Introduction
One of the most prominent legal issues in healthcare at the moment is the legalization of euthanasia and physician-assisted suicide. On the one hand, the proponents of legalization claim that every person has a right to choose to die with dignity and without pain. On the other hand, people believe that euthanasia legalization would contradict the value of human life and result in negative consequences for individuals and society.
The purpose of the paper is to explore the legalization of euthanasia and physician-assisted suicide from various aspects, including the current state of legalization, its benefits, and considerations, and possible solutions. Conclusions based on evidence will show whether or not it could be possible to yield the benefits of euthanasia legalization while avoiding its potential harmful effects.
Methods
The literature on euthanasia and physician-assisted suicide was searched to identify common trends and topics. The search was limited to reputable websites, newspapers, and scholarly journals. This allowed gathering a range of viewpoints from both academic and popular media resources. A content analysis of each source was performed to establish relevance and value to the discussion. A total of seven sources were selected, each discussing the aspects of euthanasia and PAS legalization considered in the paper.
Additionally, a video on advance directives was included as the interview. This video explores the importance of patient autonomy in death-related decision-making and highlights the impact of values and beliefs on end of life decisions. Together, the resources gathered for the review allowed to shed light on the critical aspects of the topic, including its background, the current state of legalization, benefits and considerations, and possible solutions.
Background
The legalization of euthanasia and physician-assisted suicide is among the most debated topics in the contemporary healthcare context. The generally accepted definition of physician-assisted suicide (PAS) is the “prescription of lethal medication to be voluntarily self-administered by the patient” (Goligher et al. 150). In this case, a patient can take the medication in a comfortable environment, such as their home. Euthanasia is considered to be a more complex term, and there are different types of euthanasia studied in scholarly literature. Goligher et al. explain this term in detail, stating that euthanasia, in general, refers to the direct causation a death by a physician (150).
Researchers distinguish between voluntary euthanasia, which is done with “the patient’s specific, consistent and thoroughly considered request” and involuntary euthanasia, where the patient is killed against their will (Goligher et al. 150). Additionally, there are cases of non-voluntary euthanasia, in which the patient “neither consents nor objects to euthanasia because of decisional incapacity” (Goligher et al. 150). In this context, the legalization of euthanasia refers mostly to legal documents permitting voluntary euthanasia, thus enabling physicians to use lethal injections or withdraw life-prolonging treatment based on patients’ request.
The articles also highlighted early attitudes towards euthanasia. In their report on Dr. Kevorkian, known to the public as Dr. Death, Roberts and Kjellstrand explain that before the case of Kevorkian, “doctors have helped patients to end their lives, but they did so behind closed doors, perhaps properly in order to safeguard their patients’ confidentiality” (1434).
The article highlights the ethical and legal debates on the topic, showing that doctors performing euthanasia in the past focused on fighting injustice and respecting their patients’ rights to die with dignity. The article suggests that the controversy of euthanasia from an ethical viewpoint lies in the conflict between the right to life and the right to autonomy and dignity. As other sources show, this foundation shaped the current legislative environment with respect to euthanasia.
Legalization of Euthanasia and Physician-Assisted Suicide
Today, euthanasia and PAS remain banned in the majority of countries. However, in many countries, including the United States, patients can create advance directives, which dictate their wishes regarding life-sustaining procedures and treatment. Based on the video evidence, advance directives can prevent doctors from resuscitating patients or connecting them to life support (“Advance Directives”). This means that despite legislation permitting euthanasia and PAS, people in many countries have some influence on death-related decision-making that care providers have to take into account.
With the recognition of a person’s right to autonomy in death, debates about euthanasia ignited all over the world. In fact, research shows a general trend towards the acceptance of euthanasia and physician-assisted suicide in developed societies. An article from BBC News by Lewis explains that both euthanasia and PAS are permitted in the Netherlands, Belgium, and Luxembourg. In Colombia, euthanasia is allowed, but there is no legislation on physician-assisted suicide (Lewis).
