Why Euthanasia Should Be Legal: Analysis of Arguments and Counterarguments

1. Introduction

Euthanasia, or the practice of ending one’s life in order to relieve suffering, has recently become a heated topic of debate in contemporary society. It is a complex subject matter that intersects with the fields of law, politics, philosophy, medicine, and ethics; and with such complexities comes a myriad of opinions and perspectives. Although this topic and the issues that surround it appear to be straightforward at first glance, they contain a plethora of layers that must be explored before an effective opinion can be formed. Understanding different perspectives is crucial to examining euthanasia with a critical lens, especially since societies continue to navigate its legality, morality, and implications. This discussion will focus on the analysis, in regard to the legislation and morality of euthanasia; what its implications would mean for a society that legalizes it, the arguments and counterarguments frequently posed regarding it, and ultimately, that it should be legal (Vargić, 2018). Recently, the idea of providing aid in dying to those with terminal illnesses has triggered widespread debate around the world. Many questions arise in regard to those impacted by euthanasia and end-of-life decisions: What is fair? What is humane? What is ethical? How does society want to handle these types of decisions, if at all? It is crucial to approach this discussion with an open mind, as many have preconceptions associated with euthanasia, some of which are incorrect. People picture death with assisted suicide and think of homicide. Euthanasia is not assisted suicide, nor is it homicide. Euthanasia simply allows individuals the right and choice to end a life of suffering. People who will argue against euthanasia are often coming from a place of emotion. Understandably so, as this is an emotionally-driven subject matter. However, a thorough debate must be held when discussing the implications of legalizing euthanasia, and these points of emotion must be set aside in order to logically formulate an argument. While compelling arguments against the legalization of euthanasia exist, the overall implications it would have on societal structure, especially over time, are beneficial when compared to the arguments against it. Further, it is critical to establish the legal and moral implications that would result if euthanasia were to become illegal across the board. When picturing euthanasia, it is often human emotion that comes to the forefront: Pictures of the sick, the dying, the destitute, and the heart-wrenching chaos that ensues when trying to make sense of life and death. These emotional drawings are what often shape a viewpoint on euthanasia, and it is critical to point out that these images cannot be the prism through which euthanasia is viewed. Rather, they must be set aside, and euthanasia must be viewed from a strictly legal and moral standpoint. Of course, the individuals impacted by euthanasia decisions are riddled with emotion, and society must undoubtedly be empathetic towards those individuals. But to society as a whole, in order to assess the implications of euthanasia on a legal and moral basis, emotions must not play a role. In fact, it is when emotion takes charge of a viewpoint that the perspective on euthanasia becomes skewed. Since euthanasia is painted as a moral dilemma, it is critical to frame morals and what it means to be a moral person. Morals reflect what is right and what is wrong in regard to society and how it functions. At the core, morality is a choice: A choice to either act morally or immorally. But in regard to societal morals, choices impact more than just the individual making those choices. Thus, morality, from a societal standpoint, is a balancing act of rights and wrongs that will collectively ensure the well-being of the society as a whole. A society cannot simply choose to outlaw something that it deems immoral. That choice would open the floodgates for other immoral acts to take place unchecked, setting the society on a path to inevitable chaos.

2. Historical Background of Euthanasia Laws

Euthanasia, derived from the Greek word "eu-thanatos" meaning "good death", refers to the act of intentionally ending a person's life to relieve them from suffering. A distinction is made between voluntary euthanasia, where an individual consents to it, and non-voluntary euthanasia, where consent is sought but not given. Euthanasia can also be classified as active, which involves direct action to cause death, or passive, which entails withdrawing or withholding treatment, leading to death (Vargić, 2018).

Over time, legal frameworks regarding euthanasia have evolved, often in response to shifting ethical paradigms. Initially, in ancient Rome, euthanasia was permitted for dying soldiers, reflecting a societal acceptance. However, societal shifts later deemed euthanasia as a crime, heavily influenced by Christian doctrine that prioritized suffering as part of God's plan. The Hippocratic Oath further entrenched this notion, as it prohibited physicians from causing death.

