situation ethics and euthanasia essay

Essay – Full mark 2018 essay on euthanasia & Natural law

October 8, 2018.

Assess the view that natural law is of no help with regard to the issue of euthanasia. OCR Paper H573/2 June 2018

Here is an answer written in the actual June 2018 exam that secured full marks. I have added comments to demonstrate what is good and not so good about this answer. You don’t have to write a perfect answer to gain full marks. Read my comments in italics and see if you agree. PB

Natural Law is a religious ethical theory that puts reason at the centre of moral thought and decisions. Euthanasia is a modern practice where a person/persons can be killed on their own terms, whether passively (switching of a life machine) or actively (lethal injection). In terms of the practices of euthanasia and whether it should be accepted, natural law is of no help and instead situation ethics should be adopted to the issue of euthanasia.

There are a number of good things about this opening paragraph: it has a clear thesis – situation ethics is to be preferred, although the candidate might have briefly hinted as to why. The opening emphasises reason, a point many candidates miss. And there is a clear definition of two types of euthanasia, with good issue of brackets for economy. Ia m not sure that euthanasia itself is an issue – there are issues involved in the moral debate such as slippery slope arguments or sanctity of life arguments. These might also have been hinted at rather than taking a broad approach.

  Euthanasia is being widely adopted in modern western cultures as secularism is becoming more popular. There is more emphasis being placed on the quality of life rather then sanctity of life. Natural Law theory places special emphasis on the sanctity of life arguing that only God should have the power to take away a life.

Natural Law is an ancient theory deriving from the Greeks and particularly Aristotle. Aquinas took Aristotle and attempted to reconcile his theory of ethics with Christianity. So what the candidate is talking about here is Aquinas’ version of natural law which has been a dominant moral theory in the west, as it informs the moral theology of the Catholic Church. Note the synoptic link to the Christian Thought paper and secularism.

  Natural Law is focused on the primary precepts and upholding its main components; worship God, live in an ordered society, reproduce, to learn and to defend the innocent. Euthanasia goes against possibly three of these primary precepts, and is therefore forbidden under natural law. The secondary precepts would argue that euthanasia is wrong as it goes against the precepts of defending the innocent. Killing someone voluntarily or non-voluntarily and worshipping God as only God should be able to take life away. In a period where quality of life is emphasised, natural law is incompatible with modern culture. Natural Law upholds the sanctity of life and any practice taking away life is wrong – in a society which allows this natural law is outdated. Aquinas lived when the church dominated society and culture and now the church and state are separate, showing now natural law should be adapted.

Aquinas finally gets a mention.  The word ‘adapted’ is interesting as secondary precepts are meant to be adaptable, so Aquinas argues. Secondary precepts are ‘proximate conclusions of reason’. The candidate hasn’t really explored the tantalising hint in the first paragraph that natural law is a theory of human reason. I like the mention of three precepts here: for example, candidates often miss the implications that might exist for an ordered society if euthanasia was adopted (rise in court cases for example as relatives argue about whether passive euthanasia should be applied!).

  Natural law also prohibits euthanasia on the grounds of real and apparent goods. Killing someone passively is an apparent good because it does not achieve long-term gratification as the person would be dead. However this view can be criticised as a person’s suffering would be cut shirt so best for the long-term – there is no more suffering. Many agree with natural law also b saying that euthanasia sets a dangerous precedent and makes a possibility of a ‘slippery slope’ when killing becomes natural. This is against human nature.

There seems to be a misunderstanding here about what a real and apparent good is. According to Aquinas, we cannot willingly and rationally do evil because we are by nature orientated towards the good. So if we objectively do evil it is because we subjectively believe through a defect of our reason that we are actually doing good. Because of a lack of clarity this paragraph doesn’t take the argument forward and could easily have been deleted in its entirety.

  Another weakness of natural law is that it contradicts itself. Although the primary precepts prohibit euthanasia as it actively kills a person, the doctrine of double effect allows it. If a doctor keeps prescribing a patient more medicine, which eventually leads to an overdose, the is not the doctor’s fault and is permissible through the doctrine of double effect. This is a weakness as it seems to contradict earlier teachings from Aquinas. However it could also be seen as  strength of natural law. The doctrine of double effect is a better developed by the catholic church in response to situation ethics ; it allows euthanasia to certain degree as well as upholding religious aspects  – many see this as favourable and may provide a way to treat the issue of euthanasia.

It’s only a contradiction if you misunderstand the relationship between the absolute primary precepts and the secondary precepts which are never absolute. Aquinas, not the catholic church, introduces double effect way back in the thirteenth century – so it cannot be in response to the twentieth century theory of situation ethics.

Natural law is of no use to euthanasia and so situation ethics should be adopted. Joseph Fletcher was the founder of situation ethics and was at one point president of the euthanasia society in the USA. Situation ethics allows the practice of euthanasia as it focuses on the quality of life more. Firstly, Fletcher’s view of agape is much stronger as it accounts for the most loving thing to do. In certain situations, the most loving thing is to switch of the life support machine so that a person’s suffering is ended. The most loving thing to do allows the families of patients to say goodbye allows for patient’s to assess future possible situations themselves through living wills. Situation ethics follows the propositions of pragmatism, personalism, positivism and relativism. Each one important to the issue of euthanasia. Pragmatism allows a practical approach to euthanasia and where practicality of a situation is focused on. Personalism puts people above laws so full agape can be achieved. Although a partly legalistic theory situation ethics is also antinomian where people should be making their own decisions above the law. Positivism allows the practice of euthanasia because in most cases a positive effect is being produced. Relativism is most important because it allows the situation to be weighed on a case by case basis (natural law is unable to do this as it is absolute). These propositions provide more clarification on euthanasia and allow the issue of euthanasia to be clarified.

Natural law is not absolute in terms of its secondary precepts. The name Fletcher gives to his four principles is ‘working principles’ not ‘propositions’.

  Another supporting factor for euthanasia is the six principles which seek to fulfil agape. For example, the third principle that justice is love seemed upholds the value of love distributed. The other fundamental principles also seem to clarify how love is best served and how agape is applied in different situations. In the real case of Simon’s choice, a man was diagnosed with motor neurone disease and in months ahead lost control of his bodily functions and was dependent on support. Simon made the choice to go to Switzerland to die. Natural law would not have permitted this as it breaks the precept of the sanctity of life however situation ethics would allow Simon’s choice to die based on his quality of life. The shows the more practical and reasonable approach of situation ethics is more useful.

However, situation ethics can be criticised. By describing it as relativism, euthanasia is judged on a  case by case basis, which can lead to dangerous precedents. If someone is allowed to be euthanased because they are blind, it could influence other people. With sensory issues to seek euthanasia. Even if they have a decent quality of life. Euthanasia can thereby lead to a slippery slope, where euthanasia becomes too common. This raises the question of where to draw the line with euthanasia, and situation ethics provides no guidance on this. Also doctors swear by the Hippocratic Oath, to uphold the life of the patient. Situation ethics dismisses this – instead going against the doctor’s primary role. A judgement is made about the future: in some cases a patient may get better. Overall however, these weaknesses don’t create a strong enough basis for dismissing situation ethics.

On balance, therefore natural law is of no help in regard to the issue of euthanasia and instead situation ethics should be adopted. Situation ethics is stronger as it takes  a teleological approach seeking to uphold the quality of life – this secures someone’s autonomy and secular views which are being adopted by western societies – such as Switzerland. Natural law is also absolute and deontological, upholding the sanctity of life which seems outdated. The precepts are also incomplete with modern society Fletcher’s four working principles are much more practical and relevant. Overall therefore natural law is of no help with regard t the issue of euthanasia and instead situation ethics should be adopted.

40/40 Grade A*

What is excellent about this essay (and often not achieved by candidates) is the precise focus on the question set. The very clear thesis is referred to again and again, elaborated and clarified. The justification for the case is complete. You can reconstruct the question from the answer itself. However, the answer is rather long and a bit repetitive. If you can develop your won slightly tighter style, it allows you to add even more excellent analysis. One glaring omission in this answer is the failure to develop and discuss the idea that natural law is a theory of human reason, which is mentioned in the opening paragraph. There are two concepts Aquinas introduces to confirm this: synderesis (the intuitive knowledge of first principles – the primary precepts) and phronesis (the practical wisdom we develop to judge secondary precepts rightly and make nuanced judgements about the application of double effect). Being critical, I also feel there are a number of misunderstandings here – about real and apparent goods, for example and the persistent claim that natural law is absolute and contains hard rules like Kantian ethics. Aquinas never argues for a hard form of deontology. Human beings are designed by God to use our reason to face hard choices and take responsibility for them.

  My conclusion: to gain full marks you don’t have to have knowledge that’s 100% accurate, but you do need a strong argument, a clear thesis and a comprehensive analysis and evaluation that justifies your thesis. Candidates are often preparing for this exam in the wrong way – just by learning material rather than practising their analytical writing skills.

  Peter Baron October 2018

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The Ethical and Legal Implications of Euthanasia

Generally, the topic of euthanasia has resulted in hot debates among all stakeholders, including healthcare professionals and legal experts, due to the ethical and legal issues associated with the topic. It affects both patients and their healthcare providers. Over the years, the debate on euthanasia has focused on suffering patients with terminal illnesses. However, the topic has extended to include even patients with mental illnesses like depression. Therefore, it is appropriate to look at the controversy surrounding euthanasia in a recent case study. Euthanasia is a controversial topic that requires further inquiry to fully understand different opinions offered by the opposing sides and the ethical implications associated with it.

Recent Case Study

The case published in the Catholic Herald involves a 29-year-old woman who underwent euthanasia following a series of mental illnesses. According to the author, despite being physically fit, the woman was given a lethal injection, having been granted her wish to die by the court after eight years of legal battles. In her argument, the woman claimed she had experienced extreme bouts of depression that had made her life intolerable. The case raised concerns among various stakeholders, including politicians who lamented how dangerous euthanasia could be.

Ethical Issues Involved in the Case Study

Generally, the case study raises various ethical dilemmas related to euthanasia, including when it is justifiable to end one’s life. In addition, the topic also opens up a whole discussion on the limitations of patients’ autonomy and the ethical responsibilities of healthcare professionals, as highlighted in the bioethical principles of beneficence and maleficence. Concerning autonomy, questions are raised regarding the patient’s capability to understand the decision that she was making. With superior knowledge and training, the physician is best positioned to help make an ethical decision that is in the patient’s best interest to protect patients from irresponsible choices. For patients to make an autonomous decision, they should be mentally capable of comprehending the information of the decision. In the case study, the patient has a mental health condition. Hence, her ability to make rational decisions is in question.

