We’re tackling a difficult one this week. Euthanasia is a controversial topic and divides the opinions of not only the general public but medical practitioners too.
What is it?
Euthanasia is categorized in three different ways: voluntary, non-voluntary and involuntary.
· Voluntary euthanasia is conducted with the consent of the patient. Active voluntary euthanasia is currently legal in Belgium, Luxembourg and the Netherlands; whilst passive euthanasia, more commonly known as assisted suicide, is legal in the U.S. states of Oregon, Washington and Montana along with Switzerland.
· Non-voluntary euthanasia is conducted where the consent of the patient is unavailable. Child euthanasia falls under this category and is illegal worldwide, however; it can be decriminalised in the Netherlands under specific circumstances under the Groningen Protocol.
· Involuntary euthanasia is conducted against the will of the patient and is viewed as murder.
Within all of the above categories there is the subdivision of active and passive euthanasia. Active euthanasia involves using lethal substances or forces, such as a lethal injection, to end the patient’s life. This is the most controversial out of the two. Passive euthanasia is not as severe and entails withholding the necessary treatment that would be necessary for the continuance of life.
The subject of euthanasia remains an on-going debate. Those in favour of legalizing the practice argue that:
· People have a right to self-termination and therefore, have a right to decide their own fate.
· Assisting a patient to die might be a better choice than prolonging their suffering.
· Permitting euthanasia will not necessarily lead to it being carried out in unacceptable circumstances.
On the other side, the case against the legalization and practice of euthanasia argue that:
· Not all natural deaths are painful.
· Other solutions such as cessation of treatment and the provision of painkillers are available.
· Legalizing euthanasia could have a damaging effect on the morals of society and could lead to the practice being carried out immorally.
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The latest country to take a step towards legalizing euthanasia is France. On the 2nd of March the French Medical Ethics Council ruled that assisted suicide should exceptionally be allowed when ailing patients make ‘persistent, repeated and lucid’ requests to end their life. The council stated that it was a ‘duty to humanity’ to allow patients who are suffering from a problem where treatment is no longer effective, to die. The decision to allow the patient to end their life would have to be agreed by a medical team and not a sole doctor. The council’s conclusions came after President François Hollande requested an examination of the precise circumstances under which such steps could be authorised, with a view to tabling draft legislation by June. Changes were necessary, he said, as ‘the existing legislation does not meet the legitimate concerns expressed by people who are gravely and incurably ill’. The current law allows doctors to prescribe painkillers that they know will not only provide relief, but also shorten the patient’s life expectancy. The council claimed that this current law offers ‘no solution to certain cases of prolonged agony or to psychological and/or physical pain that, despite the means employed, remain uncontrollable’ and that in such cases the patient should be allowed to be placed into a suitable, deep and terminal sedation. All of this comes after a report was given to the council that found that there was widespread dissatisfaction among terminally ill patients and their families over a “cure at all costs” culture in the medical establishment. It called for doctors to be allowed to take actions to hasten the death of terminally ill patients in three specific sets of circumstances:
· The patient issues an explicit request or gives advance instructions in the event of him or her becoming incapable of expressing an opinion.
· The second case envisages medical teams withdrawing treatment following a request by the family of a dying and unconscious patient.
· The third would apply to cases where treatment is serving only to sustain life artificially.
Euthanasia will continue to remain a controversial topic for many years to come, but it could be a sign of change that France is taking steps towards legalizing the procedure and joining the likes of Switzerland, and maybe more countries will begin to follow. Is it right to let a terminally ill patient end their life? Or will it lead to malpractice and damage the morals of society? What do you think?
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