Euthanasia

medical practice of intentionally ending a life in order to relieve pain and suffering

Euthanasia (also called assisted dying) involves purposely ending a person's life because they are suffering from disease, disability, or pain. This is different from assisted suicide, where one person helps another to kill themselves.

Euthanasia can be voluntary, where a person asks for help to end their life. Non-voluntary euthanasia occurs when a person who cannot communicate is killed or allowed to die because others think they are suffering. When a person is killed against their will, and when the goal is not to relieve suffering, the killing is usually called murder.

Euthanasia is illegal in most countries. It is allowed in just a few places, like the Netherlands; Belgium; New Zealand; and Victoria, Australia.[1][2]

Euthanasia is not legal in the United States. However, some states (including Washington, Oregon, and Montana) allow Physician-Assisted Suicide (PAD). In this process, a physician prescribes medication that a person takes in order to end their own life. In most cases, the person takes the medication whenever they choose, without the doctor's assistance. This is different from euthanasia, where a doctor would actually give the lethal medication and take the main role in ending the patient's life.

Types of euthanasia

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Euthanasia can be active or passive. It can also be voluntary, non-voluntary, or involuntary.

 
"Voluntary Euthanasia Society Poster B.20"

Active and passive euthanasia

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Passive euthanasia means letting a terminally ill person die, even if treatment could help them to live longer. This includes removing machines being used to keep the person alive (like a ventilator); allowing them to stop eating; and/or allowing them to stop drinking.

Active euthanasia means doing something to end a person's life. This could be giving them an injection or pills that will cause their death.[3]

Some people see passive euthanasia as a more acceptable choice, because it is not a deliberate act to kill. However, others argue that once someone has decided to allow another person to die, they should make it as fast and as painless as possible, and then act to bring about their death. This is also known as mercy killing.[4]

Voluntary, non-voluntary and involuntary euthanasia

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If a person asks to be killed or allowed to die, they are asking for voluntary euthanasia. People who support euthanasia often view this as the best option, since it is clear that the person wants to die.

Non-voluntary euthanasia happens when a person is unable to communicate what they want (for example, because they are in a coma or are very young). In these cases, the person is killed or allowed to die because others think that is what they would want.

Involuntary euthanasia means killing a person even though they did not ask to die.[5] Many people think that this is murder, not euthanasia.[6]

These types of euthanasia can be mixed. If someone asks to die, and another person gives them an injection that will kill them, then it is active voluntary euthanasia. If a person in a coma is kept alive with a ventilator, and the doctors turn it off, causing their death, that would be passive non-voluntary euthanasia.[7]

Euthanasia arguments

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People disagree on whether euthanasia should be allowed (and if so, which types of euthanasia).

Slippery slope

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People with disabilities are "relocated" as part of Nazi Germany's T4 "euthanasia" program

Some people believe that allowing euthanasia will lead to worse things. For example, if euthanasia is allowed for people asking to die, next it might be permitted for people who are very sick but are not able to ask to die. If that happens, then maybe it would be allowed for people who are very sick and will not recover, but do not want to die. This is called the "slippery slope" argument.[8]

Its believers point to examples like Nazi Germany. In their secret T4 Program, the Nazis killed at least 70,000 adults and children with disabilities (perhaps 200,000 or more).[9] They called this "euthanasia," but in fact, they believed people with disabilities did not deserve to live, and wanted to eliminate them from Germany. The slippery slope argument says that if euthanasia is legalized, this could happen again, so it is too big a risk to allow euthanasia at all.[8]

Other people argue that Hitler's actions were murder, not euthanasia.[8] They say there is a big difference between killing a very sick adult who asks to die, and killing a child with a disability. They do not think allowing euthanasia for sick adults will lead to killings of children with disabilities.

The American Medical Association (AMA) and other doctors believe it is a doctor's role to help, not kill people.[source?] In one study 76% of doctors said they would not carry out euthanasia, even if it was legal.[source?] They feel patients would not trust them. In the Netherlands where euthanasia is legal, 60% of older people in one study were scared that their doctors would kill them.[source?]

Alternatives to euthanasia

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Palliative care

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A Hospice House in Missouri

Palliative care is healthcare that focuses on relieving and preventing the suffering of dying patients. It involves giving special care to make the person as comfortable as possible. Palliative care can involve pain relief and help for the patient and family to come to terms with death.

