Euthanasia and assisted suicide are highly emotive moral and ethical issues and ones about which debate continues to rage. Much of the literature on the subject is biased toward one or other side of the argument.
While concerned with similar situations, the two have an essential difference as defined below.
Euthanasia translates roughly from the Greek as a good death or an easy death, eu- is a prefix meaning 'good' or 'easy' and -thanasia being derived from thanatos meaning 'death'. In English it means the killing of one person by another to relieve the suffering of that person, which can be at the request of the person who is killed or those people responsible for them.
Assisted suicide is exactly what the name implies, aiding a person who is incapable of the act themselves to commit suicide.
What are they?
In practice, both terms usually refer to the hastening of the death of a person with a terminal illness and may involve the person's family or the medical profession. Both practices are currently illegal worldwide except for the US State of Oregon which permits assisted suicide and the Netherlands where both assisted suicide and euthanasia are allowed. The state of the Northern Territory in Australia did legalise assisted suicide but has since repealed the law.
In a similar way to the abortion debate, the two sides of the argument are diametrically opposed and highly unwilling to accept the other's reasoning. The principal protagonists are also similar, the 'pro-life' camp, which tend to be conservative and/or religious groups and the more liberal 'pro-choice' group.
Arguments for Euthanasia and Assisted Suicide
The principal argument is that a person who is suffering from a terminal illness and who may be in considerable pain and limited in many activities of daily living, and who may be entirely reliant on their family or friends for their day-to-day care, should have the right to end their lives when they choose. The apparent benefits of this are that the person is relieved of the necessity to live the remainder of their life in pain and with minimal quality of life and also removes the burden which they place on their family.
There is also the argument that a person should have the right to end their life with dignity, and in comfort in whatever location they choose rather than in a hospital.
Also, from a purely economical point of view, the financial cost of long term medical and nursing care is significant. Euthanasia removes the necessity for this type of care allowing funds saved to be spent elsewhere.
Arguments against Euthanasia and Assisted Suicide
One of the arguments most emphasised against euthanasia and assisted suicide is the religious one. Certainly in Christian doctrine, suicide of any form is morally wrong because, having given life, God is the only one who has the right to take it away. The latter point also encompasses euthanasia since it moves the responsibility for taking life from God to humanity. Indeed the Fifth Commandment, 'Thou shalt not kill' (Exodus 20, verse 13), makes the point quite unequivocally.
More practically-based arguments make the point that there is an extreme danger in legalising these ideas because of the possibility of unscrupulous family members or doctors who persuade the person in question to end their life against their own free will.
Free will is also the key to the other potential problem, which centres around deciding whether a patient is competent to make that kind of decision, especially if they are already elderly which brings factors like dementia into the picture and whether drugs people may be taking for pain relief could compromise their mental functioning. In a similar vein, psychiatric conditions may also increase a person's desire to commit suicide. This is a common symptom in depression, schizophrenia, and other mental health illnesses and could lead to dangerous situations where people with undiagnosed psychiatric conditions could choose to be unnecessarily aided in their suicide.
The Current Situation
Currently in the UK and in other countries there is a fine line between what is acceptable and what is not in situations where euthanasia or assisted suicide might become an option.
It is possible for a person, if they are considered competent, to decide for themselves that in the event of them suffering a cardiac arrest, they do not wish to be resuscitated. It is also possible for their family to make this decision if the patient is considered to be incompetent to do so. The people in question are generally those who have little or no chance of recovery from their illness and have a limited quality of life and for whom death is already reasonably imminent. The option can be suggested by doctors but it is always the person (or their family if they are incompetent) who has the final say.
Also, treatment can be deliberately withdrawn for certain patients who have no hope of recovery and whose life is only being maintained by supportive machinery and medical treatment. These are often people in deep comas who have been certified as brain damaged or who have suffered complete brain death.
Another special case is in certain people who often have terminal cancer and are in constant pain. It is possible for doctors to increase the dosage of pain relieving medications above the maximum safe dose to counter the pain with the side effect of hastening the person's death. This is only considered ethical if the primary intention is to relieve pain and not to bring about the person's death.
The above arguments go a long way to rationalizing the debate over this issue but do not take into consideration the serious emotional stresses which are involved. The trauma of watching a loved one slowly deteriorating in terrible pain has already been powerful enough to drive many people to aid others in ending their life, willingly taking the chance of being tried for murder. Doctors suffer agonising decisions about relieving pain, knowing that they could be ending their patient's life in violation of one principle of the Hippocratic oath primum non nocere ('First of all, do no harm'), and families often make the painful decision that their ailing relative should not be resuscitated.
In summary, the arguments are:
- The persons right to choose when, where and how they die
- Not having to continue to live in pain or with low quality of life
- Alleviating the burden on families and carers
- Religious view of the sanctity of life
- Dangers of a person's life being ended against their will
- Questions over a person's competence to make the decision
All of these having to be taken against the background of a hugely emotional issue means that change to the current situation of a tightly limited compromise, will be slow if there is any at all.