Modern discussions of euthanasia laws began in Great Britain in 1828, following the trial of Dr. William Price, who performed euthanasia on his dying infant son. Although the 1870s saw attempts to legalize euthanasia in Parliament, these efforts failed. In contrast, the Netherlands, in response to growing public support for euthanasia, enacted the "Termination of Life on Request and Assisted Suicide" law in 2001. This marked the first instance of euthanasia being legal under criminal law provisions, stipulating strict conditions for its practice. Following this, Belgium legalized euthanasia in 2003. Today, euthanasia is fully legal in only four countries: the Netherlands, Belgium, Luxembourg, and Canada. A notable focus is on the Netherlands, as it was the first country to legalize euthanasia.

3. Arguments in Favor of Legalizing Euthanasia

There are many compelling arguments supporting the legalization of euthanasia. The first and foremost is the principle of respect for autonomy. Autonomy, or self-rule, is the idea that every individual is free to make choices regarding his/her own life and body without external interference (Vargić, 2018). It is widely considered a fundamental human right, enshrined in various national and international documents. When it comes to the end of life, respecting autonomy means allowing an individual to make personal choices regarding his/her own death, whether that means refusing or accepting medical treatment. This principle strongly supports making euthanasia legal.

Another powerful argument for allowing euthanasia is the relief of suffering. Most would frame it as a compassionate act. The act of euthanasia can end suffering and provide a peaceful and dignified death to those who wish for it. On the other hand, forbidding it would perpetuate suffering and deny a peaceful death to those who desire it. The legislation would thus allow doctors to respond to patients' wishes and act compassionately instead of being forced to prolong suffering. Those opposing euthanasia would argue that palliative care can alleviate all suffering, and therefore, euthanasia is unnecessary. However, there are many cases where pain and suffering cannot be alleviated, and patients remain in unbearable agony despite the best efforts of doctors.

An additional argument, often overlooked, comes from the field of economics. Proponents argue that legalizing euthanasia would reduce healthcare costs. According to statistics, up to 75% of healthcare costs are incurred in the last six months of a person's life. Euthanasia would be a humane and dignified way to die for those who wish for it, while also alleviating the burden on an overstrained system of hospital resources. Terminally ill patients unable to care for themselves require significant attention from healthcare workers, which could be redirected towards other patients who still have a chance at recovery.

3.1. Respect for Autonomy

One of the most crucial ethical principles, particularly within medical practice, is respect for autonomy. Autonomy encompasses the capacity for self-determination, which signifies that individuals inherently have the right to decide on matters that concern their own lives. Engaging with this desire to exercise individual autonomy and outlining the reasoning for legalizing euthanasia, societies could empower individuals to pursue their desires, including the option to die, while also alleviating suffering (Vargić, 2018). On an ethical level, respecting a person’s autonomy signifies acknowledging their ability to make informed, uncoerced decisions about their own lives. This principle finds its philosophical underpinnings in social contract theory, wherein moral obligations of society members emerge from a tacit agreement among themselves. Reasons for self-governance include the uniqueness of each individual’s perception of happiness and the ineffectiveness of external governance. Central to ethical governance is legitimacy resting on the consent of the governed, which necessitates informed consent in all interactions. Hence, fundamental to democracy and its institutions, including the health system, is the adherence to the will and choice of individuals, especially regarding their own lives.

Autonomy directly relates to dignity, particularly in situations involving terminal illnesses, debilitating conditions, or other forms of dependency. Death becomes an acceptable option if continued existence denies individual dignity in the context of personal autonomy. Respecting autonomy entails honoring an individual’s decision to refuse treatment or pursue death, as both choices pursue the same outcome — the termination of life in a way that upholds dignity. The implementation of legalized euthanasia typically includes requirements for mental competence, clarity, and uncoerced decision-making, thus minimizing the risk of losing autonomy or coercion. Nevertheless, it is argued that autonomy might not be respected even without legalized euthanasia. Vulnerable populations may be pressured to request death to alleviate burdens on family or the healthcare system, prompted by health professionals offering euthanasia as an option rather than pursuing other forms of care. However, it appears outsiders judge individual situations and a person’s will excessively. Numerous cases exist wherein individuals with treatable conditions who wished to live were euthanized nevertheless. Yet with the implementation of legal safeguards, situations in which autonomy is not respected become a matter of misconduct punishable by law rather than an argument against euthanasia's legalization. That said, examples from the Netherlands and Belgium illustrate the difficulty in preventing such situations even with legal safeguards. However, most countries successfully uphold protective laws against far greater threats to autonomy than euthanasia. Overall, autonomy suffices to argue for euthanasia’s legalization.

