Analysis of the Arguments for Euthanasia and Against It

The euthanasia debate

In contemporary society, the controversial debate of whether an individual should be allowed to control the timing of their deaths in a way that is peaceful and medically assisted is being debated. This practise is referred to as euthanasia, and is made up of the words “eu” and “Thanatos” with the Greek derivatives translating to mean “good death”. Euthanasia is also referred to as ‘voluntary assisted dying’ (VAD) or physician-assisted suicide. It involves intentionally ending an individual’s life either through giving them a lethal injection or not taking the necessary steps required to keep that individual alive. It has been defined on the official Parliament of Australia website as “when medical intervention takes place, at the patient’s request, in order to end the patient’s life’. Some countries such as Canada and Switzerland have legalised doctor-assisted suicide and/or voluntary euthanasia. The world’s first jurisdiction to pass laws giving doctor’s the right to terminate the life of a terminally ill patient at their request came into effect on the 25th of May 1995 in the Northern Territory. However, it was removed in 1997, leaving euthanasia to be considered as immoral under the law in Australia. Since June 2019, an assisted suicide scheme has been in place in Victoria, with a similar scheme coming into effect mid-2021 in Western Australia. The lack of nation-wide legislation regarding the issue triggers questions involving justice, fairness and equality as rights shouldn’t only be afforded to particular individuals (e.g. those in Victoria) but should be universal. Moreover, as this is a significant legal, ethical and social policy issue, it is extremely important to take into consideration both sides of the debate. Firstly, the potential arguments for euthanasia are discussed in this essay.

Potential arguments for euthanasia

There are numerous arguments to be made in favour of euthanasia, with many supporters adopting an utilitarian point of view when debating the issue of euthanasia, suggesting that the legalisation of the practice nation-wide would be in the best interest of society as it reinforces our collective right to autonomy. It is often argued that it should be both legally and ethically permissible in circumstances where an individual’s wellbeing and quality of life is reduced either physically, mentally or both. The first, and one of the most significant arguments in favour of the practise is an individual right to autonomy, which recognises that individuals are independent biological entities. Consequentialists suggest that euthanasia allows society to focus and implement a way that permits individuals who are inhumanely suffering to end this suffering in a consenting way. By not legalising the practice nation-wide it could be suggested that the Government is assuming that they are better equipped to protect an individual’s rights than that of the individual themselves, hence opposing an individual’s, where permitted, liberty and autonomy. Whilst, Australia has one of the highest life expectancies in the world, earning it a reputation as a ‘healthy nation’, approximately 50% of Australians are living with a chronic disease. In 2016, according to the Australian Institute of Health and Welfare (AIHW), 87% of deaths were associated with one of the eight major groups of chronic disease, according to the Australian Institute of Health and Welfare (AIHW). Hence, it could be argued that providing the option of euthanasia would be providing the greater good for the greatest number of people. Euthanasia has even been welcomed by the Australian Federation of AIDS Ogranisations’s President, Mr Tony Keenan, as he stated that the legislation was responding to community needs and demands, and is “a very good example of humane, compassionate legislation”.

In the last few decades, Australian society has seen an increase in its states and territories taking action, with the purpose of guaranteeing that an adult individual of sound mind can make the decision to cease any extraordinary measures that are being used to prolong life. NSW issued “interim guidelines” in 1993, South Australia passed the Natural Death Act in 1983, Victoria the Medical Treatment Act in 1988, the Australian Capital Territory passed the Medical Treatment Act in 1994, and the Northern Territory the Natural Death Act in 1988. Also, there seems to be increasing support for euthanasia, as confirmed by the 2018 ABC news article, “Voluntary euthanasia should be legalised in WA to end ‘unnecessary suffering’, report finds”. Ultimately, it can be argued that an individual should be in control of their own life and be able to do with it as they please as long as those decisions are lawful and have been made with contemplation and acceptance of the consequences.

