Should the practice of euthanasia be legalized to allow patients to die with dignity?

Euthanasia has been a topic of concern for many years. The etymology of the term euthanasia can be traced to the Greek language, “eu” and “thanatos” mean a good death. It is the act of ending a patient’s life by painless means. The word euthanasia was first introduced in 121 A.D by the Roman historian Suetonius in his work “On the Lives of the Caesars”. He explained the idea of an easy death and described how the emperor Augustus experienced the euthanasia he wanted. Furthermore, in ancient times, euthanasia was referred to as assisted suicide as it was merely suicide. This was where confusion between euthanasia and assisted suicide, began. The differences are visible in the role of the physician. Assisted suicide is helping a patient by giving them a life-ending drug the dose is known by the physician. In contrast, euthanasia only involves the physician giving the patient a lethal injection to relieve their suffering. So, is euthanasia murder?

Issues:

The rate of euthanasia cases in 2020 reported by the Regional Euthanasia Review Committees has increased by 9% from the 6,361 cases reported in 2019. The main reason why people choose euthanasia is solely because of the pain and suffering caused by terminal illnesses. So why is euthanasia an issue? From the beginning of time, euthanasia was seen as a crime. In the 20th century, European countries had certain punishments for euthanasia. The main issue was that religious ethics were against it as they believed God had given people life and only, He could take it. The act of euthanasia is considered as murder in the traditional Christian faith, described as a huge sin in the Ten Commandments, “You shall not commit murder” (“Exodus 20:13 ESV — “You Shall Not Murder. | Biblia”). Similarly, Islam describes life as a gift from God therefore, it is an unlawful act to end one’s life. “And do not kill yourselves [or one another].” (“Surah An-Nisa — 1–176 — Quran.com”).

The proponents of euthanasia argue that they should have the right to decide the mode and manner of death. These people believe euthanasia should be legalized so their loved ones can rest in peace. However, its legalization has its problems. Many fear that the laws will be exploited. Legalization might lead to non-voluntary euthanasia, those with disabilities might have their lives taken from them, and people would lose their trust in health care.

Perspectives:

In earlier times, doctors had to take an oath known as the Hippocratic oath, which banned the act of euthanasia (Hippocratic, Vol 1). In today’s world, this oath has been replaced with a modern oath which allows euthanasia; many countries like New Zealand and the Netherlands have adapted to it; however, the question of whether euthanasia should be legalized is still a debate. Throughout the world, only seven countries allow the practice: Spain, Canada, Luxembourg, are some of them. The first country in Latin America to decriminalize euthanasia was Colombia in 1997, and according to a news article published by NBC News, in 2021 there have been 157 cases ever since. Moreover, World Health Organization states that in 2002, The Netherlands was declared the first country to pass a bill allowing euthanasia. Furthermore, the country with the most rates, reported by Annals of Palliative Medicine (STATISTA) in 2021, was Canada with approximately 7,666 cases.

Likewise in a Ted Talk, Helen O’Shaughnessy, a nurse in Cardiology, talks about euthanasia and the dying with dignity act of Oregon. She says that palliative care is ineffective and unavailable to many. She emphasised on how the treatment for depression, hospice and palliative care has improved since its legalization. The act was put forward in 1997 and allows the request of lethal medication only under some conditions. Similarly, countries, like Belgium, have also adapted to their known acts regarding euthanasia.

The issue regarding ethics for euthanasia can also be considered in the case of Desmond Tutu, an African Bishop. He believes in the saintliness of life but also that no living soul should have to suffer. He put emphasis on the laws regarding assisted dying and euthanasia in Canada and California, USA, which allow the practice. He concluded by stating that we cannot refuse people’s wish to die, if we do then we will fail to exhibit basic Christian principles. He prayed that politicians and religious lawmakers would support his decision and act on it. (Guardian, 2016)

Considering politics regarding euthanasia there are some mixed reactions. In November 2024 a bill regarding the legalization of euthanasia in England, was debated. Shabana Mahmood, Justice Secretary was strongly against it “We should never offer death as a service”.

However, Charlie Falconer, a labour peer stated that Shabana’s views were biased and one’s religious views shouldn’t be imposed on everyone (Courea). Shabana had stated that the bill might lead to a slippery slope, but falconer disagreed. Moreover, Sir John Curtice a professor of politics at University of Strathclyde, stated that there has been a change in the last 40 years with now 2 out of 3 voters favouring a change in the law. This means that the legalization of euthanasia is less controversial compared to legalization of gay marriages (Mitchell). Finally, an article by Aljazeera stated, the UK parliament approved of the law by a vote of 330 to 275.