3.2. Relief of Suffering

A key reason for euthanasia is the relief of suffering. The rationale is simple and compassionate. It is inhumane to prolong the pain and distress of a dying person when there is compassionate choice: euthanasia (Wach, 2018). With euthanasia, there can still be suffering, but it is not now a concern. Without euthanasia, there is an indifference to the pain someone is in. Ultimately, it comes down to a choice of how one wants to die. This narrative is designed to have emotional resonance. People want to care for those suffering. Therefore, individual stories of suffering are given prominence (Vargić, 2018). The intention is to pluck at the heartstrings. In any consideration of the relief of suffering, dying individuals are at the center because their situation is the most extreme and compelling.

The purpose of this narrative is not to sway the reader or listener with heart-rending tales of suffering and distress, but rather because it is in these individuals that the relief of suffering argument finds its strongest footing. It is difficult to make an argument against euthanasia that focuses on the need to care for someone compassionately and even angrily, watch them suffer when there is a viable alternative. Still, people can suffer so much and there is nothing that can be done except increase the dosage of palliative care and hasten death. Palliative care tries to ease suffering, not solely physical pain. No matter how good and dedicated the palliative care team, suffering cannot be eliminated entirely. Suffering is the experience of intolerable anguish in the painful situation of a dying process. It is the anguish of that particular situation and helplessness about it. It is suffering of such a nature that it cannot be communicated to others because words fail. It can be only shared in silence. There are ethical considerations in euthanasia. If there is the means to ease the pain, one is obliged to do so. There is a psychological toll concerning family and caregivers. They too suffer and bear witness to the suffering of their loved one. All the while, there is a desperate struggle for control, which, whenever power slips from the dying, simply adds to the burden of suffering. With euthanasia, suffering can be shared, but it is also a choice freely made. In it, there is compassionate care given, and to watch someone choose euthanasia is to witness dignity. Compassionate care is a key obligation that has been legislated, enacted, and understood, and therefore the argument for the legalization of euthanasia finds its ethical grounding within this.

3.3. Economic Considerations

Although euthanasia is often viewed as an ethical, legal and moral issue, there are also economic implications. Euthanasia has been widely discussed in the context of increasing financial burdens on families and healthcare systems due to the full- and/or long-term care of the critically ill and the elderly . Legalized euthanasia would provide people with the choice of death, rather than with life at all costs, especially in cases of terminal conditions where treatment only prolongs the inevitable. In these situations, where people become a burden rather than an asset, it must be asked who truly has the right to decide whether a life should end. Would it be so terrible to see the end of one life if that would give an opportunity to live to another? Unfortunately, life and thus healthcare expenses usually come as a package deal. Analyzed data illustrates how, on average, over 75% of expenses in terminal conditions go for only the last 30 days of life. Dealing with the deadweight loss of end-of-life expenses raises other questions, such as what to do with large proportions of money spent on efforts to save unrecoverable patients? Would not these resources be better allocated to those who could recover? Would legalizing euthanasia actually be good for society? Or, on the contrary, would it open the pathway to free up resources at the cost of the helpless? Of lives commodified, which is often regarded as the greatest ethical dilemma of all? The discussion seeks to comprehensively address the economic argument for euthanasia while ensuring opposing views have been equally represented.

