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  • v.111(11); 2018 Nov

Euthanasia and assisted dying: what is the current position and what are the key arguments informing the debate?

Andreas fontalis.

1 St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK

Efthymia Prousali

2 Aristotle University of Thessaloniki, 54124 Thessaloniki Greece

Kunal Kulkarni

3 University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK

Assisted dying is a highly controversial moral issue incorporating both physician-assisted dying (PAD) and voluntary active euthanasia. End-of-life practices are debated in many countries, with assisted dying receiving different consideration across various jurisdictions. In this paper, we provide an analytic framework of the current position and the main arguments related to the rights and moral principles concerning assisted dying. Assisted dying proponents focus on the respect of autonomy, self-determination and forestalling suffering. On the other hand, concerns are raised regarding the interpretation of the constitutional right to life and balancing this with the premise of assisted dying, alongside the impacts of assisted dying on the doctor–patient relationship, which is fundamentally based on trust, mutual respect and the premise of ‘first do no harm’. Our review is underpinning the interpretation of constitutional rights and the Hippocratic Oath with the premise of assisted dying, alongside the impacts of assisted dying on the doctor–patient relationship. Most clinicians remain untrained in such decision making, with fears against crossing key ethical divides. Due to the increasing number of cases of assisted dying and lack of consensus, our review enables the integration of ethical and legal aspects and facilitates decision making.

Introduction

Assisted dying remains a highly controversial moral issue, with clinical, legal, political, religious and ethical considerations playing an important role. Lack of consensus and ongoing debate are features of modern life, while the law generally sustains a broader, pluralist outlook. Advances in both life-prolonging treatments and palliative care in recent years are inextricably intertwined with this complex topic, resulting in the continuing demand for amendments on current legislations. 1 This review presents an overview of the current status of this topical debate.

Definition and current legal framework

Assisted dying is a general term that incorporates both physician-assisted dying and voluntary active euthanasia . Voluntary active euthanasia includes a physician (or third person) intentionally ending a person’s life normally through the administration of drugs, at that person’s voluntary and competent request. 2 , 3 Facilitating a person’s death without their prior consent incorporates both non-voluntary euthanasia (when the patient is not capable of providing informed consent, e.g. vegetative state, young child) and involuntary euthanasia (against patient’s will). Physician-assisted dying is defined as follows: a physician intentionally helping a person to terminate their life by providing drugs for self-administration, at that person’s voluntary and competent request. 2 , 3 Consequently, in the first case a third person acts resulting in patient’s death, whereas in physician-assisted dying the action is undertaken by the patient who is given lethal medication by a physician. 2

Discussion regarding withholding or withdrawing treatment and requesting assisted death has emerged in association with the simultaneous expansion of palliative care across the world. The World Health Organization defines palliative care is an approach that

improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. 4

It intends to neither hasten nor postpone death. Nonetheless, in practice, terminally ill patients – often with full mental capacity – may develop a loss of self-determination as their condition deteriorates and express a desire for assisted dying to alleviate intractable physical symptoms.

Assisted dying is an emotionally and ethically challenging subject, which understandably receives varying degrees of acceptance among different global jurisdictions. Currently, there is legal provision for assisted dying (or variants) in only four European countries (the Netherlands, Belgium, Switzerland and Luxemburg), Canada, Colombia and the United States of America (USA) states of Oregon, Washington, Montana, Vermont, California, Colorado and Washington, DC, representing nearly 18% of the US population. 5 , 6 Switzerland is the only country which permits the act of assisted dying performed by a non-physician. Moreover, non-Swiss citizens can exploit the Swiss law by visiting Switzerland in order to access assisted dying. 7 In these more tolerant jurisdictions, palliative care is seen as an important link in the same chain as assisted dying in caring for terminally ill individuals, rather than an alternative. Elsewhere in the world, an assisted death remains a criminal offence, prosecutable through various legal routes. For example, in the UK, all forms of assisted dying remain illegal and can be considered under criminal laws of manslaughter or murder, or under the Suicide Act (1961), depending on the circumstances. 6 Prosecution guidelines were first issued by the Director of Public Prosecutions in 2009 following House of Lords ruling in the case of Debbie Purdy, which stated that there was ambiguous guidance regarding when people would be prosecuted for encouraging or assisting suicide. The guidelines suggest that while each case will be assessed on its relative merits, individuals acting in the capacity of a healthcare professional are more likely to be prosecuted for assisting or encouraging suicide, although to date no report-providing doctor or accompanying individual has been prosecuted for helping patients to travel abroad from the UK to end their life. 8 In England and Scotland, three assisted dying bills have been proposed and debated, largely based on the Oregon Death with Dignity Act (1997) from the USA, which permits assisted dying; none were passed.

We performed a systematic search of MEDLINE and EMBASE databases from conception to January 2018. The search terms used were ‘euthanasia’, ‘assisted dying OR death’, ‘assisted suicide’, ‘medical ethics’, ‘autonomy’, ‘end of life’ and ‘sanctity of life’. We also combined free text searching with Medical Subject Headings (MeSH) terms and no restrictions were set in publication date, study design and publication status.

Principles of bioethics

Autonomy and right to life.

