeasure on many occasions and cause relief on others. The evolution of these terms and the events associated with their study have allowed the evaluation of cases that have established useful definitions for the legal regulation of palliative care and public policies in the different health systems. However, there are still many aspects to be elucidated and defined. Based on the above, this review aimed to compile relevant historical aspects on the evolution of euthanasia and assisted suicide, which will allow understanding the use and research of these terms.

  • • The history of euthanasia and assisted suicide has been traumatic.
  • • The church and research have been decisive in the definition of euthanasia.
  • • The legal framework on the use of euthanasia and assisted suicide has been strengthened.

1. Introduction

Euthanasia and assisted suicide are two topics discussed throughout history, mainly because they fall within the scope of life as a human right, which has been universally defended for many years [ 1 ]. However, the mean of the word euthanasia as good death generates conflicts at social, moral, and ethical levels. Mainly because death is a loss, it is difficult to understand it as something positive and; additionally, several historical events such as the Nazi experiments related the term euthanasia more to murder than to a kind and compassionate act [ 1 ]. More current texts mention that euthanasia is the process in which, through the use or abstention of clinical measures, the death of a patient in an incurable or terminal condition can be hastened to avoid excessive suffering [ 2 ].

The difference between euthanasia and assisted suicide is that in the latter, the patient takes the final action; however, both practices can be combined in the term assisted death [ 2 ]. At present, several countries authorize assisted death, including Holland, Luxembourg, and Canada [ 3 ]. Belgium and Colombia have regulations that decriminalize only euthanasia; other places where assisted suicide is legal are Switzerland and five states of the United America states, specifically Oregon, Vermont, Washington, California, and Montana [ 2 , 3 ]. Spain recently joined the list of countries that have legislated on euthanasia through the organic law March 2021 of March 24 that regulates euthanasia in that state in both public and private institutions [ 4 ]. The fact that more and more countries were joining the legislation on euthanasia and assisted suicide has brought to light the opinion of thinkers, politicians, philosophers, and physicians. Several nations have initiated discussions on the matter in their governmental systems. Latin America is trying to advance powerfully in this medical-philosophical field. Currently, in Chile, the “Muerte digna y cuidados paliativos” law, which seeks to regulate the issue of euthanasia and assisted suicide in the country, is being debated in Congress [ 5 ].

It is essential to know the point of view of physicians on euthanasia and assisted suicide, especially taking into account that these professionals who provide care and accompany patients during this moment, which, if approved, would involve the medical community in both public and private health systems. Although it seems easy to think that physicians have a position in favor of the act of euthanasia because they are in direct and continuous contact with end-of-life situations, such as palliative care, terminally ill, and critically ill patients. It is important to remember that the Hippocratic medical oaths taken at the time of graduation of professionals are mostly categorical in mentioning the rejection of euthanasia and assisted suicide [ 6 ]. Furthermore, it is also important to note that many of the oldest universities in the Western world originated through the Catholic Church; and just this creed condemns the practice of euthanasia and continues to condemn it to this day. This situation generates that many medical students in these schools have behaviors based on humanist principles under the protection of faith and religion and therefore reject the possibility of euthanasia [ 7 , 8 ].

The relevance of the topic and the extensive discussion that it has had in recent months due to the COVID-19 pandemic added to the particular interest of bioethics in this topic and the need to know the point of view of doctors and other health professionals on euthanasia and assisted suicide.

2. Origin and meaning of the term euthanasia

The word euthanasia derives from the Greek word “eu” which means good, and the word “thanatos” which means death; therefore, the etymological meaning of this word is “good death”. Over time the evolution of the meaning has varied; even as we will see below was considered a form of eradication of people categorized under the designation of leading a less dignified life. Assisted suicide is a condition in which the patient is the one who carries out the action that ends his life through the ingestion of a lethal drug but has been dispensed in the context of health care and therefore called assisted. This care is provided by a physician trained in the area. However, it requires the prior coordination of a multidisciplinary team and even the assessment by an ethics committee to determine that the patient is exercising full autonomy, free from coercion by the situation he/she is living and free from the fatalistic desires of a psychiatric illness [ 9 ]. In a more literary sense, the word euthanasia meaning of “giving death to a person who freely requests it in order to free himself from suffering that is irreversible and that the person himself considers intolerable” [ 9 ].

Some authors go deeper into the definition and consider that for the meaning of euthanasia, are necessary to consider elements that are essential in the word itself; such as the fact that it is an act that seeks to provoke death and that carried out to eliminate the suffering in the person who is dying. Other elements with a secondary character in the definition are the patient's consent (which must be granted respecting autonomy and freedom in the positive and negative sense; that means the fact must be not be coerced in any way). Another element is the terminal nature of the disease, with an irreversible outcome that generates precariousness and a loss of dignity. The third secondary element is the absence of pain of the death through the use of drugs such as high-potency analgesics, including opioids, high-potency muscle relaxants, and even anesthetic drugs. Finally, the last element is the health context in which the action is performed (essential in some legislations to be considered euthanasia) [ 10 ]. According to the World Health Organization, the union of these two components is the current definition of euthanasia, which describes as “the action performed by a person to cause the painless death of another subject, or not preventing death in case of terminal illness or irreversible coma. Furthermore, with the explicit condition that the patient must be suffering physical, emotional, or spiritual and that affliction is uncontrollable with conventional measures such as medical treatments, analgesics, among others; then the objective of euthanasia is to alleviate this suffering” [ 11 ]. Unfortunately, the term euthanasia has been misused over the years, and other practices have been named with this word. An example of this situation occurred during the Nazi tyranny when the word euthanasia concerned the murder of people with disabilities, mental disorders, low social status, or gay people. At that time, euthanasia was even a simultaneous practice to the Jewish genocide [ 11 ].

Not only has the term been misused; also exists an enormous variability of terms to refer to euthanasia. For example, the laws created to regulate euthanasia have different names around the world; in the Netherlands (Holland), the law that regulates this practice is known as the law of termination of life; in Belgium, it is called euthanasia law, in France, it is called euthanasia law too. In Oregon (USA), it is called the death with dignity act; in California, it is the end of life option act. In Canada is called the medical assistance in dying act. Victoria (Australia) is the voluntary assisted dying bill, but all these denominations refer to the already well-known term euthanasia [ 11 ].

3. Evolution of euthanasia and assisted suicide: digging into historical events

To understand the evolution and relevance of these concepts should analyze the history of euthanasia and assisted suicide; from the emergence of the term, going through its first manifestations in antiquity; mentioning the conceptions of great thinkers such as Plato and Hippocrates; going through the role of the Catholic Church; mainly in the Middle Age, where following the thought of St. Thomas Aquinas, self-induced death or death contemplated by own will, was condemned. Later, with the renaissance age and the resurgence of science, technology, and the arts, the term euthanasia made a transition to a form similar to what we know today from thinkers such as Thomas More and Francis Bacon. Finally, the first signs of eugenics were known in London, Sweden, Germany, and the United States in the twentieth century. There was a relationship with the term euthanasia that was later used interchangeably, especially in the Nazi regime, to denote a form of systemic murder that sought to eradicate those who were not worthy of living a life.

Since the sixties, with emblematic cases, the path towards the decriminalization of euthanasia began in some countries, especially concerning the cessation of extreme support measures in cases of irreversible illness or a terminal condition. The practice has progressed to the appearance of laws on euthanasia in several countries.

4. Euthanasia and assisted suicide in ancient times

In book III of Plato's “The Republic”, the author stated that those who live their lives amidst illnesses and medicines or who were not physically healthy should be left to die; implying that it was thought that people in these conditions suffered so much that their quality of life diminished, which seemed understandable to these thinkers. However, other authors such as Hippocrates and his famous Hippocratic oath sought the protection of the patient's life through medicine, especially in vulnerable health conditions prone to fatal outcomes. This Hippocratic oath is the same oath that permeates our times and constitutes an argument among those who mark their position against euthanasia and assisted suicide [ 12 , 13 ].

Other texts that collect thoughts of Socrates and his disciple Plato point out that it was possible and well understood to think of ceasing to live in the face of a severe illness; to consider death to avoid a long and torturous agony. This fact is compatible with the conception of current euthanasia since this is the end of this health care procedure [ 13 ].