It can be argued that VAD is supremely rational and eminently logical because it recognises the needless prolonging of the inevitable for those suffering with incurable conditions and being made to suffer unnecessarily. Supporters also propose that those with debilitating mental health who are suffering from intense psychological anguish that life is unlivable should be given the option of ending their life with dignity, prompting the question of whether life should be about quality or quantity? This notion of dying with dignity is, in fact, one of the main arguments in support of assisted dying because it does not just apply to those who are in physical pain but is extended to psychological stress too. Dr Rodney Syme, the Vice President of Dying with Dignity Victoria, spoke to Huffington Post Australia for a 2017 article titled, “Here Are The Arguments For And Against Euthanasia (And Where It Could Soon Be Legal)”, and stated that “A sense of being a burden to other people is huge for many of these people. They don’t want to consume the lives of people they love and that tends to happen because they need a great deal of care”. In addition, an argument that a more civic-minded individual could make is that in Australia we have an increasing elderly population, which places a huge financial burden on our health care system, with the Australian Government spending over $18 billion on aged care in 2017-18, therefore, could it not be argued the reasonability of lessening the burden on our aged care system by allowing patients who want euthanasia to access it? The same argument could be made in regards to incurable diseases and our limited health resources.

Furthermore, it should be recognised that death is a private matter between those involved, and there is the libertarian argument that if the decision doesn’t do any harm to those not directly involved, then they don’t have the right to interfere. Therefore, it can be argued that euthanasia should be seen as morally acceptable and hence, should be legalised nation-wide.

Finally, if reasonable steps are taken in relation to the administration of euthanasia and the assessment of an individual’s eligibility, it could be argued that the practice should indeed be legalised Australia-wide as it would be like any other medical practise. The assurance of ‘reasonable steps’ is already demonstrated in the Voluntary Assisted Dying Act 2017 (Vic) which highlights eligibility and the safe-guards surrounding the practice. In regards to eligibility, an individual must; be 18 or over, has decision-making capacity meaning that they understand the information relevant to the decision and can communicate the decision in some way, as well as be diagnosed with a disease/illness or medical condition that is incurable, progressive, expected to cause death within six months and is causing unbearable suffering. It is also highlighted in the Act that individuals with a disability or mental illness alone do not satisfy the eligibility requirements. Some of the safeguards surround VAD include; the individual is required to make at least three separate requests, patients must be provided with information about their diagnosis, palliative care options, available treatment and prognosis, and it is punishable by up to 5 years imprisonment for an individual who induces another to request and/or take VAD medication. To summarise, everything in life has the potential to have positive and negative outcomes, however, regulating the practise instead of prohibiting it, will not only increase an individual’s autonomy, but will also protect them from potential abuse.

Potential arguments against euthanasia

In contrast, there are those who oppose euthanasia, aiming to highlight that the arguments for the practise are not compelling or justified enough to endorse state-sanctioned suicide as it could be the start of an increasing disregard for human life. Arguments against euthanasia could be said to take on a virtue ethics approach to ethics as these arguments aim to emphasise that life should be viewed as intrinsically worthwhile, and hence, should not be brought to a premature end intentionally. Arguments against VAD include; the negative wide-spread effects on those left behind, it doesn’t obey the law of universalizability, it is unnecessary because alternative treatments exist, autonomy is important but never absolute and it violates historically accepted codes of medical ethics

Our rights are limited by our obligations. This secular objection to euthanasia emphasises how individual decisions can have wide-spread effects, such as those on health-care professionals and an individual’s family and friends. Whilst, it was previously argued that an individual should have the right to control the decisions that affect them, especially due to the private nature of death, it can also be argued that the individual’s decision to prematurely end their lives is not a decision that solely affects the individual. When somebody chooses to end their life, they are also deciding to leave behind family and friends, which will consequently have detrimental effects such as emotional distress. Philosophers aim to emphasise the importance of regarding human beings an end in themselves rather than means to highlight the value of life and our duty to preserve it.

Another argument in opposition of euthanasia explores the belief that ethical principles that could be accepted as a universal rule should be accepted, as proposed by Immanuel Kant. If the right to euthanasia is a universally accepted principle, then it is morally acceptable. However, this is simply not the case, as there are exceptions to who is eligible for euthanasia, and whilst the law of universalisability in itself has exceptions, there are still inconsistencies in who is permitted to access the practise. Therefore, it cannot be said that euthanasia is a universally accepted principle, and hence, the opposition will argue that it shouldn’t be viewed as morally acceptable.