Beauchamp and Childress developed a standard approach to bioethics and advocated for four principles that lie at the heart of healthcare ethics and underpin decision-making. 9 , 10 Respect for autonomy is one of the fundamental concepts, in combination with justice , beneficence and non-maleficence .

In medical practice, autonomy describes the right of competent adults to make informed decisions about their own medical care, prior to any investigation or treatment taking place. For a physician, respect for autonomy includes acknowledging and preserving a patient’s right to self-determination and providing the necessary guidance, which would allow for an informed and independent choice, free of coercion.

However, autonomy is far from a straightforward consideration. Onora O'Neill, in an attempt to scrutinise the context of autonomy in her Gifford lectures, makes a clear and compelling distinction between the approach of John Stuart Mill and Kant regarding the subject of autonomy. 11 As O’Neill vividly describes, Mill stretches the bound of choice and ‘sees individuals not merely as choosing to implement whatever desires they happen to have at a given moment, but as taking charge of those desires, as reflecting on and selecting among them in distinctive ways’. 11 The Kantian version of autonomy is guided by a ‘practical reason’. Kant views autonomy as ‘a matter of acting on certain sorts of principles, and specifically on principles of obligation’ rather than a form of self-expression and supports that ‘there can be no possibility of freedom for any one individual if that person acts without reference to all other moral agents’. 12 O’Neill embraces the Kantian view and contextualises it as ‘principled autonomy’ compared to ‘individualistic autonomy’. O’Neill’s work vigorously illustrates the fragility of the concept of autonomy and its contingency on a number of other considerations, particularly the network of human relationships within which it features.

The greatest expression of autonomous self-determination is the right of ‘capacitous’ adults to refuse any proposed intervention (irrespective of rationality), even if this decision could result in harm or death, provided they are capable of freely reaching a decision in the above manner. For this reason, obtaining informed consent from a patient after they have been offered all the relevant information regarding their situation is of paramount importance. During the past decades, the development of liberal democracies has highlighted the significance of self-determination, with healthcare systems increasingly adopting more patient-centred approaches to care decisions. The right to bodily autonomy has also been enshrined under Article 8 ( Table 1 ) of the European Convention on Human Rights (ECHR).

Article 8: Right to respect for private and family life.

1. Everyone has the right to respect for his private and family life, his home and his correspondence.
2. There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic wellbeing of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others.

Taking the above into consideration, Article 8 encompasses inter alia the right to personal development. In a technical legal sense within the jurisdiction of Swiss law, it includes a patient’s choice to avoid what they consider an undignified and severe end to their life. 14 Proponents of this highly contentious argument claim that seriously ill patients should have a choice in whether or not they wish to continue living with a condition that undermines their inherent dignity and personal identity, 15 without violating the principle of sanctity of life. Therefore, it can be argued that respecting autonomy inherently involves the prima facie right of a patient to control the circumstances and time of death by requesting help in dying. This could minimise the suffering of an individual or their family and improve the quality of the end of the patient’s life, as their wishes would be respected and dignity would be preserved. 16 , 17

A further dimension that can be considered is the treating clinician’s ethical beliefs and values. During their training, most practising clinicians have not experienced the concept of assisted dying as an expected duty in the context of patients’ autonomy. 18 Nevertheless, it is important to consider the magnitude of patients’ autonomy within modern society. Individual liberty ought not to be viewed as absolute and exceptions to Article 8 should be provided in favour of preservation and reverence to life. 17 , 18

The right to life is guaranteed by Article 2 ( Table 2 ) of the European Convention on Human Rights. Under Article 2, the State is enjoined to abstain from the deliberate and illicit taking of life, as well as to protect vulnerable people against actions by which they could jeopardise their lives. The principle of sanctity of life emerges frequently in modern discussion, particularly in Anglo-American bioethics, surrounding public controversy about end of life and abortion issues. Yet, its moral foundation is rarely unriddled and understood. The sanctity of life position asserts that life has sanctity and its value prevails all other values. No individual’s life deserves priority, and sanctity is attributed to life regardless of the physiological status, imminence of death, suffering or individual’s wishes to live or die. 19

Article 2: Right to life.

1. Everyone’s right to life shall be protected by law. No one shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law.
2. Deprivation of life shall not be regarded as inflicted in contravention of this Article when it results from the use of force which is no more than absolutely necessary:
(a) in defence of any person from unlawful violence;
(b) in order to effect a lawful arrest or to prevent the escape of a person lawfully detained;
(c) in action lawfully taken for the purpose of quelling a riot or insurrection.

This argument is often associated, but not fully equated, with religious and cultural traditions that generally object to assisted death, because human life is viewed as God’s sovereign creation. From a religious perspective, God is considered the only one who can determine the beginning and end of human life. The sanctity of life is a value also clearly mirrored under Article 9 of the European Convention on Human Rights, which refers to freedom of thought, conscience and religion. 13 It is notable, though, that Article 2 does not encompass assisted dying, i.e. in situations where a person’s decision to end their life has been taken independently and with absolute perception of what it implied.

