informative essay about euthanasia

Informative essay on euthanasia

Table of Contents

Different groups and individuals have diverse viewpoints with regard to euthanasia, a view that is largely shaped on the ethical, religious, moral or professional standpoints. Over the past decades, euthanasia has grown to become an issue that has generated debates in medical, legal and ethical studies. The pertinence of the euthanasia issue is manifested in the discourse of human rights with regards to the relationship between the healthcare providers and the patients.

This paper explores a consortium of secondary sources in discussing the diverse issues and opinions in its bid to find answers of the questions surrounding the euthanasia debate. With more specificity, the paper will review literature that attempts to discuss the ethical and legal debates of either type of euthanasia. Through the rational focus on the arguments brought forth by the supporters and the opponents of euthanasia, the paper will prove that the diverse opinions about euthanasia are significant pointers to the need for more regulatory and legislative responses with the aim of safeguarding the professional and ethical obligations that govern the relationship between healthcare providers and their patient populations.

Introduction

Euthanasia is an old concept used in medical field to insinuate gentle or peaceful death. In other quarters, euthanasia has been referred to as assisted suicide, as it is considered a deliberate act of ending the life of a person in order to relieve that person of the suffering accruing from pain. In the modern day, many patients struggle with different illnesses, with some such as terminal cancer exposing them to overwhelming muscle and body tissue pains. The decision by a doctor to give such patient an overdose of muscle relaxants is referred to as euthanasia, as this ends the patient’s life.

As Levy, Azar, Huberfeld, Siegel and Strous (2012) explain, euthanasia exhibits all characteristics of an activity that speeds up the death of an individual. However, these deliberations have to be based on the existence of a terminal medical condition, as will be explained in this paper. The growing number of studies aimed at demystifying the pros and cons of euthanasia categorize euthanasia as among the current debatable issues that present many glaring questions. The stakeholders involved in this debate have further heightened the contention as the frequent encounter of ethical issues against the human approach to enjoying life present more courses for debate. In exploring the constructs of the debate surrounding euthanasia, it is important to consider the diverse viewpoints from which the supporters and opponents develop their opinions.

Literature review

In a study conducted by Strinic (2015) to ascertain the prevalence of euthanasia around the world, it was established that the concept of euthanasia remains largely dependent on the social, cultural and religious values that define a community. On a similar note, Pereira (2011) observed that across the world, glaring ambiguities and controversies cloud the regulations and laws surrounding the handling of human health, further referring to the scientific progress and technological innovation infiltrated in the healthcare provision industries.

In a bid to explain how euthanasia is administered, Quaghebeur, Dierckx de Casterle and Gastmans (2011) identified two main types of euthanasia. Active euthanasia refers to the deliberate intervention of ending an individual’s life. Active euthanasia can be conducted through injecting a person with a dose of fatal substance. On the other hand, passive euthanasia refers to the withdrawal of treatment, hence leading to the death of a person. Such treatment should be aimed at maintaining the life of a person. By withholding this form of treatment, passive euthanasia is demonstrated in the event that the person dies. For instance, a person suffering from HIV may be a victim of passive euthanasia if antiretroviral medications are withheld.

The classifications of euthanasia, however, vary depending on the decisions of the stakeholders involved, as Sulmasy, Travaline, Mitchell and Ely (2016) write. In circumstances where a person makes a conscious decision that leads him or her to ask for death, voluntary euthanasia is exercised. The individual’s consent is significant in facilitating voluntary euthanasia, unlike is the case when it concerns non-voluntary euthanasia.

Under this euthanasia classification, a person’s decision-making incapacitation is taken over by another person, who makes the decision on their behalf. Therefore, as Strinic (2015) narrates, non-voluntary euthanasia refers to an assisted decision to end the life of a person who is unable to give consent. On the other hand, other people are killed contrary to their expressed wishes, devoid of their consent. This is classified as involuntary euthanasia.

In as much as studies have established the types and categories of euthanasia, the debates surrounding the application of euthanasia in medical care continue to generate controversy. While looking at some of the arguments in favor of euthanasia, Naga and Maryyan (2013) observed that the compassion argument is the main reason why certain groups and individuals support euthanasia. As for the compassion argument, supporters hold the belief that euthanasia gives people the chance to end their lives with dignity. According to this argument, continued suffering exposes people to undignified death, which to the supporters of euthanasia is not only unkind but also inhumane.

The right to choice is among the leading arguments in support of euthanasia. Supporters of euthanasia believe that that a person’s right to make decisions and choices should be respected regardless of their condition. This standpoint, which Levy, Azar, Huberfeld, Siegel and Strous (2012) referred to as the autonomy argument, gives every patient the liberty to decide whether to continue living. Similarly, having considered the sufferings of many people that have ended up in painful deaths, supporters of euthanasia argue that the process is safeguarded by the legislative and regulatory constructs of the government.

On the other hand, Naga and Maryyan (2013) elucidate, technological and scientific advancements have made it easier for people to access advanced treatments. Along with this argument, the opponents of euthanasia claim that there are alternative types of care that can be explored rather than killing the patients. Besides, opponents argue that the there are several care options to administer in order to minimize the pain endured by a patient.

Scholars, such as Napier (2014), likened euthanasia to giving medical professionals the powers to terminate life. In his argument, the author vividly explains how doctors can misuse this power by killing without the request of the patient, with reference to the 1990s trends in Netherlands where over 1,000 patients were killed without their consent or request. Despite the fact that governments have laid bare the stipulations for euthanasia, Strinic (2015) warned that it is virtually impossible to control euthanasia, since minimal clinical reports have been made to document physician-assisted suicide, despite their legality in several jurisdictions.

The ethical arguments of euthanasia are based mainly on the constructs of practicality, human rights, ethicality and philosophy. According to the libertarian argument, euthanasia is an ethical practice that circles around the privacy of an individual. In this argument, death is considered a private matter. Basing their argument on privacy, Sulmasy, Travaline, Mitchell and Ely (2016) explained that the libertarian argument considers euthanasia as a practice that is not harmful to others. In addition, this ethical standpoint sees no need and rights for external interference.

The utilitarian argument for euthanasia considers the happiness and benefit that the society stands to gain from a decision. According to McCarthy and Gastmans (2014), utilitarianism considers an act ethical only if it provides extra human happiness. Along with this argument, the happiness of the patient is weighed against that of the society, which constitutes the friends, family and medical staff. The continued stay of a patient in hospital drains finances from the family and friends. Similarly, the pain subjected to the patient causes psychological strain to the family and friends. Euthanasia is considered ethical as it ends the mystery of the patient, just as much as it relieves the family and friends of the financial, emotional and psychological burdens.

On the other hand, euthanasia is considered unethical based on the constructs of human rights. According to Łagosz (2014), a society is deemed ethical if it exercises respect for the sanctity of life, which is protected by religion and medical profession. Therefore, euthanasia delinks the respect that the society accords to the sanctity of life.

Equality is one of the leading factors that generate harmony within societies, as Napier (2014) writes. In the face of an ethical society, each person should be treated with equality in order to uphold harmony. However, euthanasia casts aspersions on the worthlessness of other lives, such as those of the sick or disabled. Therefore, this argument claims that euthanasia is an agent of discrimination, which goes against the ethicality of an act.

There have been several developments surrounding the regulations and legislations of euthanasia. The Netherlands was the first country to legalize euthanasia in 2002, thereby imposing strict conditions that stipulate its application in situations that the patient is proven to be in unbearable pain accruing from incurable disease (Pereira, 2011). In the US, five states followed the Oregon initiative by allowing doctors to terminate the lives of terminally ill patients. Despite this, euthanasia is still illegal in the US, as it remains widely controversial.

In this discussion, euthanasia has been cast as an emotional, practical and ethical debate. Along this study, the broad history of euthanasia has been used to paint a picture of the significance of the topic. In conclusion, the diverse opinions surrounding euthanasia have been highlighted using the social, financial, emotional and ethical considerations.

• Łagosz, M. (2014). Philosophy of Life. Few Arguments against Euthanasia. Dialogue And Universalism, 24(2), 105-113. http://dx.doi.org/10.5840/du201424231
• Levy, T., Azar, S., Huberfeld, R., Siegel, A., & Strous, R. (2012). ATTITUDES TOWARDS EUTHANASIA AND ASSISTED SUICIDE: A COMPARISON BETWEEN PSYCHIATRISTS AND OTHER PHYSICIANS. Bioethics, 27(7), 402-408. http://dx.doi.org/10.1111/j.1467-8519.2012.01968.x
• McCarthy, J. & Gastmans, C. (2014). Moral distress: A review of the argument-based nursing ethics literature. Nursing Ethics, 22(1), 131-152. http://dx.doi.org/10.1177/0969733014557139
• Naga, B. & Maryyan, M. (2013). Legal and Ethical Issues of Euthanasia : Argumentative Essay. Middle East Journal Of Nursing, 7(5), 31-39. http://dx.doi.org/10.5742/mejn.2013.75330
• Napier, S. (2014). St. Ambrose, Euthanasia, and Antisenescence Arguments: Death as a Good?. Logos: A Journal Of Catholic Thought And Culture, 17(2), 39-57. http://dx.doi.org/10.1353/log.2014.0019
• Pereira, J. (2011). Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls.Current Oncology, 18(2). http://dx.doi.org/10.3747/co.v18i2.883
• Quaghebeur, T., Dierckx de Casterle, B., & Gastmans, C. (2011). Nursing and Euthanasia: a Review of Argument-Based Ethics Literature. Nursing Ethics, 16(4), 466-486. http://dx.doi.org/10.1177/0969733009104610
• Strinic, V. (2015). Arguments in Support and Against Euthanasia. British Journal Of Medicine And Medical Research, 9(7), 1-12. http://dx.doi.org/10.9734/bjmmr/2015/19151
• Sulmasy, D., Travaline, J., Mitchell, L., & Ely, E. (2016). Non-faith-based arguments against physician-assisted suicide and euthanasia. The Linacre Quarterly, 83(3), 246-257. http://dx.doi.org/10.1080/00243639.2016.1201375
• ☠️ Assisted Suicide
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Arguments in Favor of Euthanasia Essay

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Mankind has always struggled to deal with numerous illnesses that have been in existence at different periods of time. Different treatment alternatives have been employed ranging from those by traditional medicine men to the modern scientific methods.

All these efforts have been motivated by the desire to remain alive for as long as one can (Buse 7). However, there are situations when living is more problematic and either the victim or other stakeholders contemplate ending life. This is referred to as euthanasia.

It is the act of deliberately terminating life when it is deemed to be the only way that a person can get out of their suffering (Johnstone 247). Euthanasia is commonly performed on patients who are experiencing severe pain due to terminal illness.

For one suffering from terminal illness, assisted death seems to be the better way of ending their suffering. The issue of euthanasia has ignited heated debate among the professionals as well as the law makers and the general public (Otlowski 211).

The physicians should do everything humanly possible to save lives of their patients, however, euthanasia should be considered as the only alternative to save extreme cases like the terminally ill patients from their perpetual pain and suffering.

Euthanasia can either be active/voluntary, non-voluntary, or involuntary. In voluntary euthanasia, the patient suffering from terminal illness may give consent to be assisted end his/her prolonged severe pain through death (Bowie and Bowie 215).

The patient may also decline to undergo burdensome treatment, willingly terminating treatment procedures like removal of life support machinery, and simply starving. Non-voluntary euthanasia, on the other hand, involves who cannot make sound decisions.

They may be too young, in a coma, senile, mentally challenged, or other severe brain damage (Gorsuch 86). Involuntary euthanasia involves ending the life of the patient without his/her consent. This usually happens when the patient is willing to live despite being in the most dangerous situations.

For instance, an infantry man has his stomach blown up by an explosive and experiences great pain. The army doctor, realizing that the soldier would not survive and has no pain relievers decide to spare the man further suffering and executes him instantly.

Also, a person could be seen on the 10 th floor of a building on fire, the person’s clothes are on fire and cries out for help. The person on ground has a rifle and decides to shoot him dead with a strong conviction that the individual would have experience a slow and painful death from the fierce fire.

Due to the sensitivity of the issue, laws that will protect the rights of both the patient and the physicians who practice euthanasia should be put in place.

A patient has the right to demand or refuse a given form of medication as long as it will alleviate their suffering (Bowie and Bowie 216). It amounts to violation of the patient’s rights if the physician does not respect the will of the patient.

Each one has a right to determine what direction their lives should take and is their own responsibility (Buse 7). A study conducted among adult Americans indicates that about 80% of them support the idea.

They argue that someone suffering from terminal illness, a condition which no medical intervention can reverse, should be allowed to undergo euthanasia. It is inappropriate to subject an individual into a slow but painful death. Such an individual ought to be assisted to end his/her life in order to avoid a prolonged painful death.

The laws guiding the practice of euthanasia in the state of Oregon are quite clear. Active euthanasia should only be performed on a patient who is 18 years and above, of sound mind and ascertained by at least three medical doctors that assisted death is the only alternative of helping the patient (Otlowski 212).

