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Euthanasia (Greek for 'good death') is the act of ending, or aiding in ending, the life of another person due to some compelling circumstances. While these "circumstances" have connotations of "disposing of the useless," in modern discussions it usually refers to helping end the suffering of the terminally ill. Euthanasia can be a form of homicide when another person carries it out. Theorists usually distinguish between voluntary (with the person's consent) involuntary (without their consent) and non-voluntary (when the person is unable to consent, such as a comatose patient) forms of euthanasia. Generally only voluntary and non-voluntary forms of euthanasia are legal. When the act is done by the individual who is going to die, with another's help, it is referred to as assisted suicide or, more euphemistically, as "aid in dying" or "death with dignity".
Like with the issue of abortion, there are for and against arguments, each often guilty of using weasel words to show themselves in a good light. Those in favor of euthanasia concentrate on the "dignity" of the process when compared to more painful deaths at the hands of crippling diseases. Those against euthanasia prefer to talk about the "sanctity of life" and the spirit of fighting through "bad times." At the same time, they in turn invoke "dignity" to argue that euthanasia diminishes this. Sufferers of chronic conditions often resent the implication that they cannot live meaningful lives with dignity while people speaking of how "sacred" life is aren't in general bedridden or permanently drugged up with pain-killers, so they're also not in the best position to speak on the subject. In one UK poll 79% of disabled people were in favor of assisted dying while in another poll 70% of disabled people were concerned that allowing assisted dying could lead to pressure on disabled people to end their lives. Answers in opinion polls depend significantly on how questions are phrased.
There are two main methods for euthanasia.
- Active euthanasia is the act of directly terminating the patient's life, often with a series of drugs that are designed or are known to be immediately fatal. As well as being performed professionally, this can be done deliberately by the individual and perhaps a friend helping them. Numerous websites and books contain the recipes and methods needed to invoke a painless and more dignified death than more "conventional" suicide mechanisms.
- Passive euthanasia is deliberately leaving a patient without medical care so that they will die due to their condition at an earlier stage. This is common with terminal illnesses, such as cancer, where the quality of life is reduced throughout treatment. Sometimes it is the express wish of the individual not to be treated or not to be revived in the case of cardiac arrest.
The "passive" option can further be divided into what is known as "non-active" euthanasia. In this case, although death is intentional and undoubtedly caused by the action, it is indirect or technically a side effect of the action. End-of-life hospice care often involves such acts as administering pain killers at a level that will relieve intense pain and may also hasten death – a process sometimes referred to as the "principle of double effect" where the patient's death is not the desired outcome of the action, but is recognised as a side effect of the treatment. Non-active euthanasia can also include switching off life support machines or removing feeding tubes, such as in the case of Terri Schiavo. There is much debate in the moral philosophy community over whether there is any real philosophical difference between "active" and "passive" forms of euthanasia. For example, the utilitarian position holds that the two are equivalent, or that "active" euthanasia is often better in order to save pain.
While euthanasia has not found legal support in most of the United States (see Dr. Jack Kevorkian), it is possible to circumvent laws by other means. Montana, New Mexico, Oregon, Washington and Vermont allow assisted suicide to people with terminal illnesses. but not to people with other incurable conditions like quadriplegia.
Passive euthanasia is legal in most, if not all, countries, and includes things such as withdrawing life support machines or just not giving medicine to the patient. Non-active is also legal in most countries.
Active euthanasia is only legal in a few countries, such as Belgium, the Netherlands, and Switzerland. As a result of this, many people from Europe often travel to these places so that they can be euthanized, with one of the most well-known organization that provide assisted dying being Dignitas in Switzerland.
Supporters of euthanasia claim it is the humane and caring thing to do, as long as the patient is clearly sane and explicit in their wishes.
Soldiers injured beyond recovery in combat have been known to ask for death, and have received it, from enemy and fellow soldiers alike.
There is a certain disparity when in an "advanced" society, one can end the pain of a beloved pet (such as a dog or cat) but cannot do the same thing for a beloved relative who asks for it. Likewise, it is legal for able-bodied convicted murderers to be executed, against their will, by overdoses of barbiturates (described by The Peaceful Pill Handbook as the most reliable means of bringing about a peaceful death), but not for disabled, law-abiding citizens to be consensually administered the same.
Opponents invoke two main criticisms. There is a religious critique that argues that only Gawd should be the one to take (an innocent) human life; and the "slippery slope" argument that if the terminally ill are "allowed" to avail themselves with this option, other circumstances may gradually be invoked, leading to forced termination of patients (or just regular folks) for reasons of social or political convenience. Research into countries that have legalized euthanasia has yet to find any such tendency. In the case of the Netherlands, which has had euthanasia for more than twenty years, one study found that "[t]he frequency of ending of life without explicit patient request did not increase over the studied years." Further, "there is no evidence for a higher frequency of euthanasia among the elderly, people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations." In fact, since the same study shows that the rate of euthanasia has actually begun to decrease since 2005, the foretold slippery slope is slipping up.
Various controversies also exist on whether people who have been euthanized did give informed consent to the procedure, or were perhaps forced or coerced into the process, but pro-euthanasia groups agree that any legalization would need measures taken to prevent this (as laws allowing it have indeed done). This is usually in the form of signing a DNR or "Do Not Resuscitate" order in case medical intervention fails, although these are rarely legally binding, as they may not been seen as necessarily expressing the patient's wishes at time when resuscitation is needed. Baroness Jane Campbell fears disabled people may be pressured to end their lives because they are seen as a burden. Also, encouraging severely disabled people to seek euthanasia saves money while providing enough so their lives become worthwhile can be very expensive.
- So as to differentiate this form of death from policies that might be carried out by eugenics or dysgenics, such as the Holocaust.
- Assisted dying: What do disabled people think?
- BBC Ethics - Active and passive euthanasia
- Brittany Maynard: Terminally ill euthanasia activist ends life by assisted suicide
- Dignitas: Swiss suicide helpers, BBC News, 20 January 2003
- "Pro-life ends at birth and begins again at brain death," as they say.
- "Two Decades of Research from the Netherlands. What Have We Learned and What Questions Remain?", The Journal of Biomedical Ethics 6 (3). Judith A. C. Rietjens, Paul J. van der Maas, Bregje D. Onwuteaka-Philipsen, Johannes J. M. van Delden, and Agnes van der Heide. 2009.
- The Euthanasia Debate on Riyarchy (Collaborative argument map for outlining and ending the euthanasia debate)