The crucial issue is therefore one of balance . Patient autonomy has to be balanced against the principle of sanctity of life. It should be acknowledged though that the autonomy argument is secondary in its applicability on whether assisted dying is ethically permissible and cannot solely guide decisions on what is morally impermissible, as it constitutes only a piece of the puzzle. The right to end a life that an individual finds intolerable has to be considered in association with its resulting impact on other rights, regulations and the responsibilities of healthcare professionals in facilitating assisted dying. 18

As discussed, justice constitutes one of the main four fundamental principles of medical ethics. All individuals in a society should be treated equally and impartially. One of the arguments that has monopolised the debate concerning assisted dying is the ‘slippery slope’. According to this, should assisted suicide be established, then it might be applied in circumstances that fall outside the scope of morally permissible cases, such as in patients who may not be fully competent. 17 Furthermore, if a person is motivated by means other than his own will, for example through external coercion, then patient autonomy is infringed.

In this regard, concerns are raised about vulnerable populations, such as the terminally ill, the mentally incapacitated and the elderly. There remains the understandable fear that assisted dying could potentially lead society toward an attitude that suffering should not be a part of life, interdependency is a burden and the lives of disabled of terminally ill individuals are not worth living. 20 The implications of such an attitude on vulnerable populations is clear, with individuals potentially forced or coerced into assisted dying for reasons other than their own free will.

The slippery slope argument is inordinately complex and controversial evidence exists in the literature in favour of both sides. Cases of assisted dying in the Netherlands grew from 1882 in 2002 to 5306 in 2014. 21 Eight-one cases were concerned with dementia and 41 with mental health-related reasons only in 2014. 6 In the light of data from Holland, the slippery slope argument is supported in a number of respects, e.g. concerns about legislation ‘creep’, lack of availability of good palliative care and fears in the vulnerable and elderly. Early data published from Oregon were also concordant. The number of physician-assisted deaths progressively rose from 16 in 1998 to 71 during 2011; loss of autonomy (88.7%) and ability to participate in enjoyable activities (90.1%) were the two most commonly reported end-of life concerns. 22 In increasingly financially constrained health and social care systems, fears have also been raised regarding the impact of budget-cutting trends and their potential impact on terminally ill individuals for whom the alternatives are only high-cost life-prolonging or quality-enhancing (rather than curative) treatments.

However, recent data summarising the 20 years’ experience in Oregon suggest the opposite. According to the authors, patients requesting an assisted death allegedly belong to a higher than average socioeconomic class and have a higher than average education level. 23 Oregon, the first state in the US to allow assisted dying, employed strict criteria that had an influential role in other jurisdictions. 5 The criteria comprised the agreement of another doctor, the assessment of the patient’s mental capacity and the presence of a terminal illness with less than six months to live. 24 Additional measures to ensure an informed and unforced decision involved adequate pain relief and access to end-of-life care. 25 Assisted dying proponents support that safeguards and regulations in place are very powerful since only one in 50 terminally ill patients have a discussion about the process with their doctor and even fewer complete it. 26

Rhetoric from opponents has raised concerns of whether such safeguards could ever be adequate, which appears to be a key argument in the debate in some jurisdictions as well. Consequently, any future legal permissibility of assisted dying should be developed in conjunction with clear regulatory safeguards to ensure the abuse of assisted dying and protect vulnerable individuals from coercion. 3 . Such safeguards must also preserve societal justice and ensure equitability and availability of healthcare is not a deciding factor in assisted dying decision-making.

The Hippocratic Oath and the principles of beneficence and non-maleficence

The principles of beneficence and non-maleficence , plainly described in the Hippocratic Oath, have been the foundation of medical ethics for many centuries. Beneficence states that a doctor should act in the best interest of the patient. Non-maleficence states ‘first, do no harm’ – ‘ primum non nocere ’. 27 Conformation to these fundamental principles is enshrined within Hippocratic Oath, which involve aiming to benefit, or perhaps most importantly, not doing any harm to a patient. Moreover, modern medical education in most countries follows legal and cultural opposition to an assisted death. Healthcare professionals are therefore currently not adequately trained to participate in assisted dying. Professional opinion also remains divided on whether further involvement would benefit or damage public perception of the profession, given the potential conflict between these two ethical principles. The UK’s medical representative body, the British Medical Association (BMA), has acknowledged this lack of consensus, but clearly concludes with their view that assisted dying should not be made legal in the UK. 28

However, the evolution of decision-making processes in modern medicine, particularly regarding end-of-life decisions, and with patients increasingly at the heart of shared decision-making (e.g. the UK NHS’ ‘no decision about me, without me’ policy), have applied pressure on clinicians to reconsider their collective professional stance on assisted dying. Indeed, an increasing number of legal challenges from patients and assisted dying representative organisations are taking place worldwide to challenge local legislation against an assisted death.