In The Republic, the text by Plato, the physician Heroditus is also condemned for inventing a way to prolong death and over manage the symptoms of serious illnesses, which is currently known as distanasia or excessive treatment prolongs life. This kind of excessive treatment prolongs the sick person's suffering, even leading him to maintain biological signs present but in a state of alienation and absolute dependence on medical equipment such as ventilators and artificial feeding [ 13 ]. However, the strongest indication that Euthanasic suicide was encouraged in Greece lies in other thinkers such as the Pythagoreans, Aristotelians, and Epicureans who strongly condemned this practice, which suggests that it was carried out repeatedly as a method and was therefore condemned by these thinkers [ 12 , 13 ]. According to stoicism, the pain that exceeded the limits of what was humanly bearable was one of the causes for which the wise man separates himself from life. Referring to one of the nuances that euthanasia touches today, that is, at a point of elevated suffering, the dignity and essence of the person are lost, persisting only the biological part but in the absence of the person's well-being as a being. In this sense, Lucius Seneca said that a person should not love life too much or hate it; but that person should have a middle ground and end their life when they ceased to perceive life as a good, worthy, and longed-for event [ 1 , 12 ].

During the Roman Empire and in the territories under its rule, it was believed that the terminally ill who commit suicide had sufficient reasons to do so; so since suicide caused by impatience and lack of resolution to pain or illness was accepted, when there was no access to medicines. In addition, there was little development in medicine during that time, and many of the sick died without treatment [ 12 ]. This situation changed later with the emergence of the Catholic church; in this age, who attempted against own life, was deprived of burial in the ground. Saint Augustine said that the suicide was an abominable and detestable act; from 693 AD, anyone who attempted against his physical integrity was excommunicated. Rejecting to the individuals and their lineage, depriving them of the possibility of attending the funeral and even expelled from cities and stripped of the properties they owned [ 12 , 13 ].

4.1. Euthanasia and assisted suicide in the Middle Age

During the Middle Age, Catholicism governed the sciences, arts, and medicine; the sciences fell asleep. Due to this solid religious tendency and the persistence of Augustinian thought, suicide was not well seen. It was not allowed to administer a lethal substance to a person to end the suffering of a severe or terminal illness [ 9 , 12 ]. People who took their own lives at this time could not be buried “Christianly”; therefore, they did not have access to a funeral, nor to the accompaniment of their family in a religious rite. Physical suffering and pain were then seen as a path to glorification. Suffering was extolled as the form that god purified the sin, similar to the suffering that Jesus endured during his Calvary days. However, a contrary situation was experienced in battles; a sort of short dagger-like weapon was often used to finish off badly wounded enemies and thus reduce their suffering, thus depriving them of the possibility of healing and was called “mercy killing” [ 12 ].

5. Euthanasia in renaissance

With the awakening of science and philosophy, ancient philosophers' thoughts took up again, giving priority to man, the world, and nature, thus promoting medical and scientific development. In their discourse, Thomas More and Francis Bacon refer to euthanasia; however, they give a eugenic sense to the concept of euthanasia, similar to that professed in the book of Plato's Republic. It is precise with these phylosophers that the term euthanasia got its current focus, referring to the acceleration of the death of a seriously ill person who has no possibility of recovery [ 12 ]. In other words, it was during this period that euthanasia acquired its current meaning, and death began to be considered the last act of life. Therefore, it was necessary to help the dying person with all available resources to achieve a dignified death without suffering, closing the cycle of life that ends with death [ 13 , 14 ].

In his work titled “Utopia”, Thomas More affirmed that in the ideal nation should be given the necessary and supportive care to the dying. Furthermore, in case of extraordinary suffering, it can be recommended to end the suffering, but only if the patient agrees, through deprivation of food or with the administration of a lethal drug; this procedure must be known to the affected person and with the due permission of authorities and priests [ 12 , 13 ]. Later, in the 17th century, the theologian Johann Andreae, in his utopia “Christianopolis”, contradicts the arguments of Bacon and Moro, defending the right of the seriously ill and incurably ill to continue living, even if they are disturbed and alienated, advocating for the care based on support and indulgence [ 15 , 16 ]. Similarly, many physicians rejected the concepts of Plato, Moro, and Bacon. Instead, they focused on opposing euthanasia, most notably in the nineteenth century. For example, the physician Christoph Hufeland mentioned that the doctor's job was only to preserve life, whether it was a fate or a misfortune, or whether it was worth living [ 16 ].

5.1. Euthanasia in the 20th century

Before considering the relevant aspects of euthanasia in the 20th century, it is vital to highlight the manuscript by Licata et al. [ 17 ], which narrates two episodes of euthanasia in the 19th century. The first one happened in Sicily (Italy) in 1860, during the battle of Calatafimi, where two soldiers were in constant suffering, one because he had a serious leg fracture with gangrene, and the other with a gunshot wound. The two soldiers begged to be allowed to die, and how they were in a precarious place without medical supplies, they gave them an opium pill, which calmed them until they died [ 17 ]. The second episode reported by Licata et al. [ 17 ] was witnessed by a Swedish doctor named Alex Munthe; who evidenced the pain of many patients in a Parisian hospital. So he decided to start administering morphine to help people who had been seriously injured by wolves and had a poor prognosis; therefore, the purpose of opioid use was analgesia while death was occurring.

It is also important to highlight the manuscript entitled “Euthanasia” by S. Williams published in 1873 in “Popular Science Monthly”, a journal that published texts by Darwin, Edison, Pasteur, and Beecher. This text included the report for the active euthanasia of seriously ill patients without a cure, in which the physicians were advised to administer chloroform to these patients or another anesthetic agent to reduce the level of consciousness of the subject and speed up their death in a painless manner [ 16 ].

Understanding that euthanasia was already reported in the nineteenth century, years after, specifically in 1900, the influence of eugenics, utilitarianism, social Darwinism, and the new currents of thought in England and Germany; it began in various parts around the world, projects that considered the active termination of life, thus giving rise to euthanasia societies in which there were discussions between philosophers, theologians, lawyers, and medical doctors. Those societies discussed diverse cases, such as the tuberculous patient Roland Gerkan, who was considered unfit and therefore a candidate to be released from the world [ 16 ]. The scarcity of resources, famine, and wars were reasons to promote euthanasia as a form of elimination of subjects considered weak or unfit, as argued in texts such as Ernst Haeckel's. However, opponents to the practice, such as Binding and Hoche, defended the principle of free will in 1920 [ 16 ].

5.2. Euthanasia in the time of the Nazis

As mentioned above, the term euthanasia was misused during this period; approximately 275,000 subjects (as reported at the Nuremberg International Military Tribunal 1945–1946), who had some degree of physical or mental disability, were killed during Adolf Hitler's Euthanasia program [ 13 ]. However, the Nazis were not the first to practice a form of eugenics under the name of euthanasia, since the early 1900s in London had already begun the sterilization of the rejected, such as the blind, deaf, mentally retarded, people with epilepsy, criminals, and rapists. This practice spread to different countries like Sweden and the United States [ 13 , 16 ].

For the Nazis, euthanasia represented the systematic murder of those whose lives were unworthy of living [ 13 ]. The name given to this doctrine was “Aktion T4”. At first and by law, from 1939, the hospitals were obliged to account for all disabled newborns, which led to the execution of more than 5000 newborns utilizing food deprivation or lethal injection [ 12 , 18 ].

A year before that law, in 1938, one of the first known cases of euthanasia in children arose in Germany. That history called the story of child K, in which it was the father of the minor who asked Hitler in writing for euthanasia for his son because the child had a severe mental disability and critical morphic disorders. Hitler gave his consent to carry out the procedure on child K, and thus the program began to spread throughout the Aleman territory. Since then, physicians and nurses had been in charge of reporting the newborns with alterations, arising the “Kinderfachabteilugen” for the internment of children who would be sentenced to death after a committee's decision [ 12 , 18 , 19 ]. A list of diseases and conditions that were considered undesirable to be transmitted to Hitler's superior Aryan race was determined; thus, any child with idiocy, mongolism, blindness, deafness, hydrocephalus, paralysis, and spinal, head, and hip malformations were eligible for euthanasia [ 19 ].

