This page sets out the arguments against allowing euthanasia. Could euthanasia ever be safely regulated? Would legalising euthanasia have knock-on effects?
This page sets out the arguments against allowing euthanasia. Could euthanasia ever be safely regulated? Would legalising euthanasia have knock-on effects?
It's possible to argue about the way we've divided up the arguments, and many arguments could fall into more categories than we've used.
Religious people don't argue that we can't kill ourselves, or get others to do it. They know that we can do it because God has given us free will. Their argument is that it would be wrong for us to do so.
They believe that every human being is the creation of God, and that this imposes certain limits on us. Our lives are not only our lives for us to do with as we see fit.
To kill oneself, or to get someone else to do it for us, is to deny God, and to deny God's rights over our lives and his right to choose the length of our lives and the way our lives end.
Religious people sometimes argue against euthanasia because they see positive value in suffering.
Down through the centuries and generations it has been seen that in suffering there is concealed a particular power that draws a person interiorly close to Christ, a special grace.
Pope John Paul II: Salvifici Doloris, 1984
Most religions would say something like this:
We should relieve suffering when we can, and be with those who suffer, helping them to bear their suffering, when we can't. We should never deal with the problem of suffering by eliminating those who suffer.
Christianity teaches that suffering can have a place in God's plan, in that it allows the sufferer to share in Christ's agony and his redeeming sacrifice. They believe that Christ will be present to share in the suffering of the believer.
Pope John Paul II wrote that "It is suffering, more than anything else, which clears the way for the grace which transforms human souls."
However while the churches acknowledge that some Christians will want to accept some suffering for this reason, most Christians are not so heroic.
So there is nothing wrong in trying to relieve someone's suffering. In fact, Christians believe that it is a good to do so, as long as one does not intentionally cause death.
Some people think that dying is just one of the tests that God sets for human beings, and that the way we react to it shows the sort of person we are, and how deep our faith and trust in God is.
Others, while acknowledging that a loving God doesn't set his creations such a horrible test, say that the process of dying is the ultimate opportunity for human beings to develop their souls.
When people are dying they may be able, more than at any time in their life, to concentrate on the important things in life, and to set aside the present-day 'consumer culture', and their own ego and desire to control the world. Curtailing the process of dying would deny them this opportunity.
Several Eastern religions believe that we live many lives and the quality of each life is set by the way we lived our previous lives.
Those who believe this think that suffering is part of the moral force of the universe, and that by cutting it short a person interferes with their progress towards ultimate liberation.
Some non-religious people also believe that suffering has value. They think it provides an opportunity to grow in wisdom, character, and compassion.
Suffering is something which draws upon all the resources of a human being and enables them to reach the highest and noblest points of what they really are.
Suffering allows a person to be a good example to others by showing how to behave when things are bad.
M Scott Peck, author of The Road Less Travelled, has written that in a few weeks at the end of life, with pain properly controlled a person might learn
how to negotiate a middle path between control and total passivity, about how to welcome the responsible care of strangers, about how to be dependent once again ... about how to trust and maybe even, out of existential suffering, at least a little bit about how to pray or talk with God.
M Scott Peck
It isn't easy to define suffering - most of us can decide when we are suffering but what is suffering for one person may not be suffering for another.
It's also impossible to measure suffering in any useful way, and it's particularly hard to come up with any objective idea of what constitutes unbearable suffering, since each individual will react to the same physical and mental conditions in a different way.
This argument says that euthanasia is bad because of the sanctity of human life.
There are four main reasons why people think we shouldn't kill human beings:
The philosopher Immanuel Kant said that rational human beings should be treated as an end in themselves and not as a means to something else. The fact that we are human has value in itself.
Our inherent value doesn't depend on anything else - it doesn't depend on whether we are having a good life that we enjoy, or whether we are making other people's lives better. We exist, so we have value.
Most of us agree with that - though we don't put it in philosopher-speak. We say that we don't think that we should use other people - which is a plain English way of saying that we shouldn't treat other people as a means to our own ends.
