Should euthanasia be legalized?

Should individuals have the legal right to intentionally ask for a physician to end their life to
relieve suffering? Euthanasia, or physician-assisted death, raises profound questions about
autonomy, suffering, and the sanctity of life. This essay will analyze the philosophical and
legal frameworks as well as the arguments about whether euthanasia is ethical and should be
legalized, with a deeper look into the belief of James Rachels, author of “Active and Passive
Euthanasia” and David Velleman, author of “Against the Right to Die”, as well as how they
differ from each other and are there any possibility to create a common ground for all of the
existing arguments to stand on.

Euthanasia is the practice of ending the life of a patient to limit the patient’s suffering, with
the patient in question would typically be terminally ill or experiencing great pain. It has long
been a controversial issue (University of Missouri, 2023). It is important to acknowledge the
differences between active euthanasia, where death is directly caused, for example by
administering a lethal injection; and passive euthanasia, where life-sustaining treatment such
as ventilator or feeding tube is withdrawn (University of Missouri, 2023). While the latter is
often deemed less controversial, Rachels argues that the moral equivalence lies in their shared
intention: to alleviate suffering; therefore both means of euthanasia are only different in how
they execute it, not in the underlying root. Euthanasia is further divided into voluntary
euthanasia, where the patient consents; non-voluntary euthanasia, where the patient cannot
provide consent; and involuntary euthanasia, which is performed against the patient’s will
and universally condemned.

On a philosophical basis, the ethical priorities vary between different schools of thought. For
example, utilitarianism supports euthanasia as a means to maximize happiness and minimize
suffering (West and Duignan, 1999) – mostly because they believe that extending one’s life
when it is already filled with pain and struggle will do more harm than good. Later on, Peter
Singer further enforced this perspective by arguing that the choice to end one’s own life is
part of individual preferences, which in his opinion should be labeled as an ethical decision,
hence should be prioritized to fulfill (Singer, 2003). In contrast, Kantian ethics, based on
Immanuel Kant’s emphasis on autonomy and human dignity, presents a dual perspective:
while some Kantian scholars, and Immanuel Kant himself, argue that euthanasia undermines
the intrinsic dignity of life (Brassington, 2006), others assert that respecting rational
self-determination aligns with Kant’s principle of autonomy and even give euthanasia the title
“death with dignity” (Cholbi, 2017).

However, in the real world, dignity holds a much less important role in controversial cases
involving euthanasia. Controversy lies in different matters – how can we decide who should
receive euthanasia? It is believed that euthanasia might be conducted on patients who are
terminally ill and suffering, yet there is no established definition of “suffering”, and also no
scale to measure how much suffering should one be in to be suitable for euthanasia. For
example, Terri Schiavo entered a prolonged legal battle in the United States after a cardiac
arrest put her into a vegetative state. Her husband wanted to remove her feeding tube, while
her parents opposed the decision, believing that Schiavo was not in unbearable pain, nor was
she struggling. Several lawsuits were filed, and the court ultimately made a decision in favor
of passive euthanasia as they believed Schiavo herself would not have wished to continue
life-prolonging measures (Quill, 2005). In contrast, Brittany Maynard, a patient with terminal
brain cancer, highly advocated for euthanasia and decided herself to end her own life “when
the time seems right” to prevent further suffering. Maynard shown determination to support
this idea by relocated to Oregon to access physician-assisted suicide (ABC News, 2014).
These cases were the major ones that ignited debates about when should euthanasia be
applied, how can patients autonomy be reserved in cases where they are unable to make
decisions with their life, and how much should family members intervene in the process.

James Rachels – though has not come to a clear statement about whether he supports
euthanasia or not – scrutinized the conventional view that passive euthanasia is morally
permissible while active euthanasia is not by arguing that the distinction between these two
forms of euthanasia is often arbitrary and lacks ethical coherence. Using the Smith and Jones
analogy, Rachels illustrates that both actively causing death and passively allowing death are
morally equivalent when the intention and outcome are the same – both of them are carried
out in order to terminate the patient’s life, and both result in terminating the patient’s life. He
criticizes the American Medical Association's stance, which condemns active euthanasia
while still permitting passive euthanasia, as he finds no distinction between the two and
implies that if one of them is permitted, then the other should be permitted as well. However,
later on, this viewpoint has been refuted. In his work “The Ethics of Killing and Letting Die:
Active and Passive Euthanasia”, McLachlan (2008) stated that though the intention and
outcome are the same for both types of euthanasia, moral obligations are different between
them. He gave an example of a doctor switching off a ventilator upon a patient’s request,
which is an execution of passive euthanasia, and deemed this action to be fulfilling a specific
duty; contrasting with active euthanasia, where no such obligation to directly cause death
exists. McLachlan differentiates between direct causes, such as administering lethal drugs,
and indirect causes, like failing to prescribe antibiotics. While the latter may lead to death, it
is categorized as an omission rather than a direct killing; therefore, euthanasia should still be
legalized, but only in the passive form, as the active form should be labelled as murdering.

