Euthanasia Case

Voluntary Euthanasia

First published Thu Apr 18, 1996; substantive revision Mon Mar 29, 2010

The entry sets out five individually necessary conditions for anyone to be a candidate for legalized voluntary euthanasia (or, in some usages, physician-assisted suicide), outlines the moral case advanced by those in favour of legalizing voluntary euthanasia, and discusses five of the more important objections made by those opposed to the legalization of voluntary euthanasia.

*1. Introduction

*2. Five Individually Necessary Conditions for Candidacy for Voluntary Euthanasia

*3. A Moral Case for Voluntary Euthanasia

*4. Five Objections to the Moral Permissibility of Voluntary Euthanasia

*Bibliography

*Other Internet Resources

*Related Entries

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1. Introduction

When a person carries out an act of euthanasia, he brings about the death of another person because he believes the latter's present existence is so bad that she would be better off dead, or believes that unless he intervenes and ends her life, it will become so bad that she would be better off dead. The motive of the person who commits an act of euthanasia is to benefit the one whose death is brought about. (Though what was just said also holds for many instances of physician-assisted suicide, some wish to restrict the use of the latter term to forms of assistance which stop short of the physician 'bringing about the death' of the patient, such as those involving mechanical means that have to be activated by the patient.)

Our concern will be with voluntary euthanasia -- that is, with those instances of euthanasia in which a clearly competent person makes a voluntary and enduring request to be helped to die. There will be occasion to mention non-voluntary euthanasia -- instances of euthanasia where a person is either not competent to, or unable to, express a wish about euthanasia and there is no one authorised to make a substituted judgment (in which case a proxy tries to choose as the no-longer-competent patient would have chosen had she remained competent) -- in the context of considering the claim that permitting voluntary euthanasia will lead via a slippery slope to permitting non-voluntary euthanasia. Nothing will be said here about involuntary euthanasia, where a competent person's life is brought to an end despite an explicit expression of opposition to euthanasia, beyond saying that, no matter how honourable the perpetrator's motive, such a death is, and ought to be, unlawful.

Debate about the morality and legality of voluntary euthanasia has been, for the most part, a phenomenon of the second half of the twentieth century and the beginning of the twenty first century. Certainly, the ancient Greeks and Romans did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide in cases where no relief could be offered to the dying or, in the case of the Stoics and Epicureans, where a person no longer cared for his life. In the sixteenth century, Thomas More, in describing a utopian community, envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of 'torturing and lingering pain'. But it has only been in the last hundred years that there have been concerted efforts to make legal provision for voluntary euthanasia. Until quite recently, there had been no success in obtaining such legal provision (though assisted suicide has been legally tolerated in Switzerland for many years). However, in the 1970s and 80s a series of court cases in The Netherlands culminated in an agreement between the legal and medical authorities to ensure that no physician would be prosecuted for assisting a patient to die as long as certain guidelines were strictly adhered to (see Griffiths, et al. 1998) In brief, the guidelines were established to permit physicians to practise voluntary euthanasia in those instances in which a competent patient had made a voluntary and informed decision to die, the patient's suffering was unbearable, there was no way of making that suffering bearable that was acceptable to the patient, and the physician's judgements as to diagnosis and prognosis were confirmed after consultation with another physician. In the 1990s, the first legislative approval for voluntary euthanasia was achieved with the passage of a bill in the parliament of Australia's Northern Territory to enable physicians to practise voluntary euthanasia. Subsequent to the Act's proclamation in 1996, it faced a series of legal challenges from opponents of voluntary euthanasia. In 1997 the challenges culminated in the Australian National Parliament overturning the legislation when it prohibited Australian Territories (the Australian Capital Territory and the Northern Territory) from enacting legislation to permit euthanasia. In Oregon in the United States, legislation was introduced in 1997 to permit physician-assisted suicide after a second referendum clearly endorsed the proposed legislation. Later in 1997, the Supreme Court of the United States ruled that there is no constitutional right to physician-assisted suicide; however, the Court did not preclude individual states from legislating in favor of physician-assisted suicide. The Oregon legislation has, in consequence, remained operative and has been successfully utilised by a number of people. In November 2000, The Netherlands passed legislation to legalize the practice of voluntary euthanasia. The legislation passed through all the parliamentary stages early in 2001 and so became law. The Belgian parliament passed similar legislation in May 2002. (For a very helpful comparative study of relevant legislation see Lewis 2007.)

With that brief sketch of the historical background in place, we now proceed to set out the conditions that those who have advocated making voluntary euthanasia legally permissible have wished to insist should be satisfied. The conditions are stated with some care so as to give focus to the moral debate about legalization. Second, we shall go on to outline the positive moral case underpinning the push to make voluntary euthanasia legally permissible. Third, we shall then consider the more important of the morally grounded objections that have been advanced by those opposed to the legalization of voluntary euthanasia.