Subsequently, the program was extended to adults with chronic illness, so those people were selected and transported by T4 personnel to psychiatric sanatoriums strategically located far away. There, the ill patients received the injection of barbiturate overdoses, and carbon monoxide poisoning was tested as a method of elimination, surging the widely known gas chamber of the concentration camp extermination; this situation occurred before 1940 [ 12 , 19 ]. Again, physicians and nurses were the ones who designated to the patients to receive those procedures; in this case, these health professionals supported Nazi exterminations. They took the patients to the sanatoriums, where psychiatrists evaluated them and designated with red color if they should die and with a blue color if they were allowed to live (this form of selection was similar in children) [ 12 , 13 , 19 ]. In this case, the pathologies considered as criteria for death were those generating disability such as schizophrenia, paralysis, syphilis with sequelae, epilepsy, chorea, patients with chronic diseases with many recent treatments, subjects of non-German origin and individuals of mixed blood [ 19 ]. Once in the sanatoriums, they were informed that they would undergo a physical evaluation and take a shower to disinfect themselves; instead, they were killed in gas chambers [ 12 , 13 ]. Despite the church's action in 1941 against Nazis and after achieving suspension of the Aktion T4 project; the Nazi supporters kept the practices secretly, resuming them in 1942, with the difference that the victims were killed by lethal injection, by an overdose of drugs, or left to starve to death, instead of the use of gas chambers. This new modified form of euthanasia, which did not include gas chambers, became known as “savage euthanasia” [ 12 , 13 , 19 ].

5.3. Euthanasia since the 1960s

In September 1945, trials began for crimes perpetrated by Nazi supporters; the victorious Allied forces conducted these trials at the end of the war. During these tribunals, cases of human experimentation were identified and the public exposure of the Nazi euthanasia program. After the Nuremberg trials and the abolition of Nazi experiments, a series of seven documents emerged, among which the Nuremberg code containing the ten basic principles for human research stood out [ 20 , 21 ].

After these judgments, biotechnology was accelerated, with the apparition of new techniques to intervene in the health-disease process. Additionally, the increase in life expectancy and the appearance of diseases that chronically compromise the state of health of people generated a change in the conception of the critically ill patient and the terminal state of life [ 20 , 21 ]. Cases such as Karen Ann Quinlan brought to the forefront the issue of euthanasia and precisely the control of extreme treatment measures. Karen, a young American woman, was left in a vegetative state due to severe neurological damage following alcohol and barbiturate intoxication. After six months in that state and under the guardianship of a Catholic priest, Karen's parents requested the removal of the artificial respirator, arguing that in her state of consciousness prior to the incident, she had stated that she disagreed with artificially maintaining life in comatose patients. The hospital refused to remove the ventilator, arguing the legal issues for the date, and the parents went to court, which in the first instance granted the hospital the right. Nevertheless, the New Jersey Supreme Court granted Karen Ann's right to die in peace and dignity. Despite the withdrawal of the artificial respirator, he continued to live until 1985, when he finally died [ [21] , [22] , [23] ].

Another important case was Paul Brophy, which also occurred in the United States. Paul was a firefighter in Massachusetts and went into a deep coma due to the rupture of a basilar artery aneurysm; initially, his family advocated for support measures but later requested the hospital to disconnect these means to allow death, as Paul had indicated when he was still conscious. The hospital refused to carry out this procedure, so the family went to court, where the removal of the support measures (gastrostomy) was initially denied. Hence, the family went to the state supreme court, achieving the transfer of Paul to another medical center where the gastrostomy was removed, leading to his death within a few days [ 23 ].

The case of Arthur Koestler, an influential English writer and activist diagnosed with Parkinson's disease and later with leukemia, who served as vice-president of the voluntary euthanasia society (Exit) and wrote a manual book with practical advice for euthanasia called “Guide to Self-Liberation”. He stood out because he applied one of his advice and ingested an overdose of barbiturates, causing his self-death. According to his writings, Koestler was not afraid of death but of the painful process of dying [ 23 ]. In this sense, it was a relevant case because it involved someone who held an important position in an association that advocated euthanasia, in addition to being the author of several works, which made him a recognized public figure [ 23 ].

Baby Doe was a case that also occurred in the United States; it was a small child with Down syndrome who had a tracheoesophageal fistula and esophageal atresia; in this case, surgery was necessary. On the advice of the obstetrician, the parents did not allow surgery, so the hospital managers took the case before a judge who ruled that parents could decide to perform or not the surgery. The case was appealed before a county judge who upheld the parents' power to make the decision, in the course of which the case became public and many families offered to take care of the child; however, before the case reached the supreme court, the child died at six days of age [ 23 ].

In the case of Ingrid Frank, a German woman who was in a quadriplegic state by a traffic accident, who initially sought rehabilitation but later insisted on being allowed to die; it was provided with a drink containing a cyanide solution that she drank. At the same time, she was filmed, which shows a kind of assisted suicide. For that reason, this is another case that deals with this issue and is important to know as background in the development of euthanasia and assisted suicide [ 22 , 23 ].

6. Current and future perspectives

The definition of brain death, the rational use of the concept of euthanasia and assisted suicide, and scientific literacy are the objectives of global bioethics to regulate euthanasia and assisted suicide, which can be accessible in all health systems [ [24] , [25] , [26] , [27] , [28] , [29] , [30] ]. End-of-life care will continue to be a subject of debate due to the struggle between biomedical principles, the different existing legal frameworks, and the general population's beliefs. Medical education and preparation in the perception of death, especially of a dignified death, seems to be the pillar of the understanding of the need to develop medical-legal tools that guarantee the integrity of humans until the end of their existence [ 31 , 32 ]. This is the reason why the new generations of physicians must be trained in bioethics to face these ethical conflicts during the development of their professional careers.

In addition, although the conception of bioethics belongs to the Western world, it is crucial to take into account the point of view of other cultures and creeds, for example, a study carried out in Turkey, where nursing students were questioned, found that many of them understood the reasons for performing euthanasia; however, they know that Islam prohibits it, as well as its legislation, and therefore they would not participate in this type of procedure [ 33 ]. Furthermore, Christianism and Islam prohibit euthanasia, but Judaism also prohibits it; in general, the so-called Abrahamic religions are contrary to any form of assisted death, whether it is active euthanasia, passive, or assisted suicide [ 34 ].

7. Conclusiones

The history and evolution of euthanasia and assisted suicide have been traumatic throughout human history. The church, politics, and biomedical research have been decisive in defining these concepts. Over the years, the legal framework and bioethical concepts on euthanasia have been strengthened. However, there is still much work to educate the general population and health professionals about end-of-life care and dignified death.

It is also important to remember that life is a concept that goes beyond biology. Currently, bioethics seeks to prioritize the concept of dignity, which must be linked to the very definition of life. Although the phrase is often heard that it is not necessary to move to be alive, what is important is that person feels worthy even if they have limited movement. The person's treatment must be individualized in bioethics since each individual is a unique unit. Therefore, medical paternalism must be abandoned. Instead, the subject must be more involved to understand their context and perception of life and dignity.

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All authors equally contributed to the analysis and writing of the manuscript.

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Sabrina Rahman. Independent University, Dhaka, Bangladesh. [email protected] .

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Euthanasia, Research Paper Example

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Euthanasia is essentially seen as an act in which the life of a person suffering from a terminal illness or impairment is voluntarily ended. The issue is, not unexpectedly, highly controversial, and a great deal of the debate is generated by differing definitions. Then, there is the inescapable element of the act as challenging fundamental ideas as to the sanctity of life, ideas not necessarily related to religious convictions. As euthanasia has long been the subject of intense argument, it is likely to continue as such; in simple terms, euthanasia, and even under the most dire conditions, creates tension and antipathy in all societies. In the following, euthanasia will be examined in regard to its actual nature, as well as in how modern laws and attitudes are addressing the practice.

General Information, Current Law

As noted, just how euthanasia is defined serves as a major element in the debates surrounding it, a fact amplified by the acceptance in the 1990s of the term, “physician-assisted suicide.” The meanings are by no means opposed, for both go to the same idea of euthanasia exercised to end suffering through the ending of life. There are, however, other elements to consider. There is active euthanasia, in which medication is given to cause death, as the passive form usually translates to omitting or ending life-preserving treatment. Further complicating matters are voluntary and involuntary practices. In the former, the patient participates and chooses the euthanasia, while the latter usually occurs when the patient is in a vegetative state and unable to choose (Pappas xviii). As may be expected, then, these variations alone allow for a vast array of ethical arguments, which in turn very much reflect legal rights.