It applies to us too. We shouldn't treat ourselves as a means to our own ends.
And this means that we shouldn't end our lives just because it seems the most effective way of putting an end to our suffering. To do that is not to respect our inherent worth.
Many people worry that if voluntary euthanasia were to become legal, it would not be long before involuntary euthanasia would start to happen.
We concluded that it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused.
We were also concerned that vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or imagined, to request early death.
Lord Walton, Chairman, House of Lords Select Committee on Medical Ethics looking into euthanasia, 1993
This is called the slippery slope argument. In general form it says that if we allow something relatively harmless today, we may start a trend that results in something currently unthinkable becoming accepted.
Those who oppose this argument say that properly drafted legislation can draw a firm barrier across the slippery slope.
If we change the law and accept voluntary euthanasia, we will not be able to keep it under control.
Doctors may soon start killing people without bothering with their permission.
Health care costs will lead to doctors killing patients to save money or free up beds:
The Nazis engaged in massive programmes of involuntary euthanasia, so we shouldn't place our trust in the good moral sense of doctors.
Allowing voluntary euthanasia makes it easier to commit murder, since the perpetrators can disguise it as active voluntary euthanasia.
Many are needlessly condemned to suffering by the chief anti-euthanasia argument: that murder might lurk under the cloak of kindness.
A C Grayling, Guardian 2001
Some people fear that allowing euthanasia sends the message, "it's better to be dead than sick or disabled".
The subtext is that some lives are not worth living. Not only does this put the sick or disabled at risk, it also downgrades their status as human beings while they are alive.
Part of the problem is that able-bodied people look at things from their own perspective and see life with a disability as a disaster, filled with suffering and frustration.
Some societies have regarded people with disabilities as inferior, or as a burden on society. Those in favour of eugenics go further, and say that society should prevent 'defective' people from having children. Others go further still and say that those who are a burden on society should be eliminated.
People with disabilities don't agree. They say:
Supporters of euthanasia would respond that this argument includes a number of completely misleading suggestions, and refute them:
A serious problem for supporters of euthanasia are the number of cases in which a patient may ask for euthanasia, or feel obliged to ask for it, when it isn't in their best interest. Some examples are listed below:
Supporters of euthanasia say these are good reasons to make sure the euthanasia process will not be rushed, and agree that a well-designed system for euthanasia will have to take all these points into account. They say that most of these problems can be identified by assessing the patient properly, and, if necessary, the system should discriminate against the opinions of people who are particularly vulnerable.
Chochinov and colleagues found that fleeting or occasional thoughts of a desire for death were common in a study of people who were terminally ill, but few patients expressed a genuine desire for death. (Chochinov HM, Tataryn D, Clinch JJ, Dudgeon D. Will to live in the terminally ill. Lancet 1999; 354: 816-819)
They also found that the will to live fluctuates substantially in dying patients, particularly in relation to depression, anxiety, shortness of breath, and their sense of wellbeing.
Euthanasia is usually viewed from the viewpoint of the person who wants to die, but it affects other people too, and their rights should be considered.
Palliative care is physical, emotional and spiritual care for a dying person when cure is not possible. It includes compassion and support for family and friends.
Competent palliative care may well be enough to prevent a person feeling any need to contemplate euthanasia.
You matter because you are you. You matter to the last moment of your life and we will do all we can to help you die peacefully, but also to live until you die.
Dame Cicely Saunders, founder of the modern hospice movement
The key to successful palliative care is to treat the patient as a person, not as a set of symptoms, or medical problems.
The World Health Organisation states that palliative care affirms life and regards dying as a normal process; it neither hastens nor postpones death; it provides relief from pain and suffering; it integrates the psychological and spiritual aspects of the patient.
The patient's family and friends will need care too. Palliative care aims to enhance the quality of life for the family as well as the patient.