As mentioned above, the fear of non-voluntary euthanasia being practiced is also one of the issues. Non-voluntary euthanasia is when the patient or their family refuses the lethal injection, but the patient gets it anyway. The case of Carlo Mosca has feared many. Mosca, head of emergency at Montichiari Hospital, was accused of ending two of his patients’ lives by giving them anesthetics. According to a report published by The Times in 2021, Mosca was arrested for giving anaesthetics to Covid 19 patients to free up beds as Montichiari Hospital had been facing many patients, which forced the doctors to choose who to cure first resulting in deaths.

Furthermore, in 2023 according to RTE News a meeting between TDs, Senators from Ireland, UK and USA was held. In this meeting, Professor Kevin Yuill stated that countries were euthanasia is legal, there have been many cases of unnecessary euthanasia. He elaborated that in Canada, 2021, almost a fifth of those who chose euthanasia was due to loneliness or poverty.

Nevertheless, what are views of medical professionals regarding euthanasia? Where I’m from, Pakistan, a questionnaire was given to doctors in 2010 at Shifa Hospital Islamabad. According to an article by Tahir Ahmed Munir, a professor at the Collage, the results showed that 9% of the doctors agreed, whereas 77% disagreed. Later, in 2024 medical students at the Faisalabad Medical University were surveyed, most of the student’s opposed euthanasia and believed palliative care was the best option. However, there were few who agreed to the cause.

Similarly, a questionnaire by the Swedish Medical Society and Karolinska Institute, was given to physicians to study their attitudes towards physician-assisted suicide. According to the results in 2021, about 33% out of 59% of physicians were in favour. However, when asked about their trust in health care after legalization, answers varied.

Akke Vellinga, writer for Irish independent shares how her mother was able to choose euthanasia in the Netherlands. Her mother had been diagnosed with bowel cancer in 2018 and despite a successful surgery pain grew tremendously, the cancer had spread throughout her body, she was notified by her GP that palliative care would be her best option. She was suffering thus considered active euthanasia. “We were lucky, not only because my mother had this option, but also because we all supported her decision”. Akke says that for her family this was a positive memory. (Vellinga)

Courses of action:

If euthanasia was to be legalized, then the following measures should be accounted for:

1. Euthanasia should only be considered under some circumstances. The patient or patient’s family must make the request under witnesses to assure the patient’s safety. The lethal medication should only be given if patient suffers from intolerable pain because of illness or the treatment. Before continuing their request, the physician should advise the patient about palliative or hospice care.

2. Hospice care should be considered. Hospice care is the individual care that is given to terminally ill patients. A patient is enrolled on hospice if their doctor thinks it is for the patient’s benefit [VISTAS Healthcare]. Occasionally patients under hospice recover as they are given social and medical attention. I believe that hospice is the best option to opt for because it’s patient-centred care, meaning that the patient is in charge of whether they want it or not.

3. Palliative care should be improved and available to many. Though palliative care doesn’t mean a terminally ill patient will fully recover, it will prolong their life. Palliative care is given to patients individually to help prolong their life. With better palliative care, more people will consider it first. However, Palliative care is only provided in 30 countries. A report published in 2020 by the World Health Organization claimed that only 14% of people who needed palliative care received it. Many fear the cost of health care services, so earlier delivery of palliative care will mean that there will be no need for hospital admissions.

Conclusion:

To conclude, the debate over euthanasia is very complex. Currently many people are seeking euthanasia and are going to great depts to achieve it, as only seven countries allow the practice. Though euthanasia means an easy death it is highly against moral ethics, however in that case Desmond Tutu should be acknowledged. Furthermore, doctors and politicians around the world have mixed reactions some doctors even believe that they’ll lose their trust in health care if legalized. However, euthanasia should be the patient’s choice as they are the ones suffering with intolerable pain. Thus, euthanasia shouldn’t be considered murder but should be legalized under strict conditions so that patients can ensure their trust in medical care and at the same time have a choice of dying with dignity.

Bibliography:

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This report was written for IGCSE global perspectives (0457) by candidate Syeda Filza Fatima (0401) Centre no: PK815