From the Guidelines
Euthanasia, also known as mercy killing, is the intentional termination of a patient's life to relieve pain or other suffering, typically through lethal injection or other medical means. This practice is highly controversial and is only legal in a limited number of countries and jurisdictions, including the Netherlands, Belgium, Luxembourg, and Colombia, as noted in a 2017 position paper by the American College of Physicians 1. The methods used for euthanasia vary, but they often involve a combination of sedatives and neuromuscular blocking agents to induce unconsciousness and respiratory arrest.
Key Considerations
- Euthanasia is distinct from physician-assisted suicide, although both practices are intended to relieve suffering, as discussed in the 2017 paper 1.
- The ethical debate surrounding euthanasia centers on balancing patient autonomy and relief of suffering against concerns about potential abuse, the sanctity of life, and the medical profession's traditional role in healing rather than hastening death.
- Laws and regulations regarding euthanasia vary significantly worldwide, with some countries and jurisdictions permitting the practice under specific circumstances, while others prohibit it entirely, as noted in the 2017 paper 1.
Medical and Ethical Principles
- The principles of medical ethics, including beneficence, nonmaleficence, respect for patient autonomy, and promotion of fairness and social justice, guide the debate on euthanasia, as established in the 2017 paper 1.
- Physicians have a duty to relieve suffering and respect patient autonomy, but they must also avoid harm and promote fairness and social justice.
- The decision to undergo euthanasia must be made voluntarily and with informed consent, after extensive evaluation, including psychological assessment, confirmation of terminal illness, and verification that the patient is making an informed decision, as emphasized in the 2017 paper 1.
From the Research
Definition of Euthanasia
- Euthanasia is defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering" 2
- It can be further divided into voluntary and involuntary euthanasia, with the former occurring when a competent patient makes an informed request for a life-terminating event, and the latter occurring when a patient does not give informed and specific consent for such treatment 2
Types of Euthanasia
- Euthanasia can be separated into active and passive forms, with active euthanasia involving deliberate steps to end a patient's life, and passive euthanasia involving the withholding of treatments necessary for the continuance of life 2
- Some authors consider the terms "active" and "passive" euthanasia to be misleading and unhelpful, but they are still used in the literature and discussion 2
Key Issues in the Euthanasia Debate
- The establishment of standardized criteria for euthanasia eligibility 3
- The investigation of public attitudes regarding acceptable means for engaging in euthanasia 3
- The evaluation of the roles of professionals who are directly involved in euthanasia decisions 3
- The balance between the respect of autonomy, self-determination, and forestalling suffering, and the concerns regarding the interpretation of the constitutional right to life and the impacts of assisted dying on the doctor-patient relationship 4
Complexity of Euthanasia
- Euthanasia is a complex and contentious issue that crosses numerous perspectives and theoretical orientations 3
- It involves difficult decision making for health workers, particularly when existential quality of life issues are the focus 5
- The issue is further complicated by the need to interpret the concept of a patient's right, or autonomy, versus the rights and duty of a doctor 2