The Context of Euthanasia

The case study highlights euthanasia, particularly among patients with mental conditions such as depression. Historically, numerous attempts have been made to legalize euthanasia, but minimal success has occurred. The euthanasia discussion in psychiatry was awakened after the Nazi Holocaust when thousands of psychiatric patients were gassed or poisoned to death under the ‘euthanasia program’. According to Felder, the Nazi euthanasia program was used by scientists, mainly physicians, to conduct medical experiments. It is out of the scientific experiments of the Nazi physicians that ‘The Nuremberg Code’ was established to guide future experiments on human subjects.

Additionally, politicians have had their hand in the matter by sponsoring bills to legalize the act, with some opposing such attempts and publicly making their views known. From a social perspective, euthanasia has continued to be controversial, with many societies coming up to air their opinion. In the traditional Christian context and culture, euthanasia is viewed as morally unacceptable due to human life’s sacred nature. However, other social groups support euthanasia with the thought of extending dignity to death, such as the Voluntary Euthanasia Society. As such, there is no single available societal perspective regarding the issue of euthanasia. Hence, it is important to society as it touches on the critical matters of life and death.

The Differing Perspectives on Euthanasia

The individuals and societies in support of euthanasia have always centered their opinion on patient suffering. They argue that patients in the terminal stages of illness experience excruciating pain and have poor wound healing, poor social interactions, and many other aspects of physical suffering. According to the proponents, euthanasia is a more merciful response to relieve this suffering, especially where the quality of life is jeopardized. Among the patients with mental illnesses, the proponents argue that some mental conditions, including severe depression, induce intense suffering and are unresponsive to treatment. Additionally, the proponents note that since the patients request most cases of euthanasia, it is a way for physicians to show respect for personal autonomy. Thus, to the proponents, euthanasia relieves undue suffering and is in harmony with respect for autonomy and the individual’s right to a dignified death.

Contrary to the proponents’ arguments, the opponents base their argument on the intrinsic wrongness of killing, professional integrity, and the possibility of potential abuse. According to Naga and Mrayyan, willingly ending one’s life is inconsistent with human rights, and alternatives should be sought to relieve the patient’s suffering and improve their quality of life. Furthermore, Naga and Mrayyan note that administering lethal substances by physicians to end life is unethical according to guiding medical ethical practices, especially the Hippocratic Oath that restricts physicians from administering such substances to their patients or aiding their patients to die. They also note that legalizing euthanasia could lead to its potential abuse and a slippery slope where individuals will use it to escape chronic but manageable medical conditions.

Evaluation of the Arguments and Their Ethical Implications

The arguments presented by both the proponents and the opponents seem to be entirely influenced by one’s culture, moral philosophy, and personal experiences. Those opposed to euthanasia seem to be influenced by their religious cultures. Specifically, Christian teachings view life as sacred and state it should not be terminated prematurely at any cost. On the other hand, the proponents seem to subscribe to the Stoic philosophy that has always defended suicide as a reasonable departure from life, especially when intense suffering is involved. Anecdotal evidence also suggests that personal life experiences with suffering may make one choose to end one’s life. For example, seeing a cancer patient suffer may make individuals consider euthanasia if diagnosed with a similar terminal disease, as they will not want to experience the same ordeal.

While both the proponents and those opposed to euthanasia have valid arguments, myriads of ethical issues surround each side’s perspective. It is indeed true that certain illnesses, including mental conditions, lead to severe suffering and reduced quality of life. However, ethical issues arise regarding the ability of the patients requesting euthanasia to make autonomous decisions. For example, Appelbaum notes that it is common for depressed patients to reject treatment and even request death, yet change their decision once the depression is resolved. Accordingly, this raises the ethical question concerning the impact of the mental illness itself on the patient’s decision-making. It has also been observed that most patients are only resistant to one form of treatment and that other options should be tried to relieve their suffering.

Furthermore, it is noted that the right to autonomy is not always absolute and that physicians have the legal and ethical responsibility to override the patient’s decisions and continue pursuing alternative treatment in response to the patient’s symptoms and request a dignified death. Thus, the argument regarding patients’ autonomy to end their lives is weak. On the other hand, the opponents’ unethical medical practice mainly touches on physicians’ ethical responsibilities to act in good faith and protect their patients from harm. In line with non-maleficence and beneficence principles, physicians cannot administer lethal dosages to their patients as it causes more harm than good. Additionally, the claim of potential abuse if euthanasia is legalized, holds grounds owing to several reported cases, including ones with mental illnesses, where euthanasia has been performed without following due process in countries where it is legalized. Thus, the ethical questions raised by those opposed to euthanasia regarding non-maleficence, benevolence, and potential abuse are strongly supported by evidence.

Personal Perspective on Euthanasia

The issue of euthanasia among depressed patients will continue to dominate medical discussions. Subjectively, the opponents of euthanasia seem to offer a strong argument. Notably, depression can be treated just like other mental conditions, and symptoms can be controlled where treatment is impossible. Patient autonomy among psychiatric patients is in question. Mental illnesses tend to affect one’s way of thinking, and suicidal ideations are common phenomena among depressed patients. I have dealt with patients who have changed their stance on ‘mercy killing’ after a series of professional counseling sessions and continued treatment. Thinking about these experiences concerning my patients and the ethical dilemmas related to euthanasia makes me view it as an undesirable event in medical practice that I will not want to engage in.

The topic of euthanasia is controversial based on the numerous arguments aired by those in its support and those who are against it. The case study published in the Catholic Herald offers a good scenario through which the effects of euthanasia can be accessed and its ethical implications reviewed. While the Pro-euthanasia argument is based on the need to relieve undue suffering, respect autonomy, and grant the right to a dignified death, the opponents have emphasized the intrinsic wrongness of killing, professional integrity, and the possibility of a “slippery slope”. Overall, the ethical issues addressed autonomy, beneficence, and non-maleficence. Subjectively, the ethical questions touching upon professional integrity, especially the need to observe non-maleficence and doing good, are strong enough to make me offer my support against euthanasia.

📎 References:

1. Appelbaum, P. S. (2017). Should mental disorders be a basis for physician-assisted death? Law & Psychiatry, 68(4), 315-317. https://doi.org/10.1176/appi.ps.201700013 2. Beauchamp, T. L. (2016) Principlism in bioethics. In P. Serna & J. A. Seoane (Eds.), Bioethical decision making and argumentation (pp. 1-16). New York, NY: Springer. 3. Caldwell, S. (2018, February 1). Dutch doctors euthanize a 29-year old woman with depression. Catholic Herald. 4. Felder, B. M. (2013). “Euthanasia,” human experiments, and psychiatry in Nazi-occupied Lithuania, 1941-1944. Holocaust and Genocide Studies, 27(2), 242-275. https://doi.org/10.1093/hgs/dct025 5. Kim, S. Y., De Vries, R. G., & Peteet, J. R. (2016). Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands 2011 to 2014. JAMA Psychiatry, 73(4), 362-368. https://doi.org/10.1001/jamapsychiatry.2015.2887 6. Naga, B. S. B., & Mrayyan, M. T. (2013). Legal and ethical issues of euthanasia: Argumentative essay. Middle East Journal of Nursing, 7(5), 31-39. https://doi.org/10.5742/MEJN.2013.75330 7. Nunes R., & Rego, G. (2016.) Euthanasia: A challenge to medical ethics. Journal of Clinical Research & Bioethics, 7(4), 1-5. https://doi.org/10.4172/2155-9627.1000282 8. Tomasini, F. (2014). Stoic defence of physician-assisted suicide. Acta Bioethica, 20(1), 99-108. Retrieved from https://scielo.conicyt.cl/pdf/abioeth/v20n1/art11.pdf

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Critically evaluate Situation Ethics as an approach to making decisions about euthanasia. [40]

Situation Ethics: The New Morality is a book written by Joseph Fletcher, an American Episcopalian Moral Philosopher with a strong interest in medical ethics who lost his faith around the time the book was first published in 1964.  Like many Christians, Fletcher was concerned about the decline in moral standards and the growth of radical relativism which had let to genocide during WWII and was fuelling the sexual revolution and the collapse of family values in the 1960s.  Fletcher rejected such relativism for being antinomian and leading to chaos, as well as being unchristian.  Fletcher was influenced by Utilitarianism, the dominant, consequentialist approach to ethical-decision-making in the 1960s.  While it was a relativist ethic, decisions were made relative to an absolute, namely human happiness or pleasure.  While Fletcher (like many other Moral Philosophers) was critical of basic happiness or pleasure as the only desirable end, he liked the flexibility of Utilitarianism and its focus on making decisions situationally , as well as its respect for the individual moral-agent and their ability to make decisions for themselves rather than just following rules.  Fletcher was critical of the traditional, absolutist ethical systems employed by Christian Churches.  As he saw it, Roman Catholic Natural Law was guilty of legalism – being too focused on the letter of the law rather than its spirit and insufficiently focused on persons – to be truly a Christian Ethic.  Protestant Biblical Ethics were often similarly inflexible and based on narrow interpretations of ancient texts that neglected the most important ethical teaching in the Bible in Mark 2:28-32 – the need to love our neighbour as ourselves and therefore act out of agape, non-preferential humanitarian love.  For Fletcher, Christians and non-Christians alike should move forward and adopt a “new morality” which would make persons the focus, making decisions situationally and relative to agape-love.  This “new morality” is Situation Ethics.  As an approach to making personal decisions about Euthanasia it is a useful guide in countries where Euthanasia is legal, but it is not very useful for religious people or in countries where Euthanasia is illegal.  