In terms of the history of the subject as being a matter of controversy, that history is lengthy. It is also linked to the rise of Christianity in the Western world, simply because ancient civilizations did not observe faiths in which ending a life was necessarily contrary to divine will. Any suicide, in simple terms, was legal, as the prevailing cultures held to beliefs that human life was valuable only insofar as it was useful to the society and/or felt to be of value to the individual (Dowbiggin 9). The rise and dominance of Christianity would immensely alter these views, and essentially form the basis of Western cultures adamantly opposed to any taking of life beyond the scope of war. Then, as medicine evolved as a science, it could be noted how advances in it facilitated consideration of euthanasia. Not only has medicine replaced theology, to some extent, as an influence in cultural values, the sheer process of medicine’s advances created a platform for euthanasia. For example, cancer deaths in the U.S. more than doubled between 1886 and 1913 and, as the patients were usually cared for in the new hospitals, the medical community took on an immensely important role. Not only was care required, but the enormity of the illnesses added a social and cultural aspect to medical opinion and treatment (Pappas 2). The idea of “care” was extended, and this culminated in the case of Dr. John Bodkin Adams in the 1950s. Charged with ending the lives of elderly patients through medication, Adams was acquitted of one central charge because the British court held that, as his efforts went to relieving pain, the ending of the patient’s life was not criminal (Smith 152). Interestingly, some of the defense strategies employed by Adams would be used by the late Dr. Jack Kevorkian, notorious as the most outspoken proponent of physician-assisted suicide in the 1980s and 1990s.

As Euthanasia became intensely debated in the later 20 th century, Kevorkian was himself instrumental in effecting legal change. Kevorkian’s first case of assisting suicide, in fact, led to Oregon’s Death with Dignity Act of 1997 (Schneider). Today, and despite support of euthanasia reaching unprecedented levels, U.S. law is unfavorable to it. 39 states specifically prohibit assisted suicide in any form, and it is deemed either felony murder or manslaughter. Four states have no clear legislation in place regarding it, and three – Oregon, Washington, and Montana – allow it under certain restrictions (Euthanasia). It is important to note, however, that the Washington and Montana laws are only several years old, which points to an ongoing evolution in legislative response. Currently, Connecticut is wrestling with an assisted suicide bill based on Oregon’s “Death with Dignity” statute, and the process is indicative of how public opinion, along with intense interest expressed by various factions, creates a field of uncertainty in regard to legal procedure. For example, as the Connecticut legislation is largely prompted by the success of the Oregon law, opponents of it are citing issues within that perceived success. Opposition holds that the Oregon statute does not adequately address the critical element of the doctor/patient relationship, as there is objection to allowing an individual to take lethal medication with no one present (Stannard).

Essential Issues

As noted, there is no single issue rendering euthanasia a controversy. Virtually everything connected to the subject, whether it is physician-assisted or otherwise, touches upon matters of immense ethical, cultural, and legal sensitivity. For example, involuntary euthanasia, or when life-saving or life-giving procedures are ceased, is determined by a “best interests” consideration in medical and legal terms (Smith 156). This inevitably leads to argument as to who may determine best interests when the patient in incapable of response. The most profound issues as to quality of life are then further complicated by society’s efforts to assign responsibility for determining what is essentially a subjective, and consequently individual, matter.

In a sense, the American emphasis on euthanasia, while certainly a subject with some history, came to the forefront with the case of Karen Ann Quinlan in the 1970s. When Quinlan was in a vegetative coma state, her parents petitioned for her being released from life support. The petition was denied, the parents took the matter to the New Jersey courts, and in 1976 Quinlan was removed from artificial life support (Lepore). The nation was essentially galvanized into opposing camps, even as the legislature wrestled with issues ultimately admitting to no definitive course of action. In Quinlan’s case, as in subsequent others, it was believed that a proper verdict could be obtained by ascertaining if the cessation of life support would be, not necessarily in the patient’s best interests, but what the patient would elect if able (Jecker 134). Not unexpectedly, then, opposition to euthanasia responds by noting how others, and even close family members, are not necessarily entitled to make any such supposition, particularly as the incapacitation is a state of being unknown to the patient previously.

Linked to this is a widespread perception that interests other than a patient’s welfare fuel decisions and legislation regarding euthanasia. Recently, it has been noted that conservative political groups have expressed fears that the new health care systems will, in effect, unduly empower medical boards to determine when euthanasia is “ethically” warranted (Lepore). Even when social or political elements are removed, there remains the seemingly insoluble issue of the ethics of active or passive euthanasia. Today, it is widely felt that there is nothing immoral in removing life support from a patient with no hope of consciousness or recovery, yet the same factions tend to strongly resist active euthanasia in any form. However, as doctors and legislators have long noted, active euthanasia is by no means easily discounted as an inappropriate means of ending life. While the doctor’s credo of doing no harm must be maintained, the unfortunate reality is that certain cases blur the ethical distinction, as when a person is in great pain from cancer and certain to die. Withholding pain treatment, or a form of passive euthanasia, translates then to facilitating great suffering (Jecker 60). Then, ending treatment may translate to the patient taking longer to die and consequently suffering more. In such an arena, there can be no single answer to the ethics of euthanasia, and where responsibility begins and ends. That euthanasia remains highly controversial, then, is all the more explicable.

It may well be that the only definitive statement possible in regard to euthanasia is that views regarding it have been both strong and divided since the advent of Christianity. Added to essential belief issues is the reality that, as medical science has advanced, different options exist in both prolonging life and in ending it painlessly, just as these advances generate suspicion regarding actual intent. This is an arena in which science, the law, and ethics are deeply mired, and ironically due to the motives of most parties going to what is actually the most humane and ethical act. Given these enormous and mutable elements, it is probable that cases of euthanasia, in the form of physician-assisted suicide and others, will continue to generate intense debate.

Works Cited

Dowbiggin, I. A Concise History of Euthanasia: Life, Death, God, and Medicine . Lanham: Rowman & Littlefield, 2007. Print.

Euthanasia. State Laws on Physician-Assisted Suicide. 2013. Web. < >

Jecker, N. Bioethics . Sudbury: Jones & Bartlett Publishers, 2011. Print.

Lepore, J. “The Politics of Dying.” The New Yorker , 2009. Web. < >

Pappas, D. M. The Euthanasia/Assisted Suicide Debate. Santa Barbara: ABC-CLIO, 2012. Print.

Schneider, K. “Dr. Jack Kevorkian Dies at 83; A Doctor Who Helped End Lives.” The New York Times, 2011. Web. < >

Smith. G. R. Health Care, Crime and Regulatory Control. Sydney: Hawkins Press, 1998. Print.

Stannard, E. “Connecticut’s Assisted Suicide Bill Has Flaws, Some Experts Say.” New Haven Register, 2013. Web. <

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Writing help, paraphrasing tool, euthanasia - essay samples and topic ideas for free.

Euthanasia, also known as assisted dying or mercy killing, remains a deeply contested ethical and legal issue. Essays could delve into the various forms of euthanasia, such as voluntary, non-voluntary, and involuntary euthanasia, discussing the moral and legal implications of each. The discourse might extend to the examination of the cultural, religious, and societal attitudes towards euthanasia, exploring how different societies and religious groups perceive the right to die. Discussions could also focus on the experiences of countries and regions that have legalized euthanasia, examining the impact on healthcare practices, legal frameworks, and societal attitudes. Moreover, the broader implications of euthanasia on medical ethics, patient autonomy, and the sanctity of life could be explored to provide a comprehensive understanding of the complexities surrounding euthanasia and the ongoing debates on its legalization and practice. A substantial compilation of free essay instances related to Euthanasia you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Euthanasia: is it Ethical

While doing research on the topic of Euthanasia and Physician Assisted Suicide, I have come to see that people have a hard time believing that this should be an option for people who have terminal illnesses. Euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma and Physician Assisted Suicide (PAS) is The voluntary termination of one's own life by administration of a lethal substance with the direct or indirect […]

