Should euthanasia be legalised as a method of treatment for terminal illnesses?

Euthanasia is the painless termination of a patient suffering from an incurable and painful disease in a bid to end their suffering. This is becoming more and more widely discussed among medical professionals, even though it is illegal in the majority of places across the globe, such as here in the UK. Currently, instances in the UK described as euthanasia are treated as murder or manslaughter and could lead to a minimum of 14 years in prison for even discussing this matter, due to the Suicide Act 1961, directly contradicting the whole idea of assisted suicide. There have since been reviews on the 1961 Act but no significant changes, even after the Human Rights Act 1998, with campaigners claiming the law denies the right to release oneself from unbearable pain. However, this is not a clear-cut subject with many religious, moral and professional standpoints deployed against euthanasia, dividing opinions worldwide. I will aim to discuss these and many more views on whether it is, and should be, a viable treatment option. Personally, I believe that voluntary assisted dying (a case where the sick person themselves makes the choice rather than someone else) should be made legal simply because there are a huge number of incurable maladies – Parkinson’s disease and ALS – that force the patient to endure a life of pain and prolonged palliative care, which could be averted with the legalisation of euthanasia.

In an article presented by Courtney S. Campbell, the Hundere Professor in Religion and Culture at Oregon State University, he states there is little scope for religion to become lenient towards physician-assisted suicide. This can be summarised in his claim that all religions “begin with a strong predisposition to favour the preservation of life”. In all major religions we owe our lives to God, which thus “bestows a sacredness upon human life”. For example, in Roman Catholicism and Judaism euthanasia is seen as a sin and is a strong reason as to why countries such as the Republic of Ireland have stronger views for not legalising it. This article is very convincing in showing just how the majority of religions do not intend to incorporate such beliefs, and this is partly due to the credible nature of Courtney S. Campbell who is a Religious professor in a state where euthanasia is legalised, showing the clear knowledge he possesses. Campbell also states the other viewpoint that few people (such as Buddhism) see it as “mercy killing” and compassion to end suffering, but identifies that it is only a select few compared to the dominating religious idea.

On the face of it, from an economic standpoint, euthanasia can seem like something to be praised about, as it is far cheaper than keeping someone in a hospital for pointless treatments. However, in an article presented by J. Pereira, he states this has led to a long term negative impact whereby patients are almost pressured into undergoing euthanasia as it is a cheaper option for them and there healthcare system. This can be summed up in his claim of the Netherlands moving from it being regulated to “people who are terminally ill, to euthanasia of those who are chronically ill, physically ill, mentally ill – and now simply if a person is over the age of 70 and ‘tired of living’”. Although this is the case in the Netherlands and many other places where it has been legalised, and I do not agree with this broader range and less-restrictive form of assisted suicide, with heavy restrictive laws in place it will stop it from leading to this slippery slope. Pereira does not identify those places where it has led to success and is only used on terminally ill patients, such as Switzerland, and cherry picking facts from the countries such as Netherlands and Belgium, leading to skewed facts. Although this is a potential problem, it can be negated by following the structures that successful countries have shown.

As euthanasia is defined as the painless termination of a patient suffering, I think this is the main benefit for legalising euthanasia – the idea of showing compassion towards a patient and respecting their wishes. Ethically, this is the role of a doctor rather than just being a healer, and with the many people who have and will be diagnosed with a terminal illness, a large proportion of them will be in a position where the pain the face is too much to take. That is where physician-assisted suicide comes in. It allows patients to decide when and how they want to end their life, painlessly. Currently in the UK 300 people linked with a terminal illness end their own lives. This would be in a far more painful way than a lethal injection, and definitely not how they wanted it to end. Euthanasia gives people this option to do so, surrounded by family and doing so peacefully. Although many would argue the right to live is important, it is not because man (or woman) has a body, but because man lives like a human being, and certainly some diseases stop this basic necessity. Life is a beautiful thing, but a terminal illness may change that into agony and worry, and for some euthanasia is the only relieve the pains.

Some may argue that there are other options such as palliative care and hospices, which allow the final years, months or weeks of a patient to be tolerable. Firstly, is tolerable a life we want people to live? Secondly, even after all the advancements in medicine the ability of modern medical care is limited.

However, there is the religious argument that prevents a majority of states from legalising this ‘sinful’ act. It is deemed that God created life and it should be celebrated by living it to its fullest and not ending it. The right to live is important in all religions, such as Christianity, Judaism and Hinduism. The most vigorous opposition has come from Pope John Paul II who describes it as example of the “culture of death” and it abandons the protection of life.

Although few in number, there are individual theologians within both the Jewish and Christian traditions for whom euthanasia is not a contradiction but a culmination of religious values such as compassion, mercy and love.