Under such a situation, the doctor prescribes the drugs but is not allowed to administer them. The patient in question takes the drug (s) voluntarily without any assistance from the doctor. The patient will then die in dignity, without any intense pain that living with the condition would bring.

It is evident that some terminal illness may not present unbearable pain to the patient. Instead, a chronically ill patient who is in a no-pain state will not be in a humanly dignified state. The patient of doctor may propose euthanasia as the better treatment alternative.

This has been occasioned by the advancement in the field of medicine where pain can be significantly control (Buse 8). All patients are entitled to pain relief. However, most physicians have not been trained on pain management and hence the patients are usually left in excruciating pain (Johnstone 249).

Under such a condition, the patient suffers physically and emotionally causing depression. Leaving the patient in this agonizing state is unacceptable and euthanasia may be recommended.

Moreover, the physician who practices euthanasia should be protected by the law. This can be achieved by giving him/her the ‘right’ to kill. A doctor handling a patient who is in excruciating pain should be in a position to recommend euthanasia so as to assist the patient have a dignified death.

It is not required by law or medical ethics that a patient should be kept alive by all means. Hence, the patient should be allowed to demand death if he/she considers it necessary (Gorsuch 88).

It would be inhumane and unacceptable to postpone death against the wish of the patient. It would also be unwise to insist on curing a condition which has been medically regarded as irreversible or incurable.

Most terminal illnesses are very expensive to cure although they are known to be incurable. The patient as well as family members ought to be relieved of the accompanying financial burden (Buse 8). The patient, considering the amount of money and other resources used in an attempt to keep him alive, may demand to be assisted to die.

This can only be possible through euthanasia (Johnstone 253). In fact, spending more on the patient would only serve to extend the individual’s suffering. Human beings are caring by nature and none would be willing to live their loved ones to suffer on their own.

They would therefore dedicate a lot of time providing the best care that they can afford. Some would even leave their day to day activities in order to attend to the terminally or chronically ill relative or friend.

Euthanasia, therefore, serves to spare the relatives the agony of constantly watching their family member undergo intense suffering and painful death. In most occasions, attempts to keep a patient alive would mean that he/she be hospitalized for a very long period of time (Bowie and Bowie 216).

Terminally ill patients in hospitals imply that facilities would be put under great pressure at the expense of other patients who would benefit from using the same services. These facilities include; bed space, medical machines, drugs, human resource, among others. Even if they were to be given homecare, a lot of time resource and facilities would be overstretched.

Other than the issue of homecare and the financial obligations that may arise, there is also the issue of personal liberty and individual rights. Those who front this argument explain that the patient has the right to determine when and how they die.

Since the life of a person belongs to that person only, then the person should have the right to decide if he or she wants to end it, if ending life would also mean ending irreversible suffering (CNBC News para 4).

This mean that individual undergoing great and irreversible suffering have the power to chose “a good death” and thus decide when they want to die (para 7).. Furthermore, these patients are dependent on life sustaining medication, which adds only adds the misery.

This brings forth the question about whether such patients can be forced to take life sustaining drugs if the said drugs only lead to extended life full of suffering.

The law should provide for such individuals to refuse to take such drugs and also to request drugs that will lead to end of their misery, even it if mean that these drugs will end their lives.

Therefore patients in this condition should be allowed the legal tight to end their miseries through assisted suicide.

Those who oppose any form of euthanasia argue that a terminally ill patient or a person suffering irreversible pain from an incurable disease should be assisted to live by all means including any medical procedure that guarantees that they live the longest possible period.

This argument is valid but has logical flows. The argument presupposes that such patients need to be prevented from dyeing through any possible means. In reality though, this efforts are futile as when a patient has determined that death is the easier way out of the misery they are suffering, the emotional distress will only pull them closer to death (Morgan 103).

Furthermore, such efforts to prolong the patients’ lives do not prevent death, as but just postpone it at the same time extending the patients suffering. This is because such patient’s life is hanging by the thread and they have been brought near to death by the virtue of their illness.

In severe cases such patient may result to suicide, as in the case of Sue Rodriguez, Canadian woman who suffered Lou Gehrig’s disease, and was refused the right for assisted death (CNBC News para 2). As such efforts to prolong their lives pushed them closer to death

While some countries such as The Netherlands, Belgium and Denmark have embraced the idea of euthanasia, others have move at a snails pace in this direction. Canada, one of the most developed countries is such countries.

Euthanasia is still illegal in Canada and any person found trying it is subject to prosecution. Furthermore, any person found to have assisted another person commit suicide is also liable to prosecution for up to 14 years in prison.

Still in Canada, the law after many years of legal battle has differentiated euthanasia and assisted suicide. Assisted suicide is what is otherwise referred to as active euthanasia where a terminally ill patient asks for help to end life.

The law in Canada has also allowed for these patients to refuse life sustaining medication if such medication does not in any way improve the quality of their lives (CNBC para 17).

If the law acknowledges the power of a person to refuse such medication then it must also allow such a person the legal right to determine the condition and the manner in which they die. This means that there is light, though, at the end of the tunnel for Canadians patients who may wish to end their lives.

Such argument for any form of euthanasia tends to conglomerate around two valid arguments. First, if a terminally ill patient who is suffering extreme and irreversible pain is determined to be of sound mind and is adult then such patients should be allowed to make judgment about their lives.

If such a patient decides that ending their lives will be end their misery, then no doctor has the legal as well as moral obligation of coercing the patient to continue taking medication that only prolongs their suffering (Morgan 145).

If doctors manage to successfully administer the drugs against the wishes of such a patient, they will have committed an assault against the patient and this is a legal as well as a professional misconduct (Morgan 146). Secondly, the desires of such a patient are supreme.

This means that the patients’ right to self determination overrides the fundamental but not absolute belief that life is holy and should only be ended by the maker.

Therefore such patient’s should be treated as competent enough to make decisions about their lives and that no medical officer has the legal or moral right to determine that such a patient is wrong. Any medical help provide to such a patient thus be for the benefit of the patient.

From a religious point of view, it can be argued that God is love and people of God should demonstrate compassion. If someone is undergoing intense pain and a slow but sure death, it would be evil to allow such a person to experience the full extent (Gorsuch 89).

Euthanasia would therefore be the better option. Helping the patient have a dignified death can be the best show of agape love. There is also the issue of quality of life where if someone is leading low quality or worthless life, then one should opt for euthanasia.

The essay has discussed several points in favor of euthanasia as an alternative when it comes to treating people suffering from terminal illness or responding to perplexing situations where death is the ultimate end although one may go through severe pain and agonizing moments.

It has also highlighted three main forms of euthanasia; voluntary/active, non-voluntary, and involuntary. Anyone can argue against the points raised in this essay but it would be difficult to justify why an individual should be allowed to suffer for a long time either willingly or unwillingly.

The doctors should do everything humanly possible to save lives of their patients, however, euthanasia should be considered as the only alternative to save extreme cases like the terminally ill patients from their perpetual pain and suffering.

Works Cited

Bowie, Bob & Bowie, Robert A. Ethical Studies: Euthanasia (2 nd ed). Neslon Thornes, 2004, Pp. 215-216.

Buse, Anne-Kathrin. Euthanasia: Forms and their Differences . GRIN Verlag, 2008, Pp. 7-8.

CNBC news. “ The Fight for the Right to Die. ” CNBC Canada . 2011.

Gorsuch, Neil M. Euthanasia- The Future of Assisted Suicide . Princeton University Press, 2009, Pp. 86-93.

Johnstone, Megan-Jane. Euthanasia: Contradicting Perspectives (5 th ed). Elsevier Health Sciences, 2008, Pp. 247-262.

Morgan, John. An Easeful Death?: Perspectives On Death, Dying And Euthanasia. S ydney: Federation press Pty Ltd. 1996. Print.

Otlowski, Margaret. Euthanasia and the Common Law . Oxford University Press, 2000, Pp. 211-212.

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Approaching Death: Improving Care at the End of Life (1997)

Chapter: 10 conclusions and recommendations, 10 conclusions and recommendations.

Our lives are time travel, moving in one direction only. We accompany one another as long as we can; as long as time grants us.

Joyce Carol Oates, A Letter to My Mother , 1996

We go toward something that is not yet.

Paul Tillich, The Eternal Now , 1959

Dying is at once a fact of life and a profound mystery. Death comes to all, yet each person experiences it in ways that are only partly accessible to the family member or physician, the researcher or philosopher. In principle, humane and skillful care for the dying is a social obligation as well as a personal offering from those directly involved. In reality, both society and individuals fall short of what is reasonably, if not simply, achievable.

Evidence and experience both indicate that much dying is far harder than it should be. Like the mythic king Tantalus, who reached for fruit and water just beyond his grasp, the dying person has too often been destined to seek but not find a pain-free and peaceful death. Such a fate need not be; better deaths are possible now.

This is not to claim that dying and death can be made easy, although certain illnesses tend to bring less-difficult deaths than others; nor is it to suggest that caring well for those approaching death can be made an exact science or flawless art. Caring well involves a frequently stressful, imperfect effort to balance science with sentiment, honesty with hope, patterns of care with room for exceptions.

This report has identified ways in which clinicians, educators, and communities do not care adequately for those approaching death. It has pointed to steps that can improve care at the end of life and sustain improvements through difficult times. It has also highlighted the reasons for believing that professionals, policymakers, and the public are ready to support such steps. These reasons range from the examples of well-known men and women facing death with grace to the focus on deficiencies in care

stimulated by the debate over assisted suicide. In sum, the timing appears right to press for a vigorous societal commitment to improve care for the dying. Such a commitment would motivate and sustain local and national efforts to strengthen and apply the existing knowledge base, reform procedures and policies that impede good care for the dying, and stress the caring functions of health delivery systems.

Today and Tomorrow

The preceding chapters have profiled important aspects of dying in America. They have noted that three-fourths of those who die are elderly and that most people who die are covered by Medicare or other federal, state, or local programs for older, disabled, or impoverished people. Compared to earlier times, death now comes more often in old age from a chronic or progressive disease. Most deaths occur in institutions, mainly hospitals and, to a lesser extent, nursing homes. The proportion of people who die at home is, however, increasing. Only a minority of all deaths involve people cared for by formal hospice programs, and the majority of these involve cancer diagnoses. All patients can potentially benefit from good palliative care, but hospice programs as organized and financed in the United States are most applicable to those with relatively predictable prognoses.

Although specifics may vary according to the nature of a person's disease and his or her personal circumstances, care for dying people and those close to them has several broad dimensions: physical, psychological, spiritual, and practical. Each of these dimensions is intertwined in the key processes of care, which include determining and communicating diagnosis and prognosis, establishing goals and plans, and fitting palliative and other care to these goals. The way care is organized, financed, monitored, and regulated affects how these processes are carried out in different settings for different kinds of patients.

The twenty-first century will bring new realities as well as continuing problems and opportunities in care at the end of life. It will undoubtedly deliver improvements in what medical science can do to prevent and relieve distress for those approaching death, but demographic, economic, and other trends will strain systems that already find it difficult to deliver what clinical knowledge currently allows—and what compassion should grant.

The committee focused primarily on trends and expectations relevant to care for dying patients during the next 10 to 20 years. One of these expectations is that policymakers and others will need to prepare during this period for the final demographic consequences of the post-World War II baby boom. The oldest members of the baby boom generation will reach age 65 in the year 2011, and the youngest members will do so nearly 20

years later. Barring dramatic unexpected developments, older adults will constitute a larger proportion of the population than today, and the absolute numbers of dying patients will be much larger. In the face of an ever-increasing population with chronic conditions, the current system, with its emphasis on acute curative care, will fail to provide needed long-term chronic care and palliative and support services. Although health care and social service providers have a long lead time compared with the educators and communities who had to scramble to provide schooling for the baby boom generation, the difficulties that policymakers are having with Social Security and Medicare do not bode well for the nation's ability to cope with an aging population.

In addition, continuing increases in longevity will mean that the proportion of those dying past age 75 will increase. The impact on the health care system and society on larger numbers of people dying in older old age will depend in part on their health status in the years before death. The "compression of morbidity hypothesis," for which the evidence is ambiguous, posits that an increase in healthier life styles means that people will experience disabling conditions for a smaller proportion of the years before death than today. Even if this does occur, the overall impact of the larger proportion of older people and their longer life span will still pose enormous challenges for social and health care systems.

Demographic politics are likely to be complex in coming years. On the one hand, the so-called senior lobby should be strengthened by the "baby boom" cohort. The "baby boomers," throughout their childhood, youth, and early middle age, have drawn public attention to their needs and concerns. On the other hand, the burden on the smaller working-age population of supporting its elders raises the specter of a generational backlash (even though younger people could also be burdened if the social support available to their aging parents is reduced). Such a backlash could take many forms, including means-testing Social Security benefits or less sympathy for supportive services for frail elderly people, those with serious disabilities, and people who are dying.