In Canada and Switzerland, physician-assisted suicide is permitted, and some US states have also legalized assisted dying, including California, Washington, Vermont, and Montana (Lewis). The conditions under which euthanasia or PAS are allowed differ across countries and states. However, this evidence shows that more and more jurisdictions begin to recognize a person’s right to end their life. These legislative decisions are not easy, considering that euthanasia and PAS carry both benefits and risks, which are also well-documented in the literature.
Benefits and Considerations
The review of the literature and the video interview also provided some insight regarding the possible benefits of euthanasia and PAS legalization for individuals and care providers. In particular, the focus of many resources was on older adults and terminally ill patients. As explained in the video, taking part in death planning enables people to accept death more easily and relieves the anxiety associated with dying. De Bellaigue also notes that euthanasia and PAS offer patients a way to die among their loved ones, thus fulfilling the need for comfort and connectedness. In this case, family members and friends of the dying get a chance to say their goodbyes, which helps them to process grief better.
The positive effects of euthanasia and PAS are particularly evident in patient populations with terminal illnesses and other conditions that cannot be managed successfully. Goligher et al. explain that for patients who experience severe pain and discomfort that cannot be curbed by medications, death is the only option that would provide relief (152). Moreover, many patients with serious illness experience psychological symptoms that affect their wish to live. According to research, these patients experience “loss of control, pointless suffering, deterioration or loss of dignity, and weakness or suffering”, which causes them to want death (Goligher et al. 152).
As a result, the general trend in research or euthanasia that focuses on individuals’ perspective is to consider the quality of life (Goligher et al. 154). Based on this concept, individuals experiencing physical and psychological suffering should be allowed to die in comfortable settings since they can no longer enjoy life, and death would provide the relief they seek.
For care providers, the legalization of euthanasia and physician-assisted suicide would also have positive consequences. One of the most crucial principles in bioethics is autonomy, which, in this context, refers to a person’s right to make informed decisions about their life, health, and death. The questions of autonomy and decision-making capacity are pivotal to euthanasia and PAS as these practices support patients’ rights (Landry et al. 1490). Witnessing patients who are in pain while being unable to help them affects care providers psychologically (de Bellaigue). Therefore, legislation allowing euthanasia and PAS supports care providers by offering them a way to help patients who are suffering.
Moreover, researchers and journalists alike point to the benefits of euthanasia and PAS for the healthcare sector in general. It is generally agreed upon that serious physical illness has a significant effect on healthcare costs (Malone). People with end-stage cancer, for example, need continuous health care to sustain life and alleviate the symptoms. In these cases, when people want to die, fulfilling their wishes could help to prevent additional healthcare expenses.
This is particularly important for countries with free healthcare, such as Canada, which has recently legalized physician-assisted suicide. Research shows that the legalization could save the state between $34.7 million and $136.8 million in healthcare expenditure (Malone). These cost savings could be used to improve healthcare for people who want to live and who can benefit from additional services.
Nevertheless, some resources identify considerations related to the consequences of euthanasia and PAS legalization. The primary concerns relate to the procedures and conditions of euthanasia. As explained by de Bellaigue, there have been cases where patients with no severe physical illness requested euthanasia due to depression. There have also been instances when patients requested euthanasia before their mental capacity deteriorated due to a neurological condition. When physicians attempted to euthanize them later in accordance with their previous wishes, they resisted (de Bellaigue). Such cases cause distress to both patients and care providers due to the lack of clear guidelines and procedures on the legal level.
Additionally, there is scholarly evidence indicating that the legalization of euthanasia could lead to social issues. One of the primary arguments that inspired the opposition to euthanasia is religious. By many religious doctrines, including Catholicism, life is a gift given to an individual by God. In accordance with this rhetoric, taking away a person’s life, and committing suicide for any reason is considered a sin (Gandsman 579).
Thus, there are concerns that the widespread legalization of euthanasia and PAS could ignite opposition from religious groups, which could attack individuals and care providers supporting these practices. Another important consideration with regards to euthanasia and PAS is that it could increase the abuse of elderly and terminally ill persons. People fear that, with one or both of these practices allowed, family members could pressure elders or persons with disabilities into euthanasia (585). Both considerations play an essential role in legalizing euthanasia and affect how people see this potential legal development.