It has been previously recognised that supporters of euthanasia suggest that life is only instrumentally valuable and its ending should be for the autonomous individual to determine. Yet, the sole preservation of the theist that life cannot or should not intentionally be brought to an end is not just preached by papal declarations and advice from Churches, it is also evident in the pre-modern Hippocratic corpus and in modern commitments to protect, as well as celebrate human rights. As previously mentioned, euthanasia can be seen as a way of relieving terminal ill patients from their suffering, however, meticulous research in Palliative medicine has shown that the large majority of unpleasant symptoms associated with some terminal illnesses can be significantly alleviated or relieved with techniques already within our disposal. Whilst, this does not mean that all patients are benefiting from this hospice movement, as there is no denying that many individuals receive suboptimal care due to lack of access to services/care or unavailability of medical practitioners with the required skills/training to deal with the condition. It could also be argued that euthanasia places pressure on the elderly and those who have a terminal illness to end their lives in an attempt to ‘do the right thing’ and free up health resources. Therefore, wouldn’t it be better to increase training and ensure that appropriate and effective care can be achieved, instead of undermining corporate and individual incentives for providing quality care through the provision of the option of euthanasia.

Furthermore, whilst it can be argued that as human beings we all have the collective right to have a say in the decisions that affect us (autonomy), it needs to have limitations to ensure that an individual’s best interests are being protected. Euthanasia continues to be a highly commendable topic because it has significant implications for health professionals, health systems and communities around the world. There are numerous stakeholders and perspectives that need to be taken into consideration when considering both sides of the argument. For instance, in 2007 the Australian Bureau of Statistics found that 68% of Australians affiliated with a Christian based religious group. This is a substantial percentage of the Australian population, which is significant as religious views are one of the most influential viewpoints in regards to euthanasia. Euthanasia challenges the notion of “playing God”, and suicide generally being viewed as a sin against God, with this opinion being similar amongst many religious groups. Euthanasia also conflicts with the International Code of Medical Ethics, with the Hippocratic Oath, which is sworn upon by new physicians, stating that “I will give no deadly medicine to any one if asked, nor suggest such counsel…”. According to a UK survery of 986 doctors by ‘Right to Life’, 56% believe it would not be possible to set clear rules for legal euthanasia, and 74% would refuse to help a patient die. Furthermore, in the World Medical Association’s 1992 Statement of Marbella, it was confirmed that assisted suicide (including euthanasia) is unethical and must be condemned by medical professions, which means that a doctor would be acting unethically if they intentionally enable an individual to end their lives.

Moreover, with death being something individuals are gaining more control over, there is the possibility of euthanasia going too far, with doctors in the Neverlands- the euthanasia capital of the world- starting to worry about the consequences, as explored in the 2019 ‘The Guardian’ article titled, “Death on demand: has euthanasia gone too far?”. In this article, it explores what it was like for Dr Bert Keizer, a Dutch doctor who was one in approximately 60 physicians who were a part of the ‘End of Life Clinic’, and how this clinic was responsible for approximately 750 cases of euthanasia in 2017. In fact, he addresses how in the Netherlands this self-willed end has in a sense become normalised since it has been accepted since 1981 and that the long-term consequences of this are only recently becoming noticeable. Boer stated in the article that “the process of bringing in euthanasia legislation began with a desire to deal with the most heartbreaking cases- really terrible forms of death”, before continuing to say that “we have put in motion something that we have now discovered has more consequences than we ever imagined”. One of the contributing factors to the increase in euthanasia after 2007, is the expansion of the range of eligible conditions, and the definition of “unbearable suffering” wasn’t as strictly regulated. The article also raises a very valid argument: if an individual’s mental state deteriorates beyond a certain point, can or should they still be euthanized regardless of whether their original wishes. A societal conflict that has normalised in regards to euthanasia is the tension between the rights of an individual and society’s obligations to protect lives.

Conclusion

In conclusion, it is clear that legalising euthanasia nation-wide and making it a more accepted practise is a controversial and problematic debate with the potential of resolving one ethical conundrum, only to create a new one. Hence, maybe the focus should not be on the legalisation of the act, but rather the limitations surrounding it. This would mean that euthanasia is available to individuals who desire it, but rigourous criteria surrounding its admission would prevent its abuse, hence offering a compromise in an attempt to satisfy both sides of the argument.