Effective palliative care gives the patient and their loved ones a chance to spend quality time together, with as much distress removed as possible. They can (if they want to) use this time to bring any unfinished business in their lives to a proper closure and to say their last goodbyes.
Palliative care should aim to make it easier and more attractive for family and friends to visit the dying person. A survey (USA 2001) showed that terminally ill patients actually spent the vast majority of their time on their own, with few visits from medical personnel or family members.
Spiritual care may be important even for non-religious people. Spiritual care should be interpreted in a very wide sense, since patients and families facing death often want to search for the meaning of their lives in their own way.
Good palliative care is the alternative to euthanasia. If it was available to every patient, it would certainly reduce the desire for death to be brought about sooner.
But providing palliative care can be very hard work, both physically and psychologically. Ending a patient's life by injection is quicker and easier and cheaper. This may tempt people away from palliative care.
Some fear that the introduction of euthanasia will reduce the availability of palliative care in the community, because health systems will want to choose the most cost effective ways of dealing with dying patients.
Medical decision-makers already face difficult moral dilemmas in choosing between competing demands for their limited funds. So making euthanasia easier could exacerbate the slippery slope, pushing people towards euthanasia who may not otherwise choose it.
Palliative care will not always be an adequate solution:
There should be no law or morality that would limit a clinical team or doctor from administering the frequent dosages of pain medication that are necessary to free people's minds from pain that shrivels the spirit and leaves no time for speaking when, at times, there are very few hours or days left for such communication.
Dr. David Roy, Director of the Centre for Bioethics, Clinical Research Institute of Montreal
Euthanasia opponents don't believe that it is possible to create a regulatory system for euthanasia that will prevent the abuse of euthanasia.
This argument often appears as 'doctors should not be allowed to play God'. Since God arguments are of no interest to people without faith, it's presented here with the God bit removed.
Doctors should not be allowed to decide when people die:
Since doctors give patients the information on which they will base their decisions about euthanasia, any legalisation of euthanasia, no matter how strictly regulated, puts doctors in an unacceptable position of power.
Doctors have been shown to take these decisions improperly, defying the guidelines of the British Medical Association, the Resuscitation Council (UK), and the Royal College of Nursing:
This is another of those arguments that says that euthanasia should not be allowed because it will be abused.
The fear is that if euthanasia is allowed, vulnerable people will be put under pressure to end their lives. It would be difficult, and possibly impossible, to stop people using persuasion or coercion to get people to request euthanasia when they don't really want it.
I have seen . . . AIDS patients who have been totally abandoned by their parents, brothers and sisters and by their lovers.
In a state of total isolation, cut off from every source of life and affection, they would see death as the only liberation open to them.
In those circumstances, subtle pressure could bring people to request immediate, rapid, painless death, when what they want is close and powerful support and love.
evidence to the Canadian Senate Committee on Euthanasia and Assisted Suicide
People who are ill and dependent can often feel worthless and an undue burden on those who love and care for them. They may actually be a burden, but those who love them may be happy to bear that burden.
Nonetheless, if euthanasia is available, the sick person may pressure themselves into asking for euthanasia.
Family or others involved with the sick person may regard them as a burden that they don't wish to carry, and may put pressure (which may be very subtle) on the sick person to ask for euthanasia.
Increasing numbers of examples of the abuse or neglect of elderly people by their families makes this an important issue to consider.
The last few months of a patient's life are often the most expensive in terms of medical and other care. Shortening this period through euthanasia could be seen as a way of relieving pressure on scarce medical resources, or family finances.
It's worth noting that cost of the lethal medication required for euthanasia is less than £50, which is much cheaper than continuing treatment for many medical conditions.
Some people argue that refusing patients drugs because they are too expensive is a form of euthanasia, and that while this produces public anger at present, legal euthanasia provides a less obvious solution to drug costs.
If there was 'ageism' in health services, and certain types of care were denied to those over a certain age, euthanasia could be seen as a logical extension of this practice.
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