Firstly, Fletcher characterises Situation Ethics as an approach which has four working principles – Pragmatism, Relativism, Positivism and Personalism .  The first working principle of Situation Ethics is pragmatism or practicality, so it is undeniable that the legal status of euthanasia will impact on any assessment of the usefulness of Situation Ethics as an approach to decision-making.  Where Euthanasia is illegal and where effective enforcement exists, people are not really free to make their own decisions situationally.  Personalism and relativism – putting people and agape-love first – will deter anybody from deciding to help somebody end their life if such help will probably result in prosecution and punishment.  Prosecution and punishment will not only affect the person convicted of course, but also their family, friends and wider society as well, so on this basis it would be difficult to argue that breaking a law against euthanasia could be situationally justified, except perhaps in the most extreme cases of suffering.  Of course, Fletcher believed that “sometimes you’ve gotta put your principles to one side and do the right thing” and he rejected the use of the words “always” and “never” in moral decision-making, but still cases in which stopping the suffering of one person but with the consequence of causing pretty intense suffering to somebody else, their family, their friends as well as burdening the tax-payer with the expense of a long prison-term, will be pretty rare.  Additionally, by encouraging individuals to think this through and make the decision for themselves when they are in the stress of the situation and when the law prohibits euthanasia anyway is far from helpful.  In the heat of the moment, people are liable to focus on immediate consequences and the persons in the room with them and to neglect longer-term consequences and people outside the room who will also be impacted.  In this way, situational decisions, however well-intentioned, are liable to be poor decisions even with respect of the agape-love they try to promote, and often result in more people suffering than would be the case if people just followed the law. Because of this, Situation Ethics is not very useful in countries where Euthanasia is illegal.  

Secondly, despite the fact that Situation Ethics makes decisions relative to agape-love and takes this as an end on the grounds of theological positivism and Christian faith, rather than any rational argument or evidence, Fletcher’s “new morality” has been roundly rejected by all the major Christian Churches.  Even before Fletcher wrote, Pope Pius XII condemned the idea that Christians should make decisions situationally, as individuals, in 1952.  The Pope pointed out that using the individual conscience to make a decision for oneself rather than deferring to the authority of the Church and its rules risked plunging that individual into sin, with its eternal consequences.  Again, in the heat of the moment people usually focus on immediate consequences and forget or downplay long-term consequences, including of course the fate of their eternal soul (and that of the person euthanatized of course).  Because of this, Situation Ethics represents a real threat to Christians in tempting them to make decisions when they are likely to make poor decisions with the most severe of consequences.  While St. Thomas Aquinas argued that Christians must prioritise following their consciences and so make decisions for themselves rather than mindlessly deferring to absolute rules, in practice he saw the conscience in terms of synderesis or practical reason, a faculty which needs to be trained if it is to make good decisions, perhaps especially in traumatic situations.  In a way, Fletcher agreed with Aquinas; while he rejected Aquinas focus on reason as the only appropriate basis for the conscience to operate upon, Fletcher did see conscience as a decision-making faculty and process rather than as the source of moral intuition.  As Fletcher wrote “there is no conscience, “conscience” is merely a word for our attempts to make decisions…”  Aquinas was only too aware of the human tendency to pursue apparent goods over real goods and so to fall into error with the best of intentions.  It was because of this that in 1956 the Sacred Congregation for the Doctrine of the Faith banned Catholic institutions from teaching or even teaching about Situation Ethics.  Fletcher was more positive about the individual’s ability to make good decisions situationally, through their consciences, than was either Aquinas or the Congregation for the Doctrine of the Faith, but perhaps he would have been well to be more cautious given the eternal consequences poor decisions have, at least for Christians using Situation Ethics.  Any suffering that people ease by making a situational decision in favour of euthanasia is after all, temporary… but for Christians the consequences probably will be eternal suffering.  Because of this, Situation Ethics is not a useful approach to making decisions about euthanasia for religious believers.  

Thirdly, taking the example of euthanasia, in 1994 Dr Cox decided to act situationally and help his suffering patient Lilian Boyes to die by giving her a lethal injection.  As it turned out, this decision ruined his career and his life and the resultant media-storm led to a tightening of UK monitoring of physicians and enforcement procedures in cases of suspected euthanasia, making it more difficult for doctors to ease the deaths of their patients.  While Dr Cox was prioritising Mrs Boyes and showing great agape-love for her and her family, he could not have predicted the consequences his decision would have for others, including himself and his own family.  This is a major weakness of Situation Ethics as well as other consequentialist approaches to moral decision-making. As Peter Singer admits, all consequentialist decision making depends on our ability to predict the consequences of our actions accurately (the Problem of Prediction )… and consequences are often, even usually, unpredictable.  Because of this, as a Consequentialist approach to making decisions about Euthanasia, Situation Ethics is of limited usefulness.  Despite this, in countries where euthanasia is legal – such as in Canada, New Zealand, the Netherlands and in some Australian states – Situation Ethics might still be a useful guide when people are making decisions, whether about whether to request euthanasia or whether to help somebody to die.  This is because Situation Ethics encourages people to consider the persons involved in the decision ahead of their own principles and to focus on maximising agape-love rather than on the actions used to achieve this.  Where doctors might not wish to get involved in euthanasia on principle, Situation Ethics encourages them to consider each situation on its own merits and to prioritise the needs and wishes of their patients rather than sticking to “always” or “never” beliefs.  As Fletcher wrote “Situation Ethics keeps principles sternly in their place, in the role of advisors without veto-power…” (page 55) For Christian doctors, or for other Christians considering becoming involved in euthanasia, Situation Ethics encourages them to reflect on the two most important commandments (Mark 12:28-32) and to consider how their love for God relates to their love for neighbour and self.  As William Temple said – and as Fletcher would have agreed – “on freedom all spiritual life depends, and it is astonishing and terrifying that the Church has so often failed to understand that.”  Just as Jesus made decisions on the basis of persons, pragmatically and on the basis of agape-love… sometimes breaking laws, rules or norms in the process and sometimes sacrificing his own reputation to do so… so Situation Ethics encourages Christians to follow Jesus’ example and in the process helps them to develop spiritually and morally.  Of course, this is not to say that situational decisions will always or even often support euthanasia.  As Fletcher’s own examples show, the cases in which it is right to do something Christians would normally conceive of as wrong are rare and extreme.  Situation ethics would not, as Fletcher conceives it, endorse the wide-scaled legalisation of abortion or its use as a form of contraception… but it might support a doctor in terminating the pregnancy of a mentally ill teenager who had been raped.  Situation ethics would not, as Fletcher conceives it, endorse people killing themselves for no reason… but it might support a man in hastening his own inevitable death in order that his family suffers much less by his loss.  Because Situation Ethics encourages Christians to become active moral agents, it might be a useful guide in countries where euthanasia is legal.  However, the usefulness of Situation Ethics will depend a lot on the individual and the extent to which their conscience is developed and trained as a decision-making faculty.  It is probably fair to worry about the effects of using Situation Ethics in relation to issues like Euthanasia on any Christian – or indeed any person – who is unaccustomed to independent moral-decision making. 

In conclusion, as an approach to making personal decisions about Euthanasia Situation Ethics may be a useful guide in countries where Euthanasia is legal, but it is not very useful for Roman Catholics or those who believe in judgement and hell, or in countries where Euthanasia is illegal.   While Fletcher’s Situation Ethics was a sincere attempt to democratise Christian Ethics, perhaps Fletcher was too optimistic about peoples’ ability to cope with the responsibility he demands of them.  In relation to emotive, high-stakes issues like euthanasia most people are ill-equipped to predict consequences or weigh up consequences rationally and often make poor decisions as a result of Situation Ethics.  In these issues, a rules-based approach like Natural Law is more helpful to most people.   

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This work is an evaluation on the phenomenon of euthanasia from the standpoint of Joseph Fletcher‟s Situation Ethics. It primarily deals with the idea of the sacredness and dignity of human life in relation to euthanasia (the medical killing of a terminally ill person on grounds of compassion). The central problem here is whether human life has intrinsic value that should be unconditionally preserved? Arguing from the standpoint of deontological ethics, most opponents of euthanasia contend that human life is a supreme value with an inherent dignity. Human life is therefore perceived as sacred and inviolable. Contrary to this view, proponents of euthanasia approach the phenomenon from a humanistic and liberal perspective. They agree with the opponents of euthanasia that, human life is a supreme value with inherent dignity but go further to argue that, every human being is a mortal being with rationality, emotion and will, and as such, should not be compelled to undergo unnecessary prolonged dehumanizing suffering from terminal illness. This work sees both approaches of the opponents of euthanasia and the proponents as inadequate. In line with the principles of situation ethics, the work argues that, the morality or immorality of euthanasia is relative to certain situations. It also identifies certain situations like liver failure, brain damage, paralysis, comatose, kidney failure, cancer, critical accident, etc. that can justify the act of euthanasia situationally.

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Euthanasia and assisted dying: the illusion of autonomy—an essay by Ole Hartling

Read our coverage of the assisted dying debate.

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• Ole Hartling , former chairman
• Danish Council of Ethics, Denmark
• hartling{at}dadlnet.dk

As a medical doctor I have, with some worry, followed the assisted dying debate that regularly hits headlines in many parts of the world. The main arguments for legalisation are respecting self-determination and alleviating suffering. Since those arguments appear self-evident, my book Euthanasia and the Ethics of a Doctor’s Decisions—An Argument Against Assisted Dying 1 aimed to contribute to the international debate on this matter.

I found it worthwhile to look into the arguments for legalisation more closely, with the hope of sowing a little doubt in the minds of those who exhibit absolute certainty in the matter. This essay focuses on one point: the concept of “autonomy.”

(While there are several definitions of voluntary, involuntary, and non-voluntary euthanasia as well as assisted dying, assisted suicide, and physician assisted suicide, for the purposes of brevity in this essay, I use “assisted dying” throughout.)

Currently, in richer countries, arguments for legalising assisted dying frequently refer to the right to self-determination—or autonomy and free will. Our ability to self-determine seems to be unlimited and our right to it inviolable. The public’s response to opinion poll questions on voluntary euthanasia show that people can scarcely imagine not being able to make up their own minds, nor can they imagine not having the choice. Moreover, a healthy person answering a poll may have difficulty imagining being in a predicament where they simply would not wish to be given the choice.

I question whether self-determination is genuinely possible when choosing your own death. In my book, I explain that the choice will always be made in the context of a non-autonomous assessment of your quality of life—that is, an assessment outside your control. 1

All essential decisions that we make are made in relation to other people. Our decisions are affected by other people, and they affect other people. Although healthy people find it difficult to imagine themselves in situations where they do not decide freely, it is also true that all of us are vulnerable and dependent on others.

Yet autonomy in relation to assisted dying is often viewed in the same way as our fundamental right to choose our own course in life. If we are able to control our lives, then surely we can also control our death. Autonomy with respect to your own death, however, is already halved: you can choose to die if you don’t want to live, but you cannot choose to live if you are about to die.

