South Australia’s parliament is set to debate euthanasia for the seventeenth time in twenty-five years, this time under the title of “Voluntary Assisted Dying” (as opposed to involuntary assisted dying, which is called murder). Advocates for euthanasia argue for it on compassionate grounds. Surely allowing a person who is suffering to choose whether they must continue suffering or not is the moral and reasonable thing, right?
Euthanasia, a term derived from the Greek words for ‘good’ and ‘death’, is the practice of a doctor deliberately ending the life of a patient, usually via lethal injection. It is a tragic fact of life and the human condition that sometimes we are faced with terrible physical, mental and emotional pain at the end of life, and euthanasia advocates hope to see patients given the choice to not have to endure such pain. One often hears that euthanasia is needed when there is little or no “quality of life.”
On the surface, this argument appears to make sense, and it certainly appeals to our compassionate sensibilities. At a superficial glance, those who oppose euthanasia can be characterized as pro-suffering and therefore immoral people, or as allowing their religious convictions to cloud their judgment (although you don’t need to be religious to be against euthanasia), or as never having endured seeing a loved one suffer. This is simply slander, it’s far easier to attribute ill motivations to an opponent than it is to actually argue with them using reason, facts and logic.
There are a number of philosophical and moral issues which arise from euthanasia, and a superficial appeal to ending suffering is not sufficient for making an informed decision about this issue. Here are three objections to legalizing euthanasia (the remaining two will be discussed in Part Two).
1. Euthanasia is suicide
The argument for euthanasia equally applies to suicide in general. The difference is that when a person commits suicide, they do so by their own hand, whereas euthanasia involves another actor in the death. In Australia, helping someone commit suicide, such as by supplying them with the necessary drugs, is illegal. Euthanasia advocates argue that people who are facing insurmountable suffering, usually because they are terminally ill, should, as autonomous individuals, have the right to opt out of this suffering by ending their lives. There is no reason why this logic doesn’t apply more broadly to suicide in general.
Euthanasia advocates will object that not all people who want to commit suicide are terminally ill, but, as we will explore in Part Two, not all euthanasia applicants or recipients are either.
With all of the emphasis on mental health in our culture, clearly, most people view suicide as a bad thing. There are two reasons for this: Those who commit suicide do so because they are desperate, depressed, and dealing with various problems which amount to them needing help, and suicide doesn’t only affect the person who makes the decision, it traumatizes others too.
Our culture is simultaneously saying “Life is worth living, we must help those who contemplate suicide” and “people should have the right to decide if their life is worth living or not.” These views are incompatible. If you support euthanasia, there’s no clear reason why you shouldn’t believe that anybody has the right to end their life if they want to.
2. The purpose of the medical profession is the healing and preservation of life
The ancient Greek code of medical ethics, the Hippocratic Oath, taken by ancient students of medicine and still, in modified forms, taken by medical students today, reads:
“I will do no harm or injustice to [patients]. Neither will I administer a poison to anybody when asked to do so, nor will I suggest a such a course… Into whatsoever house I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm…”
The Hippocratic Oath captures the essence of the medical profession – to help the sick. People still suffered at the end of life in Hippocrate’s day, yet the Greeks perceived that ending patients’ lives would be unethical, and anticipated that patients would ask them to do so. Killing patients, even if they want to die, violates the underpinning principle of the medical vocation itself. The focus must be on ensuring that palliative care is as excellent as possible, not on making it easier for patients to die.
Some euthanasia advocates will object that ending a patient’s life is sometimes necessary, such as when a person’s life-support is switched off, but this is a categorically different situation. Turning off life-support is ceasing to keep someone alive artificially, euthanasia is killing someone who could still go on living, and such a person ought to be protected by medical professionals.
3. Euthanasia isn’t just about the individual, it affects society
Euthanasia advocates often tout the right of the individual to decide how they wish to live, or not live, as the paramount consideration in this debate, as though it doesn’t impact society at all. However, people intuitively understand that suicide doesn’t only affect the individual. It would be bizarre if someone argued that the person who shoots themselves, also a potentially quick and painless death (though not always, as is also the case with euthanasia), is empowered because they are making the choice for themselves.
In Victoria, where euthanasia is legal, palliative care units are under-funded to meet their needs, and there is a shortage of palliative care doctors. If the Victorian government took the purpose of healthcare seriously, they would remedy this, but having the option of euthanasia muddies the waters. One has to wonder whether improving palliative care would be a greater priority if euthanasia weren’t an option. With modern medicine, technology and palliative care methods, a tremendous amount can be done to alleviate patients’ suffering.
Alarmingly, there is evidence that there is a correlation between euthanasia and increased suicide rates. Euthanasia laws may have an educative effect about the value of life. After all, via euthanasia the government and culture implicitly affirm that some lives aren’t worth living.
Two further objections will be explored in Part Two.