From the Guidelines
Ethics of Euthanasia
Euthanasia, or mercy killing, is not advisable due to the potential for abuse and the importance of upholding the value of human life [ 1 ].
Palliative Care and Symptom Management
In situations where patients are experiencing unbearable suffering, palliative care and symptom management should be prioritized. This may include the use of medications such as:
- Morphine
- Fentanyl
- Midazolam to alleviate pain and discomfort [ 1 ]. The dosage and duration of these medications should be carefully titrated and monitored by a qualified healthcare professional to ensure effective symptom control while minimizing the risk of adverse effects.
Approach to Each Situation
It is essential to approach each situation with caution and consider the individual patient's circumstances, values, and wishes. A thorough discussion with the patient, their family, and the healthcare team is necessary to determine the best course of action [ 1 ]. In general, it is recommended to focus on providing compassionate and supportive care, rather than resorting to mercy killing. The rule of double effect holds that an action undertaken with the intent of achieving a benefit is morally acceptable even if it has a harmful side effect, provided that the harmful side effect is not intended, the side effect is not the cause of the benefit, and the benefit outweighs the harm [ 1 ]. Vigorous management of pain and symptoms at the end of life is ethical, even if the risk for shortening life is foreseeable, if the intent is to relieve those symptoms [ 1 ].
Key Considerations
- Patient autonomy is critical and must be respected, but it is not absolute and must be balanced with other ethical principles [ 1 ].
- Physicians have duties to patients based on the ethical principles of beneficence, nonmaleficence, respect for patient autonomy, and promotion of fairness and social justice [ 1 ].
- The law and ethics surrounding euthanasia vary by country and region, with some places legalizing physician-assisted suicide and others rejecting it [ 1 ].
- The U.S. Supreme Court has overruled lower courts that had found a constitutional right to physician-assisted suicide [ 1 ].
From the Research
Definition and Types of Euthanasia
- Euthanasia, also known as mercy killing, is the act of inducing death, often in terminally ill individuals, for reasons assumed to be merciful 2.
- It can be classified into two main types: active and passive euthanasia, and voluntary and involuntary euthanasia 2.
- Active euthanasia involves the use of an agent, such as a drug, to terminate life, while passive euthanasia refers to the withholding of potentially life-prolonging treatment 2.
Moral and Ethical Considerations
- The concept of mercy killing is filled with moral and ethical dilemmas, as well as legal implications 2, 3.
- The term "mercy killing" can be ambiguous and has been used to characterize different types of killings, including acts of punitive leniency, killings motivated by pity, and voluntary or involuntary euthanasia 3.
- Some argue that mercy killing can never be morally defended, and that there is a significant moral difference between allowing a person to die with care and actively killing them 4.
Legal and Social Implications
- Euthanasia is viewed differently in various countries, with some considering it a murder, while others have decriminalized it as a medical procedure 5.
- The concept of euthanasia raises practical and ethical questions, particularly with regards to living wills and informed decision-making between patients and healthcare professionals 6.
- It is essential to understand the social impact of euthanasia and to distinguish it from suicide, while also considering the interference of religion and legal differences between countries 6, 5.