Decisions about your own death are not made in normal day-to-day contexts. The wish to die arises against a backdrop: of desperation, a feeling of hopelessness, possibly a feeling of being superfluous. Otherwise, the wish would not be there. Thus, it is under these circumstances that the right to self-determination is exercised and the decision is made. Such a situation is a fragile basis for autonomy and an even more fragile basis for decision making. The choice regarding your own death is therefore completely different from most other choices usually associated with the concept of autonomy.

Here are just some of the critical matters that would arise if assisted dying were legalised.

A duty to die

The possibility of choosing to die would inhabit everyone’s consciousness—the patient, the doctor, the relatives, and the care staff—even if not formulated as an out-and-out offer. But if a law on assisted dying gives the patient a right to die, that right may turn into a duty to die. How autonomously can the weakest people act when the world around them deems their ill, dependent, and pained quality of life as beyond recovery?

Patients can find themselves directly or indirectly under duress to choose that option if they consider themselves sufficiently pained and their quality of life sufficiently low. Patients must be at liberty to choose assisted dying freely, of course—that is how it is presented—but the point is that the patient cannot get out of having to choose. It has been called the “prison of freedom.”

Internalised external pressure

Pressure on the patient does not have to be direct or articulated. As pointed out by the US professor of biomedical ethics Daniel Sulmasy it may exist as an “internalised external pressure.” 2 Likewise, the French bioethicist Emmanuel Hirsch states that individual autonomy can be an illusion. The theologian Nigel Biggar quotes Hirsch saying that a patient “may truly want to die, but this desire is not the fruit of his freedom alone, it may be—and most often is—the translation of the attitude of those around him, if not of society as a whole which no longer believes in the value of his life and signals this to him in all sorts of ways. Here we have a supreme paradox: someone is cast out of the land of the living and then thinks that he, personally, wants to die.” 3

The end of autonomy

An inherent problem of autonomy in connection with assisted dying is that a person who uses his or her presumed right to self-determination to choose death definitively precludes himself or herself from deciding or choosing anything. Where death is concerned, your right to self- determination can be exerted only by disposing of it for good. By your autonomy, in other words, you opt to no longer have autonomy. And those around must respect the right to self-determination. The respect refers to a person who is respected, but this is precisely the person who disappears.

Danish philosopher Johannes Sløk, who supported legalisation, said, “The actual concept of death has no content, for death is the same as nothing, and one cannot choose between life and nothing. Rather, therefore, one must speak of opting out; one opts out of life, without thereby choosing anything else. Death is not ‘something other’ than life; it is the cessation or annihilation of life.”

Autonomy is a consistent principle running through the care and management of patients and is enshrined in law. However, a patient’s autonomy means that he or she has the right to decline any treatment. It does not entail a right to have any treatment the patient might wish for. Patients do not have the right to demand treatment that signifies another’s duty to fulfil that right. If that were so, autonomy would be the same as “autocracy”—rule of the self over others. Even though patients have the right to reject any intervention, they do not have the right to demand any intervention. Rejecting any claim that the person might make is not a violation of a patient’s self- determination—for example, there may be sound medical reasons for not complying with a demand. The doctor also has autonomy, allowing him or her to say no. Refusing to kill a person or assist in killing cannot be a violation of that person’s autonomy.

The killing ban

Assisted dying requires the doctor’s moral and physical help. It is a binding agreement between two people: the one who is to be killed and the one who is to kill or assist in killing. But our society does not condone killing as a relationship between two legally competent, consenting people. Exemptions from the killing ban involve war or self-defence and are not justified on the grounds that the killing is done for the “benefit” of someone else.

Valuation of a life

If the action is to be decriminalised, as some people wish, it means the doctor will have to enter into deliberations and arguments for and against a request for assisted dying each time. That is, whether he or she is willing to grant it. The alternative would be to refer the patient to another doctor who might be willing to help—that doctor would still have to assess whether the patient’s life was worth preserving.

Thus, autonomy is not the only factor or even always the key factor when deciding whether assisted dying can be granted. It is not only the patient’s own evaluation that is crucial. The value of the patient’s life must also be assessed as sufficiently low. This demonstrates the limitation of the patient’s self-determination.

Relieving suffering

If a competent and legally capable person must have the option of voluntarily choosing assisted dying in the event of unbearable suffering, why does suffering have to be a requirement? The answer is straightforward: our concepts of assisted dying imply that compassion must form a crucial aspect of the decision—mercy killing and compassionate killing are synonyms. But this leads instantly to the question of why we should not also perform assisted dying on people who are not in a position to ask for it themselves but are also suffering.

Some people find the reasoning unproblematic. It stands to reason that relieving suffering is a duty after all. But in this context it is not unproblematic, because it effectively shifts the focus from the autonomy claimed. According to prevailing ideas about autonomy, patients initially evaluate their quality of life themselves, but ultimately it is those around them who end up gauging that quality and the value of their life. That is to say, the justification for assisted dying is borne on the premise that certain lives are not worth living rather than the presence of a request. The whole point is that in the process, respect for the right to self-determination becomes relative.

Autonomy is largely an illusion in the case of assisted dying. 1 A patient overwhelmed by suffering may be more in need of compassion, care, and love than of a kind offer to help end his or her life. It is not a question of whether people have a right to say that they are unworthy. It is a question of whether they have a right to be believed when saying it.

Ole Hartling is a physician of over 30 years standing, doctor of medical sciences at the University of Copenhagen, professor of health promotion at the University of Roskilde, and an author and co-author of several books and scientific articles published mainly in Scandinavia. Between 2000 and 2007 he was a member of the Danish Council of Ethics and its chair for five years. During this time, the council extensively debated the ethics of euthanasia and assisted dying.

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

• Gastmans C ,
• MacKellar C

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Voluntary euthanasia: A utilitarian perspective

• Center for Human Values

Research output : Contribution to journal › Article › peer-review

Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life - if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

All Science Journal Classification (ASJC) codes

• Health(social science)
• Health Policy

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• 10.1111/1467-8519.00366

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• Euthanasia, Active, Voluntary Medicine & Life Sciences 100%
• Euthanasia Arts & Humanities 90%
• euthanasia Social Sciences 66%
• Doctors Arts & Humanities 26%
• Capital Punishment Medicine & Life Sciences 22%
• Ethical Review Medicine & Life Sciences 20%
• Assisted Suicide Medicine & Life Sciences 19%
• George W. Bush Arts & Humanities 18%

T1 - Voluntary euthanasia

T2 - A utilitarian perspective

AU - Singer, Peter

PY - 2003/10

Y1 - 2003/10

N2 - Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life - if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

AB - Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life - if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

UR - http://www.scopus.com/inward/record.url?scp=0142147067&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0142147067&partnerID=8YFLogxK

U2 - 10.1111/1467-8519.00366

DO - 10.1111/1467-8519.00366

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JO - Bioethics

JF - Bioethics

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• v.75; 2022 Mar

Euthanasia and assisted suicide: An in-depth review of relevant historical aspects

Yelson alejandro picón-jaimes.

a Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia

Ivan David Lozada-Martinez

b Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia

Javier Esteban Orozco-Chinome

c Department of Medicine, RedSalud, Santiago de Chile, Chile

Lina María Montaña-Gómez

d Department of Medicine, Keralty Salud, Bogotá, Colombia

María Paz Bolaño-Romero

Luis rafael moscote-salazar.

e Colombian Clinical Research Group in Neurocritical Care, Latin American Council of Neurocritical Care, Bogotá, Colombia

Tariq Janjua

f Department of Intensive Care, Regions Hospital, Minnesota, USA

Sabrina Rahman

g Independent University, Dhaka, Bangladesh

End-of-life care is an increasingly relevant topic due to advances in biomedical research and the establishment of new disciplines in evidence-based medicine and bioethics. Euthanasia and assisted suicide are two terms widely discussed in medicine, which cause displeasure on many occasions and cause relief on others. The evolution of these terms and the events associated with their study have allowed the evaluation of cases that have established useful definitions for the legal regulation of palliative care and public policies in the different health systems. However, there are still many aspects to be elucidated and defined. Based on the above, this review aimed to compile relevant historical aspects on the evolution of euthanasia and assisted suicide, which will allow understanding the use and research of these terms.

• • The history of euthanasia and assisted suicide has been traumatic.
• • The church and research have been decisive in the definition of euthanasia.
• • The legal framework on the use of euthanasia and assisted suicide has been strengthened.

1. Introduction

Euthanasia and assisted suicide are two topics discussed throughout history, mainly because they fall within the scope of life as a human right, which has been universally defended for many years [ 1 ]. However, the mean of the word euthanasia as good death generates conflicts at social, moral, and ethical levels. Mainly because death is a loss, it is difficult to understand it as something positive and; additionally, several historical events such as the Nazi experiments related the term euthanasia more to murder than to a kind and compassionate act [ 1 ]. More current texts mention that euthanasia is the process in which, through the use or abstention of clinical measures, the death of a patient in an incurable or terminal condition can be hastened to avoid excessive suffering [ 2 ].

The difference between euthanasia and assisted suicide is that in the latter, the patient takes the final action; however, both practices can be combined in the term assisted death [ 2 ]. At present, several countries authorize assisted death, including Holland, Luxembourg, and Canada [ 3 ]. Belgium and Colombia have regulations that decriminalize only euthanasia; other places where assisted suicide is legal are Switzerland and five states of the United America states, specifically Oregon, Vermont, Washington, California, and Montana [ 2 , 3 ]. Spain recently joined the list of countries that have legislated on euthanasia through the organic law March 2021 of March 24 that regulates euthanasia in that state in both public and private institutions [ 4 ]. The fact that more and more countries were joining the legislation on euthanasia and assisted suicide has brought to light the opinion of thinkers, politicians, philosophers, and physicians. Several nations have initiated discussions on the matter in their governmental systems. Latin America is trying to advance powerfully in this medical-philosophical field. Currently, in Chile, the “Muerte digna y cuidados paliativos” law, which seeks to regulate the issue of euthanasia and assisted suicide in the country, is being debated in Congress [ 5 ].