Possible Solutions
The appraisal of research evidence suggests that there are specific steps that can be taken to address the considerations identified previously. In particular, authors of various articles on the topic focused on examining current practices in euthanasia and physician-assisted suicide in countries and states where they are legal. For example, as explained by Lewis, in the Netherlands, physician-assisted suicide and euthanasia are only permitted when the patient’s suffering is “unbearable, with no prospect of improvement”. In this country, the suffering is not limited to physical pain or terminal illness, and may also be related to severe, long-term depression and other mental illness (Lewis).
The laws in Belgium and Canada are similar, whereas, in US states permitting physician-assisted dying, the procedure is only conducted for terminally ill patients (Lewis). Hence, the research shows that the legislation can be tailored to respond to the considerations related to pressure from family members.
Other safeguards can also be put in place to ensure that the legalization of euthanasia and PAS will not have negative consequences. For instance, in the United Kingdom, a recent bill proposed to require a judge to make euthanasia and PAS decisions based on the evidence presented (Lewis). Second opinions from doctors are used in the Netherlands and Belgium to evaluate patients’ suffering more objectively (Lewis).
Furthermore, the article by de Bellaigue suggests that specific guidelines are required for euthanasia requests in patients with mental illness. This could help to prevent distress in patients who completed euthanasia requests before their mental health deteriorated and prevent the negative influence of family members on their decisions. Overall, the evidence shows that the successful regulation of euthanasia and PAS would help to ensure that these procedures fulfill their purpose of alleviating suffering in a fair and just manner.
Conclusions
On the whole, the purpose of the research was to provide an informative review of the literature on the issue of the legalization of euthanasia and physician-assisted suicide. The report fulfilled this goal by gathering evidence from scholarly and popular media sources, as well as a video containing expert opinions. As shown by a content analysis of the sources, the four topics that were considered in literature in great detail were the background of the problem, the current state of legislation globally, benefits and considerations of euthanasia and PAS, and potential solutions to the problems caused by legalization.
The findings show that the legalization of euthanasia and physician-assisted suicide is a controversial topic, but developed societies are making slow progress towards accepting a person’s right to die in a comfortable way. The benefits of legalizing euthanasia and physician-assisted suicide concern patients who are physically and mentally ill, as well as care providers who cannot provide them relief in any other way.
Additionally, the survey shows the potential financial benefits of legalizing euthanasia and physician-assisted suicide. Considerations regarding these practices stem primarily from the fears that individuals will be pressured into requesting euthanasia and that people might change their wishes depending on their mental capacity. However, these concerns can be addressed through legislation, ensuring that euthanasia and PAS will only be available to people who are genuinely suffering and who made their decision independenly.
Works Cited
“Advanced Directives.” PBS Religion & Ethics NewsWeekly. 2011. Web.
De Bellaigue, Christopher. “Death on Demand: Has Euthanasia Gone Too Far?” The Guardian. 2019. Web.
Gandsman, A. (2016). “‘A Recipe for Elder Abuse’: From Sin to Risk in Anti-Euthanasia Activism.” Death Studies, vol. 40, no. 9, 2016, pp. 578-588.
Goligher, Ewan C., et al. “Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues.” Critical Care Medicine, vol. 45, no. 2, 2017, pp. 149-155.
Landry, Joshua T., et al. “Ethical Considerations in the Regulation of Euthanasia and Physician-Assisted Death in Canada.” Health Policy, vol. 119, no. 11, 2015, pp. 1490-1498.
Lewis, Penney. “Assisted Dying: What Does the Law in Different Countries Say?” BBC News. 2015. Web.
Malone, Kelly. “Medically Assisted Deaths Could Save Millions in Health Care Spending: Report.” CBC News Canada. 2017. Web.
Roberts, John, and Carl Kjellstrand. “Jack Kevorkian: a medical hero.” British Medical Journal, vol. 312, 1996, p. 1434.