Assisted dying therefore challenges the conflict faced between the ultimate purpose of modern medical and social care and its founding ethical principles. Relief of suffering through an assisted death can be argued as a distinct entity to palliative care, with the former – if safely and carefully considered – potentially an important way of fulfilling a clinician’s duty to preserve autonomy and do good for a patient – for example, in cases where alternatives are treatments which provide no benefit or do not prolong or improve the quality of life of a terminally ill patient. 27 , 29 A further consideration is that of an individual doctor’s ethical and moral beliefs, which are also an important factor should a patient request an assisted death; indeed, the British Medical Association has proposed that should assisted dying legislation be derived, then there should be a clear demarcation between those physicians who do and do not offer this option. 30

Freedom of thought, conscience and religion

A further controversial issue is raised by Article 9 of the European Convention on Human Rights, which protects the rights of freedom of thought, conscience and religion. Its impact on the assisted dying debate centres on whether requesting an assisted, dignified death constitutes a manifestation of belief, therefore falling within the remit of Article 9. Several European Court decisions have determined that individual views are entitled to protection only if they ‘attain a certain level of cogency, seriousness, cohesion and importance’. 31

Seriousness and importance are undoubtedly justified when considering an individual’s decision to end their life. On the other hand, an informed desire to die with dignity may well constitute a coherent and cogent view. For instance, it remains debatable whether approaching death through a solely palliative care lens constitutes a less dignified way to die than assisted dying. 31 Article 9 may therefore provide a preferable framework for decisions relating to the right to die with dignity than Article 8, which focuses on a patients’ autonomy; while the former aims to protect truly coherent and cogent decisions, it may be argued that the latter in isolation could potentially open a bigger door to a broader attitude towards assisted dying. 13

Furthermore, Article 3 should also be considered as a safeguard, as this prohibits torture and degrading treatment. 17 Ultimately, each potential assisted dying case is unique and its various facets should therefore be approached carefully under the scope of relevant legislation (e.g. European Convention on Human Rights Articles 2, 3, 8 and 9), and individual/societal ethical and moral perspectives ( Tables 1 ​ 1 ​ to ​ to4 4 ).

Article 3: Prohibition of torture.

No one shall be subjected to torture or to inhuman or degrading treatment or punishment.

Article 9: Freedom of thought, conscience and religion.

1. Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief and freedom, either alone or in community with others and in public or private, to manifest his religion or belief, in worship, teaching, practice and observance.
2. Freedom to manifest one’s religion or beliefs shall be subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedoms of others.

Implications of assisted dying in the doctor–patient relationship

As discussed, a key concern of the medical profession remains the impact of legalisation of assisted dying on the doctor–patient relationship. This relationship is fundamentally based on trust. Although aspects of assisted dying may be considered in conflict with certain underlying ethical obligations placed upon doctors, considering a patient’s autonomous wishes, alongside the moral perspectives of the doctor, is also an important aspect of this relationship. 32 , 33 This quandary is recognised by the Swiss Academy of Medical Sciences in their ethical guidelines, which acknowledges that ‘in certain special cases a doctor’s personal decision to assist a dying patient to commit suicide is in accordance with his or her conscience and has to be respected’. 18

The delicate balance between the views of patients, doctors and society can pose an ethical dilemma, with the potential to serve a disruptive influence on the sanctity of the doctor–patient relationship and negatively distorting how society perceives the role and motives of healthcare professionals. For example, as previously considered, particularly in healthcare systems where doctors play the role of gatekeeper to healthcare, a doctor’s support for an assisted death for a terminally ill individual might be negatively interpreted as a conflict of interest, with a desire to help relieve the social and economic burden of a patient’s illness upon society overriding the patient’s individual interests. Ultimately, should appropriate safeguarding measures be deployed alongside relevant legislation, assisted dying may risk eroding doctors’ professional integrity. 34

Current position of doctors’ professional groups in the UK and the USA

As expected, the discussion around adopting assisted dying has caused much controversy among the doctors’ professional groups and bodies. Several professional organisations in the UK have clearly expressed their opposing views to assisted dying such as the British Medical Association, the Royal College of General Practitioners and the Royal College of Surgeons of England, whereas others maintain a neutral position including the Royal College of Nursing, the Royal College of Psychiatrists and the Royal Pharmaceutical Society. 5 The Royal Society of Medicine has no policy on the issue since ‘its remit is the education of doctors and health professionals and the promotion of debate, not the making of policy’. 35

In the US, the American Medical Association, representing nearly 250,000 members, vehemently opposes legalisation of assisted dying as does the American College of Physicians with more than 150,000 members. 6

Conclusions

The debate surrounding assisted dying is never far from the headlines, particularly while its legal status in most jurisdictions remains inadequate and discursive. However, alongside the evolution of palliative care, there appears to be an increasingly vocal desire for legislation to support assisted dying in selected cases. 21 Developing a sensitive balance between established cultural norms and a progressive, well-balanced, transparent and safe attitude towards assisted dying is key. 24 More patient-centred attitudes towards health and social care increasingly place patients – quite rightly – at the heart of everything health professionals do. Patients’ needs, attitudes and beliefs must be therefore at the forefront of decision-making. However, when considering these alongside the fundamental principles of bioethics as well as legislation and doctors’ own beliefs, conflict can arise, thereby leaving the assisted dying debate in a state of limbo. Whether assisted dying should be legalised (albeit with stringent controls) remains controversial; as considered in this essay, even the basic moral principles can conflict when considering the arguments for and against supporting an assisted death, making consensus building far from straightforward.

Ultimately, individual patients’ autonomy should be balanced with a fundamental right to life, impacts on the individual doctor–patient relationship and wider society and the safeguards required to prevent misuse of any assisted dying regulations. The challenge remains for society to decide where this balance lies, guided by regional religious, cultural and legislative perspectives.