Cultural trends add further complexity to demographic politics. Immigrants, who tend to be young and have more children than native-born Americans, have been a major source of growth in the total U.S. population (NRC, 1997). Nonhispanic Caucasians—now a majority—are a decreasing proportion of the U.S. population. Thus, the large elderly population in the first decades of the next century will be dependent on a smaller and more culturally diverse population of younger people.

As described in preceding chapters, health care in the United States is undergoing major changes. The use of hospital services has dropped significantly, and further declines are likely, particularly in those areas with continued relatively high rates of use. Hospital care will likely be less available

to dying patients, potentially including some who could benefit from such care as well as many who will do better with alternatives.

Despite indications that health care spending increases have moderated from years past, the pressure to cut health care costs does not appear to be abating. In particular, given the bleak financial picture for Medicare and the significant portion of spending accounted for by beneficiaries in their last year of life, these constraints may be manifested in some degree of age-based rationing. That is, older people could be denied services simply because of their age, without regard to their life expectancies, function, or expected benefit from care. Decreased access to advanced technologies intended to prolong life could be a highly visible issue, although it is relatively unimportant for the great majority of those dying at an advanced age.

If successful, increased efforts to shift Medicare beneficiaries into various forms of managed care will test these entities, whose enrollment now is overwhelmingly concentrated in younger, healthier age groups. Potential problem areas include payment, contracting, and utilization review mechanisms that limit access to clinicians and care teams experienced in palliative care, patient scheduling norms that limit time for careful clinician-patient communication, marketing strategies intended to discourage enrollment or encourage disenrollment by seriously ill people, drug formularies that exclude or restrict important medications, and bureaucratic hurdles that discourage people from seeking care or preclude them from receiving requested services. One characteristic of many managed care organizations is an emphasis on moving more responsibility for diagnosis and patient management to primary care clinicians, including nurse practitioners, nurses, and other nonphysicians. How well this will work for seriously ill and elderly patients is not yet clear. A major role for nurses and other health care professionals is, however, already well tested in hospice, social health maintenance organizations, and other settings that care for patients dying of advanced progressive diseases, particularly cancer, and for frail elderly people.

As well as focusing attention on competing ethical and policy values, this prospect of constrained resources underscores the need for more valid and reliable tools for assessing health status, measuring outcomes, and linking them to health interventions. Considerable progress is being made in this arena. In addition, improved computer-based information and decision support systems promise several benefits. At the level of the individual, they will help patients, families, and clinicians in making more informed decisions about care at the end of life. At the system or societal level, they will strengthen structures and processes of accountability involving health care providers, purchasers, patient/consumers, and public officials.

Moreover, advanced information and communications technologies may make health care more accessible for some who face geographic or

other barriers to care. Although the potential for practical, effective, and affordable "medicine at a distance" is more promised than proved, telemedicine could help bring palliative and other expertise and services to homes, nursing homes, and other places where they are not very available today (IOM, 1996e). People who have chronic and advanced illnesses but do not qualify for hospital inpatient care could benefit.

Findings and Recommendations

Although the committee found many problems, it also found much that was good and improving in care for those approaching death. It was impressed by the principles, aspirations, and practices being advanced by the field of palliative medicine and being implemented or attempted through interdisciplinary care teams in varied settings, including hospices, hospitals, nursing homes, and private homes. More effort is now being devoted to understanding differences in people's paths toward death and developing programs that are flexible enough to accommodate these differences. In addition to dedicated professionals, many volunteers contribute their time and energy to provide emotional and practical support to dying patients and those close to them. People from a variety of backgrounds have also joined together to direct the attention of policymakers and ordinary citizens to the need to remove barriers to good care created by laws, regulations, organizational practices, and lack of supportive community resources.

Care for the dying should also benefit from ongoing efforts to improve continuity of care, strengthen information systems, prevent health problems, and create accountability for the quality of care. The developing fields of outcomes measurement can make important contributions to the care of the dying by teaching us how to conceptualize and measure quality of life and well-being for those approaching death. Quality improvement strategies are helping to identify and remedy system problems that impede good care. The committee is encouraged by the growing interest in end-of-life issues as recently evidenced by the publication of books and articles for lay and professional audiences, the commitment of foundation resources to support research and education, and the organization of conferences, working groups, and other initiatives sponsored by professional societies and others.

Deficiencies in Care at the End of Life

Notwithstanding these positive features, the committee concluded that very serious problems remain. Indeed, in this committee's view, if physician and hospital performance in infection control were as poor as it is, for

example, in pain management, the ensuing national outcry would create an immediate demand for responses from clinicians, managers, and educators.

The committee identified four broad deficiencies in the current care of people with life-threatening and incurable illnesses. First , too many people suffer needlessly at the end of life both from errors of omission—when caregivers fail to provide palliative and supportive care known to be effective—and from errors of commission—when caregivers do what is known to be ineffective and even harmful. As reported in Chapter 3 , studies have repeatedly indicated that a significant proportion of dying patients and patients with advanced disease experience serious pain, despite research identifying a range of effective pharmacological and other options for relieving most pain. Other symptoms are less well studied, and more research on symptom prevalence and management is needed, but the information available to the committee suggested similar care problems. Deficiencies in the application of existing knowledge to prevent and manage pain and other distressing symptoms stem from an unfortunate mix of ignorance about effective pharmacological and other interventions, misplaced concern about opioid addiction, and inadequate attention to people's quality of life while dying. These problems are reinforced by care systems that are not structured to provide the clinical expertise, reliability, continuity, and emotional support needed by people approaching death. Cultural biases and fears about illness, disability, and death may also contribute to avoidance of dying patients and those close to them.

In perverse counterpoint to the problem of undertreatment, the aggressive use of ineffectual and intrusive interventions may prolong and disfigure the period of dying. Some of this care is knowingly accepted; some is provided counter to patients' wishes; much is probably provided and accepted with little knowledge or consideration of its probable benefits and burdens. Medical culture still tolerates and even rewards the misapplication of life-sustaining technologies while slighting the prevention and relief of suffering.

Second , legal, organizational, and economic obstacles conspire to obstruct reliably excellent care at the end of life. Despite some reforms, outdated and scientifically flawed drug-prescribing laws, regulations, and interpretations by state medical boards still frustrate and intimidate physicians who wish to relieve their patients' pain. Addiction to appropriately prescribed opioids is virtually nonexistent whereas their underprescription for pain is well documented. Organizational structures often interfere with the coordination and continuity of care and impede the further development and application of palliative care strategies in patient care, professional education, and research.

Financial incentives also discourage health care practitioners and providers from rearranging care so that it serves dying patients well. Tradi-

tional financing mechanisms—including arrangements based on discounted fees—provide incentives for the overuse of procedural services and the under-provision of the assessment, evaluation, management, and supportive services so important for people with serious chronic or progressive medical problems. Medicare hospice benefits have helped fill gaps for a small segment of dying patients, but many more have conditions that do not readily fit the current hospice model or requirements. Alternatives to fee-for-service financing in combination with restrictive administrative practices pose different potential hazards that are largely unstudied as they affect seriously and incurably ill people.

Third , the education and training of physicians and other health care professionals fails to provide them with the knowledge, skills, and attitudes required to care well for the dying patient. Many deficiencies in practice stem from fundamental prior failures in professional education. Despite encouraging signs of change, most clinicians-in-training experience and learn too little of the caring that helps people to live well while dying. Undergraduate, graduate, and continuing medical education do not sufficiently prepare health professionals to recognize the final phases of illnesses, construct effective strategies for care, communicate with patients and those close to them, and understand and manage their own emotional reactions to death and dying.

Fourth , current knowledge and understanding are inadequate to guide and support the consistent practice of evidence-based medicine at the end of life. In addition to existing knowledge not being well used, we still know too little about how people die; how they want to die; and how different kinds of physical, emotional, and spiritual care might better serve the dying and those close to them. Biomedical and clinical research have emphasized the development of knowledge that contributes to the prevention, detection, or cure of disease and to the prolongation of life. Research on the end stages of diseases and the physiological bases of symptoms and symptom relief has been less well supported. Epidemiological and health services research has likewise not provided a strong base for understanding the degree to which people suffer symptoms (except, perhaps, cancer pain), experience death alone rather than in the company of those who care, comprehend diagnostic and prognostic information, and achieve a dying that is reasonably consistent with their preferences, community norms, and palliative care principles. Methods development is important to define and measure outcomes other than death (including patient and family perceptions) and to monitor and improve the quality of care for those approaching death.

More generally, it seems that this nation has not yet discovered how to talk realistically but comfortably about the end of life, nor has it learned how to value the period of dying as it is now experienced by most people.

For most of human history, death came fairly quickly in childhood or at adult ages that today seem relatively young. As the twentieth century ends, most people in economically advanced countries live fairly healthy lives into older age but then experience progressive disability for some time before they die. Except what can be inferred from newspaper obituary pages, this reality is largely shunned by the news, information, and entertainment media as distasteful or uninteresting. One result is an unhelpful combination of public fear, misinformation, and oversimplification that views misery as inescapable, pain as unavoidable, and public spending as misdirected for people who are approaching death.

Recommendations and Future Directions

The committee developed seven recommendations directed at different decisionmakers and different deficiencies in care at the end of life. These recommendations and a brief explanation follow. Each applies generally to people approaching death, including those for whom death is imminent and those with serious, eventually fatal illnesses who may live for some time.

RECOMMENDATION 1: People with advanced, potentially fatal illnesses and those close to them should be able to expect and receive reliable, skillful, and supportive care . Educating people about care at the end of life is a critical responsibility of physicians, hospitals, hospices, support groups, public programs, and media. Most patients and families need information not only about diagnosis and prognosis but also about what support and what outcomes they should reasonably be able to anticipate. They should, for example, not be allowed to believe that pain is inevitable or that supportive care is incompatible with continuing efforts to diagnose and treat. They should learn—before their last few days of life—that supportive services are available from hospices and elsewhere in the community and that those involved in their care will help arrange such services. Patient and family expectations and understanding will be aided by advance care planning that considers needs and goals, identifies appropriate surrogate decisionmakers, and avoids narrow preoccupation with written directives. To these ends, health care organizations and other relevant parties should adopt policies regarding information, education, and assistance related to end-of-life decisions and services. For those who seek to build public understanding of dying as a part of life and to generate public demand for reliable and effective supportive services, one model can be found in the perspectives, spirit, and strategies that have guided efforts to promote effective prenatal care and develop mother- and family-oriented arrangements for childbirth.

RECOMMENDATION 2: Physicians, nurses, social workers, and other health professionals must commit themselves to improving care for dying patients and to using existing knowledge effectively to prevent and relieve pain and other symptoms. Most patients depend on health care professionals to prevent and manage the varying physical and psychological symptoms that accompany advanced illness. To meet their obligations to their patients, practitioners must hold themselves and their colleagues responsible for using existing knowledge and available interventions to assess, prevent, and relieve physical and emotional distress. Unrelieved pain and other symptoms are the most evident problems that practitioners can readily avoid for the great majority of patients, but problems with communication, appropriate regard for patient and family wishes, and timely referral to palliative care specialists or teams are other areas in need of improvement. When good practice is hindered by organizational, financial, or legal impediments, health professionals have the responsibility as individuals and members of larger groups to advocate for system change.

RECOMMENDATION 3: Because many deficiencies in care reflect system problems, policymakers, consumer groups, and purchasers of health care should work with health care providers and researchers to

Although individuals must act to improve care at the end of life, systems of care must be changed to support such action. System change requires the involvement of public and private purchasers of care, regulators, and others whose policies and practices may create incentives for inappropriate care and barriers to excellent care.

Better information systems and tools for measuring outcomes and evaluating care are critical to the creation of effective and accountable systems of care and to the effective functioning of both internal and external systems of quality monitoring and improvement. Reliable and valid information about quality of care should be available to patients, purchasers, and ac-

crediting organizations, but organizations also need to audit their structures and processes for problem areas and commit themselves to improving care on an ongoing basis. Problem areas include insufficient numbers and types of properly trained personnel, nonexistent or inadequate protocols for symptom assessment and management, and poor procedures for evaluating the need for patient transfers or referrals and for carrying out such transfers without harm to patients. The committee supports the development of guidelines for clinical practice that assist clinicians in preventing and relieving symptoms and in managing the end stages of specific diseases.

Policymakers and purchasers need to consider both the long-recognized deficiencies of traditional fee-for-service arrangements and the less thoroughly understood strengths and limitations of alternatives, including various kinds of capitated and per case payment methods that apply in diverse ways to individual practitioners, interdisciplinary care teams, specific institutions, networks of providers, or integrated systems of care. Particularly in need of attention are the levels of payment for home and nursing home visits by physicians, the interpretation of evaluation and management codes, the lack of diagnosis- or condition-related adjustments in hospice payments for both home and inpatient care, and other financing incentives that may discourage hospices or health plans from enrolling sicker patients. In addition, reimbursement methods and related incentives should encourage continuity of care that supports patients all the way through death and reduces disconnected and episodic care. Health care professionals and organizations also need to formulate ethical guidelines to guard against possible conflicts of interest in capitated and other care systems.

