Euthanasia is an emotionally charged topic of debate, and it is easy to lose sight of the facts when people talk about wanting to kill themselves for whatever reason. Most of the people that seek physician-assisted suicide are suffering from terminal illnesses that cause them a great deal of pain that cannot be properly controlled with medications. For these individuals, the relief of death is preferred to their continuing suffering. The ethical debate over euthanasia, though, is colored by millennia of human thinking concerning the value of life and biblical proscriptions against suicide in any form. This paper examines the arguments in support of euthanasia as well as arguments against the practice to determine the facts and to provide rationale in support of legalizing euthanasia.
Humans can be said to really own one thing outright: their lives. There are laws in most countries, though, that prevent people from taking their own lives or having a physician help them in the process. Advocates of euthanasia maintain an individual's right to autonomy means that people are automatically entitled to physician-assisted suicide and a relatively painless death (Sinha & Basu, 2012). Opponents of euthanasia argue that physicians should not participate in physician-assisted suicide because the practice would be violative of the central tenet of the medical profession (Sinha & Basu, 2012). The ethical debate over euthanasia has become more intensified in recent years as Oregon legalized physician-assisted suicide and some countries such as The Netherlands and Belgium have also legalized physician-assisted suicides and more people are opting for this way to end their lives (Marcoux & Mishara, 2007).
This paper provides a review of the relevant peer-reviewed and scholarly literature to demonstrate that euthanasia is a humane and acceptable practice that should be implemented by the United States based on the example used in The Netherlands, followed by a summary of the research and important findings concerning these issues in the conclusion.
The term euthanasia is derived from the Greek and means a "gentle and easy death" (Keown, 2002). In this context, it is reasonable to suggest that everyone would support this type of passing, and advocates of euthanasia argue that this should be everyone's fundamental right (Keown, 2002). Besides improving palliative care and expanded hospices, euthanasia advocates are also "arguing that doctors should in certain circumstances be allowed to ensure an easy death not just by killing the pain but by killing the patient" (Keown, 2002, p. 10). Euthanasia is defined by Sinha and Basu "as the administration of a lethal agent by another person to a patient for the purpose of relieving the patient's intolerable and incurable suffering. Typically, the physician's motive is merciful and intended to end suffering." (p. 177). The precision of the definition used for euthanasia is vitally important because some misleading definitions are used intentionally to support or refute the legalization of euthanasia (Somerville, 2003).
Notwithstanding the arguments in support of euthanasia, many critics rely on age-old proscriptions about killing and the need to prevent death to support their cause. In this regard, Nelson emphasizes that, "It generally is assumed in our society that the act of suicide should be prevented. This assumption is founded upon another, more basic, assumption, which holds that life is preferable to death" (1984, p. 1328). It is also reasonable to suggest that these assumptions are not applicable to everyone, including those with terminal illnesses that suffer enormous pain while they wait for nature to take its course. As Keown points out, "Euthanasia is the belief that death would benefit the patient, that the patient would be better off dead, typically because the patient is suffering gravely from a terminal or incapacitating illness" (p. 10).
Proponents of euthanasia have become increasingly vocal in recent years, spurred by some high-profile cases. For instance, Sinha and Basu (2012) report that, "Advocates demanding autonomy for patients regarding how and when they die have been increasingly vocal during recent years, sparked by the highly publicized cases of Drs Jack Kevorkian, Timothy Quill, and Aruna Shanbaug . These cases have centered on the plight of dying patients with terminal illnesses" (p. 177). Likewise, Marcoux and Mishara report that, "Debates concerning euthanasia have become more frequent during the past two decades" (2007, p. 235). Many legislative debates have drawn on opinion polls that indicate sustained and strong public support for the legalization of euthanasia (Marcoux & Mishara, 2007). Indeed, a majority of the population in Australia, Canada, Great Britain, The Netherlands, and the United States favor legalizing euthanasia (Marcoux & Mishara, 2007).
Euthanasia is legal in The Netherlands and despite concerns about the potential for people lining up for Kevorkian suicide machines, the practice is still fairly rare. The Dutch apply three conditions that must be satisfied before physician-assisted suicide is permitted: (1) the patient's voluntary and persistent request; (2) the hopeless situation of the patient; (3) consultation of a colleague (ten Have & Welie, 1999). Despite the current status of the laws concerning euthanasia in other countries, a growing number of physicians in other countries have recognized the value of the practice for their patients and provide some type of assistance in the form of drug overdoses or withholding life-sustaining care under these circumstances (ten Have & Welie, 1999). When physicians take deliberate actions to end a patient's life, it is referred to as "active euthanasia." By contrast, when physicians withhold the resources needed to maintain life, it is termed "passive euthanasia" (Sinha & Basu, 2012). In addition, there are three different types of active euthanasia: (1) voluntary euthanasia which is performed at the request of the patient; (2) involuntary euthanasia, also known as "mercy killing," involves taking the life of a patient who has not requested it with the intent of relieving his pain and suffering; and (3) nonvoluntary euthanasia which is carried out even though the patient is not in a position to give consent (Sinha & Basu, 2012, p. 177). Because the end result is essentially the same irrespective of whether physicians take deliberate actions to end a patient's life or simply withhold life-sustaining treatment, some observers maintain that passive and active euthanasia are morally indistinguishable. For instance, according to Marcoux and Mishara, "Some people believe that there is no moral distinction between acts or omissions that result in death. They contend that 'passive' and 'active' euthanasia are morally equivalent. However, legislation as well as medical practice invariably distinguish between these practices" (2007, p. 235).
There are two schools of thought concerning opposition to legalizing euthanasia. The first school of thought is founded on the principle that, with the exception of self-defense or the defense of others, it is fundamentally wrong for one human to purposely kill another human (Somerville, 2003). The second school of thought is founded on the utilitarian belief that legalizing euthanasia is harmful to people and society in general in ways that counter any potential benefits (Somerville, 2003). Because life is so precious and most people believe that it should be prolonged as long as possible, the notion of premature death is repugnant and colors the debate over the appropriateness of euthanasia. In this regard, Nelson advises that, "On the basis of wide-ranging experience with the tendency of living things to cling tenaciously to life, most people readily conclude that premature death is something that should be avoided" (1984, p. 1328). This belief, though, runs contrary to euthanasia advocates that believe some people would be better off dead and living through misery and suffering.
Nevertheless, humans appear to be hard-wired for life and the thought that some people could be better off by dying simply flies in the face of overarching social values that hold life to be the preferable condition irrespective of any suffering involved. For instance, according to Nelson, "Upon the foundation of these life-sustaining biological drives, one finds an overlay of social values that tend to be manifestly prolife in terms of the assumed importance of an individual's life to self and others" (1984, p. 1328). Indeed, the American Medical Association's Council on Ethical and Judicial Affairs made its position clear on physician-assisted suicide by describing it as "fundamentally incompatible with the physician's role as healer" (cited in Whitney, Brown, Brody, Alscer, Bachman & Greely, 2001, p. 290). In addition, opponents of euthanasia cite the possibility for undiagnosed clinical depression to play a role in the patient's decision as well as the potential for some people to be coerced into asking for euthanasia (Sinha & Basu, 2012).
Moreover, opponents charge that legalizing euthanasia would "damage important, foundational societal values and symbols that uphold respect for human life" (Somerville, 2003, p. 34). An interesting point made by Somerville is that like the tango, it takes two people to perform euthanasia. In this regard, Somerville points out that, "With euthanasia, how we die cannot be just a private matter of self-determination and personal beliefs, because euthanasia is an act that requires two people to make it possible and a…