Developing the required ethical competencies among medical professionals is also key; given the current absence of legal support for assisted dying in most jurisdictions, most clinicians remain untrained in such decision-making. Indeed with understandable fears against crossing key ethical divides, physician support for an assisted death tends to be lower than that of patients. 36 Dying is a natural part of human life. With growing demand worldwide, the assisted dying debate will increasingly come to the fore – something healthcare professionals, politicians and legislators cannot ignore.

Declarations

Competing interests.

None declared.

Ethics approval

Ethics approval was not required for this review.

Contributorship

AF and EP conceived, designed the study and performed the literature search. All authors analysed the data and drafted the manuscript. All authors contributed to and approved the final version of the manuscript.

Acknowledgements

Not commissioned; peer-reviewed by David Misselbrook.

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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 […]

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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

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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 […]

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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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Home — Essay Samples — Social Issues — Human Rights — Euthanasia

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Essays About Euthanasia

Euthanasia essay: examples, types of euthanasia essays:.

  • Euthanasia Argumentative Essay: This type of essay presents arguments for and against euthanasia and requires the writer to take a position on the issue.
  • Euthanasia Persuasive Essay: The purpose of this essay is to persuade the reader to support or reject the idea of euthanasia. The writer needs to use convincing arguments and evidence to support their position.
  • Euthanasia Controversy Essay: This type of essay explores the controversies surrounding euthanasia, including ethical, moral, legal, and religious issues. The writer needs to analyze and present different perspectives on the issue.

Euthanasia: Argumentative Essay

  • Choose a clear position: Before you start writing, it's important to decide where you stand on the issue of euthanasia. Do you believe that euthanasia should be legalized, or do you think it should remain illegal? Your position will guide your research and the evidence you present.
  • Conduct thorough research: Euthanasia is a complex and controversial issue, so it's essential to do your research before starting to write. Look for reliable sources of information, such as academic articles, government reports, and medical journals.
  • Develop a strong thesis statement: Your thesis statement should clearly state your position on euthanasia and provide a roadmap for the rest of your essay. It should be clear, concise, and easy to understand.
  • Provide evidence to support your arguments: Use evidence to support your arguments, such as statistics, expert opinions, and case studies. Make sure that your evidence is credible and comes from reputable sources.
  • Address counterarguments: It's important to address counterarguments to your position to demonstrate that you have considered all perspectives on the issue. Addressing counterarguments will also make your essay more persuasive.
  • Use persuasive language: Use persuasive language to make your argument more convincing. Use strong, clear language that emphasizes your point of view.

Euthanasia: Persuasive Essay

  • Conduct research: The writer should conduct thorough research on the topic to gather as much information as possible to support their argument.
  • Develop a clear thesis statement: The writer should clearly state their position on euthanasia in the thesis statement.
  • Present convincing evidence: The writer should use credible and convincing evidence to support their argument, such as statistics, case studies, and expert opinions.
  • Address counterarguments: The writer should acknowledge and address counterarguments to their position, and provide strong rebuttals.
  • Use persuasive language: The writer should use persuasive language and techniques, such as emotional appeals and rhetorical questions, to convince the reader of their position.

Euthanasia Controversy Essay

  • Start with a clear and concise introduction that presents the topic and the main arguments.
  • Conduct thorough research on the topic, using credible sources, such as academic journals, government reports, and expert opinions.
  • Present a balanced view of the issue by providing arguments for and against euthanasia.
  • Use clear and concise language, avoiding emotional language that may detract from the argument.
  • Consider the ethical and moral implications of euthanasia, and the different perspectives of stakeholders involved.
  • Conclude the essay with a summary of the main arguments and a final thought on the topic.

Tips for Choosing a Topic for Euthanasia Essays:

  • Identify your stance: Before choosing a topic, decide on your position on euthanasia. This will help you select a suitable topic for your essay.
  • Conduct research: Thoroughly research the topic of euthanasia to gain a better understanding of the subject matter. Use reliable sources such as books, journals, and academic articles.
  • Brainstorm: Create a list of potential topics related to euthanasia and narrow down your choices based on your research and personal interest.
  • Focus on a specific aspect: Instead of trying to cover the entire topic of euthanasia in your essay, focus on a specific aspect such as the ethical or legal implications.

Hook Examples for Euthanasia Essays

Anecdotal hook.

Meet John, a terminally ill patient who faces excruciating pain every day. His decision to seek euthanasia sparks a controversial debate over the right to die with dignity.

Question Hook

Is it ethical for physicians to assist patients in ending their lives to relieve unbearable suffering? Explore the moral dilemmas surrounding the topic of euthanasia.

Quotation Hook

"Dying is not a crime." — Jack Kevorkian. Investigate the legacy of Dr. Kevorkian, who championed the cause of physician-assisted suicide, and its impact on the euthanasia debate.

Statistical or Factual Hook

Did you know that euthanasia is legal in several countries, while it remains illegal in others? Examine the global landscape of euthanasia laws and the factors that influence these decisions.

Definition Hook

What exactly is euthanasia, and how does it differ from other end-of-life choices? Delve into the definitions, types, and terminology associated with this complex issue.

Rhetorical Question Hook

Should individuals have the autonomy to decide when and how they will end their lives, especially in cases of terminal illness? Analyze the arguments for and against euthanasia's role in preserving personal freedom.

