Euthanasia is the ending of a severely sick person’s life to free such a person from suffering. Frequently, it is done when the patient who dies requests for it, although there are instances labeled as euthanasia where an individual is not in a position to ask for it. The exercise involves either active euthanasia (administration of drugs with the overt purpose of ending life) or passive euthanasia that comprises practices such as treatment denial, withdrawal of medication, or double effect, i.e., providing drugs to lessen the pain but which are ultimately lethal. Conversely, physician-assisted suicide or PAS is a scenario where a practitioner offers knowledge or prescribes medication for sick persons to end their own life. Assisted dying (euthanasia/PAS) is voluntary when patients with correct mental capacity ask for death, non-voluntary in situations in which their wishes are unknown, or involuntary where they are killed in their best interests but contrary to their desires. There are critical ethical, legal, religious, and political concerns that bedevil the controversial practice of euthanasia/PAS. This essay concentrates on an in-depth analysis of those issues. In addition, the author’s opinion on the subject and defense of that viewpoint is deliberated.
The subject of euthanasia is a controversial one. The whole fuse revolves around whether some instances of benevolent killing ought to be legalized or not. The proponents of euthanasia/PAS develop their case based on the foundation of a secular, liberal judicial system while the antagonists anchor their arguments on the canon of inviolability of life and the inability of governments to formulate satisfactory regulations. The debate on euthanasia/PAS ensues from conflicting values and interests, strong interdependencies of the practice to other factors in society, and significant levels of uncertainty concerning the ramifications. Essentially, euthanasia/PAS is a crisis of interactions that is disjointed rather than a coherent one. Therefore, every person possesses some truth about it.
The ranges of disputes that arise from assisted dying are strikingly complicated and diverse. First, such debates entail questions of moral theory, e.g., whether death is profitable to a person, or if the concept of good death can exist. Secondly, questions of political justice are debatable. These include setting priorities in resourcing palliative care and balancing between the cost of life extension and that of improved quality of life. Thirdly, issues of political morality encompass whether the State decides to lawfully institute policies on assisted dying, or if it possesses the authority to stop patients from exercising control over how they die. Also, an aspect of regulatory caution that is often contentious is whether acceptable policies can be adhered to in practice.
Euthanasia/PAS poses several moral or ethical concerns. One may wonder if it is right at all to end the life of a critically ill person passing through agonizing pains and suffering, ponder on the circumstances under which such actions may be justified, and if there is a moral difference between assisted dying and letting patients die naturally.
Recent advances in medical technology have transformed the doctor-patient relationship from the traditional status where the medic presumed he knew all that was best for the consumer to the current partnership arrangement where the physician consults the patient regarding treatment. This new relationship gives rise to conflict between the patient and the doctor concerning patient liberty, communal responsibility, and professional autonomy. The values of privacy, the power to control a person’s own body, and independence grant an individual the legal and moral right to choose to live or not. It is on that basis that supporters of assisted dying argue that death is a personal affair and as long as it does not harm others, the society or state has no mandate to interfere. Many states that have legalized euthanasia ceded to this argument. Thus, where the actual wishes of the patient (that are devoid of compulsion or manipulation by the relatives, physician, and society) are presented, those requests to die are often considered. In a situation where a patient’s actual wishes cannot be expressed, the moral issue that emerges is to ascertain the amount of discretion that is given to the relatives of such a person to make decisions on his or her behalf.
Another issue of moral dilemma is the practice of PAS and the need for doctors to adhere to the principles of medical ethics. Physician beliefs on euthanasia/PAS are polarized and depend on variables such as gender, place of work, age, field, whether the doctor is practicing or retired, whether the sick person is cared for through the end of life and whether the physician has prior experience with patient requests for euthanasia. Medical doctors must observe the Hippocratic Oath, which upholds that they should act as agents to affirm life, and not to speed up death. Hence, a professional ethics question that arises is whether the practice of medicine can involve both caring and killing concurrently. Thus, physicians are faced with an overwhelming challenge of how to provide the best care for people with terminal ailments.