Arguments for and against Euthanasia

Euthanasia is also known as physician-assisted suicide or good death. It refers to the method where animals that are suffering or in discomfort are helped to rest in death. Many pet owners consider Euthanasia a more compassionate manner of bidding their beloved animals goodbye. In the case of people, many states have not legalized euthanasia for people with dementia or those suffering from incurable diseases. Euthanasia creates an ethical dilemma on three main lines: legal, medical, and philosophical. There are […]

Ethics Behind Physician-Assisted Suicide

Assisted suicide is the act of intentionally killing yourself with the assistance of someone else. In the United States, physician-assisted suicide is when a physician provides a patient, who meets the criteria of having a terminal illness, with medication in order to terminate their life to relieve pain and/or suffering. Physician-assisted suicide is often confused with euthanasia. Euthanasia is illegal in the US. It requires a doctor, or another individual, to administer the medication to the patient. Other terms for […]

Why Euthanasia should be Legalised

Did you know that the word euthanasia comes from Greek which means good death? However, Only 9 out of the 196 countries in the world have legalised euthanasia or assisted death, including the Netherlands, Belgium, Switzerland and Japan. - posted on Deccan Chronicle. These are all first world countries that value freedom and I strongly believe that Euthanasia should be extended to all other countries. There are 4 different types of euthanasia voluntary, involuntary, active and passive euthanasia. First, I […]

The Ban on Euthanasia

Imagine your girl best friend gets into a car crash. After the incident, you find out she suffered major spinal cord damage and her legs will be paralyzed for the rest of her life. You go to visit her in the hospital the same week but arrive to shocking news. She tells you she has lost the will to live and wants to be euthanized, or painlessly killed. She tells you she is worried about how this accident will affect […]

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Assisted Suicide the Rights we have

The right to assisted suicide is one of the most controversial topics ever discussed because of the fact that other people control your life when you are unable to. But some people think that they can stop you from dying even though death is inevitable when one is terminally ill. They think that because of religious and moral reasons they could stop someone from ending their own life. Assisted suicide also known as ""Euthanasia"" is used to make a painless […]

Economic Benefits of Euthanasia

Euthanasia is assisted suicide, it is an action taken by a doctor with consent of the patient in order to relieve immense pain and suffering. However, is the overall process of Euthanasia beneficial for the economy? Based on research, euthanasia is beneficial to the economy, and saves a vast amount of money for families for hospital stays, private insurance companies, taxpayers, and medicare each year. For a hospital stay, the average cost per inpatient day is $2,534.00 for a local […]

Euthanasia Debate

The intention to deliberately help someone accelerate the death of an incurable patient, even to stop his or her suffering has never been an easy task. The ethics of euthanasia is one that has been debated over since the fourth century B.C. Euthanasia is translated from Greek as "good death" or "easy death. At first, the term referred to painless and peaceful natural deaths in old age that occurred in comfortable and familiar surroundings. Today the word is currently understood […]

Physician-assisted Suicide: Right to Die

You may have heard of Physician-assisted suicide before, but what exactly is it? Physician-Assisted suicide is when someone who is terminally ill and completely competent of making choices the right to take their own life, legally with the help of a doctor. Though it seems as if they should be able to do that, in most states the law does get in the way of that. There are ethical and moral issues surrounding this issue. Regardless of those issues, those […]

Religious Perspectives on Euthanasia

Death is one of the most important things that religions deal with. All faiths offer meaning and explanations for death and dying; all faiths try to find a place for death and dying within human experience. Most religions disapprove of euthanasia. Some of them absolutely forbid it. Virtually all religions state that those who become vulnerable through illness or disability deserve special care and protection and that proper end of life care is a much better thing than euthanasia. Religions […]

Active and Passive Euthanasia

Euthanasia is the termination of a terminally ill person's life in order to relieve patients of their severe and untreatable pain. It is further broken down into two types: active and passive. In this paper, I will be focusing on active euthanasia and will argue that it is morally justifiable for a physician to alleviate agony for a patient and their family via direct action. Active euthanasia is morally permissible when a patient explicitly states their consent due to the […]

Physician Assisted Suicide: Medical Practice

Physician assisted suicide is when a physician provides a patient with the necessary means and information to help the patient perform a life ending act. Physician assisted suicide is when is when a person gets prescribed a lethal dose of medication from their physician that they can take when they get ready too. Physician assisted suicide has become an option for those around the world and even legal in certain States in the US. This option is legal in 6 […]

The Controversy over Euthanasia

Euthanasia, as defined by the Merriam-Webster Dictionary, is the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy. The growing euthanasia epidemic has raised a profusion of controversy in recent years due to the legal and moral implications. Although described as relatively painless,euthanasia is something that should be methodically and thoroughly thought through because of the permanent effect it […]

Euthanasia and Death Penalty

Euthanasia and death penalty are two controversy topics, that get a lot of attention in today's life. The subject itself has the roots deep in the beginning of the humankind. It is interesting and maybe useful to learn the answer and if there is right or wrong in those actions. The decision if a person should live or die depends on the state laws. There are both opponents and supporters of the subject. However different the opinions are, the state […]

Physician Assisted Suicide: the Growing Issue of Dying with Dignity and Euthanasia

Is someone wanting to die with dignity more important than the conscience of a doctor who provides care for others? The issue of physician-assisted death can be summed up by simply saying it has a snowball effect. What starts as physician-assisted death turns into euthanizing and from there it could end up in the killing of patients without their full comprehension as to what they agreed to. The solution to this issue is accepting there is a problem and figuring […]

Definition of Euthanasia

Euthanasia defined as an intentionally ending of the life of the terminally ill person in order to relieve pain or suffering, done by a physician, legally. This is not to be confused with the similar physician assisted suicide, the suicide of patient suffering from an incurable disease, effected by the taking of lethal drug by a doctor for this purpose. It is legal in only a few places of the world, and the laws vary by the places. That means […]

Physician Assisted Suicide

Healthcare isn't as perfect as we think it should be considering there are so many medications and treatments that can help restore or cure one's illness. When needing the assistance of a healthcare facility, there are many different challenges that can impact patients and their families. Challenges that include life or death decision making, insurance coverage, the need for medications, cost of services, and so on. As these challenges may seem as if they are minor to some, they truly […]

Euthanasia and Physician-Assisted Suicide

In a documentary, Charles Scott was a man who loved to read, sing, and enjoy being outdoors. He was diagnosed with lymphoma. Struggling every day just to breathe after walking 10 steps to the bathroom and dealing with his eyesight deteriorating, He found life to be full of pain instead of joy. He found no want in having to wait through multiple medications, operations, pain, hospice, and finally him dying suffocating trying to catch his breath” he wished to die […]

Physician-Assisted Euthanasia/Suicide

Part 1: Ethical Question Should doctors have a choice to opt out of assisting terminally ill patients with euthanasia/suicide? Part 2: Introduction Some people think being a physician is an exciting job for the most part. However, physicians have the task of making tough decisions that could hurt many people emotionally. The morality of assisted euthanasia and suicide has been questioned by many people. Some may consider euthanasia and suicide immoral any wrong. Unfortunately, euthanasia and suicide may be the […]

Arguments for Legalizing Euthanasia

I once heard euthanasia is a heart-wrenching kindness and i believe that to be true.Although we as vet techs know it is the right thing to do, being apart of ending there pain and suffering,it is hard being the one to end it knowing the bond an animal has with its owner.Everyone has their own thoughts about this topic and how we prefer to handle it.There are different tolerances everyone has on how it should be done and what the […]

Why Active Euthanasia and Physician Assisted Suicide should be Legalized

This reference source gives us an overview of why euthanasia should be legalized. It goes into depth about how patients and doctors are affected by the decision to end a person's life, and moral issues, and whether it is right or wrong to purposely end someone's life. This source highlights that euthanasia should be in the best interest of the patient who is suffering from an illness, such as an incurable disease or a serious health issue. Doctors should be […]

Physician-assisted Suicide is not Federally Mandated

Physician-assisted suicide is not federally mandated due to the lack of bipartisanship in Congress, the principles of federalism, and contributions from conservative organizations and interest groups. The attitudes and moral acceptability about certain behaviors and actions differ significantly among Republicans and Democrats. According to a 2007 survey, 62% of Democrats support doctors assisting a terminally ill patient to commit suicide, while only 49% of Republicans support this notion (Gallup, Inc 2007). 59% of Democrats also find physician-assisted suicide to be […]