The problems with laws relating to prescribing practices are twofold. One problem is outdated, scientifically flawed laws and regulations themselves. The other problem is clinician, regulator, and public misunderstanding of the appropriate use of opioids. State medical societies, licensing boards, legislative committees, and other groups should cooperate to review state laws, regulations, board practices, and physician attitudes and practices to identify problem areas and then devise revisions in those statutes and regulations that unduly burden clinical management of pain. Regulatory review and revision should be accompanied by educational efforts to increase scientifically and clinically based knowledge and correct misperceptions about the appropriate medical use of opioids and about the biological mechanisms of opioid dependence, addiction, and pain management. Legal change should help—but cannot be relied upon alone—to correct undertreatment.

RECOMMENDATION 4: Educators and other health professionals should initiate changes in undergraduate, graduate, and continuing education to ensure that practitioners have the relevant attitudes, knowledge, and

skills to care well for dying patients. Dying is too important a part of life to be left to one or two required (but poorly attended) lectures, to be considered only in ethical and not clinical terms, or to be set aside on the grounds that medical educators are already swamped with competing demands for time and resources. Every health professional who deals directly with patients and families needs a basic grounding in competent and compassionate care for seriously ill and dying patients. For clinicians and others to be held truly accountable for their care of the dying, educators must be held accountable for what they teach and what they implicitly and explicitly honor as exemplary practice. Textbooks and other materials likewise need revision to reflect the reality that people die and that dying patients are not people for whom "nothing can be done." As described in Chapter 8 , a number of promising curriculum models exist, and others are being developed and tested.

RECOMMENDATION 5: Palliative care should become, if not a medical specially, at least a defined area of expertise, education, and research. The objective is to create a cadre of palliative care experts whose numbers and talents are sufficient to (a) provide expert consultation and role models for colleagues, students, and other members of the health care team; (b) supply educational leadership and resources for scientifically based and practically useful undergraduate, graduate, and continuing medical education; and (c) organize and conduct biomedical, clinical, behavioral, and health services research. More generally, palliative care must be redefined to include prevention as well as relief of symptoms. Attention to symptoms should begin at earlier points during the trajectory of an illness because early treatment may well contribute to lessening pain at the end of life. The model for palliative care stresses interdisciplinary, comprehensive, and continuing care of patients and those close to them.

RECOMMENDATION 6: The nation's research establishment should define and implement priorities for strengthening the knowledge base for end-of-life care. The research establishment includes the National Institutes of Health, other federal agencies (e.g., the Agency for Health Care Policy and Research, the Health Care Financing Administration, the National Center for Health Statistics), academic centers, researchers in many disciplines, pharmaceutical companies, and foundations supporting health research. Their active support and involvement is necessary to advance basic and clinical research on the physiological mechanisms and treatment of symptoms common during the end of life, including neuropsychiatric problems. To extend understanding of quality-of-life issues in the treatment of advanced disease, those supporting clinical trials should encourage the collection of more information on the quality of life of those who die while

enrolled in such trials. A further step is to support more research on the physiological mechanisms and treatment of symptoms common during the end of life, including neuropsychiatric problems. Pain research appears to supply a good model for this enterprise to follow. In addition, pathways need to be developed to further the dissemination and replication of proven health care interventions and programs. Demonstration projects to test new methods of financing and organizing care should be a priority for the Health Care Financing Administration. To encourage change in the attitudes and understandings of the research establishment, the committee urges the National Institutes of Health and other public agencies to take the lead in organizing a series of workshops, consensus conferences, and agenda-setting projects that focus on what is and is not known about end stage disease and symptom prevention and treatment and that propose an agenda for further research. For the Agency for Health Care Policy and Research, the committee encourages support for the dissemination and replication of proven health care interventions and programs through clinical practice guidelines and other means.

RECOMMENDATION 7: A continuing public discussion is essential to develop a better understanding of the modern experience of dying, the options available to dying patients and families, and the obligations of communities to those approaching death. Individual conversations between practitioners and patients are important but cannot by themselves provide the supportive environment for the attitudes and actions that make it possible for most people to die free from avoidable distress and to find the peace or meaning that is significant to them. Although efforts to reduce the entertainment and news media's emphasis on violent or sensational death and unrealistic medical rescue have not been notably successful, a modicum of balance has recently been provided by thoughtful analyses; public forums; and other coverage of the clinical, emotional, and practical issues involved in end-of-life care. Regardless of how the current, highly publicized policy debate over physician-assisted suicide is resolved, the goal of improving care for those approaching death and overcoming the barriers to achieving that goal should not be allowed to fade from public consciousness. Much of the responsibility for keeping the public discussion going will rest not with the media but with public officials, professional organizations, religious leaders, and community groups.

Finally, the committee agreed that it was not prepared to take a position on the legality or morality of physician-assisted suicide. The issue should not, in any case, take precedence over those reforms to the health care system that would improve care for all dying patients. The goal of those who favor legalizing physician-assisted suicide is to promote patient autonomy, but true autonomy is not possible when significant numbers of

people have the limited choice between suicide or continued suffering. If the laws permitting physician-assisted suicide are implemented at the state level, careful monitoring of their consequences for the quality of care and the public's trust in health care will be very important.

Concluding Thoughts

Improving care at the end of life will require many changes in attitudes, policies, and actions. Such changes will involve a multitude of people and institutions that have a role in making and implementing decisions about patient care or in structuring the environments in which such decisions are reached and realized. Clearly, what patients and their families know, expect, and desire is important. Health care professionals play critical roles in diagnosis, communication, guidance and direction, treatment, negotiation, and advocacy for patients at many levels. Decisions by health plan managers, institutional administrators, and governmental officials shape and often impede the ability of patients, families, and clinicians to construct a care plan that serves the dying person well.

In general, changes in systems of care—not just individual beliefs and actions—are necessary if real gains are to be made in helping people live well despite fatal illness. Such widespread changes depend in part on a stronger social consensus on what constitutes appropriate and supportive care for those approaching death. Widely publicized—albeit not necessarily typical—instances of patient and family powerlessness to stop what they see as futile and painful treatments reflect a lack of such consensus. Paradoxically, this lack of consensus also is evident when patients or families demand treatments that practitioners see as useless, counterproductive, or even inhumane. It similarly reveals itself in a health care delivery and financing system that still rewards life-prolonging interventions (even when they will be ineffectual) and slights palliative and supportive services for those for whom life-extending treatment is neither helpful nor desired.

Freud may have been right that "our unconscious does not believe in its own death; it behaves as if immortal" (Freud, 1915, in Freud, 1959, p. 304). The committee was optimistic, nonetheless, that this society would cultivate the conscious intelligence and spirit to recognize the reality of death and the likelihood that it will bring distress. It likewise was optimistic that people would work together to create humane systems of care that assure the consistent use of existing knowledge to prevent and relieve suffering and that support efforts to provide people the right care at the right time in the right way. The analyses, conclusions, and recommendations presented here are offered with optimism that we can, individually and together, "approach" death constructively and create humane care systems that people can trust to serve them well as they die.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening.

Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care.

This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life:

• Determining diagnosis and prognosis and communicating these to patient and family.
• Establishing clinical and personal goals.
• Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances.

Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

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Euthanasia and assisted dying: the illusion of autonomy—an essay by Ole Hartling

Read our coverage of the assisted dying debate.

• Related content
• Peer review
• Ole Hartling , former chairman
• Danish Council of Ethics, Denmark
• hartling{at}dadlnet.dk

As a medical doctor I have, with some worry, followed the assisted dying debate that regularly hits headlines in many parts of the world. The main arguments for legalisation are respecting self-determination and alleviating suffering. Since those arguments appear self-evident, my book Euthanasia and the Ethics of a Doctor’s Decisions—An Argument Against Assisted Dying 1 aimed to contribute to the international debate on this matter.

I found it worthwhile to look into the arguments for legalisation more closely, with the hope of sowing a little doubt in the minds of those who exhibit absolute certainty in the matter. This essay focuses on one point: the concept of “autonomy.”

(While there are several definitions of voluntary, involuntary, and non-voluntary euthanasia as well as assisted dying, assisted suicide, and physician assisted suicide, for the purposes of brevity in this essay, I use “assisted dying” throughout.)

Currently, in richer countries, arguments for legalising assisted dying frequently refer to the right to self-determination—or autonomy and free will. Our ability to self-determine seems to be unlimited and our right to it inviolable. The public’s response to opinion poll questions on voluntary euthanasia show that people can scarcely imagine not being able to make up their own minds, nor can they imagine not having the choice. Moreover, a healthy person answering a poll may have difficulty imagining being in a predicament where they simply would not wish to be given the choice.

I question whether self-determination is genuinely possible when choosing your own death. In my book, I explain that the choice will always be made in the context of a non-autonomous assessment of your quality of life—that is, an assessment outside your control. 1

All essential decisions that we make are made in relation to other people. Our decisions are affected by other people, and …

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Tips on How to Write a Euthanasia Argumentative Essay

Abortion, birth control, death sentencing, legalization of medical marijuana, and gender reassignment surgery remain the most controversial medical issues in contemporary society.  Euthanasia is also among the controversial topics in the medical field. It draws arguments from philosophy, ethics, and religious points of view.

By definition derives from a Greek term that means good death, and it is the practice where an experienced medical practitioner or a physician intentionally ends an individual's life to end pain and suffering. The names mercy killing or physician-assisted suicide also knows it.

Different countries have different laws as regards euthanasia. In the UK, physician-assisted suicide is illegal and can earn a medical practitioner 14 years imprisonment. All over the world, there is a fierce debate as regards mercy killing.

Like any other controversial topic, there are arguments for and against euthanasia. Thus, there are two sides to the debate. The proponents or those for euthanasia believe it is a personal choice issue, even when death is involved.

On the other hand, those against euthanasia or the opponents believe that physicians must only assist patients when the patients are sound to make such a decision. That is where the debate centers.

This article explores some of the important basics to follow when writing an exposition, argumentative, persuasive, or informative essay on euthanasia.

Steps in Writing a Paper on Euthanasia

When assigned homework on writing a research paper or essay on euthanasia, follow these steps to make it perfect.

1. Read the Prompt

The essay or research paper prompt always have instructions to follow when writing any academic work. Students, therefore, should read it to pick up the mind of the professor or teaching assistant on the assigned academic task. When reading the prompt, be keen to understand what approach the professor prefers. Besides, it should also tell you the type of essay you are required to write and the scope.

2. Choose a Captivating Topic

After reading the prompt, you are required to frame your euthanasia essay title. Make sure that the title you choose is captivating enough as it invites the audience to read your essay. The title of your essay must not divert from the topic, but make it catchy enough to lure and keep readers. An original and well-structured essay title on euthanasia should give an idea of what to expect in the body paragraphs. It simply gives them a reason to read your essay.

3. Decide on the Best Thesis Statement for your Euthanasia Essay

Creating a thesis statement for a euthanasia essay does not deviate from the conventions of essay writing. The same is consistent when writing a thesis statement for a euthanasia research paper. The thesis statement can be a sentence or two at the end of the introduction that sums up your stance on the topic of euthanasia. It should be brief, well crafted, straight to the point, and outstanding. Right from the start, it should flow with the rest of the essay and each preceding paragraph should support the thesis statement.

4. Write an Outline

An outline gives you a roadmap of what to write in each part of the essay, including the essay hook, introduction, thesis statement, body paragraphs, and the conclusion. We have provided a sample euthanasia essay outline in this article, be sure to look at it.

5. Write the First Draft

With all ingredients in place, it is now time to write your euthanasia essay by piecing up all the different parts. Begin with an essay hook, then the background information on the topic, then the thesis statement in the introduction. The body paragraphs should each contain an idea that is well supported with facts from books, journals, articles, and other scholarly sources. Be sure to follow the MLA, APA, Harvard, or Chicago formatting conventions when writing the paper as advised in the essay prompt.

6. Proofread and Edit the Essay

You have succeeded in skinning the elephant, and it is now time to cut the pieces and consume. Failure to proofread and edit an essay can be dangerous for your grade. There is always an illusion that you wrote it well after all. However, if you take some time off and come to it later, you will notice some mistakes. If you want somebody to proofread your euthanasia essay, you can use our essay editing service . All the same, proofreading an essay is necessary before turning the essay in.

Creating a Euthanasia Essay or Research Paper Outline

Like any other academic paper, having a blueprint of the entire essay on euthanasia makes it easy to write. Writing an outline is preceded by choosing a great topic. In your outline or structure of argumentative essay on euthanasia, you should highlight the main ideas such as the thesis statement, essay hook, introduction, topic sentences for the body paragraphs and supporting facts, and the concluding remarks. Here is a sample outline for a euthanasia argumentative essay.

