Euthanasia

Euthanasia, also known as assisted suicide, physician-assisted suicide, doctor-assisted

dying (suicide) and more loosely termed mercy killing, means to take a deliberate action with
the express intention of ending a life to relieve intractable (persistent, unstoppable) suffering.

Some interpret euthanasia as the practice of ending a life in a painless manner. Many
disagree with this interpretation, because it needs to include a reference to intractable suffering.
In the majority of countries euthanasia or assisted suicide is against the law.

There are two main classifications of euthanasia:

 Voluntary euthanasia - this is euthanasia conducted with consent. Since 2009 voluntary
euthanasia has been legal in Belgium, Luxembourg, The Netherlands, Switzerland, and the
states of Oregon (USA) and Washington (USA).

 Involuntary euthanasia - euthanasia is conducted without consent. The decision is made

by another person because the patient is incapable to doing so himself/herself.

Also, there are two procedural classifications of euthanasia:

 Passive euthanasia - this is when life-sustaining treatments are withheld. The definition of
passive euthanasia is often not clear cut. For example, if a doctor prescribes increasing doses
of opioid analgesia (strong painkilling medications) which may eventually be toxic for the
patient, some may argue whether passive euthanasia is taking place - in most cases, the
doctor's measure is seen as a passive one. Many claim that the term is wrong, because
euthanasia has not taken place, because there is no intention to take life.

 Active euthanasia - lethal substances or forces are used to end the patient's life. Active
euthanasia includes life-ending actions conducted by the patient or somebody else.

Active euthanasia is a much more controversial subject than passive euthanasia. Individuals
are torn by religious, moral, ethical and compassionate arguments surrounding the issue.
Euthanasia has been a very controversial and emotive topic for a long time.

Nowadays, various forms of medical assisted suicide have been approved in the following
states and nations.Each law has its own limits, rules and guidelines. All but Switzerland forbid
foreigners this type of help to die. The countries which allows it are: Switzerland – 1940, Oregon
(U.S.) – 1994, Colombia – 1997, The Netherlands – 2002, Belgium – 2002, Washington (U.S.)
– 2008, Luxembourg – 2009, Montana (U.S.) - 2009 (court ruling only), England & Wales -
2010 (prosecution policy statement), Vermont (U.S.) – 2014, New Mexico (U.S.) - 2015 court
ruling under appeal) , Quebec (Can.) – 2015, California (U.S.) – 2015 and Canada – 2016.
 In the Netherlands, the patient's suffering must be unbearable, with no prospect of
improvement. The suffering need not be related to a terminal illness and is not limited to
physical suffering such as pain. It can include, for example, the prospect of loss of personal
dignity or increasing personal deterioration, or the fear of suffocation.

The Belgian law is similar. The patient's suffering must be constant and unbearable,
resulting from a serious and incurable disorder. There is no requirement that the patient be
diagnosed with a terminal illness, although additional checks are imposed if the patient is not
terminally ill.

In Canada, patients will qualify for assistance if they have a grievous and irremediable
medical condition that causes enduring and intolerable suffering.

The five US states permit assisted dying only, so the patient must be terminally ill. There is
no additional requirement relating to the patient's experience of the disease or any minimum
level of suffering.

The arguments for euthanasia:

1 We need it - the compassion argument. Supporters of euthanasia believe that allowing

people to ‘die with dignity’ is kinder than forcing them to continue their lives with suffering.

2 We want it - the autonomy argument. Some believe that every patient has a right to choose
when to die.

3 We can control it - the public policy argument. Proponents believe that euthanasia can
be safely regulated by government legislation.

The counter arguments:

1 Alternative treatments are available, such as palliative care and hospices. We do not
have to kill the patient to kill the symptoms. Nearly all pain can be relieved.

2 There is no ‘right’ to be killed and there are real dangers of ‘slippery slopes’. Opening
the doors to voluntary euthanasia could lead to non-voluntary and involuntary euthanasia, by
giving doctors the power to decide when a patient’s life is not worth living. In the Netherlands
in 1990 around 1,000 patients were killed without their request.

3 We could never truly control it. Reports from the Netherlands, where euthanasia and
physician-assisted suicide are legal, reveal that doctors do not always report it.

4 The assumption that patients should have a right to die would impose on doctors a
duty to kill, thus restricting the autonomy of the doctor. Also, a ‘right to die’ for some people
might well become a ‘duty to die’ by others, particularly those who are vulnerable or dependent
upon others.
 Gross v. Switzerland 30 September 2014 (Grand Chamber judgment)

The case concerned the complaint of an elderly woman – who had wished to end her life but had
not been suffering from a clinical illness – that she had been unable to obtain the Swiss authorities’
permission to be provided with a lethal dose of a drug in order to commit suicide. The applicant
complained that by denying her the right to decide by what means and at what point her life would end
the Swiss authorities had breached Article 8 (right to respect for private and family life) of the
Convention.

In its Chamber judgment in the case on 14 May 2013, the Court held, by a majority, that there had
been a violation of Article 8 (right to respect for private life) of the Convention. It found in particular
that Swiss law was not clear enough as to when assisted suicide was permitted. The case was
subsequently referred to the Grand Chamber at the request of the Swiss Government.

In January 2014 the Swiss Government informed the Court that it had learned that the applicant
had died in November 2011. In its Grand Chamber judgment of 30 September 2014 the Court has, by a
majority, declared the application inadmissible. It came to the conclusion that the applicant had
intended to mislead the Court on a matter concerning the very core of her complaint. In particular, she
had taken special precautions to prevent information about her death from being disclosed to her
counsel, and thus to the Court, in order to prevent the latter from discontinuing the proceedings in her
case. The Court therefore found that her conduct had constituted an abuse of the right of individual
application (Article 35 §§ 3 (a) and 4 of the Convention). As a result of this judgment, the findings of the
Chamber judgment of 14 May 2013, which had not become final, are no longer legally valid.