Physician-assisted Suicide and Euthanasia

Physician-assisted suicide and euthanasia have become some of the most highly controversial topics discussed in medicine, making those who have medicine as an occupation question the morality behind the act. A common misconception people often times make is confusing the fact that physician-assisted suicide and voluntary active euthanasia as the same thing. The NCI dictionary of cancer terms states euthanasia is accessibility to ""[a]n easy or painless death or the intentional ending of the life of a person suffering from […]

Euthanasia and Physician Assisted Suicide

Sometimes people criticize euthanasia and physician-assisted suicide from what is called "pro-life" perspectives and other times from "pro-death" perspectives; each perspective has a different argument about their position and the side they are on in this debate. This paper will review some of these arguments that have been made to date, as well as some of the more recent developments in this issue (Dieterle 129). To begin with, many people argue that euthanasia and physician-assisted suicide are morally acceptable because […]

Hinduism and Buddhist Perspective of Suicide and Euthanasia

The principle of ahimsa, or no violence, is fervently held in Hinduism and is reflective in followers' everyday lives. This concept extends to oneself as well as others. For one, suicide is condemned in this religion because all life is considered sacred. Humans life is perceived as precious because only through one of the three human realms can liberation be achieved. Other living things, such as insects and animals, do not receive the same opportunity, so it is crucial followers […]

Euthanasia – One of the most Debated Topics Today

The topic of euthanasia is one of the most debated topics today. Elderly patients can be pressured into a decision they don't want to make. Citizens can also be unfairly euthanized as well. Euthanasia should stay illegal due to the obligation to elderly patients, non permitted euthanization, of an individual, and which can open hopefully widen perspective on this issue, as well as many others. Euthanasia is a complex topic that can't be described simply and without depth. Euthanasia can […]

Physician-assisted Suicide Debate

Let's say a patient is in incredible pain or has an incurable illness and the patient can only be kept alive by machines or by enduring their pain. Should any patient who is in these circumstances be allowed to choose death over this life? Many people go against assisted suicide because of religion and or whatever they believe in. Another reason why people may disagree is that the patients who are not in the right mind and or are too […]

Ethics and Challenges of Euthanasia

As there are other patients who have a higher chance of living, euthanizing the patient was the more practical option. Euthanasia advocates argue that futile care may harm others. For instance, a young child with an acute respiratory disease, who has a potentially higher chance of getting cured, could not get a bed and ventilator in the ICU because others were using it even though they are not getting any personal benefit from the treatment (Niederman & Berger, 2010). This […]

Euthanasia: Merciful Death or Playing God

A death by suicide. Just hearing the word suicide can send chills down one's spine. How could someone get to the point of self-termination? Why would anybody ever consider such a terrible way to die? The thing is, suicide does not have to be a terrible or scary way to die if one is faced with insurmountable troubles accompanying an untreatable disease. With assistance from licensed professionals, it can give those suffering a painless option if they so choose to […]

What is Euthanasia?

Euthanasia is a easy death, some may say euthanasia is a undeviating act for taking a life through prescription drugs. A patient that has a short expand of life can address such an issue with their healthcare provider. Counseling can be provided before the final decision is made by doctor and the patient. At anytime the patient reserves the right to with draw from the process. The patient however must have good reason for the process before a doctor will […]

Related topic

Essays About Mercy Killing Also known as mercy killing, euthanasia is defined as the intentional ending of someone’s life to relieve severe suffering and pain. Physician-assisted suicide is closely related to it and is a popular study topic in college. The main difference with assisted suicide is that the act of euthanasia requires a physician to carry out the procedure, generally by administrating a lethal dose of a substance to a patient. While assisted suicide requires a physician to supply the lethal substance for the person’s personal use.  Every country has a different law regarding the practice. Euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, and Canada. Assisted suicide is legal in Switzerland, Germany, the Netherlands, Washington, Oregon, Colorado, Hawaii, Vermont, and Montana. While many people view the right to die as basic human right euthanasia can raise moral questions, too. It is a widely studied topic and one with many polar opinions. There are lots of health professional courses that require in-depth essays on various topics related to the pros and cons of euthanasia. We offer help when it comes to the topic and has a variety of examples from the persuasive essay style to argumentative essay style. Any essay on euthanasia that a student writes is likely to need a strong introduction, debate, and conclusion as well as a detailed outline of the case at hand. That’s where our team can help. We offer pro writing on the complex topic. So, whether it’s a comparison essay, a research paper about euthanasia, a debate, or an outline of the varying laws in each country regarding euthanasia, we have examples to cover all bases.

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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.

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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 they affect other people. Although healthy people find it difficult to imagine themselves in situations where they do not decide freely, it is also true that all of us are vulnerable and dependent on others.

Yet autonomy in relation to assisted dying is often viewed in the same way as our fundamental right to choose our own course in life. If we are able to control our lives, then surely we can also control our death. Autonomy with respect to your own death, however, is already halved: you can choose to die if you don’t want to live, but you cannot choose to live if you are about to die.

Decisions about your own death are not made in normal day-to-day contexts. The wish to die arises against a backdrop: of desperation, a feeling of hopelessness, possibly a feeling of being superfluous. Otherwise, the wish would not be there. Thus, it is under these circumstances that the right to self-determination is exercised and the decision is made. Such a situation is a fragile basis for autonomy and an even more fragile basis for decision making. The choice regarding your own death is therefore completely different from most other choices usually associated with the concept of autonomy.

Here are just some of the critical matters that would arise if assisted dying were legalised.

A duty to die

The possibility of choosing to die would inhabit everyone’s consciousness—the patient, the doctor, the relatives, and the care staff—even if not formulated as an out-and-out offer. But if a law on assisted dying gives the patient a right to die, that right may turn into a duty to die. How autonomously can the weakest people act when the world around them deems their ill, dependent, and pained quality of life as beyond recovery?

Patients can find themselves directly or indirectly under duress to choose that option if they consider themselves sufficiently pained and their quality of life sufficiently low. Patients must be at liberty to choose assisted dying freely, of course—that is how it is presented—but the point is that the patient cannot get out of having to choose. It has been called the “prison of freedom.”

Internalised external pressure

Pressure on the patient does not have to be direct or articulated. As pointed out by the US professor of biomedical ethics Daniel Sulmasy it may exist as an “internalised external pressure.” 2 Likewise, the French bioethicist Emmanuel Hirsch states that individual autonomy can be an illusion. The theologian Nigel Biggar quotes Hirsch saying that a patient “may truly want to die, but this desire is not the fruit of his freedom alone, it may be—and most often is—the translation of the attitude of those around him, if not of society as a whole which no longer believes in the value of his life and signals this to him in all sorts of ways. Here we have a supreme paradox: someone is cast out of the land of the living and then thinks that he, personally, wants to die.” 3

The end of autonomy

An inherent problem of autonomy in connection with assisted dying is that a person who uses his or her presumed right to self-determination to choose death definitively precludes himself or herself from deciding or choosing anything. Where death is concerned, your right to self- determination can be exerted only by disposing of it for good. By your autonomy, in other words, you opt to no longer have autonomy. And those around must respect the right to self-determination. The respect refers to a person who is respected, but this is precisely the person who disappears.

Danish philosopher Johannes Sløk, who supported legalisation, said, “The actual concept of death has no content, for death is the same as nothing, and one cannot choose between life and nothing. Rather, therefore, one must speak of opting out; one opts out of life, without thereby choosing anything else. Death is not ‘something other’ than life; it is the cessation or annihilation of life.”

Autonomy is a consistent principle running through the care and management of patients and is enshrined in law. However, a patient’s autonomy means that he or she has the right to decline any treatment. It does not entail a right to have any treatment the patient might wish for. Patients do not have the right to demand treatment that signifies another’s duty to fulfil that right. If that were so, autonomy would be the same as “autocracy”—rule of the self over others. Even though patients have the right to reject any intervention, they do not have the right to demand any intervention. Rejecting any claim that the person might make is not a violation of a patient’s self- determination—for example, there may be sound medical reasons for not complying with a demand. The doctor also has autonomy, allowing him or her to say no. Refusing to kill a person or assist in killing cannot be a violation of that person’s autonomy.