This is a skeleton for your euthanasia essay:

Introduction

• Hook sentence/ attention grabber
• Thesis statement
• Background statement (history of euthanasia and definition)
• Transition to Main Body
• The legal landscape of euthanasia globally
• How euthanasia affects physician-patient relationships
• Biblical stance on euthanasia
• Consequences of illegal euthanasia
• Ethical and moral issues of euthanasia
• Philosophical stance on euthanasia
• Transition to Conclusion
• Restated thesis statement
• Unexpected twist or a final argument
• Food for thought

Sample Euthanasia Essay Outline

Title: Euthanasia is not justified

Essay hook - It is there on TV, but did you know that a situation could prompt a doctor to bring to an end suffering and pain to a terminally ill patient? There is more than meets the eye on euthanasia.

Thesis statement : despite the arguments for and against euthanasia, it is legally and morally wrong to kill any person, as it is disregard of the right to life of an individual and the value of human life.

Paragraph 1: Euthanasia should be condemned as it ends the sacred lives of human beings.

• Only God gives life and has the authority to take it and not humans.
• The bible says, Thou shalt not kill.
• The Quran states, "Whoever killed a Mujahid (a person who is granted the pledge of protection by the Muslims) shall not smell the fragrance of Paradise though its fragrance can be smelt at a distance of forty years (of traveling).

Paragraph 2: Euthanasia gives physicians the power to determine who lives and who dies.

• Doctors end up playing the role of God.
• It could be worse when doctors make mistakes or advance their self-interests to make money. They can liaise with family members to kill for the execution of a will.

Paragraph 3: it destroys the patient-physician relationship

• Patients trust the doctors for healing
• When performed on other patients, the remaining patients lose trust in the same doctor of the facility.
• Under the Hippocratic Oath, doctors are supposed to alleviate pain, end suffering, and protect life, not eliminate it.

Paragraph 4: euthanasia is a form of murder

• Life is lost in the end.
• There are chances that when tried with other therapeutic and non-therapeutic approaches, terminally ill patients can always get better.
• It is selfish to kill a patient based on a medical report, which in itself could be erratic.
• Patients respond well to advanced care approaches.

Paragraph 5: ( Counterargument) euthanasia proponents argue based on relieving suffering and pain as well as reducing the escalating cost of healthcare.

• Euthanasia helps families avoid spending much on treating a patient who might not get well.
• It is the wish of the patients who have made peace with the fact that they might not recover.

  Conclusion

In sum, advancement in technology in the medical field and the existence of palliative care are evidence enough that there is no need for mercy killing. Even though there are claims that it ends pain and suffering, it involves killing a patient who maybe could respond to novel approaches to treatment.

Abohaimed, S., Matar, B., Al-Shimali, H., Al-Thalji, K., Al-Othman, O., Zurba, Y., & Shah, N. (2019). Attitudes of Physicians towards Different Types of Euthanasia in Kuwait.  Medical Principles and Practice ,  28 (3), 199-207.

Attell, B. K. (2017). Changing attitudes toward euthanasia and suicide for terminally ill persons, 1977 to 2016: an age-period-cohort analysis.  OMEGA-Journal of Death and Dying , 0030222817729612.

Barone, S., & Unguru, Y. (2017). Should Euthanasia Be Considered Iatrogenic? AMA journal of ethics, 19(8), 802-814.

Emanuel, E. (2017). Euthanasia and physician-assisted suicide: focus on the data.  The Medical Journal of Australia ,  206 (8), 1-2e1.

Inbadas, H., Zaman, S., Whitelaw, S., & Clark, D. (2017). Declarations on euthanasia and assisted dying.  Death Studies, 41 (9), 574-584.

Jacobs, R. K., & Hendricks, M. (2018). Medical students' perspectives on euthanasia and physician-assisted suicide and their views on legalising these practices in South Africa.  South African Medical Journal ,  108 (6), 484-489.

Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: the right to life vs right to die.  The Indian journal of medical research, 136 (6), 899.

Reichlin, M. (2001). Euthanasia in the Netherlands.  KOS , (193), 22-29.

Saul, H. (2014, November 5). The Vatican Condemns Brittany Maynard's Decision to end her Life as �Absurd'.

Sulmasy, D. P., Travaline, J. M., & Louise, M. A. (2016). Non-faith-based arguments against physician-assisted suicide and euthanasia.  The Linacre Quarterly, 83 (3), 246-257.

Euthanasia Essay Introduction Ideas

An introduction is a gate into the compound of your well-reasoned thoughts, ideas, and opinions in an essay. As such, the introduction should be well structured in a manner that catches the attention of the readers from the onset.

While it seems the hardest thing to do, writing an introduction should never give you the fear of stress, blank page, or induce a writer's block. Instead, it should flow right from the essay hook to the thesis statement.

Given that you can access statistics, legal variations, and individual stories based on personal experiences with euthanasia online, writing a euthanasia essay introduction should be a walk in the park.

Ensure that the introduction to the essay is catchy, appealing, and informative. Here are some ideas to use:

• Rights of humans to life
• How euthanasia is carried out
• When euthanasia is legally allowed
• Stories from those with experience in euthanasia
• The stance of doctors on euthanasia
• Definition of euthanasia
• Countries that allow euthanasia
• Statistics of physicians assisted suicide in a given state, locality, or continent.
• Perception of the public given the diversity of culture

There are tons of ideas on how to start an essay on euthanasia.  You need to research, immerse yourself in the topic, and scoop the best evidence. Presenting facts in an argumentative essay on euthanasia will help convince the readers to argue for or against euthanasia. Based on your stance, make statements in favor of euthanasia or statements against euthanasia known from the onset through the strong thesis statement.

Essay Topics and Ideas on Euthanasia

• Should Euthanasia be legal?
• What are the different types of euthanasia?
• Is euthanasia morally justified?
• Cross-cultural comparison of attitudes and beliefs on euthanasia
• The history of euthanasia
• Euthanasia from a Patient's Point of View
• Should euthanasia be considered Iatrogenic?
• Does euthanasia epitomize failed medical approaches?
• How does euthanasia work?
• Should Physician-Assisted Suicide be legal?
• Sociology of Death and Dying
• Arguments for and against euthanasia and assisted suicide
• Euthanasia is a moral dilemma
• The euthanasia debate
• It Is Much Better to Die with Dignity Than to Live with Pain Essay
• Euthanasia Is a Moral, Ethical, and Proper
• Euthanasia Law of Euthanasia in California and New York
• Effect of Euthanasia on Special Population
• Euthanasia is inhuman
• Role of nurses in Euthanasia
• Are family and relative decisions considered during the euthanasia
• The biblical stance on euthanasia

Related Articles:

• Argumentative essay topics and Ideas
• Topics and ideas for informative essays

Get Help with Writing Euthanasia Argumentative Essay for School

We have covered the tips of writing an argumentative essay on euthanasia. Besides, we have also presented a sample euthanasia essay outline, which can help you write your essay. However, sometimes you might lack the motivation to write an essay on euthanasia, even when you have access to argumentative essay examples on euthanasia. 

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Essay on Euthanasia: 100, 200 and 300 Words Samples

• Updated on  
• Feb 22, 2024

Essay on Euthanasia: Euthanasia refers to the act of killing a person without any emotions or mercy. Euthanasia is an ethnically complex and controversial topic, with different perspectives and legal regulations on different topics. School students and individuals preparing for competitive exams are given assigned topics like essays on euthanasia. The objective of such topics is to check the candidate’s perspectives and what punishment should be morally and legally right according to them. 

If you are assigned an essay on euthanasia, it means your examiner or teacher wants to know your level of understanding of the topic. In this article, we will provide you with some samples of essays on euthanasia. Feel free to take ideas from the essays discussed below.

Master the art of essay writing with our blog on How to Write an Essay in English .

Table of Contents

• 1 Essay on Euthanasia in 150 Words
• 2.1 Euthanasia Vs Physician-Assisted Suicide
• 2.2 Euthanasia Classification
• 3 Is Euthanasia Bad?

Essay on Euthanasia in 150 Words

Euthanasia or mercy killing is the act of deliberately ending a person’s life.  This term was coined by Sir Francis Bacon. Different countries have their perspectives and laws against such harmful acts. The Government of India, 2016, drafted a bill on passive euthanasia and called it ‘The Medical Treatment of Terminally Ill Patient’s Bill (Protection of Patients and Medical Practitioners). 

Euthanasia is divided into different classifications: Voluntary, Involuntary and Non-Voluntary. Voluntary euthanasia is legal in countries like Belgium and the Netherlands, with the patient’s consent. On one side, some supporters argue for an individual’s right to autonomy and a dignified death. On the other hand, the opponents raise concerns about the sanctity of life, the potential for abuse, and the slippery slope towards devaluing human existence. The ethical debate extends to questions of consent, quality of life, and societal implications.

Also Read: Essay on National Science Day for Students in English

Essay on Euthanasia in 350 Words

The term ‘Euthanasia’ was first coined by Sir Francis Bacon, who referred to an easy and painless death, without necessarily implying intentional or assisted actions. In recent years, different countries have come up with different approaches, and legal regulations against euthanasia have been put forward. 

In 2016, the government of India drafted a bill, where euthanasia was categorised as a punishable offence. According to Sections 309 and 306 of the Indian Penal Code, any attempt to commit suicide and abetment of suicide is a punishable offence. However, if a person is brain dead, only then he or she can be taken off life support only with the help of family members.

Euthanasia Vs Physician-Assisted Suicide

Euthanasia is the act of intentionally causing the death of a person to relieve their suffering, typically due to a terminal illness or unbearable pain. 

Physician-assisted suicide involves a medical professional providing the means or information necessary for a person to end their own life, typically by prescribing a lethal dose of medication.

In euthanasia, a third party, often a healthcare professional, administers a lethal substance or performs an action directly causing the person’s death.

It is the final decision of the patient that brings out the decision of their death.

Euthanasia Classification

Voluntary Euthanasia

It refers to the situation when the person who is suffering explicitly requests or consents to euthanasia. A patient with a terminal illness may express his or her clear and informed desire to end their life to a medical professional.

Involuntary

It refers to the situation when euthanasia is performed without the explicit consent of the person, often due to the individual being unable to communicate their wishes.

Non-Voluntary

In this situation, euthanasia is performed without the explicit consent of the person, and the person’s wishes are unknown.

Active euthanasia refers to the deliberate action of causing a person’s death, such as administering a lethal dose of medication.

It means allowing a person to die by withholding or withdrawing treatment or life-sustaining measures.

Euthanasia and assisted suicide are a defeat for all. We are called never to abandon those who are suffering, never giving up but caring and loving to restore hope. — Pope Francis (@Pontifex) June 5, 2019

Also Read: Essay on Cleanliness

Is Euthanasia Bad?

Euthanasia is a subjective term and its perspectives vary from person to person. Different cultures, countries and religions have their own set of values and beliefs. Life is sacred and gifted to us by god or nature. Therefore, intentionally causing death goes against moral and religious beliefs. 

However, some people have raised concerns about the potential for a slippery slope, where the acceptance of euthanasia could lead to the devaluation of human life, involuntary euthanasia, or abuse of the practice. Some even argue that euthanasia conflicts with their traditional medical ethics of preserving life and prioritizing the well-being of the patient.

Today, countries like the Netherlands and Belgium have legalised euthanasia. In India, the USA and the UK, it is a punishable offence with varying sentences and fines. Euthanasia is a complex and controversial topic and creating a law against or for it requires a comprehensive study by experts and the opinions of all sections of society. 

Ans: Euthanasia refers to the act of killing a person without any emotions or mercy. Euthanasia is an ethnically complex and controversial topic, with different perspectives and legal regulations on different topics.

Ans: The term ‘Euthanasia’ was first coined by Sir Francis Bacon, who referred to an easy and painless death, without necessarily implying intentional or assisted actions. In recent years, different countries have come up with different approaches, and legal regulations against euthanasia have been put forward.  In 2016, the government of India drafted a bill, where euthanasia was categorised as a punishable offence. According to Sections 309 and 306 of the Indian Penal Code, any attempt to commit suicide and abetment of suicide is a punishable offence. However, if a person is brain dead, only then he or she can be taken off life support only with the help of family members.

Ans: Belgium and the Netherlands have legalised euthanasia. However, it is banned in India.