Finally, the concern that legalized euthanasia would primarily be abused by the weakest and the most vulnerable is certainly legitimate. However, it should also be emphasized that legal euthanasia does not promote the killing of anyone against their will. On the contrary, legislation should ensure the greatest possible protection to eliminate any chance of exploitation. Thus, criteria for euthanasia should also be much stricter than those for assisted suicide, and people should find euthanasia accessible only in the most desperate situations. The objective of the subsequent analysis is to challenge the traditional view that end-of-life care costs are largest shortly before death, supported by data and projections. Euthanasia is viewed as a pragmatic cure for the deadweight loss of end-of-life care while clarifying the ethical implications thereof in regard to the commodification of life and death. Euthanasia is also advocated as a reasonable personal choice, but certainly not a necessity.

4. Counterarguments Against Legalizing Euthanasia

With regards to the topic of euthanasia, there are strong counter arguments against its legalization that need to be considered seriously. Firstly, there is the argument based on the sanctity of life, which holds that life is inherently valuable and must be preserved under all circumstances. There are religious adherents who believe that life is a gift from God and only God should determine when an individual dies. There are those who are concerned that if euthanasia becomes an option, it would alter individuals’ and society’s perceptions of the value of life. Individual lives would be viewed as disposable under some circumstances, which could cause harm to those who are already vulnerable due to old age, disability or severe mental health issues (Wach, 2018). In such cases, society may become unsympathetic to those who are suffering and instead promote euthanasia as a solution. These fears have caused some countries to block attempts to legalize euthanasia despite a long history of such efforts. An extension of this argument is the slippery slope warning. Even if euthanasia would only be legal in certain strictly defined circumstances, there is fear that it would soon extend beyond that. For example, in the Netherlands, euthanasia was initially legalized only for those suffering unbearable pain with no prospect of improvement. However, now it can also be applied for psychological suffering and, there is discussion about allowing it for children (Khaled Al Hamarsheh and Mrayyan, 2018). Moreover, even with the best safeguards in place, there is a concern that abuses would still take place. For instance, in Belgium, there have been reports of individuals being euthanized without their explicit consent. Overall, there is a fear that society is unable to safeguard the vulnerable from potential abuses if euthanasia were to be legalized. In particular, there is a worry that many of today’s safeguards could fail tomorrow, for instance if the economy took a downturn. Would ailing the elderly, for example, still be viewed as valuable members of society? There are already concerns today that some individuals with diminished capacities make decisions in a coercive context, for example because they feel a financial burden to their families. These counterarguments highlight the complexity of the debate on euthanasia as there are concerns on both sides that are valid in many ways. So, while there is a strong case for euthanasia, it is also necessary to consider the opposing argument strongly and weigh it.

4.1. Sanctity of Life Argument

Opponents of the legalization of euthanasia and physician-assisted suicide use the sanctity of life moral argument and the slippery slope non-moral argument (Wach, 2018). The sanctity of life argument assumes the immorality of all forms of killing, and terminal illness and related suffering are not circumstances justifying the interruption of life. Taking life, even at a person’s request, is seen as a moral crime. Such acts indicate a violation of moral obligations to the individual whose life is taken and society as a whole. Moreover, they are seen as a violation of obligations to God, who is the sole master of life and death (Goroncy, 2017). The protection of life is the foundation of society; without it, institutions ensuring security, justice, and freedom would be meaningless. Furthermore, the value of individual lives is generally questioned. Proponents of this argument believe that society as a whole is threatened when the value of life is challenged. Because life and suffering are seen as a gift from God, views that question their value are considered heretical. Those who challenge the sanctity of life or the dignity of suffering reveal a misguided understanding of humanity, the world, and God. Taking care of the dying by alleviating suffering through killing cannot be reconciled with protecting the dignity of life.