It is essential to know the point of view of physicians on euthanasia and assisted suicide, especially taking into account that these professionals who provide care and accompany patients during this moment, which, if approved, would involve the medical community in both public and private health systems. Although it seems easy to think that physicians have a position in favor of the act of euthanasia because they are in direct and continuous contact with end-of-life situations, such as palliative care, terminally ill, and critically ill patients. It is important to remember that the Hippocratic medical oaths taken at the time of graduation of professionals are mostly categorical in mentioning the rejection of euthanasia and assisted suicide [ 6 ]. Furthermore, it is also important to note that many of the oldest universities in the Western world originated through the Catholic Church; and just this creed condemns the practice of euthanasia and continues to condemn it to this day. This situation generates that many medical students in these schools have behaviors based on humanist principles under the protection of faith and religion and therefore reject the possibility of euthanasia [ 7 , 8 ].

The relevance of the topic and the extensive discussion that it has had in recent months due to the COVID-19 pandemic added to the particular interest of bioethics in this topic and the need to know the point of view of doctors and other health professionals on euthanasia and assisted suicide.

2. Origin and meaning of the term euthanasia

The word euthanasia derives from the Greek word “eu” which means good, and the word “thanatos” which means death; therefore, the etymological meaning of this word is “good death”. Over time the evolution of the meaning has varied; even as we will see below was considered a form of eradication of people categorized under the designation of leading a less dignified life. Assisted suicide is a condition in which the patient is the one who carries out the action that ends his life through the ingestion of a lethal drug but has been dispensed in the context of health care and therefore called assisted. This care is provided by a physician trained in the area. However, it requires the prior coordination of a multidisciplinary team and even the assessment by an ethics committee to determine that the patient is exercising full autonomy, free from coercion by the situation he/she is living and free from the fatalistic desires of a psychiatric illness [ 9 ]. In a more literary sense, the word euthanasia meaning of “giving death to a person who freely requests it in order to free himself from suffering that is irreversible and that the person himself considers intolerable” [ 9 ].

Some authors go deeper into the definition and consider that for the meaning of euthanasia, are necessary to consider elements that are essential in the word itself; such as the fact that it is an act that seeks to provoke death and that carried out to eliminate the suffering in the person who is dying. Other elements with a secondary character in the definition are the patient's consent (which must be granted respecting autonomy and freedom in the positive and negative sense; that means the fact must be not be coerced in any way). Another element is the terminal nature of the disease, with an irreversible outcome that generates precariousness and a loss of dignity. The third secondary element is the absence of pain of the death through the use of drugs such as high-potency analgesics, including opioids, high-potency muscle relaxants, and even anesthetic drugs. Finally, the last element is the health context in which the action is performed (essential in some legislations to be considered euthanasia) [ 10 ]. According to the World Health Organization, the union of these two components is the current definition of euthanasia, which describes as “the action performed by a person to cause the painless death of another subject, or not preventing death in case of terminal illness or irreversible coma. Furthermore, with the explicit condition that the patient must be suffering physical, emotional, or spiritual and that affliction is uncontrollable with conventional measures such as medical treatments, analgesics, among others; then the objective of euthanasia is to alleviate this suffering” [ 11 ]. Unfortunately, the term euthanasia has been misused over the years, and other practices have been named with this word. An example of this situation occurred during the Nazi tyranny when the word euthanasia concerned the murder of people with disabilities, mental disorders, low social status, or gay people. At that time, euthanasia was even a simultaneous practice to the Jewish genocide [ 11 ].

Not only has the term been misused; also exists an enormous variability of terms to refer to euthanasia. For example, the laws created to regulate euthanasia have different names around the world; in the Netherlands (Holland), the law that regulates this practice is known as the law of termination of life; in Belgium, it is called euthanasia law, in France, it is called euthanasia law too. In Oregon (USA), it is called the death with dignity act; in California, it is the end of life option act. In Canada is called the medical assistance in dying act. Victoria (Australia) is the voluntary assisted dying bill, but all these denominations refer to the already well-known term euthanasia [ 11 ].

3. Evolution of euthanasia and assisted suicide: digging into historical events

To understand the evolution and relevance of these concepts should analyze the history of euthanasia and assisted suicide; from the emergence of the term, going through its first manifestations in antiquity; mentioning the conceptions of great thinkers such as Plato and Hippocrates; going through the role of the Catholic Church; mainly in the Middle Age, where following the thought of St. Thomas Aquinas, self-induced death or death contemplated by own will, was condemned. Later, with the renaissance age and the resurgence of science, technology, and the arts, the term euthanasia made a transition to a form similar to what we know today from thinkers such as Thomas More and Francis Bacon. Finally, the first signs of eugenics were known in London, Sweden, Germany, and the United States in the twentieth century. There was a relationship with the term euthanasia that was later used interchangeably, especially in the Nazi regime, to denote a form of systemic murder that sought to eradicate those who were not worthy of living a life.

Since the sixties, with emblematic cases, the path towards the decriminalization of euthanasia began in some countries, especially concerning the cessation of extreme support measures in cases of irreversible illness or a terminal condition. The practice has progressed to the appearance of laws on euthanasia in several countries.

4. Euthanasia and assisted suicide in ancient times

In book III of Plato's “The Republic”, the author stated that those who live their lives amidst illnesses and medicines or who were not physically healthy should be left to die; implying that it was thought that people in these conditions suffered so much that their quality of life diminished, which seemed understandable to these thinkers. However, other authors such as Hippocrates and his famous Hippocratic oath sought the protection of the patient's life through medicine, especially in vulnerable health conditions prone to fatal outcomes. This Hippocratic oath is the same oath that permeates our times and constitutes an argument among those who mark their position against euthanasia and assisted suicide [ 12 , 13 ].

Other texts that collect thoughts of Socrates and his disciple Plato point out that it was possible and well understood to think of ceasing to live in the face of a severe illness; to consider death to avoid a long and torturous agony. This fact is compatible with the conception of current euthanasia since this is the end of this health care procedure [ 13 ].

In The Republic, the text by Plato, the physician Heroditus is also condemned for inventing a way to prolong death and over manage the symptoms of serious illnesses, which is currently known as distanasia or excessive treatment prolongs life. This kind of excessive treatment prolongs the sick person's suffering, even leading him to maintain biological signs present but in a state of alienation and absolute dependence on medical equipment such as ventilators and artificial feeding [ 13 ]. However, the strongest indication that Euthanasic suicide was encouraged in Greece lies in other thinkers such as the Pythagoreans, Aristotelians, and Epicureans who strongly condemned this practice, which suggests that it was carried out repeatedly as a method and was therefore condemned by these thinkers [ 12 , 13 ]. According to stoicism, the pain that exceeded the limits of what was humanly bearable was one of the causes for which the wise man separates himself from life. Referring to one of the nuances that euthanasia touches today, that is, at a point of elevated suffering, the dignity and essence of the person are lost, persisting only the biological part but in the absence of the person's well-being as a being. In this sense, Lucius Seneca said that a person should not love life too much or hate it; but that person should have a middle ground and end their life when they ceased to perceive life as a good, worthy, and longed-for event [ 1 , 12 ].

During the Roman Empire and in the territories under its rule, it was believed that the terminally ill who commit suicide had sufficient reasons to do so; so since suicide caused by impatience and lack of resolution to pain or illness was accepted, when there was no access to medicines. In addition, there was little development in medicine during that time, and many of the sick died without treatment [ 12 ]. This situation changed later with the emergence of the Catholic church; in this age, who attempted against own life, was deprived of burial in the ground. Saint Augustine said that the suicide was an abominable and detestable act; from 693 AD, anyone who attempted against his physical integrity was excommunicated. Rejecting to the individuals and their lineage, depriving them of the possibility of attending the funeral and even expelled from cities and stripped of the properties they owned [ 12 , 13 ].

4.1. Euthanasia and assisted suicide in the Middle Age

During the Middle Age, Catholicism governed the sciences, arts, and medicine; the sciences fell asleep. Due to this solid religious tendency and the persistence of Augustinian thought, suicide was not well seen. It was not allowed to administer a lethal substance to a person to end the suffering of a severe or terminal illness [ 9 , 12 ]. People who took their own lives at this time could not be buried “Christianly”; therefore, they did not have access to a funeral, nor to the accompaniment of their family in a religious rite. Physical suffering and pain were then seen as a path to glorification. Suffering was extolled as the form that god purified the sin, similar to the suffering that Jesus endured during his Calvary days. However, a contrary situation was experienced in battles; a sort of short dagger-like weapon was often used to finish off badly wounded enemies and thus reduce their suffering, thus depriving them of the possibility of healing and was called “mercy killing” [ 12 ].

5. Euthanasia in renaissance

With the awakening of science and philosophy, ancient philosophers' thoughts took up again, giving priority to man, the world, and nature, thus promoting medical and scientific development. In their discourse, Thomas More and Francis Bacon refer to euthanasia; however, they give a eugenic sense to the concept of euthanasia, similar to that professed in the book of Plato's Republic. It is precise with these phylosophers that the term euthanasia got its current focus, referring to the acceleration of the death of a seriously ill person who has no possibility of recovery [ 12 ]. In other words, it was during this period that euthanasia acquired its current meaning, and death began to be considered the last act of life. Therefore, it was necessary to help the dying person with all available resources to achieve a dignified death without suffering, closing the cycle of life that ends with death [ 13 , 14 ].

In his work titled “Utopia”, Thomas More affirmed that in the ideal nation should be given the necessary and supportive care to the dying. Furthermore, in case of extraordinary suffering, it can be recommended to end the suffering, but only if the patient agrees, through deprivation of food or with the administration of a lethal drug; this procedure must be known to the affected person and with the due permission of authorities and priests [ 12 , 13 ]. Later, in the 17th century, the theologian Johann Andreae, in his utopia “Christianopolis”, contradicts the arguments of Bacon and Moro, defending the right of the seriously ill and incurably ill to continue living, even if they are disturbed and alienated, advocating for the care based on support and indulgence [ 15 , 16 ]. Similarly, many physicians rejected the concepts of Plato, Moro, and Bacon. Instead, they focused on opposing euthanasia, most notably in the nineteenth century. For example, the physician Christoph Hufeland mentioned that the doctor's job was only to preserve life, whether it was a fate or a misfortune, or whether it was worth living [ 16 ].

