Tag Archives: Physician Assisted Suicide

Mental Health Ethics: Euthanasia

Pedro Gondim asked:

Euthanasia (Greek: ????????? – ?? “good”, ??????? death”), according to the Penguin Dictionary of Psychology, is described as the “easy and painless death or the means for producing one. Advocated by many for those suffering from intractable pain that accompanies the terminal stages of many incurable diseases. A distinction worth noting (in respect to matters legal and ethical) is that drawn between passive euthanasia, when one simply ceases to supply requisite extraordinary support measures needed to keep an individual alive, and active euthanasia, when specific means are taken to terminate life.” (Page 253)

Active Euthanasia, Passive Euthanasia and Assisted Suicide

The distinction between these terms is one of the main discussion points regarding euthanasia and its legal-social effects. The so-called active euthanasia, as previously described, consists in a direct or indirect action with the purpose of ending one’s life. Such actions would include, for example, the injection of a lethal substance into the patient’s bloodstream. The passive euthanasia consists in ceasing life support supplies (or treatment), such as a respiratory tube or a specific medication.

Although this does not constitute in a direct action towards ending one’s life, it does have the same purpose and result. In legal terms, both definitions fall under the same category – and there are people who argue that passive euthanasia is a mis-term of what would be simply another active form of the event. In the other hand, assisted suicide is the term which defines the supply of means to end one’s life. It is almost the same as euthanasia; the difference is that in this case, the patient is responsible for performing the final action which results in his/her own death. This definition comprises the term physician-assisted suicide, which occurs when a doctor assists a patient, whether by giving information or access to means, to commit suicide.

This has been the center of much discussion among several societies, as it represents a paradox to common medical ethics* – and it also raises a discussion of priorities in health care.

*Most doctors are ethically obliged to the Hippocratic Oath, a document written by the famous Greek physician Hippocrates, which states that a doctor shall not provide any means to help producing death.

The ‘Slippery Slope’ Argument

A common person would probably argue that, upon request, an individual should be allowed to choose between life and death. After all, it is a matter of freedom of choice, which is one of the basic principles of a democratic society. However, both euthanasia and assisted suicide invoke a deeper concern in health specialists – a problem commonly called the slippery slope.

According to them, the legalisation of both practices would cause the society to gradually switch their views towards life and death issues involving severely ill, disabled (both mentally and physically) and other patients unable to express their will – allowing euthanasia to be such a common practice that, at some point, patients would feel pressured to end their lives in order to spare resources to maintain them alive, or end their family suffering. In an overall perspective, life would be less valued, and people would become increasingly insensitive to patients in severe conditions.

Palliative Care and the Development of Health Care

Some advocates of the previous argument also affirm that, in a certain period of time, when healthcare has become widely available and non-costly – it would be possible to legalise both euthanasia and assisted suicide. Ideally, those conditions would allow both medical staff and the public to place life care as an ultimate priority. This can be considered as utopian, however, the progressive advances in technology could play a main role in creating this environment.

Current Situation

Until this article was written (2005), only few places in the world legally allow euthanasia and assisted suicide. The only country to approve both practices is the Netherlands. Meanwhile, Switzerland and the US state of Oregon allowed assisted suicide, and in Belgium, only voluntary euthanasia (authorised by the patient) is fully legal. Other areas, including the UK, have been analysing the possibility of legalising one or both of these activities. In 1996, The Rights of the Terminally Ill Act (ROTI) was passed by the Parliament of the Northern Territory by one vote. In 1997, the Australian Parliament overturned the ROTI Bill, and voluntary euthanasia became illegal again.

The discussion around euthanasia remains a polemic and unsolved issue. Several pro-euthanasia institutions have been established throughout the world, and every year, a growing number of patients travel to Switzerland in order to peacefully end their lives. However, researched data has not concluded whether the slippery slope effect will become prominent or not – and whether other issues regarding the legalisation of euthanasia could take place.

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