Opponents point out that the killing of one group of people may not be seen as immoral, while the killing of another group is seen as a moral crime. A person who considers the lives of others as useless questions their humanity, even if they see themselves as human. What defines humanity is questioned. The sanctity of life argument focuses on the implications for one group of people as a whole. It is argued that the introduction of an exception to the inviolability of life may create a slippery slope, leading to the killing of the sick, aged, or handicapped without consent. Changes in legislation are believed to shape social awareness, leading to questioning the value of human life in general. Under new circumstances, the activities of some may lead to the devaluation of certain lives, particularly those of marginalized populations, in the eyes of others. Emotional narratives are used to illustrate the weight of this belief. The right to life, which is viewed as an inalienable gift from God, is echoed by national and international foundational documents. It is held not only individually but also communally by families, clans, and nations. Killing is a violation of the most serious obligations to individuals and community members. Lives are held as sacred, and humanity, as a living peoples’ way of being, cannot be conceived apart from life. Thus, it is with the deepest conviction that the belief in the sanctity of life and the prohibition of killing as a way to protect life is upheld. With this, the sanctity of life argument highlights the most profound moral challenge to the pro-euthanasia stance, demanding consideration of its implications.

4.2. Slippery Slope Argument

Concerns regarding potential consequences arising from the legalization of a specific form of euthanasia fall within the slippery slope argument. The crux of this perspective posits that despite radical differences, once euthanasia is permitted due to extreme circumstances, it can become normalized for other situations (Wach, 2018). A local politician disputed the idea of employing specialists from outside, questioning how, in a country with the world’s second-largest Muslim population, one could be “so naïve as to use Greek architects, who build temples and theaters, and not mosques?” This analogy illustrates that what may seem improbable today does not preclude the possibility of it happening tomorrow.

Proponents of legalized euthanasia typically focus solely on a handful of carefully selected cases. While these cases undoubtedly evoke compassion and understanding, they cannot serve as a foundation for widespread legislation. Even taking these extreme cases into account, the situation in countries where similar legislation has been adopted suggests that the original intention is often disregarded or that completely different scenarios arise, altering the context beyond recognition (Vargić, 2018). It is one thing to consider euthanasia for a terminally ill, fully conscious individual in severe agony with no prospect of improvement, who, having expressed a desire for assistance in dying, is unexpectedly subjected to a lack of comprehension and the denial of this request, and quite another to contemplate what this entails for groups susceptible to social coercion. Following these adjustments, an atmosphere of social paranoia emerged, as discussions began concerning the legality of pedophilia and sexual relations between children and animals. This was accompanied by the advent of organizations advocating such rights.

Most alarmingly, fears regarding the coercion of the elderly and disabled persist not only as abstract theoretical possibilities but also as concrete local instances fully justifying such anxieties. In Belgium, a woman in her forties chose to die because she could no longer endure the agony of her mother’s death, despite herself being healthy. In another case, a woman suffering from a hearing disability was coerced into euthanasia after a series of medical examinations, as her advocates alleged that medical staff could not adequately address her needs, a claim the staff disputed. In such instances, the very concept of disability requires scrutiny, as the great disability rights advocate once contended that all humanity is healthy only in a statistical sense, and that ever more elaborate social adjustments should be made to effectively care for the elderly in society rather than to attend to purely individual needs. Of even greater concern is the idea that the elderly, after a lifetime of diligent labor, are merely burdensome to the younger generation, unable to comprehend the broader context of these considerations.

Trust between patients and medical professionals is typically regarded as an ethical principle, along with an obligation to rid practicing medicine of all non-ethical influences. However, this obligation cannot remain absolute, as society has a legitimate interest in ensuring that those possessing the right to kill abide by strict rules, particularly when such rights are denied to the police in the case of people. Thus, the societal obligation to keep the legality of euthanasia outside the purview of the medical profession’s ethics and to subject it to purely social or legal ethics emerges. In other words, the legislation’s potential abuse should be expected to occur in a manner entirely different from the medical understanding of abuse. For instance, a doctor cannot be coerced into performing an abortion, and neither can those opposed to euthanasia be compelled to conduct it. However, should this procedure be legalized, medical professionals will possess all rights necessary for its application. Thus, questions arise regarding who should oversee a doctor’s decision to assist a patient in dying, as this violates the fundamental principle of medicine: to heal rather than harm.