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Euthanasia - Essay Samples And Topic Ideas For Free

Euthanasia, also known as assisted dying or mercy killing, remains a deeply contested ethical and legal issue. Essays could delve into the various forms of euthanasia, such as voluntary, non-voluntary, and involuntary euthanasia, discussing the moral and legal implications of each. The discourse might extend to the examination of the cultural, religious, and societal attitudes towards euthanasia, exploring how different societies and religious groups perceive the right to die. Discussions could also focus on the experiences of countries and regions that have legalized euthanasia, examining the impact on healthcare practices, legal frameworks, and societal attitudes. Moreover, the broader implications of euthanasia on medical ethics, patient autonomy, and the sanctity of life could be explored to provide a comprehensive understanding of the complexities surrounding euthanasia and the ongoing debates on its legalization and practice. A substantial compilation of free essay instances related to Euthanasia you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Euthanasia: is it Ethical

While doing research on the topic of Euthanasia and Physician Assisted Suicide, I have come to see that people have a hard time believing that this should be an option for people who have terminal illnesses. Euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma and Physician Assisted Suicide (PAS) is The voluntary termination of one's own life by administration of a lethal substance with the direct or indirect […]

Arguments for and against Euthanasia

Euthanasia is also known as physician-assisted suicide or good death. It refers to the method where animals that are suffering or in discomfort are helped to rest in death. Many pet owners consider Euthanasia a more compassionate manner of bidding their beloved animals goodbye. In the case of people, many states have not legalized euthanasia for people with dementia or those suffering from incurable diseases. Euthanasia creates an ethical dilemma on three main lines: legal, medical, and philosophical. There are […]

Ethics Behind Physician-Assisted Suicide

Assisted suicide is the act of intentionally killing yourself with the assistance of someone else. In the United States, physician-assisted suicide is when a physician provides a patient, who meets the criteria of having a terminal illness, with medication in order to terminate their life to relieve pain and/or suffering. Physician-assisted suicide is often confused with euthanasia. Euthanasia is illegal in the US. It requires a doctor, or another individual, to administer the medication to the patient. Other terms for […]

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Why Euthanasia should be Legalised

Did you know that the word euthanasia comes from Greek which means good death? However, Only 9 out of the 196 countries in the world have legalised euthanasia or assisted death, including the Netherlands, Belgium, Switzerland and Japan. - posted on Deccan Chronicle. These are all first world countries that value freedom and I strongly believe that Euthanasia should be extended to all other countries. There are 4 different types of euthanasia voluntary, involuntary, active and passive euthanasia. First, I […]

The Ban on Euthanasia

Imagine your girl best friend gets into a car crash. After the incident, you find out she suffered major spinal cord damage and her legs will be paralyzed for the rest of her life. You go to visit her in the hospital the same week but arrive to shocking news. She tells you she has lost the will to live and wants to be euthanized, or painlessly killed. She tells you she is worried about how this accident will affect […]

Assisted Suicide the Rights we have

The right to assisted suicide is one of the most controversial topics ever discussed because of the fact that other people control your life when you are unable to. But some people think that they can stop you from dying even though death is inevitable when one is terminally ill. They think that because of religious and moral reasons they could stop someone from ending their own life. Assisted suicide also known as ""Euthanasia"" is used to make a painless […]

Economic Benefits of Euthanasia

Euthanasia is assisted suicide, it is an action taken by a doctor with consent of the patient in order to relieve immense pain and suffering. However, is the overall process of Euthanasia beneficial for the economy? Based on research, euthanasia is beneficial to the economy, and saves a vast amount of money for families for hospital stays, private insurance companies, taxpayers, and medicare each year. For a hospital stay, the average cost per inpatient day is $2,534.00 for a local […]

Euthanasia Debate

The intention to deliberately help someone accelerate the death of an incurable patient, even to stop his or her suffering has never been an easy task. The ethics of euthanasia is one that has been debated over since the fourth century B.C. Euthanasia is translated from Greek as "good death" or "easy death. At first, the term referred to painless and peaceful natural deaths in old age that occurred in comfortable and familiar surroundings. Today the word is currently understood […]

Physician-assisted Suicide: Right to Die

You may have heard of Physician-assisted suicide before, but what exactly is it? Physician-Assisted suicide is when someone who is terminally ill and completely competent of making choices the right to take their own life, legally with the help of a doctor. Though it seems as if they should be able to do that, in most states the law does get in the way of that. There are ethical and moral issues surrounding this issue. Regardless of those issues, those […]

Religious Perspectives on Euthanasia

Death is one of the most important things that religions deal with. All faiths offer meaning and explanations for death and dying; all faiths try to find a place for death and dying within human experience. Most religions disapprove of euthanasia. Some of them absolutely forbid it. Virtually all religions state that those who become vulnerable through illness or disability deserve special care and protection and that proper end of life care is a much better thing than euthanasia. Religions […]

Active and Passive Euthanasia

Euthanasia is the termination of a terminally ill person's life in order to relieve patients of their severe and untreatable pain. It is further broken down into two types: active and passive. In this paper, I will be focusing on active euthanasia and will argue that it is morally justifiable for a physician to alleviate agony for a patient and their family via direct action. Active euthanasia is morally permissible when a patient explicitly states their consent due to the […]

Physician Assisted Suicide: Medical Practice

Physician assisted suicide is when a physician provides a patient with the necessary means and information to help the patient perform a life ending act. Physician assisted suicide is when is when a person gets prescribed a lethal dose of medication from their physician that they can take when they get ready too. Physician assisted suicide has become an option for those around the world and even legal in certain States in the US. This option is legal in 6 […]

The Controversy over Euthanasia

Euthanasia, as defined by the Merriam-Webster Dictionary, is the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy. The growing euthanasia epidemic has raised a profusion of controversy in recent years due to the legal and moral implications. Although described as relatively painless,euthanasia is something that should be methodically and thoroughly thought through because of the permanent effect it […]

Euthanasia and Death Penalty

Euthanasia and death penalty are two controversy topics, that get a lot of attention in today's life. The subject itself has the roots deep in the beginning of the humankind. It is interesting and maybe useful to learn the answer and if there is right or wrong in those actions. The decision if a person should live or die depends on the state laws. There are both opponents and supporters of the subject. However different the opinions are, the state […]

Physician Assisted Suicide: the Growing Issue of Dying with Dignity and Euthanasia

Is someone wanting to die with dignity more important than the conscience of a doctor who provides care for others? The issue of physician-assisted death can be summed up by simply saying it has a snowball effect. What starts as physician-assisted death turns into euthanizing and from there it could end up in the killing of patients without their full comprehension as to what they agreed to. The solution to this issue is accepting there is a problem and figuring […]

Definition of Euthanasia

Euthanasia defined as an intentionally ending of the life of the terminally ill person in order to relieve pain or suffering, done by a physician, legally. This is not to be confused with the similar physician assisted suicide, the suicide of patient suffering from an incurable disease, effected by the taking of lethal drug by a doctor for this purpose. It is legal in only a few places of the world, and the laws vary by the places. That means […]

Physician Assisted Suicide

Healthcare isn't as perfect as we think it should be considering there are so many medications and treatments that can help restore or cure one's illness. When needing the assistance of a healthcare facility, there are many different challenges that can impact patients and their families. Challenges that include life or death decision making, insurance coverage, the need for medications, cost of services, and so on. As these challenges may seem as if they are minor to some, they truly […]

Euthanasia and Physician-Assisted Suicide

In a documentary, Charles Scott was a man who loved to read, sing, and enjoy being outdoors. He was diagnosed with lymphoma. Struggling every day just to breathe after walking 10 steps to the bathroom and dealing with his eyesight deteriorating, He found life to be full of pain instead of joy. He found no want in having to wait through multiple medications, operations, pain, hospice, and finally him dying suffocating trying to catch his breath” he wished to die […]

Physician-Assisted Euthanasia/Suicide

Part 1: Ethical Question Should doctors have a choice to opt out of assisting terminally ill patients with euthanasia/suicide? Part 2: Introduction Some people think being a physician is an exciting job for the most part. However, physicians have the task of making tough decisions that could hurt many people emotionally. The morality of assisted euthanasia and suicide has been questioned by many people. Some may consider euthanasia and suicide immoral any wrong. Unfortunately, euthanasia and suicide may be the […]

Arguments for Legalizing Euthanasia

I once heard euthanasia is a heart-wrenching kindness and i believe that to be true.Although we as vet techs know it is the right thing to do, being apart of ending there pain and suffering,it is hard being the one to end it knowing the bond an animal has with its owner.Everyone has their own thoughts about this topic and how we prefer to handle it.There are different tolerances everyone has on how it should be done and what the […]

Why Active Euthanasia and Physician Assisted Suicide should be Legalized

This reference source gives us an overview of why euthanasia should be legalized. It goes into depth about how patients and doctors are affected by the decision to end a person's life, and moral issues, and whether it is right or wrong to purposely end someone's life. This source highlights that euthanasia should be in the best interest of the patient who is suffering from an illness, such as an incurable disease or a serious health issue. Doctors should be […]

Physician-assisted Suicide is not Federally Mandated

Physician-assisted suicide is not federally mandated due to the lack of bipartisanship in Congress, the principles of federalism, and contributions from conservative organizations and interest groups. The attitudes and moral acceptability about certain behaviors and actions differ significantly among Republicans and Democrats. According to a 2007 survey, 62% of Democrats support doctors assisting a terminally ill patient to commit suicide, while only 49% of Republicans support this notion (Gallup, Inc 2007). 59% of Democrats also find physician-assisted suicide to be […]

Physician-assisted Suicide and Euthanasia

Physician-assisted suicide and euthanasia have become some of the most highly controversial topics discussed in medicine, making those who have medicine as an occupation question the morality behind the act. A common misconception people often times make is confusing the fact that physician-assisted suicide and voluntary active euthanasia as the same thing. The NCI dictionary of cancer terms states euthanasia is accessibility to ""[a]n easy or painless death or the intentional ending of the life of a person suffering from […]

Euthanasia and Physician Assisted Suicide

Sometimes people criticize euthanasia and physician-assisted suicide from what is called "pro-life" perspectives and other times from "pro-death" perspectives; each perspective has a different argument about their position and the side they are on in this debate. This paper will review some of these arguments that have been made to date, as well as some of the more recent developments in this issue (Dieterle 129). To begin with, many people argue that euthanasia and physician-assisted suicide are morally acceptable because […]

Hinduism and Buddhist Perspective of Suicide and Euthanasia

The principle of ahimsa, or no violence, is fervently held in Hinduism and is reflective in followers' everyday lives. This concept extends to oneself as well as others. For one, suicide is condemned in this religion because all life is considered sacred. Humans life is perceived as precious because only through one of the three human realms can liberation be achieved. Other living things, such as insects and animals, do not receive the same opportunity, so it is crucial followers […]

Euthanasia – One of the most Debated Topics Today

The topic of euthanasia is one of the most debated topics today. Elderly patients can be pressured into a decision they don't want to make. Citizens can also be unfairly euthanized as well. Euthanasia should stay illegal due to the obligation to elderly patients, non permitted euthanization, of an individual, and which can open hopefully widen perspective on this issue, as well as many others. Euthanasia is a complex topic that can't be described simply and without depth. Euthanasia can […]

Physician-assisted Suicide Debate

Let's say a patient is in incredible pain or has an incurable illness and the patient can only be kept alive by machines or by enduring their pain. Should any patient who is in these circumstances be allowed to choose death over this life? Many people go against assisted suicide because of religion and or whatever they believe in. Another reason why people may disagree is that the patients who are not in the right mind and or are too […]

Ethics and Challenges of Euthanasia

As there are other patients who have a higher chance of living, euthanizing the patient was the more practical option. Euthanasia advocates argue that futile care may harm others. For instance, a young child with an acute respiratory disease, who has a potentially higher chance of getting cured, could not get a bed and ventilator in the ICU because others were using it even though they are not getting any personal benefit from the treatment (Niederman & Berger, 2010). This […]

Euthanasia: Merciful Death or Playing God

A death by suicide. Just hearing the word suicide can send chills down one's spine. How could someone get to the point of self-termination? Why would anybody ever consider such a terrible way to die? The thing is, suicide does not have to be a terrible or scary way to die if one is faced with insurmountable troubles accompanying an untreatable disease. With assistance from licensed professionals, it can give those suffering a painless option if they so choose to […]

What is Euthanasia?

Euthanasia is a easy death, some may say euthanasia is a undeviating act for taking a life through prescription drugs. A patient that has a short expand of life can address such an issue with their healthcare provider. Counseling can be provided before the final decision is made by doctor and the patient. At anytime the patient reserves the right to with draw from the process. The patient however must have good reason for the process before a doctor will […]

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How To Write An Essay On Euthanasia

Introduction to the concept of euthanasia.

When embarking on an essay about euthanasia, it’s crucial to begin with a clear definition of what euthanasia entails. Euthanasia, often referred to as "mercy killing," is the act of intentionally ending a person's life to relieve them of suffering, typically from a terminal illness or an incurable condition. In your introduction, outline the various types of euthanasia, such as voluntary, non-voluntary, and involuntary, and the ethical, legal, and moral questions they raise. This introductory segment sets the stage for an in-depth exploration of the arguments for and against euthanasia and its implications in the realms of medicine, ethics, and law.