5.1. Euthanasia in the 20th century

Before considering the relevant aspects of euthanasia in the 20th century, it is vital to highlight the manuscript by Licata et al. [ 17 ], which narrates two episodes of euthanasia in the 19th century. The first one happened in Sicily (Italy) in 1860, during the battle of Calatafimi, where two soldiers were in constant suffering, one because he had a serious leg fracture with gangrene, and the other with a gunshot wound. The two soldiers begged to be allowed to die, and how they were in a precarious place without medical supplies, they gave them an opium pill, which calmed them until they died [ 17 ]. The second episode reported by Licata et al. [ 17 ] was witnessed by a Swedish doctor named Alex Munthe; who evidenced the pain of many patients in a Parisian hospital. So he decided to start administering morphine to help people who had been seriously injured by wolves and had a poor prognosis; therefore, the purpose of opioid use was analgesia while death was occurring.

It is also important to highlight the manuscript entitled “Euthanasia” by S. Williams published in 1873 in “Popular Science Monthly”, a journal that published texts by Darwin, Edison, Pasteur, and Beecher. This text included the report for the active euthanasia of seriously ill patients without a cure, in which the physicians were advised to administer chloroform to these patients or another anesthetic agent to reduce the level of consciousness of the subject and speed up their death in a painless manner [ 16 ].

Understanding that euthanasia was already reported in the nineteenth century, years after, specifically in 1900, the influence of eugenics, utilitarianism, social Darwinism, and the new currents of thought in England and Germany; it began in various parts around the world, projects that considered the active termination of life, thus giving rise to euthanasia societies in which there were discussions between philosophers, theologians, lawyers, and medical doctors. Those societies discussed diverse cases, such as the tuberculous patient Roland Gerkan, who was considered unfit and therefore a candidate to be released from the world [ 16 ]. The scarcity of resources, famine, and wars were reasons to promote euthanasia as a form of elimination of subjects considered weak or unfit, as argued in texts such as Ernst Haeckel's. However, opponents to the practice, such as Binding and Hoche, defended the principle of free will in 1920 [ 16 ].

5.2. Euthanasia in the time of the Nazis

As mentioned above, the term euthanasia was misused during this period; approximately 275,000 subjects (as reported at the Nuremberg International Military Tribunal 1945–1946), who had some degree of physical or mental disability, were killed during Adolf Hitler's Euthanasia program [ 13 ]. However, the Nazis were not the first to practice a form of eugenics under the name of euthanasia, since the early 1900s in London had already begun the sterilization of the rejected, such as the blind, deaf, mentally retarded, people with epilepsy, criminals, and rapists. This practice spread to different countries like Sweden and the United States [ 13 , 16 ].

For the Nazis, euthanasia represented the systematic murder of those whose lives were unworthy of living [ 13 ]. The name given to this doctrine was “Aktion T4”. At first and by law, from 1939, the hospitals were obliged to account for all disabled newborns, which led to the execution of more than 5000 newborns utilizing food deprivation or lethal injection [ 12 , 18 ].

A year before that law, in 1938, one of the first known cases of euthanasia in children arose in Germany. That history called the story of child K, in which it was the father of the minor who asked Hitler in writing for euthanasia for his son because the child had a severe mental disability and critical morphic disorders. Hitler gave his consent to carry out the procedure on child K, and thus the program began to spread throughout the Aleman territory. Since then, physicians and nurses had been in charge of reporting the newborns with alterations, arising the “Kinderfachabteilugen” for the internment of children who would be sentenced to death after a committee's decision [ 12 , 18 , 19 ]. A list of diseases and conditions that were considered undesirable to be transmitted to Hitler's superior Aryan race was determined; thus, any child with idiocy, mongolism, blindness, deafness, hydrocephalus, paralysis, and spinal, head, and hip malformations were eligible for euthanasia [ 19 ].

Subsequently, the program was extended to adults with chronic illness, so those people were selected and transported by T4 personnel to psychiatric sanatoriums strategically located far away. There, the ill patients received the injection of barbiturate overdoses, and carbon monoxide poisoning was tested as a method of elimination, surging the widely known gas chamber of the concentration camp extermination; this situation occurred before 1940 [ 12 , 19 ]. Again, physicians and nurses were the ones who designated to the patients to receive those procedures; in this case, these health professionals supported Nazi exterminations. They took the patients to the sanatoriums, where psychiatrists evaluated them and designated with red color if they should die and with a blue color if they were allowed to live (this form of selection was similar in children) [ 12 , 13 , 19 ]. In this case, the pathologies considered as criteria for death were those generating disability such as schizophrenia, paralysis, syphilis with sequelae, epilepsy, chorea, patients with chronic diseases with many recent treatments, subjects of non-German origin and individuals of mixed blood [ 19 ]. Once in the sanatoriums, they were informed that they would undergo a physical evaluation and take a shower to disinfect themselves; instead, they were killed in gas chambers [ 12 , 13 ]. Despite the church's action in 1941 against Nazis and after achieving suspension of the Aktion T4 project; the Nazi supporters kept the practices secretly, resuming them in 1942, with the difference that the victims were killed by lethal injection, by an overdose of drugs, or left to starve to death, instead of the use of gas chambers. This new modified form of euthanasia, which did not include gas chambers, became known as “savage euthanasia” [ 12 , 13 , 19 ].

5.3. Euthanasia since the 1960s

In September 1945, trials began for crimes perpetrated by Nazi supporters; the victorious Allied forces conducted these trials at the end of the war. During these tribunals, cases of human experimentation were identified and the public exposure of the Nazi euthanasia program. After the Nuremberg trials and the abolition of Nazi experiments, a series of seven documents emerged, among which the Nuremberg code containing the ten basic principles for human research stood out [ 20 , 21 ].

After these judgments, biotechnology was accelerated, with the apparition of new techniques to intervene in the health-disease process. Additionally, the increase in life expectancy and the appearance of diseases that chronically compromise the state of health of people generated a change in the conception of the critically ill patient and the terminal state of life [ 20 , 21 ]. Cases such as Karen Ann Quinlan brought to the forefront the issue of euthanasia and precisely the control of extreme treatment measures. Karen, a young American woman, was left in a vegetative state due to severe neurological damage following alcohol and barbiturate intoxication. After six months in that state and under the guardianship of a Catholic priest, Karen's parents requested the removal of the artificial respirator, arguing that in her state of consciousness prior to the incident, she had stated that she disagreed with artificially maintaining life in comatose patients. The hospital refused to remove the ventilator, arguing the legal issues for the date, and the parents went to court, which in the first instance granted the hospital the right. Nevertheless, the New Jersey Supreme Court granted Karen Ann's right to die in peace and dignity. Despite the withdrawal of the artificial respirator, he continued to live until 1985, when he finally died [ [21] , [22] , [23] ].

Another important case was Paul Brophy, which also occurred in the United States. Paul was a firefighter in Massachusetts and went into a deep coma due to the rupture of a basilar artery aneurysm; initially, his family advocated for support measures but later requested the hospital to disconnect these means to allow death, as Paul had indicated when he was still conscious. The hospital refused to carry out this procedure, so the family went to court, where the removal of the support measures (gastrostomy) was initially denied. Hence, the family went to the state supreme court, achieving the transfer of Paul to another medical center where the gastrostomy was removed, leading to his death within a few days [ 23 ].

The case of Arthur Koestler, an influential English writer and activist diagnosed with Parkinson's disease and later with leukemia, who served as vice-president of the voluntary euthanasia society (Exit) and wrote a manual book with practical advice for euthanasia called “Guide to Self-Liberation”. He stood out because he applied one of his advice and ingested an overdose of barbiturates, causing his self-death. According to his writings, Koestler was not afraid of death but of the painful process of dying [ 23 ]. In this sense, it was a relevant case because it involved someone who held an important position in an association that advocated euthanasia, in addition to being the author of several works, which made him a recognized public figure [ 23 ].

Baby Doe was a case that also occurred in the United States; it was a small child with Down syndrome who had a tracheoesophageal fistula and esophageal atresia; in this case, surgery was necessary. On the advice of the obstetrician, the parents did not allow surgery, so the hospital managers took the case before a judge who ruled that parents could decide to perform or not the surgery. The case was appealed before a county judge who upheld the parents' power to make the decision, in the course of which the case became public and many families offered to take care of the child; however, before the case reached the supreme court, the child died at six days of age [ 23 ].

In the case of Ingrid Frank, a German woman who was in a quadriplegic state by a traffic accident, who initially sought rehabilitation but later insisted on being allowed to die; it was provided with a drink containing a cyanide solution that she drank. At the same time, she was filmed, which shows a kind of assisted suicide. For that reason, this is another case that deals with this issue and is important to know as background in the development of euthanasia and assisted suicide [ 22 , 23 ].

6. Current and future perspectives

The definition of brain death, the rational use of the concept of euthanasia and assisted suicide, and scientific literacy are the objectives of global bioethics to regulate euthanasia and assisted suicide, which can be accessible in all health systems [ [24] , [25] , [26] , [27] , [28] , [29] , [30] ]. End-of-life care will continue to be a subject of debate due to the struggle between biomedical principles, the different existing legal frameworks, and the general population's beliefs. Medical education and preparation in the perception of death, especially of a dignified death, seems to be the pillar of the understanding of the need to develop medical-legal tools that guarantee the integrity of humans until the end of their existence [ 31 , 32 ]. This is the reason why the new generations of physicians must be trained in bioethics to face these ethical conflicts during the development of their professional careers.

In addition, although the conception of bioethics belongs to the Western world, it is crucial to take into account the point of view of other cultures and creeds, for example, a study carried out in Turkey, where nursing students were questioned, found that many of them understood the reasons for performing euthanasia; however, they know that Islam prohibits it, as well as its legislation, and therefore they would not participate in this type of procedure [ 33 ]. Furthermore, Christianism and Islam prohibit euthanasia, but Judaism also prohibits it; in general, the so-called Abrahamic religions are contrary to any form of assisted death, whether it is active euthanasia, passive, or assisted suicide [ 34 ].

7. Conclusiones

The history and evolution of euthanasia and assisted suicide have been traumatic throughout human history. The church, politics, and biomedical research have been decisive in defining these concepts. Over the years, the legal framework and bioethical concepts on euthanasia have been strengthened. However, there is still much work to educate the general population and health professionals about end-of-life care and dignified death.

It is also important to remember that life is a concept that goes beyond biology. Currently, bioethics seeks to prioritize the concept of dignity, which must be linked to the very definition of life. Although the phrase is often heard that it is not necessary to move to be alive, what is important is that person feels worthy even if they have limited movement. The person's treatment must be individualized in bioethics since each individual is a unique unit. Therefore, medical paternalism must be abandoned. Instead, the subject must be more involved to understand their context and perception of life and dignity.