Historical Hook

Travel through history to explore the evolution of euthanasia practices and laws. Discover how societies have grappled with the idea of mercy killing across centuries.

Contrast Hook

Contrast the perspectives of medical professionals who advocate for euthanasia as a compassionate choice with those who argue for preserving the sanctity of life at all costs. Explore the ethical dilemmas inherent in these differing viewpoints.

Narrative Hook

Step into the shoes of a family member faced with the agonizing decision of whether to support a loved one's request for euthanasia. Their personal story sheds light on the emotional complexities involved.

Shocking Statement Hook

Prepare to be shocked by the cases of covert euthanasia that occur outside the boundaries of the law. These stories expose the gray areas and ethical challenges surrounding end-of-life decisions.

Euthanasia, Assisted Dying and The Right to Die

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The Issues Why Physician-assisted Suicide Should not Be Legalized

Physician-assisted suicide (pas), a controversy over the issue of physician assisted suicide, right to die: euthanasia issues, let us write you an essay from scratch.

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My Views on The Issue of Assisted Suicide

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Discussion on Whether Human Euthanasia Should Be Made Illegal

Natural death and euthanasia: the catholic church’s historical response, the popularity of euthanasia among the american population, a moral interpretation of euthanasia and murder, analysis of physician-assisted suicide (pas) in terms of bioethics, a debate over allowing physician assisted suicide, arguments expressed by proponents of the legalization of physician-assisted suicide (pas), persuasive essay pro euthanasia, why physician-assisted suicide for terminally ill patients should be legalized, the arguments for euthanasia: a critical analysis, advantages and disadvantages of euthanasia, death with dignity act: ethical dilemma regarding euthanasia, the right to die: debating euthanasia in modern society, advocating for legalizing euthanasia, an assisted suicide: roller coasters as tools for euthanasia, euthanasia: examining arguments, ethics, and legalities, voluntary euthanasia persuasive speech, the struggle with physician assisted suicide in the united states, why euthanasia should not be allowed, physician aid in dying: a controversial ethical issue.

Euthanasia is the practice of intentionally ending life to relieve pain and suffering.

Euthanasia is categorized in different ways, which include voluntary (when a person wills to have their life ended), non-voluntary (when a patient's consent is unavailable), or involuntary (.done without asking for consent or against the patient's will)

Jack Kevorkian, Philip Nitschke, Barbara Coombs Lee.

The United States (Washington, Oregon, California, Colorado, Montana, Vermont, Hawaii), Switzerland, Germany, Japan, the Netherlands, Belgium, Luxembourg, Colombia, Canada.

Though euthanasia is still illegal in England, King George V was euthanized. Euthanasia is mostly administered by giving lethal doses of painkiller or other drugs. Despite Euthanasia being generally illegal in India, there is a tradition of forced euthanasia in South India.

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Discursive Essay on Euthanasia.

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Discursive Essay on Euthanasia

        What is euthanasia? The word euthanasia originates from the Greek language, meaning good death. It is any action intended in ending the life of a human being on the grounds that their life is no longer worth living. It also means a gentle and easy death, but is a premature ending to life necessarily the best thing to do? If you asked someone who is involved in caring for the terminally ill, they would probably disagree, but there are some people in this "modern" world who are fighting to make assisted suicide legal.

        This all started in the early nineteenth century. It was 1806, when Dr. Cristoph Hufeland, wrote that, “The physician should and may do nothing else but preserve the life. Whether it is valuable or not, that is none of his business. If he once permits such considerations to influence his action, the doctor will become the most dangerous man in the state” This just means that a doctor should only look after the patient and nothing else, he should not concern him-self with moral issues such as, if life is sacred or not. This is merely scratching the whole issue of euthanasia.

        One person who is involved in this everlasting issue is Dr. Jack Kervorkian who is better known as Dr. Death. He has made it his life's mission to travel across the United States of America, at his own expense, to help people, who consider their lives no longer worth living to assist them in committing suicide. This is illegal throughout the world except for Australia, which legalised euthanasia in 1994, but this law has recently been overturned. Four deaths had occurred and the son of the first man to die under this new law expressed serious regrets soon after his father died.

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         So far, Mr Kervorkian is known to have more than forty patients. Each were said to be suffering from a terminal disease. These included diseases such as PVS, M.E and Motor Neurone Disease. But in a post-mortem carried out by a coroner, called Llibusia Dragowich, it was discovered that out of thirty-nine patients: Ten were suffering from a terminal disease, twenty-six were in a little pain but death was not an option and three had nothing wrong with them at all. People say that how was Jack to know? He had carried out thorough investigation into the patient. He had talked to them and got an idea into their reasons for dying.

        His 37 th  patient was a woman called Rebecca Badger. She was thirty-nine years old and had been diagnosed as having multiple sclerosis (MS), but in a later autopsy, it was revealed that she had been diagnosed wrongly. She was one of the three who were wrongly helped to commit suicide. Rebecca had a history of alcohol abuse and had tried to commit suicide twice.

        Raymond Voet is a lawyer who strongly disagrees with what Jack is doing. His arguments are that Jack’s patients are not in that much pain and are just depressed about being handicapped or being diagnosed as having a terminal illness. A part of me agrees with what Raymond says, but I still feel that some patients maybe truly in that much  pain and suffering.