Exploring the Arguments For and Against Euthanasia

The body of your essay should delve into the complex arguments surrounding euthanasia. On one hand, proponents argue that euthanasia is a compassionate response to unbearable suffering, respecting an individual's right to choose death over prolonged pain. They may also cite the importance of dignity in death and the reduction of medical costs for terminally ill patients. On the other hand, opponents raise concerns about the sanctity of life, the potential for abuse, and the slippery slope towards non-voluntary or involuntary euthanasia. They may also discuss the moral obligations of medical professionals to preserve life. This section should present a balanced view of the debate, providing a comprehensive understanding of the various perspectives on euthanasia.

Ethical and Legal Considerations

A crucial aspect of your essay should be an examination of the ethical and legal considerations surrounding euthanasia. Discuss the ethical principles involved, such as autonomy, beneficence, non-maleficence, and justice. Explore how different countries and cultures view and legislate euthanasia, noting the variations in legal frameworks and the criteria required for it to be carried out. This analysis should provide insight into the complexities of legalizing and regulating euthanasia, and the ethical dilemmas faced by healthcare providers, patients, and their families.

Concluding with Personal Reflections and Broader Implications

Conclude your essay by summarizing the key points and offering personal reflections on the topic. Reflect on the implications of euthanasia for society and the field of healthcare. Consider how advances in medical technology and changes in societal attitudes might influence the future of euthanasia. Your conclusion should not only provide closure to your essay but also encourage further thought and dialogue on this sensitive and contentious issue, highlighting the ongoing importance of ethical deliberation in decisions about life and death.

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• v.75; 2022 Mar

Euthanasia and assisted suicide: An in-depth review of relevant historical aspects

Yelson alejandro picón-jaimes.

a Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia

Ivan David Lozada-Martinez

b Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia

Javier Esteban Orozco-Chinome

c Department of Medicine, RedSalud, Santiago de Chile, Chile

Lina María Montaña-Gómez

d Department of Medicine, Keralty Salud, Bogotá, Colombia

María Paz Bolaño-Romero

Luis rafael moscote-salazar.

e Colombian Clinical Research Group in Neurocritical Care, Latin American Council of Neurocritical Care, Bogotá, Colombia

Tariq Janjua

f Department of Intensive Care, Regions Hospital, Minnesota, USA

Sabrina Rahman

g Independent University, Dhaka, Bangladesh

End-of-life care is an increasingly relevant topic due to advances in biomedical research and the establishment of new disciplines in evidence-based medicine and bioethics. Euthanasia and assisted suicide are two terms widely discussed in medicine, which cause displeasure on many occasions and cause relief on others. The evolution of these terms and the events associated with their study have allowed the evaluation of cases that have established useful definitions for the legal regulation of palliative care and public policies in the different health systems. However, there are still many aspects to be elucidated and defined. Based on the above, this review aimed to compile relevant historical aspects on the evolution of euthanasia and assisted suicide, which will allow understanding the use and research of these terms.

• • The history of euthanasia and assisted suicide has been traumatic.
• • The church and research have been decisive in the definition of euthanasia.
• • The legal framework on the use of euthanasia and assisted suicide has been strengthened.

1. Introduction

Euthanasia and assisted suicide are two topics discussed throughout history, mainly because they fall within the scope of life as a human right, which has been universally defended for many years [ 1 ]. However, the mean of the word euthanasia as good death generates conflicts at social, moral, and ethical levels. Mainly because death is a loss, it is difficult to understand it as something positive and; additionally, several historical events such as the Nazi experiments related the term euthanasia more to murder than to a kind and compassionate act [ 1 ]. More current texts mention that euthanasia is the process in which, through the use or abstention of clinical measures, the death of a patient in an incurable or terminal condition can be hastened to avoid excessive suffering [ 2 ].

The difference between euthanasia and assisted suicide is that in the latter, the patient takes the final action; however, both practices can be combined in the term assisted death [ 2 ]. At present, several countries authorize assisted death, including Holland, Luxembourg, and Canada [ 3 ]. Belgium and Colombia have regulations that decriminalize only euthanasia; other places where assisted suicide is legal are Switzerland and five states of the United America states, specifically Oregon, Vermont, Washington, California, and Montana [ 2 , 3 ]. Spain recently joined the list of countries that have legislated on euthanasia through the organic law March 2021 of March 24 that regulates euthanasia in that state in both public and private institutions [ 4 ]. The fact that more and more countries were joining the legislation on euthanasia and assisted suicide has brought to light the opinion of thinkers, politicians, philosophers, and physicians. Several nations have initiated discussions on the matter in their governmental systems. Latin America is trying to advance powerfully in this medical-philosophical field. Currently, in Chile, the “Muerte digna y cuidados paliativos” law, which seeks to regulate the issue of euthanasia and assisted suicide in the country, is being debated in Congress [ 5 ].

It is essential to know the point of view of physicians on euthanasia and assisted suicide, especially taking into account that these professionals who provide care and accompany patients during this moment, which, if approved, would involve the medical community in both public and private health systems. Although it seems easy to think that physicians have a position in favor of the act of euthanasia because they are in direct and continuous contact with end-of-life situations, such as palliative care, terminally ill, and critically ill patients. It is important to remember that the Hippocratic medical oaths taken at the time of graduation of professionals are mostly categorical in mentioning the rejection of euthanasia and assisted suicide [ 6 ]. Furthermore, it is also important to note that many of the oldest universities in the Western world originated through the Catholic Church; and just this creed condemns the practice of euthanasia and continues to condemn it to this day. This situation generates that many medical students in these schools have behaviors based on humanist principles under the protection of faith and religion and therefore reject the possibility of euthanasia [ 7 , 8 ].

The relevance of the topic and the extensive discussion that it has had in recent months due to the COVID-19 pandemic added to the particular interest of bioethics in this topic and the need to know the point of view of doctors and other health professionals on euthanasia and assisted suicide.

2. Origin and meaning of the term euthanasia

The word euthanasia derives from the Greek word “eu” which means good, and the word “thanatos” which means death; therefore, the etymological meaning of this word is “good death”. Over time the evolution of the meaning has varied; even as we will see below was considered a form of eradication of people categorized under the designation of leading a less dignified life. Assisted suicide is a condition in which the patient is the one who carries out the action that ends his life through the ingestion of a lethal drug but has been dispensed in the context of health care and therefore called assisted. This care is provided by a physician trained in the area. However, it requires the prior coordination of a multidisciplinary team and even the assessment by an ethics committee to determine that the patient is exercising full autonomy, free from coercion by the situation he/she is living and free from the fatalistic desires of a psychiatric illness [ 9 ]. In a more literary sense, the word euthanasia meaning of “giving death to a person who freely requests it in order to free himself from suffering that is irreversible and that the person himself considers intolerable” [ 9 ].

Some authors go deeper into the definition and consider that for the meaning of euthanasia, are necessary to consider elements that are essential in the word itself; such as the fact that it is an act that seeks to provoke death and that carried out to eliminate the suffering in the person who is dying. Other elements with a secondary character in the definition are the patient's consent (which must be granted respecting autonomy and freedom in the positive and negative sense; that means the fact must be not be coerced in any way). Another element is the terminal nature of the disease, with an irreversible outcome that generates precariousness and a loss of dignity. The third secondary element is the absence of pain of the death through the use of drugs such as high-potency analgesics, including opioids, high-potency muscle relaxants, and even anesthetic drugs. Finally, the last element is the health context in which the action is performed (essential in some legislations to be considered euthanasia) [ 10 ]. According to the World Health Organization, the union of these two components is the current definition of euthanasia, which describes as “the action performed by a person to cause the painless death of another subject, or not preventing death in case of terminal illness or irreversible coma. Furthermore, with the explicit condition that the patient must be suffering physical, emotional, or spiritual and that affliction is uncontrollable with conventional measures such as medical treatments, analgesics, among others; then the objective of euthanasia is to alleviate this suffering” [ 11 ]. Unfortunately, the term euthanasia has been misused over the years, and other practices have been named with this word. An example of this situation occurred during the Nazi tyranny when the word euthanasia concerned the murder of people with disabilities, mental disorders, low social status, or gay people. At that time, euthanasia was even a simultaneous practice to the Jewish genocide [ 11 ].

Not only has the term been misused; also exists an enormous variability of terms to refer to euthanasia. For example, the laws created to regulate euthanasia have different names around the world; in the Netherlands (Holland), the law that regulates this practice is known as the law of termination of life; in Belgium, it is called euthanasia law, in France, it is called euthanasia law too. In Oregon (USA), it is called the death with dignity act; in California, it is the end of life option act. In Canada is called the medical assistance in dying act. Victoria (Australia) is the voluntary assisted dying bill, but all these denominations refer to the already well-known term euthanasia [ 11 ].

3. Evolution of euthanasia and assisted suicide: digging into historical events

To understand the evolution and relevance of these concepts should analyze the history of euthanasia and assisted suicide; from the emergence of the term, going through its first manifestations in antiquity; mentioning the conceptions of great thinkers such as Plato and Hippocrates; going through the role of the Catholic Church; mainly in the Middle Age, where following the thought of St. Thomas Aquinas, self-induced death or death contemplated by own will, was condemned. Later, with the renaissance age and the resurgence of science, technology, and the arts, the term euthanasia made a transition to a form similar to what we know today from thinkers such as Thomas More and Francis Bacon. Finally, the first signs of eugenics were known in London, Sweden, Germany, and the United States in the twentieth century. There was a relationship with the term euthanasia that was later used interchangeably, especially in the Nazi regime, to denote a form of systemic murder that sought to eradicate those who were not worthy of living a life.

Since the sixties, with emblematic cases, the path towards the decriminalization of euthanasia began in some countries, especially concerning the cessation of extreme support measures in cases of irreversible illness or a terminal condition. The practice has progressed to the appearance of laws on euthanasia in several countries.

4. Euthanasia and assisted suicide in ancient times

In book III of Plato's “The Republic”, the author stated that those who live their lives amidst illnesses and medicines or who were not physically healthy should be left to die; implying that it was thought that people in these conditions suffered so much that their quality of life diminished, which seemed understandable to these thinkers. However, other authors such as Hippocrates and his famous Hippocratic oath sought the protection of the patient's life through medicine, especially in vulnerable health conditions prone to fatal outcomes. This Hippocratic oath is the same oath that permeates our times and constitutes an argument among those who mark their position against euthanasia and assisted suicide [ 12 , 13 ].

Other texts that collect thoughts of Socrates and his disciple Plato point out that it was possible and well understood to think of ceasing to live in the face of a severe illness; to consider death to avoid a long and torturous agony. This fact is compatible with the conception of current euthanasia since this is the end of this health care procedure [ 13 ].

In The Republic, the text by Plato, the physician Heroditus is also condemned for inventing a way to prolong death and over manage the symptoms of serious illnesses, which is currently known as distanasia or excessive treatment prolongs life. This kind of excessive treatment prolongs the sick person's suffering, even leading him to maintain biological signs present but in a state of alienation and absolute dependence on medical equipment such as ventilators and artificial feeding [ 13 ]. However, the strongest indication that Euthanasic suicide was encouraged in Greece lies in other thinkers such as the Pythagoreans, Aristotelians, and Epicureans who strongly condemned this practice, which suggests that it was carried out repeatedly as a method and was therefore condemned by these thinkers [ 12 , 13 ]. According to stoicism, the pain that exceeded the limits of what was humanly bearable was one of the causes for which the wise man separates himself from life. Referring to one of the nuances that euthanasia touches today, that is, at a point of elevated suffering, the dignity and essence of the person are lost, persisting only the biological part but in the absence of the person's well-being as a being. In this sense, Lucius Seneca said that a person should not love life too much or hate it; but that person should have a middle ground and end their life when they ceased to perceive life as a good, worthy, and longed-for event [ 1 , 12 ].

During the Roman Empire and in the territories under its rule, it was believed that the terminally ill who commit suicide had sufficient reasons to do so; so since suicide caused by impatience and lack of resolution to pain or illness was accepted, when there was no access to medicines. In addition, there was little development in medicine during that time, and many of the sick died without treatment [ 12 ]. This situation changed later with the emergence of the Catholic church; in this age, who attempted against own life, was deprived of burial in the ground. Saint Augustine said that the suicide was an abominable and detestable act; from 693 AD, anyone who attempted against his physical integrity was excommunicated. Rejecting to the individuals and their lineage, depriving them of the possibility of attending the funeral and even expelled from cities and stripped of the properties they owned [ 12 , 13 ].

4.1. Euthanasia and assisted suicide in the Middle Age

During the Middle Age, Catholicism governed the sciences, arts, and medicine; the sciences fell asleep. Due to this solid religious tendency and the persistence of Augustinian thought, suicide was not well seen. It was not allowed to administer a lethal substance to a person to end the suffering of a severe or terminal illness [ 9 , 12 ]. People who took their own lives at this time could not be buried “Christianly”; therefore, they did not have access to a funeral, nor to the accompaniment of their family in a religious rite. Physical suffering and pain were then seen as a path to glorification. Suffering was extolled as the form that god purified the sin, similar to the suffering that Jesus endured during his Calvary days. However, a contrary situation was experienced in battles; a sort of short dagger-like weapon was often used to finish off badly wounded enemies and thus reduce their suffering, thus depriving them of the possibility of healing and was called “mercy killing” [ 12 ].