It may include hospice care at home or in a special hospital for people who are dying. In some cases, doctors will give patient drugs which make them stay asleep, so that they will not feel pain.[10][11]

Palliative care is not perfect, so not everyone views it as a replacement for euthanasia. Patients receiving the best palliative care can still experience pain and feel very sick. Also, palliative care is not available to everyone, and not all people who wish to die through euthanasia are so sick that they will die soon. Some people have healthy bodies, but they are suffering in other ways, and palliative care will not always help them.[8]

Principle of double effect

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According to the principle of double effect, sometimes it is all right for a person to do a bad thing - if something good results, and they did not want anything bad to happen.[12]

Thomas Aquinas first described this effect over 700 years ago.[12] He used the example of self-defense: if a person is attacked, they may accidentally kill their attacker by fighting back - but killing was not what the person was trying to do. They only wanted to protect themselves. So even though killing someone was bad, wanting to protect themselves was not.[13]

Some people suggest that doctors might treat a person to reduce their pain, and that treatment might cause the patient to die sooner. If the doctor were to give that treatment in order to help the patient die, that would be euthanasia. But if the doctor gave the treatment to relieve pain, and did not intend for the patient to die, then this might not be euthanasia - even if the doctor knew that the treatment would kill the patient.[13]

Assisted suicide

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When a person kills themselves, they have died by suicide. Assisted suicide involves helping a person kill themselves.[14]

Laws about assisted suicide vary. In some countries, it is legal to give any help that does not involve actually killing the person.[15] This is sometimes viewed as a more acceptable option than euthanasia because the person makes the choice to die.[14] Because the assisting person did not kill, it is not always considered to be euthanasia.[8]

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References

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  • Diaconescu, A. (2012). Euthanasia. Contemporary Readings In Law & Social Justice, 4(2), 474-483.
  1. Edwards, Jean (29 November 2017). "Euthanasia: Victoria becomes the first Australian state to legalise voluntary assisted dying". ABC News. Retrieved 5 July 2017.
  2. McClure, Tess (2022-02-09). "At least 32 people take advantage of New Zealand assisted dying laws in first three months". The Guardian. ISSN 0261-3077. Retrieved 2024-10-16.
  3. Tulloch, Gail (2005). Euthanasia, Choice and Death. Edinburgh University Press. pp. 33–34. ISBN 9780748618811.
  4. Rachels, James (1975). "Active and Passive Euthanasia". New England Journal of Medicine. 292 (2): 78–80. doi:10.1056/NEJM197501092920206. PMID 1109443. S2CID 46465710.
  5. Glover, Jonathan (1980). Causing Death and Saving Lives. England: Penguin Books. pp. 182, 190–192. ISBN 0140220038.
  6. Biggs, Hazel (2001). Euthanasia, Death With Dignity and the Law. Oxford: Hart Publishing. p. 12. ISBN 9781841130910.
  7. MacKinnon, Barbara (2012). Theory and Contemporary Issues, Concise Edition. Cengage Learning. pp. 85–88. ISBN 9781133049746.
  8. 8.0 8.1 8.2 8.3 8.4 Young, Robert (2010). "Voluntary Euthanasia". In Edward N. Zalta (ed.). The Stanford Encyclopedia of Philosophy (Fall 2010 Edition). Retrieved June 22, 2012.
  9. "T4 Program | Definition and History | Britannica". Encyclopedia Britannica. 2024-10-03. Retrieved 2024-10-16.
  10. "Euthanasia and physician-assisted suicide: a view from an EAPC Ethics Task Force". Palliative Medicine. 17 (2): 97–101. 2003. doi:10.1191/0269216303pm673oa. PMID 12701848. S2CID 1498250. {{cite journal}}: Unknown parameter |authors= ignored (help)
  11. Kingsbury, Kathleen (March 21, 2008). "When Is Sedation Really Euthanasia?". Time. Archived from the original on June 17, 2012. Retrieved June 27, 2012.
  12. 12.0 12.1 Mayled, Jon; Oliphant, Jill (2009). GCSE Religious Studies: Philosophy and Applied Ethics for OCR B through Christianity and secular viewpoints. Hodder Education. p. 123. ISBN 978-0340-985-878.
  13. 13.0 13.1 McIntyre, Alison (2011). "Doctrine of Double Effect". In Edward N. Zalta (ed.). The Stanford Encyclopedia of Philosophy (Fall 2011 Edition). Retrieved June 23, 2012.
  14. 14.0 14.1 Glover, Jonathan (1980). Causing Death and Saving Lives. England: Penguin Books. pp. 182–184. ISBN 0140220038.
  15. Manu, Constantin Dan (2010). "Assisted Suicide". Journal of Medicine and Life. 3 (1): 52–59. PMC 10395114. PMID 20302196.
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