5. Ethical and Legal Frameworks

A central part of the debate over euthanasia focuses on the ethical and legal frameworks surrounding practice. This frames the discussion of arguments and counterarguments over the need for euthanasia legislation. Provisions for euthanasia with guidelines on how practice should take place have been enacted in some countries. It is noted at the outset that regulations differ significantly in form and scope. Euthanasia is permitted in the Netherlands, Belgium, Luxembourg, Colombia, Canada, some states in Australia and the USA, and Spain. However, in some countries, including countries with similar cultural and socio-economic development, euthanasia is not permitted, and legislative attempts have failed. Therefore, a comparative approach is applied to some of the countries where euthanasia is legal, looking at what guidelines have been enacted in order to ensure the practice is ethical (Vargić, 2018). Moreover, it highlights countries where, despite similar cultural and political settings, euthanasia legislation has not been enacted. This approach serves to clarify how, in particular, the controversial practice of euthanasia can be ethically and legally managed in society.

Euthanasia is a deeply controversial issue, and as such, any proposed legislation is likely to be opposed by a vocal minority. Nevertheless, in countries where it is legal, practice generally reflects the ethical considerations put forward in the legislation. In countries such as the Netherlands, Belgium, and Canada, where euthanasia legislation has been in place for a number of years, it is the healthcare providers involved who are primarily considered responsible for ensuring ethical practice. Nevertheless, the impetus for legislation is often public dissatisfaction with existing end-of-life options and a desire for greater patient rights and control. Therefore, public opinion that favors euthanasia generally plays a key role in enacting these frameworks. Of course, these frameworks must be robust enough to prevent abuses of the system, and the focus must remain on the rights of the patient. However, as the Dutch experience shows, ample safeguards can be in place to prevent abuse and still allow for sufficient flexibility to provide the option for euthanasia where desired. Ultimately, discussion and debate should remain a key part of any ethical or legal framework. Legislators, ethicists, and the medical community should continually discuss the implications of legislation, and practice should always be informed by the latest research and discussions.

6. Conclusion

Legalizing euthanasia is a nuanced and complex discussion that raises an array of important ethical, social, and political considerations. Autonomy remains a central pillar of the argument for euthanasia, as certain rights and freedoms are integral to being human. The right to life encompasses the right to freely determine how to live one’s life, a belief shaped by Western individualistic societies. Therefore, it is also reasonable that the right to life entails the right to death, especially when facing insufferable suffering and an irrevocable decline in dignity. Furthermore, extending the same compassion afforded in life by permitting death should also be afforded at life’s end. Accepting the arguments for euthanasia does not dismiss the significance of life, rather death is seen as a part of life, and it should be as dignified as possible (Vargić, 2018). These arguments are framed by reflections on the historical evolution of religious influence over ethics and the law, moral and ethical considerations regarding life, death, suffering, and dignity, and contemporary considerations of individual freedoms. It is also important to acknowledge that current laws and values can never wholly disregard the past, which sees a complex interplay of myriad values and beliefs in a turbulent discourse on euthanasia. Finally, in respect to the content and the need for further discussion and research, the goal of this essay is to present awareness of the complexities and nuances of the euthanasia debate to policymakers and those who may seek to shape policy. With the best interests of all people in mind, it is vital for policy to consider compassion in its choices regarding euthanasia. As this discussion indicates, choices will always have implications, desirable and undesirable, intended and unintended. Ultimately, it is hoped that this discourse could instill in readers the desire for reflection on what their considerations regarding the implications of euthanasia might be.

References:

• Vargić, H. "Should euthanasia and assisted suicide be legal? Addressing key arguments and analysing the consequences of legalization." 2018. [PDF]
• Wach, B. "Argumenty w sporze o legalizację eutanazji i wspomaganego samobójstwa. Część I." 2018. [PDF]
• Khaled Al Hamarsheh, M. and Mrayyan, M. "Cancer Patients Who Elect Euthanasia as an Option: An Argumentative Essay." 2018. [PDF]
• Goroncy, J. "Euthanasia: Some theological considerations for living responsibly." 2017. [PDF]