Another moral stance for why euthanasia should not be legalised is the fact that many people who contemplate assisted suicide are in so much pain that they are not mentally capable to make such as important decision. Yet the decision they are making is based upon a valid justification, and it is affecting their judgement, but all decisions are made upon a reason, and living in such excruciating pain is as justified a reason as one can get. Also, that is why in certain states and countries where it is legalised, the patient is given plenty of time to reflect on their emphatic decision, so they are able to make a capable and justified decision, weighing out all the risks and benefits it would entail.

Finally, the economic argument provides a good reason as to why euthanasia should be legalised. Euthanasia provides a very cheap alternative to patients who would not be benefitting from expensive treatment. Not only is it a financial burden to the individuals, but mainly to the healthcare system. This allows resources to be distributed to patients that would actually benefit from it, rather than those who only need it for palliative care. Likewise, terminally ill patients can help others who need organ transplants, again showing the same idea of distributing resources to where they are needed most. Especially with the donor crisis the NHS is experiences, with many people having to wait years before they get a transplant, this could certainly alleviate some of the stress.

However, this could lead to a situation where many more people are abusing this ‘cheap’ system simply because they cannot afford the treatment. For example, in Oregon they displayed pressures when the state Medicaid informed patients that many prescriptions and painkillers would not be covered but assisted suicide would. In effect this indirectly pushed them towards this option, simply because they cannot afford the high costs of drugs that are not associated with physician-assisted suicide. Another potential problem that could once it has been implemented is the ‘slippery slope effect’. Because patients with certain illnesses are viable to undergo assisted suicide, why aren’t others? Eventually it could get to that stage where it will be practiced on individuals who are not terminally ill, but suffer from depression and other psychiatric illnesses, and is just another option for suicide.

But there is one simple solution to negate this. That is to maintain strong laws and a very good regulatory system to ensure that only terminally ill people who have the mental capacity to decide are eligible, benefitting those who won’t benefit from any other method of treatment.

To conclude, I would say that euthanasia should be legalised as a method of treatment for terminal illnesses. As mentioned, the question of legalising physician-assisted suicide is a very complex matter, as there are a plethora of different opinions, not only between countries, but individuals within a country. This in turn stops any real push towards any legislation being made about this topic, predominantly due to the huge backlash that will be evident no matter what the outcome. For example in a survey to determine attitudes among NHS doctors about moving the law on euthanasia towards how it currently is in Netherlands, 146 agreed with the statement, 103 disagreed and 60 were undecided. This clearly shows how many health professionals differ on what the law should be, and only takes us many steps back in deciding what to do. On the other hand, it has been successfully done in Switzerland and other countries, showing how it can work well to achieve the aim of giving someone the choice to end their life in extreme circumstances.  I believe that this is necessary and part of the reasons why people chose to become doctors – to show compassion to the patients situation and empathise with the difficult position they have unfortunately been put in. Looking at the many personal stories of people who have been diagnosed with motor-neurone diseases, ALS, Parkinson’s, terminal cancer, and have to suffer their last years in pain, it only strengthens the argument for having euthanasia as an applicable treatment option. Although there are other arguments for doing so, such as economic reasons, the morals and personal stories behind it are what aligns my view towards the way it is. However, there are huge barriers towards setting it up, and once it is set up there must be a fixed procedure to stop many people that are not terminally ill to undergo euthanasia. The current steps in Netherlands, Washington, California and Oregon are vital in doing so, and would have to be implemented in the UK if we were to legalise euthanasia. They are only limited to terminally ill AND mentally competent adults, with the cases assessed by doctors and a high court judge, to ensure that patients aren’t undergoing euthanasia themselves as they are too poor to afford treatment or because they don’t have the mental capacity to make a wise decision. It also doesn’t force doctors who do not want to perform euthanasia to do so, respecting their views and interests. Although it is an extremely difficult subject to implement into the NHS, I believe doing so (with a heavily restricted regime, limiting it to only terminally ill patients) would only fruit benefits to the 300 dying people who end their own lives in this country every year and many others.

Bibliography:

  • Euthanasia and Religion by Courtney S. Campbell
  • The Economic Incentive for Assisted Suicide: Life is Expensive, But Death Is Free by Hans von Spakovsky
  • https://www.bmj.com/content/assisted-dying
  • https://www.dignityindying.org.uk
  • Attitudes Among NHS Doctors to Requests for Euthanasia by P A Tate
  • The Ethical Considerations of Physician-Assisted Suicide by Madeline Jordan
  • Legalising Euthanasia: The Illusion of Safeguards and Control by J. Pereira

Photo Credits due to: https://dailytimes.com.pk/261370/the-emerging-debate-on-euthanasia/

Rushil Shah