The killing ban

Assisted dying requires the doctor’s moral and physical help. It is a binding agreement between two people: the one who is to be killed and the one who is to kill or assist in killing. But our society does not condone killing as a relationship between two legally competent, consenting people. Exemptions from the killing ban involve war or self-defence and are not justified on the grounds that the killing is done for the “benefit” of someone else.

Valuation of a life

If the action is to be decriminalised, as some people wish, it means the doctor will have to enter into deliberations and arguments for and against a request for assisted dying each time. That is, whether he or she is willing to grant it. The alternative would be to refer the patient to another doctor who might be willing to help—that doctor would still have to assess whether the patient’s life was worth preserving.

Thus, autonomy is not the only factor or even always the key factor when deciding whether assisted dying can be granted. It is not only the patient’s own evaluation that is crucial. The value of the patient’s life must also be assessed as sufficiently low. This demonstrates the limitation of the patient’s self-determination.

Relieving suffering

If a competent and legally capable person must have the option of voluntarily choosing assisted dying in the event of unbearable suffering, why does suffering have to be a requirement? The answer is straightforward: our concepts of assisted dying imply that compassion must form a crucial aspect of the decision—mercy killing and compassionate killing are synonyms. But this leads instantly to the question of why we should not also perform assisted dying on people who are not in a position to ask for it themselves but are also suffering.

Some people find the reasoning unproblematic. It stands to reason that relieving suffering is a duty after all. But in this context it is not unproblematic, because it effectively shifts the focus from the autonomy claimed. According to prevailing ideas about autonomy, patients initially evaluate their quality of life themselves, but ultimately it is those around them who end up gauging that quality and the value of their life. That is to say, the justification for assisted dying is borne on the premise that certain lives are not worth living rather than the presence of a request. The whole point is that in the process, respect for the right to self-determination becomes relative.

Autonomy is largely an illusion in the case of assisted dying. 1 A patient overwhelmed by suffering may be more in need of compassion, care, and love than of a kind offer to help end his or her life. It is not a question of whether people have a right to say that they are unworthy. It is a question of whether they have a right to be believed when saying it.

Ole Hartling is a physician of over 30 years standing, doctor of medical sciences at the University of Copenhagen, professor of health promotion at the University of Roskilde, and an author and co-author of several books and scientific articles published mainly in Scandinavia. Between 2000 and 2007 he was a member of the Danish Council of Ethics and its chair for five years. During this time, the council extensively debated the ethics of euthanasia and assisted dying.

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

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137 Euthanasia Research Topics & Essay Examples

📝 euthanasia research papers examples, 🏆 best euthanasia essay titles, 🎓 simple research topics about euthanasia, ❓ euthanasia research questions, 📣 euthanasia discussion questions.

