Euthanasia: Ethical Dilemma, Laws, and Nursing Practice

Introduction to Euthanasia

Euthanasia, referred to as "mercy killing" in common parlance, is the action of ending the life of an individual suffering from a painful and extended injury or illness (Center for Health Ethics, 2011). Euthanasia implies that another individual — excluding the patient — carries out an action with the intention of ending the patient's life; for instance, a lethal dose of medicine being injected into the patient. It may be voluntary if the patient approves of it, involuntary if the patient refuses it, or non-voluntary if the patient is unable to give approval. In euthanasia, an individual makes the means of death available in addition to acting as death's direct agent (American Nurses Association, 2013).

Euthanasia is the act of ending a patient's life to rid them of their suffering. Typically, such a patient would be terminally ill or enduring immense pain and suffering.

The term "euthanasia" originates from the Greek words eu, meaning "good," and thanatos, meaning "death." Its underlying concept is that rather than condemning an individual to a slow, agonizing, or undignified death, euthanasia would permit the patient to experience a "good death."

Ethical Arguments For and Against Euthanasia

Several arguments have been presented either in support of or in opposition to euthanasia. The main ethical positions are outlined below.

Rights-based argument: Supporters of the act maintain that a patient possesses the right to decide how and when they should die (Bartels & Otlowski, 2010; Kerridge, Lowe, & Stewart, 2009). This concept is known as autonomy.

Beneficence: Proponents of euthanasia argue that the primary moral values of a society — mercy and empathy — require that no patient should endure intolerable suffering, and that mercy killing should therefore be permitted (Norval & Gwyther, 2003).

The sanctity of life: This argument can be viewed from both a religious and a secular basis. The central philosophy is that human life ought to be valued and preserved. From a Christian perspective, life is a gift from God, and taking it away is considered an affront to the divine. Similarly, according to the Islamic faith, it is only God who possesses the right to give and take away life (Bulow et al., 2008).

Abuse of autonomy and human rights: The principle of autonomy itself prohibits the voluntary elimination of the conditions necessary for autonomy to exist. Furthermore, it has been argued that patients' demands for euthanasia are seldom truly independent, since many terminally ill patients may not be of sound mind and may be incapable of making important decisions on their own accord (Ebrahimi, 2012).

The Code of Ethics for Nurses with Interpretive Statements, Provision 1, Interpretive Statement 1.3 (American Nurses Association, 2001) addresses the obligation of nurses to uphold the intrinsic value, self-respect, and rights of every human being regardless of the nature of the health issue. An individual's worth is not diminished by death, disability, functional condition, or proximity to death. This respect extends to everyone who requires nursing services for health promotion, illness prevention, health restoration, the lessening of suffering, and the provision of care to the dying (p. 12).

Legal Landscape: Australia and the United States

Although many nations have no laws permitting active euthanasia, reports reveal that it is sometimes carried out illegally by medical practitioners and by family members or friends of critically ill patients.

Australia: Euthanasia was first legalized in Australia's Northern Territory. The Rights of the Terminally Ill Bill 1995, a private member's bill, became law on 25 May 1995 and was assented to on 16 June 1995. It was utilized by only four individuals, all assisted in dying by Dr. Philip Nitschke, before being revoked by the Australian Senate on 25 March 1997 (The Life Resources Charitable Trust, 2011).

United States: Euthanasia is permitted in a small number of U.S. states, though the practice remains illegal in most. The "aid in dying" movement has made incremental legislative gains in recent years, yet the subject remains highly contentious (The Guardian, 2014).