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Sabrina Rahman. Independent University, Dhaka, Bangladesh. [email protected] .

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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The Ethics of Euthanasia

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Introduction, advantages of euthanasia, disadvantages of euthanasia, counterarguments and rebuttals, relieving pain and suffering, autonomy and personal choice, reducing medical costs, moral and ethical implications, the risk of abuse, impact on medical professionals, ethical considerations and alternatives, safeguards against abuse and potential solutions.

• New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMp0804651
• Journal of Medical Ethics. https://jme.bmj.com/content/early/2013/05/15/medethics-2012-101093

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The Ethics of Euthanasia Essay

Statement of issue, research plan, overview of claims.

Euthanasia should be viewed as not simply a medical procedure carried out based on the principles of healthcare ethics (i.e., terminating the suffering of the patient), but also as an irrefutable right of a person to die.

It is required to identify the key arguments against and in favor of euthanasia. Moreover, it is necessary to nail down the reasons for people to approve of euthanasia or to dismiss it. In order to carry out the analysis of the existing opinions, several ways of viewing the issue must be provided, including ethical, medical and legal ones. It will also be required to consider the recent researches on euthanasia, as well as case studies and court cases. After a thorough literature review is carried out, the discussion of the existing arguments will commence. In the analysis of the claims in favor and against euthanasia, the cause and effect relationships between the factors affecting the choice of euthanasia should be established.

Main topic: Euthanasia must be accepted as the procedure that allows for the compliance with one of the basic human rights, i.e., the right to die. Despite the fact that euthanasia is currently prohibited in all states of the USA, it should be noted that self-assisted dying is legal in Washington and several other states (Montana, Oregon, New Mexico and Vermont). While involuntary euthanasia is not to be allowed, euthanasia as the method of terminating the suffering of a patient must be practiced in the U.S. healthcare institutions.

Claim 1:.The right to die is one of the basic human rights that must be appreciated and complied with by the state governmental bodies. Therefore, people should be provided with an opportunity to terminate their suffering in case when medical assistance is impossible.

Type of argument: inductive (Wood, 2015)

Support (use at least one outside source): Lachman, V. (2010). Physician-assisted suicide: Compassionate liberatio or murder? MEDSURG Nursing, 19 (2), 121–125.

Claim 2: Though healthcare ethics presupposes that the healthcare specialist must not carry out any actions that will do the patient any harm, it could be argued that in case of a terminal and painful disease the inaction is even more harmful than action; therefore, euthanasia as the action aimed at relieving the patient of their pain can be considered the only ethical step possible.

Type of argument: deductive

Support (use at least one outside source): ANA Center for Ethics and Human Rights. (2013). Position statements: Euthanasia, Assisted suicide and aid in dying . Washington, DC: American Nurses Association.

Claim 3: By claiming that euthanasia should be banned, people care not about the person, who may be suffering more than (s)he can handle, but themselves, i.e., their concept of ethics and the compliance with the existing moral code, not to mention the threats of legal issues that the introduction of the law may entail. Therefore, when considering the argument, one may dismiss the ethical concerns of the opponents as invalid.

Type of argument:deductive

Support (use at least one outside source): Ebrahimi, N. (2012). The ethics of euthanasia. Australia Medical Student Kournal, 3 (1), 73–75.

With the integration of personal and professional responsibility into the U.S. healthcare, as well as the reconsideration of some of the current legislation principles from the perspective of basic human rights (the right to die in particular), one must admit the necessity to consider euthanasia a legal procedure.

ANA Center for Ethics and Human Rights. (2013). Position statements: Euthanasia, assisted suicide and aid in dying . Washington, DC: American Nurses Association.

Ebrahimi, N. (2012). The ethics of euthanasia. Australia Medical Student Kournal, 3 (1), 73–75.

Lachman, V. (2010). Physician-assisted suicide: Compassionate liberation or murder? MEDSURG Nursing, 19 (2), 121–125.

Wood, N. (2015). Perspectives on argument (8th ed.). London, UK: Longman.

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IvyPanda. (2024, February 15). The Ethics of Euthanasia. https://ivypanda.com/essays/the-ethics-of-euthanasia/

"The Ethics of Euthanasia." IvyPanda , 15 Feb. 2024, ivypanda.com/essays/the-ethics-of-euthanasia/.

IvyPanda . (2024) 'The Ethics of Euthanasia'. 15 February.

IvyPanda . 2024. "The Ethics of Euthanasia." February 15, 2024. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

1. IvyPanda . "The Ethics of Euthanasia." February 15, 2024. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

Bibliography

IvyPanda . "The Ethics of Euthanasia." February 15, 2024. https://ivypanda.com/essays/the-ethics-of-euthanasia/.

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• Why Active Euthanasia is Morally Wrong
• Euthanasia and Modern Society
• Euthanasia and Assisted Suicide
• Euthanasia: A Legalized Right to Die
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A Level Philosophy & Religious Studies

Situation Ethics A* grade summary notes

Full notes       this page: a* summary notes      c/b summary notes, situation ethics ao1: .

• Legalism: the traditional approach to Christian ethics of following strict rules – Fletcher rejects this for not taking the situation into account.
• Antinomianism: having no rules to follow at all – Fletcher rejects this because it leads to moral chaos.
• Situationism: Fletcher’s proposed middle-ground between these two ‘extremes’ – where ethics is about following one guiding principle (not a rule), the principle of agape, which has to be applied and worked out in every situation.
• Agape – Christian love – selfless love of your neighbour (Jesus’ command)
• four working principles – Pragmatism – actions must take situation into account. Positivism – ethics cannot be based on reason, it is  based on faith – in Jesus’ command to love. Personalism – people are more important than rules. Relativism – an action is right/wrong relative to agape.
• six fundamental principles – 
• Only love is intrinsically good (good in itself)
• Love is the ruling norm of Christian moral decision making
• Love and justice are the same – justice is just love distributed
• Love wills the neighbours good whether we like them or not
• Only the ends justify the means, nothing else (as long as agape is maximised, the action used is justified).
• Love decides there and then – you have to decide in the situation and quickly what the loving thing to do is.
• Conscience. Fletcher rejects the traditional view of conscience as a part of our mind that tells us what is right or wrong. Fletcher argues that ‘conscience’ is a verb, not a noun. So conscience is like a process or action, rather than a thing – it is the process of figuring out which action will maximise agape in the situation you are in.

Fletcher & Robinson: humanity ‘come of age’

• They argue that humanity has ‘come of age’. This means that humanity has become more mature. 
• In medieval times, when humanity had not come of age people were less educated and self-controlling. This meant that they needed fixed, clear rules to follow because they could not be trusted to understand and act on the differences and complexities in how a rule could be bent or broken if the situation called for it. 
• However, now people are more civilised to the point that giving them more autonomy (a person’s ability to act on his or her own values and interests) will increase love without risking stability of society. 

Barclay counter-argument

• William Barclay disagrees with this. He says that situations ethics gives people a dangerous amount of freedom. For freedom to be good, love has to be perfect. 
• If there is no or not enough love then freedom can become selfishness ir even cruelty. 
• If everyone was a saint then situation ethics would be perfect. 
• He says that mankind has not yet come of age and still needs the protection of law. 
• Although people may seem like they have improved in modern times, if granted freedom to do what they want they wont choose the loving thing, they will choose the selfish or cruel thing to do. 
• This argument suggests that power corrupts. 
• It also adds to the argument that human nature is corrupt such as by original sin. 
• There is evidence from psychology which justifies Barclay’s argument, such as the stanford prison experiment. It showed that power has a corrupting influence when participants were given roles of authority like being a prison guard.

Fletcher vs sola scriptura

• Traditional Christians – like those who adhere to sola scriptura – would argue that Fletcher’s theory is not genuine Christian ethics, because fletcher has ignored most of the commands in the Bible, focusing only on Agape.
• The Bible is full of other commands – e.g. God says ‘thou shalt not kill’, so Euthanasia would be wrong – God also said thou shalt not commit adultery.
• Yet, Fletcher says killing or adultery are both fine in situations where they have a loving outcome.
• So, Fletcher fails because he claims to be Christian yet does not follow the Bible.
• Furthermore: Mouw’s critique. Mouw pointed out that Jesus made other commands. It makes no sense for Jesus to have only wanted us to follow the command of agape – then why would Jesus make other commands..?

Fletcher’s defence: liberal view of the Bible

• Fletcher doesn’t think we can follow the Bible literally, but if we interpret it then we can’t tell whose interpretation is right.
• He concludes that the only valid approach to the Bible is to follow its general themes.
• The most consistent theme of the Bible is love – agape.
• So, Fletcher thinks he is following the Bible actually.
• Furthermore, Jesus did say that loving your neighbour as yourself was the ‘greatest commandment’ – the fact that it’s the ‘greatest’ supports Fletcher’s approach of thinking it takes precedence over all others. 
• Fletcher says the Bible is not a ‘legalistic rules-book’.
• Fletcher’s defence here is successful because he’s right that taking the Bible literally is a very bad option – but so is the chaos of everyone having their own interpretation, so the best approach to the Bible is following its general theme – and it’s beyond dispute or interpretation that the Bible recommends being loving.

The subjectivity issue

Strength of situation ethics: 

• Situation ethics demands that we do the loving thing in each situation, which seems like a good ethical principle. It’s hard to see how acting based on love could ever be morally wrong.

Evaluation:

• Love is subjective – everyone has a different perspective on what love is – this makes it confusing about what the right to do is and it could even justify immoral actions if someone thinks it is loving – E.g. some nazis thought they were doing a loving thing.

Further evaluation

• Love is subjective but Agape is not – agape means more than love – it means selfless love of your neighbour – there’s no way the nazis were engaging in selfless love of their neighbour – since Jesus was clear that everyone is your neighbour. So, agape is not as subjective or confusing as love is.

Optional final evaluation:

• Agape actually is subjective. A Nazi might genuinely think that if they were discovered to be jewish, then they would want to be killed. So technically they are loving their neighbour the way they would want to be loved.
• The way people love themselves is subjective, and so loving your neighbour as yourself is equally subjective.