        

There are many arguments for euthanasia. One of these arguments is that it is a quick and humane ending to someone’s suffering and it is what he or she wants. It cannot always be in the best circumstances because of social ideas.

Another dispute is that it can help to relieve and shorten the grief for the sufferers loved ones. It can also help people to realize that they can die with dignity. Then they could face death "face on".

There is a myth that the human body is sacred, but Jack says, “try to stop a vet from putting an animal to death and you would be arrested. Try to stop a man from putting another man to death and nothing would happen”.

People are all different and that they should have a choice and it depends on the quality of life for the person.

Another argument for euthanasia is that people have the right to decide – this means that everybody should have the right to choose how he or she lives or dies. Each person has value and is worthy of respect, has basic rights and freedom and the power to choose their own destiny.

One major argument is passive euthanasia against active euthanasia – This simply means that doctors can legally practise "passive" euthanasia – by taking away or withholding treatment even if the person will die. However, doctors cannot help the person to die, by for example, the lethal injection. This can be argued that passive euthanasia has exactly the same moral and practical results as active euthanasia, lethal injection at the patient’s request.

Euthanasia already goes on – this literally means the euthanasia already goes on. As you are reading this, the probability is that someone is considering or is undertaking the procedure known as assisted suicide.

There are also many arguments against euthanasia. One of these arguments is that if we make it legal then people will take advantage of the system.    

     

There are many painkilling drugs on the market, which can help the sufferer die naturally. People use this as an argument against the legalisation of euthanasia.

One other argument is that a person may not be able to make a rational decision because of being depressed.

A big argument against euthanasia is that old people might think that they are a burden to others, when they actually want to live on. This can be easily undiscovered when people like Jack talk to his patients.

A religious argument is that euthanasia devalues life by making it disposable, many people claim that life is a gift from God and only God can take it away.

Another argument against this case is that if there were better facilities for the dying, and then euthanasia would be less of a problem.

        Increasingly new ways of dying are being invented for use in euthanasia. The particular "death machine" that Dr. Death prefers to use, is a machine which firstly injects the patient with a tranquilliser which makes you partly unconscious then it relaxes your muscles then finally injects a substance which stops your heart beating. This is only one of the many ways you can die with the help of euthanasia.                  

Discursive Essay on Euthanasia.

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Euthanasia (Argumentative Essay Sample)

Euthanasia is one of the subjects that have faced intense debate over time, the legalization of euthanasia have been debated for many years with different views presented in terms of  ethical and legal consideration for both patients and health care providers. Healthcare providers are faced with ethical dilemmas when caring for terminally ill patients. They are forced to make tough decisions by using their moral reasoning to overcome some of the ethical dilemmas related to euthanasia.

Euthanasia is viewed as murder, however, ethically; physician has the moral obligation to comply with patients’ decisions. Making such decision to either withhold or withdraw treatment for any patient is not an easy decision to make based on the cultural, religious and legal factors.  Death resulting to euthanasia is different between countries. Patients who experience extreme pain due to the nature of their illness are permitted to die with dignity in several countries while other countries totally condemn the use of euthanasia. Therefore, such individuals are among the few cases that continue to convince stakeholders to legalize euthanasia.

From a religious perspective; religious leaders see euthanasia to be unnecessary because for them, pain and suffering are not only a medical problem it is more than physical pain.  Pain and suffering are as a result of several factors; these include psychosocial, cultural and spiritual. Such views have changed the perspective of the debate about euthanasia.  The other aspect of euthanasia that has been ignored. It is a fact that the doctor has an obligation to fulfill patient’s request.

By not legalizing euthanasia is viewed as violating patient rights as the doctor refuses to help patients die. Even though many people are against euthanasia because it is viewed as murder, those who advocate for its usage view euthanasia from a different perspective. For them, the issue of cost and violation of human rights are the two most important arguments presented during euthanasia debates.  Even though those who support Euthanasia argue that it helps patients die with and help in containing the overall cost of treatment, others view Euthanasia as an immoral act. Other people view euthanasia as patient’s choice, not a physician; therefore, killing patients even when physicians have signed the code of ethics, is in line with the healthcare standards because the patient has the final say. The physician does not violate human rights.

I believe that there are valid reasons for patients to consider euthanasia because it saves both the patient and their family members from many financial burdens associated with terminal diseases. Euthanasia is the choice, and an alternative for patients who suffer immensely and their decision should be respected to help them alleviate suffering.  In many countries where euthanasia is permitted health care cost have been significantly contained. Patients with chronic illnesses do not have much choice but to die peacefully and with dignity.  Terminally ill patients are permitted to request from euthanasia to stop suffering.

Euthanasia remains one of the hot topics among many interest groups; some people believe that it is the only humane way to end suffering. Christians believe that humans have to undergo suffering because it’s part of God’s plan. In this debate considering the political, religious, legal and personal views all these people want to justify their reasons as to why euthanasia should be legalized or not. Euthanasia remains a debatable subject because of the varied views that might be valid to a certain point.

discursive essay on euthanasia

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Higher English Discursive Essay Euthanasia / Assisted Dying

Higher English Discursive Essay Euthanasia / Assisted Dying

Subject: English

Age range: 14-16

Resource type: Other

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5 December 2020

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discursive essay on euthanasia

A grade Higher English discursive essay (around 1300 words) on euthanasia / assisted dying. Full bibliography included.