Similarly, aspects of the quality of life are frequently used in support or rejection of physician-assisted suicide. Innovations in the health sector have enabled people with chronic and degenerative disorders to live long. These patients endure prolonged, excruciating pain and choose PAS as a humane way to end their plight. The lack of effective palliative care, endless suffering, and prolonged death are situations that foster suicidal tendencies. However, many chronically ill patients go for euthanasia due to potentially treatable conditions like depression, enduring pain, drug abuse, and physical debilitation. The request for assisted death based on such quality of life issues is unfitting, since such a wish may be a cry for help. Therefore, a careful examination of the surrounding problems is necessary.
All religions acknowledge the position of death in human experience, and often perceive it as an instance of gaining powerful spiritual revelation and as a means of preparing for the afterlife. Consequently, most religions hold strong sentiments on euthanasia. For example, in a majority of Islamic States, life is considered a sacred gift and is not owned by a person. Therefore, assisted dying is wrong and unlawful. Other religions hold the same position and opine that since life is a gift from God, He alone should decide when to end it. Accordingly, those who become incapacitated by ailments deserve special care and protection.
In most jurisdictions, assisted dying is unlawful. In such instances, euthanasia/PAS is considered murder or manslaughter and is punishable by law. Even in a country such as the US, the duty of deciding whether euthanasia is legal or unlawful lies with the individual states. As a result, different states have different legal standpoints about the practice, with the exercise being lawful in some territories and illegitimate in others. Many countries seem to approve physician-assisted death as compared to euthanasia. The support for euthanasia/PAS in the society tends to be high among the atheists, those with high household incomes, those with high levels of education, those with previous experience in attending to terminally ill relatives, and those who are older. Similarly, ethnicity, race, and marital status influence attitudes towards the practice with the whites, the divorced being more supportive of euthanasia than the traditionally marginalized groups and the married.
Palliative Care and Assisted Dying
Rivals of assisted dying insist on the need to improve terminal and palliative care instead of settling for euthanasia. According to them, good quality palliative care eliminates the requirement for assisted dying. Contrariwise, the practice of euthanasia diminishes the need for palliative medicine by creating room for physicians to deny essential medical resources and demoralizing them from providing the best care for the sick. As a result, there is low input in research and development of new cures and treatments for degenerative diseases. On the other hand, euthanasia/PAS proponents claim that allowing terminally ill patients to die helps free up health care resources for other uses.
One of the critical logistical aspects regarding assisted dying is how to assess a prognosis without compromising patient autonomy. Other key considerations include making clinical decisions, independence of physicians, regulation of the assisted dying system to ensure accurate reporting, and detection of the incidences of complications or failed assisted dying. The legalization of assisted dying may culminate in various developments. First, it could promote a false attitude towards the weak by making them appear burdensome, pathetic, and unworthy to live. Second, it provides an occasion for misuse, especially by patients who are lonely and individualistic. Likewise, unnatural death allegedly grants too much power to physicians, a scenario likely to be abused. Fourthly, it may create an avenue for involuntary euthanasia. The notion is based on the slippery slope argument that permitting something moderately harmless signals a trend that leads to social acceptance of another that is potentially harmful. However, proponents of euthanasia assert that the practice cannot be allowed without instituting the right regulatory and control mechanisms. Nevertheless, it is imperative to protect vulnerable people (the disabled, the elderly, and the mentally ill) from involuntary euthanasia.
The decision to support or reject assisted dying demands scrutiny of all elements surrounding the practice. Obviously, factors such as social, religious, and moral upbringing play a significant role in influencing one’s sentiments. However, personal feelings towards social values, norms, and structure often change as one becomes more enlightened. There are circumstances where euthanasia/PAS should be allowed. Particularly, situations where the entire patient’s conditions point to ultimate death and the efforts to keep that person alive continue to inflict unbearable pain and suffering. Such special cases should be documented and each incident handled collaboratively to avoid manipulation and to eliminate situations of the involuntary killing of patients for ulterior motives. The moral principle of justice implies that all people have equal access to care and that health care is provided justly and equitably to all. Thus, irrespective of our attitudes towards euthanasia, it is essential that people are granted the health care services they require.
Overall, there is a remarkable heterogeneity about viewpoints towards euthanasia/PAS, which accounts for the unpredictability, intricacy, and controversial nature of the topic. Evidently, various phenomena and factors play a more significant role in influencing how one views the practice of assisted dying. Furthermore, an insight into how the society regards assisted dying avails a broader knowledge base that is vital for fruitful debates and informed decision making in the process of formulating end of life policies.