  • Physician Assisted Suicide The issues of the practice of Physician Assisted Suicide are contentious for most people. This paper is an argument against the use of PAS as a tool of ending human suffering.
  • Medical Ethics: End of Life Issue - the Right to Die The paper elaborates on different types of euthanasia. At the same time, the paper reveals the differences between them. The paper further tackles the ethical issues raised by each type.
  • Death with Dignity Act: Physician-Assisted Suicide The paper enumerates the fundamental aspects regarding the Death with Dignity Act (DDA) as well as the Physician-Assisted Suicide (PAS).
  • Death with Dignity Act in Oregon The Death with Dignity Act (DDA) sets up the procedures and safeguards related to the application and administering of the prescription medications.
  • Euthanasia and Assisted Suicide There are critical ethical, legal, religious, and political concerns that bedevil the controversial practice of euthanasia/PAS.
  • Assisted Suicide: Ethical Dilemma and Stakeholders in Euthanasia This paper examines the assisted suicide ethical dilemma and euthanasia stakeholders ✚ safeguards for euthanasia in ⚖️ the Death with Dignity law in Oregon.
  • Euthanasia Debates, Death and Dying The issue of voluntary euthanasia elicits heated debates. The contention is usually based on religious views concerning whether individuals can decide the fate of life.
  • Utilitarianism and Euthanasia: Ethical View on Assisted Suicide Want to learn about utilitarianism and euthanasia? ✅ Read our essay example to discover the utilitarianism view on euthanasia ✚ Bentham utilitarian calculus.
  • Euthanasia in Non-Terminally Ill Patients This paper reviews history and social context of euthanasia in non-terminally ill patients, its moral relevance, and arguments surrounding this evidence-based medical practice.
  • Physician-Assisted Suicide as Liberation from Suffering Physician-Assisted Suicide, the death of a patient as a result of being aided to undertake a life-ending act by a physician, is a contentious issue of importance in society.
  • Medical and Religious Ethics in Death and Dying The paper is devoted to the investigation of a particular ethical dilemma presented in a patient’s case study and religious perspectives on it.
  • Why Euthanasia Should Be Legalized and Regulated The essay discusses the reasons why euthanasia should be legalized all over the world but most importantly it should also be a carefully regulated aspect.
  • Feeding Tubes: Techniques, Problems and Solutions The problem of maintaining the life of severely ill patients has been a highly controversial topic for a long time. Many clinicians emphasize the drawbacks of inserting feeding tubes.
  • Assisted Suicide Controversy in Medical Ethics Assisted suicide is one of the most controversial topics in the field of health care. There are valid arguments presented on both sides of the discussion.
  • Significance of Euthanasia in Society Euthanasia is an issue that has stirred a lot of controversy in many countries and at international forums as to whether it should be legalized or illegalized.
  • Research of the Euthanasia An Euthanasia doen't harm society and even underlines the humane qualities of people, who are able to differentiate right from wrong and offer help to others in their time of need.
  • Euthanasia and Physician-Assisted Suicide: Interesting Facts The generic definition of euthanasia states that it is an omission or an action that, by intension or itself, causes death alleviating suffering.
  • Euthanasia: Ethical Issues in Nursing and the Impact of Technology Wondering about euthanasia ✚ ethical issues in nursing? ✅ Check this paper to learn about euthanasia: ethical dilemma and its relation to technology.
  • Voluntary Euthanasia: Arguments for and Against The purpose of this article is to briefly consider the problem of euthanasia from the point of view of supporters and opponents of this practice.
  • Nurses Intention and Motivation to Practice Euthanasia The research aims at investigating the determinants of nurses "intentions and motivations to practice euthanasia".
  • Euthanasia. Effectiveness or Necessity Euthanasia remains the controversial topic as far as there is no direct answer concerning its effectiveness or necessity.
  • Euthanasia: Discussion and Ethical Position Euthanasia still remains a controversial topic because of the patient’s inalienable right to life, and the ethical responsibilities of the healthcare worker.
  • Case Study: An Ethics of Euthanasia Euthanasia is illegal in most of the world countries for a good reason. Statistics show, that developments in countries with legalized euthanasia are quite disturbing.
  • Euthanasia-Related Ethical and Legal Issues The ethical issues associated with euthanasia are related to the dilemma of whether it is appropriate and up to a human being to decide to end a life of a person who suffers.
  • Legal, Ethical and Moral Issues Facing Nurses in Cases of Patient-Requested Suicide Suicide, whether assisted or unassisted, is a common issue affecting practitioners in nursing, clinical and biomedical fields. Legal, moral, and ethical decision is required.
  • Professional Values, Ethics, and Law Small mistakes by healthcare practitioners may lead to loss of life. In addition, errors in their activities may lead to the development of life-threatening conditions.
  • Euthanasia Should Be Illegal Because of Its Harm The goal of healthcare providers is to help patients improve their well-being and promote health, and euthanasia distorts these values.
  • Pros and Cons of Physically-Assisted Suicide The paper discusses that even though physician-assisted suicide contradicts ethics, the evidence shows the prevalence of towards the practice among terminally ill patients.
  • Euthanasia & Physician-Assisted Suicide (PAS) This paper discusses euthanasia and physician-assisted suicide, whether it is ethical, and analyzes alternatives to PAS – hospice and palliative care.
  • Physician-Assisted Suicide is a Basic Right Physician-assisted suicide has been a subject of numerous debates for as long as it has been available. PAS is legal in Colorado and some other states in the US.
  • Euthanasia & Physician Assisted Suicide The medical definition of euthanasia states that it is the practice or method of performing specific actions by a doctor at a patient's request.
  • Euthanasia and Arguments in Favor Despite the advantages of practicing assisted suicide in critical situations, some countries or people are against it, terming it unethical conduct which violates human rights.
  • The Problem of Euthanasia The problem of euthanasia lies at the intersection of a huge complex of disciplines and the full discussion of it requires the participation of specialists.
  • Euthanasia & Physician Assisted Suicide (PAS) The problem of euthanasia goes beyond the scope of purely medical issues since it confronts moral, socio-economic, philosophical, legal, and political aspects.
  • The Problems With Medical Research and Euthanasia
  • Business Ethics Decision Situation in Veterinary Practice The paper analyses a business ethics decision situation in veterinary practice and an ethics dilemma witnessed in veterinary practice as a client.
  • Active and Passive Euthanasia Is Not a Morally Relevant Problem
  • Analysing Biopower and Agency Linked to Euthanasia Philosophy
  • Top Ten Reasons for Legalizing Euthanasia
  • Euthanasia as Physician-Assisted Suicide Among patients there are people who do not recognize euthanasia. Nevertheless, we must recognize that the interruption of life is contrary to the basic tenets of Christianity.
  • Legalizing Euthanasia for Terminally Ill Patients Is Necessary
  • Assisted Suicide and Euthanasia – It Is Not Murder, It Is Mercy
  • Circumstances That Justify the Use of Physician-assisted Suicide and Euthanasia
  • Arguments for Legalizing Euthanasia
  • Assisted Suicide: Euthanasia and Self-Determination Although assisted suicide is legal in certain parts of the world, in most places, the debate about whether it should be legal continues.
  • Philosophy & Arguments Against Euthanasia
  • The Argument for the Legalization of Euthanasia in British Columbia
  • Critical Thinkings About Euthanasia as an Ethical Alternative to a Life of Suffering
  • Vincent Humbert and Euthanasia in France
  • Why Euthanasia Should Be Legal From the perspective of ethical theories, euthanasia should be legalized because it promotes dignified death.
  • Dying With Better Dignity: From Euthanasia To Advanced Dying Culture
  • Hinduism and Buddhist Perspective of Suicide and Euthanasia
  • Australian Governments’ and Catholic Church’s Attitudes on the Practice of Euthanasia
  • Utilitarian and Libertarian Views on Euthanasia
  • Aristotle’s Virtue Theory on Euthanasia This paper will explore Aristotle’s virtue theory and use its concepts to discuss euthanasia, a controversial contemporary issue.
  • Death With Dignity Act: Ethical Dilemma Regarding Euthanasia
  • The Nazi Euthanasia Programme Based on Racial Purity Theories
  • Arguments Against Legalized Euthanasia
  • About Should Euthanasia Be Permitted in Cases of Terminally Ill Patients
  • Euthanasia: Status and Medical Implications This paper presents a debate in which the idea of euthanasia is rejected with totality based on the conviction that euthanasia ignores the importance and value of a human’s life.
  • Euthanasia and the Current Legal Position of Euthanasia
  • Euthanasia and the Hippocratic Oath
  • Nonvoluntary Euthanasia Means Causing Death in Violation of the Patient’s Consent
  • Facts About Euthanasia and the Oregon Death With Dignity Act
  • Capital Punishment Reintroduction in the UK The death penalty is what they call the “execution sentence for murder and other capital crimes, serious crimes or grave crimes such as murder, treason, rape and the like.
  • Customize Your Death: Why Some Forms of Euthanasia May Be Ethically Justified
  • United States Legal System and Euthanasia Cases
  • Demystifying Assisted Suicide and Euthanasia
  • Euthanasia and the Case of Comatose Elderly Patients
  • States’ Laws on Physician-Assisted Suicide and Euthanasia The State passed the “Oregon Death with Dignity Act” in the year 1994. The law allows physician-assisted dying with certain restrictions.
  • Critically Consider the Ethical and Legal Arguments for and Against Euthanasia
  • America Needs Voluntary Euthanasia and Assisted Suicide
  • Euthanasia: Comparing Kantian and Utilitarian Ideas
  • Ethical Issues Surrounding the Choice of Euthanasia in the United States
  • Suicide and Long Term Grief in Significant Others in Relation to Dying The reasons behind suicide and the qualitative essence of suicide-related grief cannot be assessed outside of affected people’s ability to operate with highly abstract categories.
  • Euthanasia, Physician-assisted Suicide, and Our Aged and Frail Population
  • Understanding Euthanasia and the Controversy Surrounding It in the US
  • Can Hegelian Dialectics Justify Euthanasia?
  • Why Should Active Euthanasia and Physician-assisted Suicide Be Legalized?
  • What Is the Attitude Towards Euthanasia in the Netherlands?
  • Why Are Euthanasia and Abortion So Often Compared?
  • Should a Physician Discourage Voluntary Euthanasia?
  • How Active Euthanasia Works?
  • Are Physician-assisted Suicide and Euthanasia Ethical?
  • How Has Euthanasia Changed in the 21st Century?
  • What Are the Main Objections to the Legalization of Euthanasia in Hong Kong?
  • How Does Brian Clark Use Theatre to Dramatise the Euthanasia Debate?
  • What Are the Bioethical Problems of Euthanasia in Modern Conditions?
  • What’s Wrong With Involuntary Euthanasia?
  • Why Does Euthanasia Open the Door for Legalized Killing?
  • Euthanasia: When the Pain of Dying Exceeds the Pleasure of Living?
  • What Does Euthanasia Mean to Society Today?
  • In Which Countries Is Euthanasia Legalized?
  • How May the Religious Faith Inform the Issue Over Euthanasia?
  • Does Euthanasia Answer the Prayers of the Dying?
  • How Does Parenting Make Euthanasia More Acceptable?
  • Euthanasia: Why Do People Want To Die Earlier?
  • Euthanasia: Should Doctors Intervene at the End of Life?
  • Why Euthanasia Devalues Human Life?
  • What Is the History of the Emergence of Euthanasia?
  • What Are the Three Main Reasons Why Euthanasia Should Be Legalized?
  • Voluntary Euthanasia: What’s Right and Wrong?
  • What Medications Are Used in Euthanasia?
  • What Are the Main Drugs That Are Used for Euthanasia?
  • Is Euthanasia a Humane and Dignified Solution?
  • Can Euthanasia Help the Terminally Ill?
  • What Is the Law in Oregon Regarding Euthanasia?
  • What Are the Key Ethical Considerations Surrounding Euthanasia?
  • Is Euthanasia Morally Justified for Animals?
  • Why Is the Role of Doctors in Euthanasia a Controversial Issue?
  • What Is the Double Effect of Euthanasia?
  • How Do Different Countries Approach the Involvement of Doctors in Euthanasia?
  • What Is the Most Humane Form of Euthanasia?
  • How Does the Physician-Patient Relationship Influence Euthanasia Decisions?
  • What Does Euthanasia Do to the Brain?
  • How Do End-of-Life Care and Euthanasia Differ in the Medical Community?
  • What Is the Difference Between Voluntary and Passive Euthanasia?
  • How Do Cultural and Religious Beliefs Influence Doctors’ Views on Euthanasia?
  • What Is the Moral Philosophy of Euthanasia?
  • Why Is It Important for Doctors to Maintain Open Communication with Patients About Euthanasia?
  • What Ethical Principles Underlie the Practice of Euthanasia?
  • Is Euthanasia Sometimes Morally Permissible?
  • How Can Medical Ethics and Guidelines Evolve to Address the Challenges of Euthanasia?
  • Should Passive Euthanasia Be Allowed?
  • How Does Euthanasia Affect the Moral and Ethical Compass of Medical Professionals?
  • What Are the Most Common Reasons Patients Seek Euthanasia?
  • Is Euthanasia a Serious Option to Escape Pain or Misery?
  • What Is the Gunshot Method of Euthanasia?
  • Why Is Euthanasia Often Considered a Last Resort in Medical Care?
  • Is Human Euthanasia Legal in Any US State?
  • How Do Different Cultures and Societies View the Practice of Euthanasia?
  • What Legal Frameworks Exist for Euthanasia Around the World?
  • Why Are Christians Against Euthanasia?
  • How Has Euthanasia Shaped Public Opinion and Attitudes Toward Death?
  • Should People with Mental Illnesses Have the Right to Euthanasia?
  • How Can Euthanasia Laws Be Safeguarded Against Abuse and Misuse?
  • Why Is Psychological Evaluation Essential in Euthanasia Decision-Making?

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