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The arguments about euthanasia can take many forms and the reasons put forward here are by no means exhaustive but aim to capture the essence of the debate and are written in conjunction with the arguments against.
Autonomy (see glossary)
Autonomy is defined as the "the right of self government or personal freedom"1. Every person has the right to make personal and private decisions about their own lives defined in the American Constitution as "the right to privacy". Since death is the most personal of all things, the individual should have the right to dictate when they die and in what circumstances they do so.
To deny people the choice of death by active euthanasia is to force them to do something that is against their will and may well prolong their suffering, and therefore lose human dignity and decency. Death should be with dignity but modern medicine has prevented nature running its natural course. Not allowing a patient to end their life with dignity and free from pain is inhuman and leads to an increase in the callousness of society and a development of a disregard for the quality of life in the face of a choice with quantity of life
Those against euthanasia
claim that patients are often too affected by their illness to
make adequate decisions about their future, but this denies them
their true autonomy because every decision that is made
regardless of the context is always influenced by internal and
external factors.
If "society recognises the autonomy of individuals by granting them the right to pursue their views about the good life and create their own lives" then the logical consequence is to allow people to decide their own death.
Beneficence
Euthanasia allows patients death with dignity because continuing to live can inflict more problems, on both the patient having to cope with the pain and indignity of a prolonged death, and the family because it is distressing having to witness the gradual decline of a loved one.
With terminal illness there are two choices: let the disease run its course, or allow the inevitable to death to come sooner. The question is which one is of more benefit to the patient and acts in their best interests? Death is the lesser of two evils with regards to pain and suffering for 2 reasons:
The problem is that there is no definitive point at which it can be said that life becomes too burdensome for an individual. To cope with this society can allow the withdrawal of treatment from individuals when it is deemed futile but this only serves to prolong the agony and may increase the suffering of the patient. The legalisation of euthanasia would allow the introduction of a quick and easy death when all other medical interventions are futile and is deemed to beneficent to the patient. Since one of the main aims of medicine is to relieve suffering, it is surely a medical duty to relieve the suffering of a patient through death
Non-maleficence (see glossary)
These arguments are closely combined with that of beneficence. Is there a risk that we start to harm patients by turning the "prolongation of living into the prolongation of dying"3 ? If the patient opts to have a medical intervention removed, then they have to endure the suffering of withdrawal from the treatments and the effects of the illness. Euthanasia can remove that suffering and provides least harm to the patient.
Justice (see glossary)
Justice is "the moral obligation to act on the basis of fair adjudication between competing claims"2. Therefore the legislation which governs euthanasia contravenes the true meaning of justice because they see laws which deny people an easy death with dignity as inhumane. They are preventing "fair, equitable and appropriate treatment in the light of what is due or owed to a person"3.
Utility
Euthanasia allows the greatest good for the greatest number of people because:
The Hippocratic Oath
Anti-euthanasia arguments often use the fact that there has been an apparently seismic shift in the codes of medical ethics and especially that euthanasia violates the Hippocratic Oath. This is not in fact the case.
It can also be argued that the oath has no real relevance nowadays, and doctors should not be bound to something that was written without the consideration of modern medicine and the implications that it has for the treatment and rights of patients and doctors.
Euthanasia does not always involve killing a person
There is a difference between a human being and a person and when a human stops being a person then it is morally acceptable to end their life.
There is a difference between the physical or biological life and the biographical life – that which gives it meaning, for example dreams, aspirations, achievements etc. If that is lost, then there is no person because they have lost their distinctive value. The sanctity of life no longer applies to a human that has lost all the characteristics that make it a person.
Quality of life
Human life is sacred
it should not be degraded by reducing the quality of life for the
sake of extending the quantity
of life. When a person has
no quality of life, then they should be able to choose to die
because it is unfair to force them to continue it.
There is no difference between killing and allowing to die
The act of omission or withdrawal of treatment in terms of consequence is identical to active euthanasia in that the patient dies. Some argue that the intent of the physician is different, that with 'double effect' (see glossary) the doctor only foresees the shortening of the patient's life, but does not intend for that to happen since their only goal is to relieve suffering. However, this it not morally right, as intention should include all foreseen and foreseeable, consequences of the doctor's actions. Thus, euthanasia cannot be separated from the 'double-effect', and since the 'double-effect' is very much accepted in medical practice, euthanasia should also form one of the legal options.
Bad practical consequences are remote and shouldn’t form public policy
Doctor – patient relationship
The doctor – patient relationship will not be undermined by the legalisation of active euthanasia, instead it will clarify and confirm the relationship. Patients will know that there is the "psychological insurance" (see beneficence) that can define the perimeters of the consultations and means they can have security in their future.
Undermining the commitment to medicine
Instead of removing quality of care and doctors using and promoting early death as an easy option, the introduction of euthanasia will enhance care and provide a greater number of treatment options.
Slippery slope
Some feel that the introduction of legislation allowing voluntary active euthanasia will cause a gradual movement to non-voluntary euthanasia and the killing of people whom doctors feel are no longer serving a purpose in society or are taking up needed hospital beds. This however is countered by evidence from the Netherlands that this has not occurred and that as long as consent is maintained as the cornerstone of voluntary euthanasia and that the process is tightly regulated then this will not occur.
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