As for David Velleman, he does not oppose euthanasia in principle. However, he argues that
legalizing euthanasia may put many demographics, such as the elderly or disabled, in
vulnerable situations with societal pressures to justify their continued existence. Velleman
compares this burden to the fact that it was considered dishonorable to decline a dueling that
one is invited to. By that logic, legalizing euthanasia may create implicit coercion,
particularly for individuals who fear becoming a burden on their families or society.
Furthermore, as stated earlier in this essay, a framework, or at least a scale to determine how
much “suffering and pain” should one be in to be put into euthanasia, has yet to be
established. Therefore, the vulnerable demographics’ lives might be in other people’s hands –
their caretakers might one day find them to be a burden and decide to file an euthanasia
request to eventually get rid of them. Without any clear guidelines, physicians could make
subjective judgments, or worse, be influenced by caretakers' manipulation or bribery, which
results in an unwanted euthanasia where the victim has no choice than being lawfully put to
death. It is also true that this situation can easily be prevented by imposing a law stating that
the decision to be put into euthanasia can only be made by the person themselves, in a lucid
state, instead of the caretakers, however, there would still be too many “what ifs” left open.
What if the caretakers put the person into a situation where their only option is to sign on an
euthanasia request, which would still count as an agreement to be given euthanasia under the
victim’s lawful discretion?

Personally, I would advocate for the legalization of euthanasia with an official framework,
with a metric to determine who qualifies for euthanasia – that metric can either be a very
intensive check-up for people who do not appear to be suffering, such as people in vegetative
state; or a decision based on the stage of terminal illness, such as stage 4 cancer for patients
who are already on death bed. Legalizing euthanasia, in my view, would be a turning point
for moral progress of the society. Historically, societies have adapted their moral frameworks
to accept practices such as organ donation and in vitro fertilization – practices that were once
deemed ethically contentious. Euthanasia, similarly, represents an evolution in ethical
reasoning, where the prioritization of dignity and relief from suffering is recognized as a
profound aspect of life itself. That is to say, the society has to be continuously evolving and
has already reached a high level of compassion and justice to adapt new medical practices
requiring moral frameworks. That society would be able to recognize that extending life at all
costs may not always align with the principles of dignity and well-being, and may not be
what every patient wants when they find out they are already terminally ill; especially when
the advancement in medicine field nowadays is coming up with more and more way to
prolong life of its patients, wishing to extend the probability of curing their diseases but also
at the same time create extended suffering for many. Perhaps the scenario where euthanasia
exists as an option is also ideal for people whose family members or friends are terminally ill
patients – family and friends of cancer patients who died by euthanasia had less traumatic
grief symptoms, less current feeling of grief, and less post-traumatic stress reactions than the
family and friends of patients who died of natural causes (Swarte et al., 2003).

Another viewpoint that I found rarely considered is that the legalization of euthanasia, though
not the most crucial factor, has potential in strengthening the bond between healthcare
providers and patients. By being transparent and establish a clear framework on which case
deserves euthanasia and who can apply for it, the healthcare field might ensure that their
patients feel respected, as their autonomy and dignity are carefully considered and their
decisions, whether to be put into death peacefully or to carry on with their life, are taken into
consideration. This bond might mitigate the distrust in the medicine field that many people
hold, which is one of the most significant reasons under the harmful pseudoscience activism
like anti-vaccine and such. Far from undermining the sanctity of life, legalizing euthanasia
affirms it by valuing the quality of life over mere biological existence. Such legalization, I
believe, would make a step toward aligning societal values with the principles of justice,
autonomy, and empathy, if imposed.

All in all, while the legalization of euthanasia wage controversy between schools of thought,
a common ground may lie in creating a framework that prioritizes dignity, autonomy, and
strict safeguards for the patients’ sake. It opens a door for patients who are suffering in pain,
but also comes with many problems that the legislation system has yet to be able to solve.
Therefore, though this move is beneficial for the society, an official framework must be
carefully worked on to avoid any unwanted situation.

References

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euthanasia but did not. Journal of Medical Ethics, 32(10), 571–574.

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Cholbi, M. (2017). Dignity and Assisted Dying. In Oxford Scholarship Online. Oxford

University Press. https://doi.org/10.1093/oso/9780190675967.003.0009

McLachlan, H. V. (2008). The Ethics of Killing and Letting Die: Active and Passive

Euthanasia. Journal of Medical Ethics, 34(8), 636–638.

http://www.jstor.org/stable/27720159

Quill, T. E. (2005). Terri Schiavo — A Tragedy Compounded. New England Journal of

Medicine, 352(16), 1630–1633. https://doi.org/10.1056/nejmp058062

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526–541. https://doi.org/10.1111/1467-8519.00366

Swarte, N., et al. (2003). Effects of euthanasia on the bereaved family and friends: a cross

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University of Missouri. (2023). Euthanasia. School of Medicine; University of Missouri.

https://medicine.missouri.edu/centers-institutes-labs/health-ethics/faq/euthanasia
West, H. R., & Duignan, B. (1999, July 26). Utilitarianism | Definition, Philosophy,

Examples, Ethics, Philosophers, & Facts. Encyclopedia Britannica.

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