Natural law critique that situation ethics leads to antinomianism 

• followers of Natural law argue that liberal attempts to grant people more freedom by reducing religious laws actually leads to antinomianism. For example, if you get rid of the sanctity of life principle (as Fletcher does) then people will be more likely to kill each other, and society will fall apart. Mother Theresa said, about abortion, ‘if a mother can kill her own child in her own womb, then what is left but for us to kill each other?’ – Theresa is making this natural law critique – if you lessen the religious laws then society will fall apart. If we no longer view life as sacred, there will be negative social consequences for that – life will be considered less valuable in society and killing will become more common. Fletcher is dangerously wrong to abandon legalism, therefore.
• The catholic natural law argument seems to be incorrect. Countries which have allowed abortion and euthanasia are not in danger of falling apart – far from it, they are actually the best, most equal, most educated societies in the world (northern europe).

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Situation ethics and Euthanasia ESSAY- ethics

Subject: Religious education

Age range: 16+

Resource type: Assessment and revision

Last updated

9 October 2019

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“Situation ethics is the best method of assessing whether Euthanasia is morally acceptable” FULL A/A* grade RS a level essay. Thesis, Introduction, Paragraphs, Counter Arguments, EVALUATION, conclusion. Links between topics. ETHICS- application essay

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Essay on Euthanasia: 100, 200 and 300 Words Samples

• Updated on  
• Feb 22, 2024

Essay on Euthanasia: Euthanasia refers to the act of killing a person without any emotions or mercy. Euthanasia is an ethnically complex and controversial topic, with different perspectives and legal regulations on different topics. School students and individuals preparing for competitive exams are given assigned topics like essays on euthanasia. The objective of such topics is to check the candidate’s perspectives and what punishment should be morally and legally right according to them. 

If you are assigned an essay on euthanasia, it means your examiner or teacher wants to know your level of understanding of the topic. In this article, we will provide you with some samples of essays on euthanasia. Feel free to take ideas from the essays discussed below.

Master the art of essay writing with our blog on How to Write an Essay in English .

This Blog Includes:

Essay on euthanasia in 150 words, euthanasia vs physician-assisted suicide, euthanasia classification, is euthanasia bad.

Euthanasia or mercy killing is the act of deliberately ending a person’s life.  This term was coined by Sir Francis Bacon. Different countries have their perspectives and laws against such harmful acts. The Government of India, 2016, drafted a bill on passive euthanasia and called it ‘The Medical Treatment of Terminally Ill Patient’s Bill (Protection of Patients and Medical Practitioners). 

Euthanasia is divided into different classifications: Voluntary, Involuntary and Non-Voluntary. Voluntary euthanasia is legal in countries like Belgium and the Netherlands, with the patient’s consent. On one side, some supporters argue for an individual’s right to autonomy and a dignified death. On the other hand, the opponents raise concerns about the sanctity of life, the potential for abuse, and the slippery slope towards devaluing human existence. The ethical debate extends to questions of consent, quality of life, and societal implications.

Also Read: Essay on National Science Day for Students in English

Essay on Euthanasia in 350 Words

The term ‘Euthanasia’ was first coined by Sir Francis Bacon, who referred to an easy and painless death, without necessarily implying intentional or assisted actions. In recent years, different countries have come up with different approaches, and legal regulations against euthanasia have been put forward. 

In 2016, the government of India drafted a bill, where euthanasia was categorised as a punishable offence. According to Sections 309 and 306 of the Indian Penal Code, any attempt to commit suicide and abetment of suicide is a punishable offence. However, if a person is brain dead, only then he or she can be taken off life support only with the help of family members.

Euthanasia is the act of intentionally causing the death of a person to relieve their suffering, typically due to a terminal illness or unbearable pain. 

Physician-assisted suicide involves a medical professional providing the means or information necessary for a person to end their own life, typically by prescribing a lethal dose of medication.

In euthanasia, a third party, often a healthcare professional, administers a lethal substance or performs an action directly causing the person’s death.

It is the final decision of the patient that brings out the decision of their death.

Voluntary Euthanasia

It refers to the situation when the person who is suffering explicitly requests or consents to euthanasia. A patient with a terminal illness may express his or her clear and informed desire to end their life to a medical professional.

Involuntary

It refers to the situation when euthanasia is performed without the explicit consent of the person, often due to the individual being unable to communicate their wishes.

Non-Voluntary

In this situation, euthanasia is performed without the explicit consent of the person, and the person’s wishes are unknown.

Active euthanasia refers to the deliberate action of causing a person’s death, such as administering a lethal dose of medication.

It means allowing a person to die by withholding or withdrawing treatment or life-sustaining measures.

Euthanasia and assisted suicide are a defeat for all. We are called never to abandon those who are suffering, never giving up but caring and loving to restore hope. — Pope Francis (@Pontifex) June 5, 2019

Also Read: Essay on Cleanliness

Euthanasia is a subjective term and its perspectives vary from person to person. Different cultures, countries and religions have their own set of values and beliefs. Life is sacred and gifted to us by god or nature. Therefore, intentionally causing death goes against moral and religious beliefs. 

However, some people have raised concerns about the potential for a slippery slope, where the acceptance of euthanasia could lead to the devaluation of human life, involuntary euthanasia, or abuse of the practice. Some even argue that euthanasia conflicts with their traditional medical ethics of preserving life and prioritizing the well-being of the patient.

Today, countries like the Netherlands and Belgium have legalised euthanasia. In India, the USA and the UK, it is a punishable offence with varying sentences and fines. Euthanasia is a complex and controversial topic and creating a law against or for it requires a comprehensive study by experts and the opinions of all sections of society. 

Ans: Euthanasia refers to the act of killing a person without any emotions or mercy. Euthanasia is an ethnically complex and controversial topic, with different perspectives and legal regulations on different topics.

Ans: The term ‘Euthanasia’ was first coined by Sir Francis Bacon, who referred to an easy and painless death, without necessarily implying intentional or assisted actions. In recent years, different countries have come up with different approaches, and legal regulations against euthanasia have been put forward.  In 2016, the government of India drafted a bill, where euthanasia was categorised as a punishable offence. According to Sections 309 and 306 of the Indian Penal Code, any attempt to commit suicide and abetment of suicide is a punishable offence. However, if a person is brain dead, only then he or she can be taken off life support only with the help of family members.

Ans: Belgium and the Netherlands have legalised euthanasia. However, it is banned in India.

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Shiva Tyagi

With an experience of over a year, I've developed a passion for writing blogs on wide range of topics. I am mostly inspired from topics related to social and environmental fields, where you come up with a positive outcome.

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I Think Therefore I Teach

Tips for A level students. Lesson ramblings for teachers (helpful ideas too!)

“Natural law provides a helpful approach when dealing with issues surrounding euthanasia”: Student’s Work

Writing application essays can be very difficult. You not only are juggling your topic with evaluation but applying it to an ethical issue. Here are some examples of introductions and main paragraphs to show the structure:

This is an example of what I would class as a good introduction.  This is because it displays to an examiner all the necessary elements in a simple and clear way, yet remaining informative (not descriptive) and is effective in the way it handles the question. From reading this introduction it is obvious what the question is. Always a sign of a good start!

This is another introduction example. This demonstrates a different style of writing, yet the core structure (as above) is present. See how this student focuses on developing their evaluative tone with rhetorical questions (red) and demonstrates wider understanding through added details (green)

This is an example of a very sophisticated paragraph. See how the student not only links to euthanasia but also demonstrates understanding through a specific case. This student also evaluates the use of reason in relation to euthanasia by presenting both a strength and a weakness. What makes this evaluation even better is the link between Barth and the question (unhelpful) and then a defence argument from Aquinas:

This is an example of a paragraph from a different student. The structure is very much the same: theme, link, strength, example, strength. What works with this paragraph is the student compares NL to situation ethics but they never forget the theme of the paragraph: apparent and real goods. So whilst the feedback (from me) on this paragraph would have been to say whether the slippery slope issue makes apparent and real goods therefore less helpful, the student demonstrates a developing technique and attempts at the higher level discussion:

Please let me know if you would like a copy of these essays by leaving a comment at the bottom or following the ‘contact me’ details on the Homepage.

For further guidance in developing your essay technique just click on the image below to be transferred to the shop.

Check out this Tips from a Tired Teacher Preview on How to Write an Application Essay:

To continue watching this Top Tips video as well as having access to all 30 revision podcasts and Mark with Me’s then join I Think Therefore I Teach’s exclusive membership on the Home page.

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16 thoughts on “ “natural law provides a helpful approach when dealing with issues surrounding euthanasia”: student’s work ”.

Brilliant. Thank you for your excellent resources. Please can you email me a copy of the essays and the tables. Thanks again. 🙂

Amazing, could you link me a copy of essay for euthanasia? That be great.

So helpful. Thank you. Can i have a copy of the essays please.

Dear Aimee,

thank you so much for all the posts that you have shared on the new A level. It has been like having a friend on line sharing the pain [😊]

If it as all possible I would love a copy of the essays please. It would certainly help stretch our more able students

thank you again for all the time you have given and your unselfish sharing

kind regards

Julie Stewart

Wales High School

01909 771291

email; [email protected]

________________________________

Thank you for your lovely comment. I am so pleased you find my blog useful. I will send those essays over to you now 🙂

Really useful. Thanks. I would very much appreciate copies of those essays too. Would be invaluable. Forbes Walker Emanuel School London SW11 1HS

Wow Thank you for putting all this online. I found your YouTube channel by accident the other day – excellent summaries for my students (and so refreshing not to have music to disctract me) These essays are particularly helpful as we have moved over from AQA (separate questions for AO1 and AO2) Any copies would be gratefully received. Thank you

Hi Nicole, I have tried several times to send you the work but my emails are being rejected. Could you send me another email please 🙂

I found this really useful – thank you very much, Aimee. Please could I have a copy of the essays please? Thank you! Sian

Thanks for sharing your work- it is very much appreciated. I am purchasing your Y2 DCT bundle. Could you also send me a copy of the essays. Thanks again. Marty

Hi Aimee- I would be most grateful if you could send me these Euthanasia essays. With thanks Hannah

I’d be really grateful for a copy of these essays please. Many thanks [email protected]

I’d be very grateful for the essays too 🙂 [email protected]

Hi I’d really appreciate a copy of these sample answers, extremely useful. Thanks very much Sarah

Hi, These are amazing. Thank you so much for all you are doing. I’d greatly appreciate a copy of these sample answers. Invaluable!

Mrs. Holmgren

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