5. Euthanasia in renaissance

With the awakening of science and philosophy, ancient philosophers' thoughts took up again, giving priority to man, the world, and nature, thus promoting medical and scientific development. In their discourse, Thomas More and Francis Bacon refer to euthanasia; however, they give a eugenic sense to the concept of euthanasia, similar to that professed in the book of Plato's Republic. It is precise with these phylosophers that the term euthanasia got its current focus, referring to the acceleration of the death of a seriously ill person who has no possibility of recovery [ 12 ]. In other words, it was during this period that euthanasia acquired its current meaning, and death began to be considered the last act of life. Therefore, it was necessary to help the dying person with all available resources to achieve a dignified death without suffering, closing the cycle of life that ends with death [ 13 , 14 ].

In his work titled “Utopia”, Thomas More affirmed that in the ideal nation should be given the necessary and supportive care to the dying. Furthermore, in case of extraordinary suffering, it can be recommended to end the suffering, but only if the patient agrees, through deprivation of food or with the administration of a lethal drug; this procedure must be known to the affected person and with the due permission of authorities and priests [ 12 , 13 ]. Later, in the 17th century, the theologian Johann Andreae, in his utopia “Christianopolis”, contradicts the arguments of Bacon and Moro, defending the right of the seriously ill and incurably ill to continue living, even if they are disturbed and alienated, advocating for the care based on support and indulgence [ 15 , 16 ]. Similarly, many physicians rejected the concepts of Plato, Moro, and Bacon. Instead, they focused on opposing euthanasia, most notably in the nineteenth century. For example, the physician Christoph Hufeland mentioned that the doctor's job was only to preserve life, whether it was a fate or a misfortune, or whether it was worth living [ 16 ].

5.1. Euthanasia in the 20th century

Before considering the relevant aspects of euthanasia in the 20th century, it is vital to highlight the manuscript by Licata et al. [ 17 ], which narrates two episodes of euthanasia in the 19th century. The first one happened in Sicily (Italy) in 1860, during the battle of Calatafimi, where two soldiers were in constant suffering, one because he had a serious leg fracture with gangrene, and the other with a gunshot wound. The two soldiers begged to be allowed to die, and how they were in a precarious place without medical supplies, they gave them an opium pill, which calmed them until they died [ 17 ]. The second episode reported by Licata et al. [ 17 ] was witnessed by a Swedish doctor named Alex Munthe; who evidenced the pain of many patients in a Parisian hospital. So he decided to start administering morphine to help people who had been seriously injured by wolves and had a poor prognosis; therefore, the purpose of opioid use was analgesia while death was occurring.

It is also important to highlight the manuscript entitled “Euthanasia” by S. Williams published in 1873 in “Popular Science Monthly”, a journal that published texts by Darwin, Edison, Pasteur, and Beecher. This text included the report for the active euthanasia of seriously ill patients without a cure, in which the physicians were advised to administer chloroform to these patients or another anesthetic agent to reduce the level of consciousness of the subject and speed up their death in a painless manner [ 16 ].

Understanding that euthanasia was already reported in the nineteenth century, years after, specifically in 1900, the influence of eugenics, utilitarianism, social Darwinism, and the new currents of thought in England and Germany; it began in various parts around the world, projects that considered the active termination of life, thus giving rise to euthanasia societies in which there were discussions between philosophers, theologians, lawyers, and medical doctors. Those societies discussed diverse cases, such as the tuberculous patient Roland Gerkan, who was considered unfit and therefore a candidate to be released from the world [ 16 ]. The scarcity of resources, famine, and wars were reasons to promote euthanasia as a form of elimination of subjects considered weak or unfit, as argued in texts such as Ernst Haeckel's. However, opponents to the practice, such as Binding and Hoche, defended the principle of free will in 1920 [ 16 ].

5.2. Euthanasia in the time of the Nazis

As mentioned above, the term euthanasia was misused during this period; approximately 275,000 subjects (as reported at the Nuremberg International Military Tribunal 1945–1946), who had some degree of physical or mental disability, were killed during Adolf Hitler's Euthanasia program [ 13 ]. However, the Nazis were not the first to practice a form of eugenics under the name of euthanasia, since the early 1900s in London had already begun the sterilization of the rejected, such as the blind, deaf, mentally retarded, people with epilepsy, criminals, and rapists. This practice spread to different countries like Sweden and the United States [ 13 , 16 ].

For the Nazis, euthanasia represented the systematic murder of those whose lives were unworthy of living [ 13 ]. The name given to this doctrine was “Aktion T4”. At first and by law, from 1939, the hospitals were obliged to account for all disabled newborns, which led to the execution of more than 5000 newborns utilizing food deprivation or lethal injection [ 12 , 18 ].

A year before that law, in 1938, one of the first known cases of euthanasia in children arose in Germany. That history called the story of child K, in which it was the father of the minor who asked Hitler in writing for euthanasia for his son because the child had a severe mental disability and critical morphic disorders. Hitler gave his consent to carry out the procedure on child K, and thus the program began to spread throughout the Aleman territory. Since then, physicians and nurses had been in charge of reporting the newborns with alterations, arising the “Kinderfachabteilugen” for the internment of children who would be sentenced to death after a committee's decision [ 12 , 18 , 19 ]. A list of diseases and conditions that were considered undesirable to be transmitted to Hitler's superior Aryan race was determined; thus, any child with idiocy, mongolism, blindness, deafness, hydrocephalus, paralysis, and spinal, head, and hip malformations were eligible for euthanasia [ 19 ].

Subsequently, the program was extended to adults with chronic illness, so those people were selected and transported by T4 personnel to psychiatric sanatoriums strategically located far away. There, the ill patients received the injection of barbiturate overdoses, and carbon monoxide poisoning was tested as a method of elimination, surging the widely known gas chamber of the concentration camp extermination; this situation occurred before 1940 [ 12 , 19 ]. Again, physicians and nurses were the ones who designated to the patients to receive those procedures; in this case, these health professionals supported Nazi exterminations. They took the patients to the sanatoriums, where psychiatrists evaluated them and designated with red color if they should die and with a blue color if they were allowed to live (this form of selection was similar in children) [ 12 , 13 , 19 ]. In this case, the pathologies considered as criteria for death were those generating disability such as schizophrenia, paralysis, syphilis with sequelae, epilepsy, chorea, patients with chronic diseases with many recent treatments, subjects of non-German origin and individuals of mixed blood [ 19 ]. Once in the sanatoriums, they were informed that they would undergo a physical evaluation and take a shower to disinfect themselves; instead, they were killed in gas chambers [ 12 , 13 ]. Despite the church's action in 1941 against Nazis and after achieving suspension of the Aktion T4 project; the Nazi supporters kept the practices secretly, resuming them in 1942, with the difference that the victims were killed by lethal injection, by an overdose of drugs, or left to starve to death, instead of the use of gas chambers. This new modified form of euthanasia, which did not include gas chambers, became known as “savage euthanasia” [ 12 , 13 , 19 ].

5.3. Euthanasia since the 1960s

In September 1945, trials began for crimes perpetrated by Nazi supporters; the victorious Allied forces conducted these trials at the end of the war. During these tribunals, cases of human experimentation were identified and the public exposure of the Nazi euthanasia program. After the Nuremberg trials and the abolition of Nazi experiments, a series of seven documents emerged, among which the Nuremberg code containing the ten basic principles for human research stood out [ 20 , 21 ].

After these judgments, biotechnology was accelerated, with the apparition of new techniques to intervene in the health-disease process. Additionally, the increase in life expectancy and the appearance of diseases that chronically compromise the state of health of people generated a change in the conception of the critically ill patient and the terminal state of life [ 20 , 21 ]. Cases such as Karen Ann Quinlan brought to the forefront the issue of euthanasia and precisely the control of extreme treatment measures. Karen, a young American woman, was left in a vegetative state due to severe neurological damage following alcohol and barbiturate intoxication. After six months in that state and under the guardianship of a Catholic priest, Karen's parents requested the removal of the artificial respirator, arguing that in her state of consciousness prior to the incident, she had stated that she disagreed with artificially maintaining life in comatose patients. The hospital refused to remove the ventilator, arguing the legal issues for the date, and the parents went to court, which in the first instance granted the hospital the right. Nevertheless, the New Jersey Supreme Court granted Karen Ann's right to die in peace and dignity. Despite the withdrawal of the artificial respirator, he continued to live until 1985, when he finally died [ [21] , [22] , [23] ].

Another important case was Paul Brophy, which also occurred in the United States. Paul was a firefighter in Massachusetts and went into a deep coma due to the rupture of a basilar artery aneurysm; initially, his family advocated for support measures but later requested the hospital to disconnect these means to allow death, as Paul had indicated when he was still conscious. The hospital refused to carry out this procedure, so the family went to court, where the removal of the support measures (gastrostomy) was initially denied. Hence, the family went to the state supreme court, achieving the transfer of Paul to another medical center where the gastrostomy was removed, leading to his death within a few days [ 23 ].

The case of Arthur Koestler, an influential English writer and activist diagnosed with Parkinson's disease and later with leukemia, who served as vice-president of the voluntary euthanasia society (Exit) and wrote a manual book with practical advice for euthanasia called “Guide to Self-Liberation”. He stood out because he applied one of his advice and ingested an overdose of barbiturates, causing his self-death. According to his writings, Koestler was not afraid of death but of the painful process of dying [ 23 ]. In this sense, it was a relevant case because it involved someone who held an important position in an association that advocated euthanasia, in addition to being the author of several works, which made him a recognized public figure [ 23 ].

Baby Doe was a case that also occurred in the United States; it was a small child with Down syndrome who had a tracheoesophageal fistula and esophageal atresia; in this case, surgery was necessary. On the advice of the obstetrician, the parents did not allow surgery, so the hospital managers took the case before a judge who ruled that parents could decide to perform or not the surgery. The case was appealed before a county judge who upheld the parents' power to make the decision, in the course of which the case became public and many families offered to take care of the child; however, before the case reached the supreme court, the child died at six days of age [ 23 ].

In the case of Ingrid Frank, a German woman who was in a quadriplegic state by a traffic accident, who initially sought rehabilitation but later insisted on being allowed to die; it was provided with a drink containing a cyanide solution that she drank. At the same time, she was filmed, which shows a kind of assisted suicide. For that reason, this is another case that deals with this issue and is important to know as background in the development of euthanasia and assisted suicide [ 22 , 23 ].

6. Current and future perspectives

The definition of brain death, the rational use of the concept of euthanasia and assisted suicide, and scientific literacy are the objectives of global bioethics to regulate euthanasia and assisted suicide, which can be accessible in all health systems [ [24] , [25] , [26] , [27] , [28] , [29] , [30] ]. End-of-life care will continue to be a subject of debate due to the struggle between biomedical principles, the different existing legal frameworks, and the general population's beliefs. Medical education and preparation in the perception of death, especially of a dignified death, seems to be the pillar of the understanding of the need to develop medical-legal tools that guarantee the integrity of humans until the end of their existence [ 31 , 32 ]. This is the reason why the new generations of physicians must be trained in bioethics to face these ethical conflicts during the development of their professional careers.

In addition, although the conception of bioethics belongs to the Western world, it is crucial to take into account the point of view of other cultures and creeds, for example, a study carried out in Turkey, where nursing students were questioned, found that many of them understood the reasons for performing euthanasia; however, they know that Islam prohibits it, as well as its legislation, and therefore they would not participate in this type of procedure [ 33 ]. Furthermore, Christianism and Islam prohibit euthanasia, but Judaism also prohibits it; in general, the so-called Abrahamic religions are contrary to any form of assisted death, whether it is active euthanasia, passive, or assisted suicide [ 34 ].

7. Conclusiones

The history and evolution of euthanasia and assisted suicide have been traumatic throughout human history. The church, politics, and biomedical research have been decisive in defining these concepts. Over the years, the legal framework and bioethical concepts on euthanasia have been strengthened. However, there is still much work to educate the general population and health professionals about end-of-life care and dignified death.

It is also important to remember that life is a concept that goes beyond biology. Currently, bioethics seeks to prioritize the concept of dignity, which must be linked to the very definition of life. Although the phrase is often heard that it is not necessary to move to be alive, what is important is that person feels worthy even if they have limited movement. The person's treatment must be individualized in bioethics since each individual is a unique unit. Therefore, medical paternalism must be abandoned. Instead, the subject must be more involved to understand their context and perception of life and dignity.

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All authors equally contributed to the analysis and writing of the manuscript.

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Not commissioned, externally peer reviewed.

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Sabrina Rahman. Independent University, Dhaka, Bangladesh. [email protected] .

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Home / Essay Samples / Health / Euthanasia / Euthanasia: Examining the Ethics and Personal Views

Euthanasia: Examining the Ethics and Personal Views

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• Topic: Death , Ethical Dilemma , Euthanasia

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