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Euthanasia Discursive

Euthanasia Discursive

For my topic I have chosen Euthanasia because it’s an important issue today because a lot of terminally ill people want euthanasia as they don’t want to endure the pain. Also a lot of people think that no one, no matter what circumstances should have a right or the power to take someone’s life away because you have to take into consideration how it would affect the family’s of those who wish to do euthanasia and also how it would affect health care on those that do not have a terminal illness.

Although many people think that it is a very good idea that they will end pointless sufferings for the terminally al they need to see how it would affect everything from families to health care and how it will affect normal people as well. One of my main arguments against Euthanasia is religious people think it’s wrong because the bible tells them not to kill, and they believe that only God can take life away. Also it could just lead to abuse by doctors, but legal voluntary Euthanasia could just open the way for non-voluntary Euthanasia.

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That would mean doctors could decide that a patient’s life is basically not worth wasting their time on, and just use euthanasia on them. It has already appended before in the Netherlands in the 1 ass’s when the law was relatively new, but over a thousand people had died of non-voluntary Euthanasia. A lot of people were also worried that if it were to be legalized in the I-J in the same way as the Netherlands, double the amount Of people would lose their life.

Another one of my main argument against Euthanasia’s if it legalized the terminally ill and sick treatment would not be as good because doctors would just use euthanasia to just get them out of the way. But many patients who feel that they have no purpose in life or are a burden to their families can just dead them to wanting to take the easy way out. The hospice cares for the patients and their families a lot too. There is also an addition to these arguments because the fact there is alternative treatments which are available such as a palliative care and hospices.

They do not kill the patients, they just make sure that their last months or year is comfortable and as painless as possible to make the person forget they are going to die. This lets the family of their patients have more time with their loved ones and make sure that their last moments are the best they ever had. Euthanasia could never really be controlled and this point is actually proven. A study indicated that 2010, 23 per cent Of all Euthanasia deaths had gone unreported in the Netherlands. This made an increase from 20 per cent In 2005.

Also the study showed that the Netherlands were really struggling to control the amount of Euthanasia that was being used, and who says this couldn’t happen to the rest of the world. Another argument against Euthanasia, would that doctors be might make a mistake about someone diagnosis. This could lead to the person choosing Euthanasia after being wrongly told that they have a terminally ill condition, meaning they basically have died for no reason. This could also lead to the doctor feeling guilty for taking someone’s life who did not have to die.

Another argument for Euthanasia is the pragmatic argument as people believe Euthanasia is already a big wide spread practice, and it is just that some people are not willing to admit it. But they also believe Euthanasia would be perfectly fine if regulated. An example would be that people could refuse treatment if their heart fails, so many people feel the exact same as Euthanasia but in a different form. The ethical argument basically suggests that life should only continue as long s a person feels their life is worth living.

An example would be that if someone who supports the use of Euthanasia based on the ethical argument could possibly believe that a person should be able to choose to end their life now and if they were living in so much pain and their quality of life is not want they want it all to end rather than have to bare the pain day in day out. Am fully against Euthanasia because I hold the same view as the religious groups that ifs not our place to take human life away, and that we should just let them die of natural causes.

In conclusion, the negatives outweigh the societies because arguments like this could never really be controlled. The topic is so controversial because both sides have strong arguments. Although the positives suggest it would help a person end needless sufferings and they would be able to die peacefully, defiantly say that the negatives are the strongest because they are looking at euthanasia from all aspects and not just how it would affect the person with a terminal illness but how it would have a ripple affect on everyone’s life – not just the dying person. 58 words Sources ethical argument – that people should have freedom of choice, including the eight to control their own body and life (as long as they do not abuse any other person’s rights), and that the state should not create laws that prevent people being able to choose when and how they die pragmatic argument – that euthanasia, particularly passive euthanasia, is allegedly already a widespread practice, just not one that people are willing to admit to, so it is better to regulate euthanasia properly religious argument – that these practices can never be justified for religious reasons; for example, many people believe that only God has the right to end a human life ‘slippery slope’ argument – this is based on the concern that cleansing euthanasia could lead to significant unintended changes in our healthcare system and society at large that we would later come to regret medical ethics argument – that asking doctors, nurses or any other healthcare professional to carry out euthanasia or assist in a suicide would be a violation of fundamental medical ethics alternative argument – that there is no reason for a person to suffer either mentally or physically because effective end of life treatments are available; therefore, euthanasia is not a valid treatment option.

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Euthanasia Discursive Essay

Dec 20, 2023

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COMMENTS

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    Euthanasia Essay examples. Euthanasia is often called &quot;mercy killing&quot;. It is intentionally making someone die, rather than allowing that person to die naturally. It is sometimes the act of ending someone&#039;s life, who is terminally ill, or is suffering in severe pain. Euthanasia is mostly illegal in the world today.

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  18. Discursive essay on euthanasia Free Essays

    Discursive Essay . Euthanasia. Euthanasia ‚ also known as "assisted suicide" is what happens when somebody takes their own life‚ or assists someone in taking theirs when the person is seriously ill or in extreme pain. It is loosely known as "mercy killing" as the patient is no longer suffering‚ hence it is sometimes allegedly ...