Euthanasia and Assisted Suicide: Concepts and Issues

Most people die of diseases Most people die of diseases. Before the twentieth century, people lived shorter lives. The main cause of death was acute, infectious diseases (e.g. smallpox, cholera).

3 things that happened in the twentieth century have significantly increased the average lifespan of the general population: medical breakthroughs (e.g. antibiotics) greater public awareness of hygiene improved healthcare provision

People today live longer lives, and most are likely to die of chronic, degenerative diseases such as heart disease, cancer or stroke.

Patients with chronic, degenerative diseases usually have to be admitted to and discharged from hosptial several times and suffer for several months to several years before they eventually die.

Euthanasia is the termination of a patient’s life in order to relieve him or her of suffering. It is usually carried out in the best interest of the patient.

Classification of euthanasia in terms of the patient’s consent: voluntary euthanasia (with the patient’s explicit consent) involuntary euthanasia (without the patient’s consent) non-voluntary euthanasia (the patient cannot give consent)

Classification of euthanasia in terms of method: active euthanasia (e.g. lethal injection) passive euthanasia (withholding or withdrawal of life-sustaining treatment) physician-assisted suicide (the doctor provides the means for the patient to commit suicide)

In physician-assisted suicide, the doctor may prescribe morphine, barbiturate, or some other drug to a terminally-ill patient. Taken in small doses, the drug can be used as a painkiller. But excessive dosages can be fatal.

The patient has to decide whether to use the drug to relieve pain, or to use it to commit suicide. (Some suggest that physician-assisted suicide should be distinguished from euthanasia because the doctor is not directly involved in the patient’s death.)

The right to die can be understood as the right to make the end-of-life decisions for oneself. There are 2 main questions concerning the right to die: (1) Do we have a right to die? (2) If we do, is this right a positive right or a negative right?

Arguments against the right to die are usually based on the sanctity of life principle (e.g. that all of us have a duty to preserve life). Supporters of the sanctity of life principle oppose killing as well as abortion, suicide and euthanasia.

Kantian arguments against suicide: The maxim of using suicide as a way to avoid suffering cannot be universalized. People who commit suicide fail to respect their own dignity because in giving up their lives, they use themselves as a mere means to avoid suffering.

At the heart of patient autonomy is the concept of ‘informed consent’, the idea that patients should be given all the information they need to make decisions for themselves, such as (1) what kind of disease they have, (2) the prospect of recovery, (3) treatment options available, and (4) possible side effects of treatment.

The argument from compassion is based on the following considerations: the doctor’s judgment of the patient’s quality of life; sympathy for the patient; and respect for the patient’s wish to die with dignity.

The quality of life of some terminally-ill patients may have declined or deteriorated to the point that keeping them alive may be even worse than allowing them to die.

Terminally-ill patients are often transferred to a facility called a ‘hospice’ where they are given palliative care rather than life-sustaining treatment.

Palliative care can be seen as an important aspect of end-of-life care which aims at maintaining patients’ quality of life by reducing their pain and suffering.