Introduction
Humanitarian and ethical concerns of euthanasia (assisted suicide) are some of the most discussed points in the medical ethics of the 21st century. The societies around the world are divided on the subject, as it concerns many aspects of the existing legal, governmental, medical, economic, and religious systems in place. As of February 2018, 12 countries had euthanasia and assisted suicide legalized. These countries include Colombia, Belgium, Netherlands, Canada, Luxembourg, India, Switzerland, Germany, Japan, South Korea, Australia (one state), and the USA (some states) (“Euthanasia regulations,” 2018). However, the majority of the world does not allow for assisted suicides and euthanasia to take place in their clinics and hospitals.
The need for euthanasia arose from the existence of many untreatable diseases and conditions associated with extreme pain and low quality of life. The major argument offered by the supporters of euthanasia is that it would be more ethical to allow the person to die rather than artificially prolong the life of suffering. The opposition to euthanasia is largely concerned with legal, governmental, religious, and political implications of the policy, pointing out various ways, in which “government-sanctioned murders” can be abused (Doherty & Purtilo, 2015). Debates around the issue of euthanasia largely revolve on utilizing various sets of arguments, the value of which is subjective to every individual. However, medicine is a practice heavily governed by ethics, which are often left out of the analysis in favor of specific arguments. The purpose of this paper is to assess whether assisted suicide would be a humanitarian way out for patients and families through the prism of utilitarian ethics, Kantian ethics, and rights ethics.
Euthanasia and Utilitarian Ethics
The majority of arguments offered for the legalization of euthanasia are utilitarian. Jeremy Bentham introduced utilitarian ethics at the beginning of the 19th century, but the roots of the concept could be traced back to Epicurean philosophy (Mandal, Ponnambath, & Parija, 2016). Utilitarian ethics works on principles of maximizing pleasure and minimizing human suffering. Many nursing ethical frameworks include the promotion of health and improvements to the quality of life, which adhere to the ideas of utilitarian ethics. Supporting a critically ill patient causes a lot of suffering not only to the patient but to their families as well. In such a context, taking the patient’s life would be an appropriate course of action, according to utilitarian ethics. Thus, the utilitarian framework largely supports the idea of euthanasia.
Euthanasia and Kantian Ethics
Kantian deontological ethics were introduced by Emmanuel Kant, an 18th – century thinker and philosopher, in a series of works titled “Groundwork of the Metaphysic of Morals,” “Critique of Practical Reason,” and “Metaphysics of Morals” (Donaldson, 2017). His views had a strong influence on the development of medical ethical frameworks in Europe. His ideas of ethics revolve around the concept of duty and morality as values separate from the results of the actions. The reason why Kantian ethics became popular in medicine is because of the main postulate, upon which the framework is based: “Treat people as ends-within-themselves, rather than means to something else.” Although the matter of euthanasia is not specifically mentioned in Kant’s works, it is possible to extrapolate his ethical framework upon the issue. According to Donaldson (2017), Kantian ethics view euthanasia as immoral based on the principle of life being an end-within-itself, as neither the patients nor their families have the moral right to treat their lives as means to their ends.
Euthanasia and Rights-Based Ethics
Rights-based ethics were first introduced by John Locke, an English 17th-century philosopher, who came up with the concept of natural and unalienable rights that human beings are entitled to by simply existing (Brazier & Cave, 2016). The existing declaration of human rights was built upon Locke’s ideology. In regards to euthanasia and assisted suicide, the rights approach does not offer a conclusive answer, as the majority of the debates revolve around the argument on whether or not the right to die is an unalienable and essential human right or not (Brazier & Cave, 2016). According to the supporters of euthanasia, terminally ill persons have a right to avoid excruciating pain and embrace a timely and dignified death. Rights to marriage, relationships, procreation, and the termination of life-saving medical treatment indirectly support this notion. The opposition to the right for assisted suicide is based on the historical rejection of virtually any attempts to legalize it, which implies that the right for assisted suicide is not a fundamental right protected by the Due Process Clause (Brazier & Cave, 2016).
Euthanasia from a Physician’s Perspective
The majority of the debates regarding euthanasia are surprisingly one-sided in that they involve only the side of the patient and his or her immediate relatives, but rarely take the physician tasked with the prospect of ending another person’s life into consideration. If from the patient’s side of things, the three ethical frameworks offered an inconclusive response (one pro, one against, one undecided), if we take the doctor’s perspective, it is a different story.
Utilitarian perspective, in this case, is inconclusive, as the balance between suffering from having to see a terminal patient endure pain versus ending the patient’s life would differ from one physician to another. The majority of physicians, however, express extreme discomfort with the idea of killing someone, even on request, as it contradicts the very premise of their profession and violates the first tenet of the Hippocratic Oath, which is to not cause any harm to the patient (Doherty & Purtilo, 2015).
From Kantian duty-based perspective, the obligation of a physician to assist in ending a patient’s life creates a major contradiction with the very basis of the ethical framework – on one hand, it forbids killing others, while on the other it forces the doctor to follow their duty and perform the euthanasia (Holland, 2015). Thus, from a Kantian perspective, it is not ethical for the physician to perform the procedure.
The necessity to perform the euthanasia would also cause a contradiction between the patient’s alleged right to assisted suicide and the doctor’s right to refuse based on ethical concerns and religious beliefs. Resolving this conundrum would inevitably deprive either the patient or the physician of their rights (Holland, 2015).
Based on the physician’s perspectives in regards to euthanasia, it can be concluded that neither framework perceives the procedure as ethical.
Conclusions
Euthanasia and assisted suicide are morally dubious actions that cannot be completely justified while taking the interests, duties, and rights of every party involved in the process. At the same time, the procedure is associated with many concerns in regards to abuse by various parties – the government, the medical workers, the families, and the patients themselves, who would prefer the easy way out instead of a long, but potentially effective treatment. While euthanasia provides potential outlets for suffering patients and families, it usually puts a tremendous moral strain on the physicians operating. From an ethical perspective, justifying euthanasia is difficult, as it violates the tenets of the majority of ethical frameworks that medicine is based upon. It is concluded that euthanasia, while a quick and convenient way out for some patients, is far from being humanitarian or ethical.
References
Brazier, M., & Cave, E. (2016). Medicine, patients, and the law (6th ed.). Manchester, UK: Manchester University Press.
Doherty, R. F., & Purtilo, R. B. (2015). Ethical dimensions in the health professions (6th ed.). New York, NY: Elsevier.
Donaldson, C. M. (2017). Using Kantian ethics in medical ethics education. Medical Science Educator, 27(4), 841-845.
Euthanasia regulations around the world. (2018). Web.
Holland, S. (2015). Public health ethics (2nd ed.). Cambridge, UK: Polity Press.
Mandal, J., Ponnambath, D. K., & Parija, S. C. (2016). Utilitarian and deontological ethics in medicine. Tropical Parasitology, 6(1), 5-7.