Euthanasia is a Greek term that originally means ‘good health’. Now it refers to the practice of ‘intentional ending of a life in order to relieve unbearable pain and suffering’.
The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition as “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.”
Historical Background of Euthanasia
There is a historical background of euthanasia. It was strongly opposed in the Judeo-Christian tradition. Thomas Aquinas argued that the practice of euthanasia contradicted our natural instincts of survival. Nevertheless, there were voices arguing in favour of euthanasia, such as John Donne in 1624, and euthanasia continued to be practised off and on. Suicide and euthanasia were more acceptable under Protestantism and during the ‘Age of Enlightenment’. Thomas More wrote of euthanasia in his ‘Utopia’, though it is not clear if More was intending to endorse the practice. Other countries have taken different views, for example, in Japan suicide has not traditionally been viewed as a sin, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.
Classification of Euthanasia
However, euthanasia must be intended as a “merciful death”, and “not for personal gain”, such as to claim an inheritance, etc. Euthanasia may be classified into three types: voluntary, non-voluntary, and involuntary.
Voluntary Euthanasia: Euthanasia conducted with the consent of the patient is termed ‘voluntary euthanasia’.
Non-voluntary Euthanasia: Euthanasia where the consent of the patient is unavailable due to the patient’s condition, such as in an irreversible coma, is termed ‘non-voluntary euthanasia’.
Involuntary Euthanasia: Euthanasia conducted against the will of the patient is termed ‘involuntary euthanasia’. In fact, involuntary euthanasia is not euthanasia in its true sense; rather it is simply killing or murder.
Passive and Active Euthanasia: Euthanasia can also be further divided into passive and active variants. Passive euthanasia entails the withholding of common life-saving treatments, such as antibiotics, etc. Active euthanasia entails the use of lethal substances or forces, such as pushing a lethal injection, electric shock, etc., though it is still considered to be controversial means.
Active voluntary euthanasia is legal in Belgium, Luxembourg, and the Netherlands. Passive voluntary euthanasia is legal throughout the US and the UK.
There are different euthanasia laws in different countries. The British House of Lords Select Committee on Medical Ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering.” In the Netherlands, euthanasia is understood as “termination of life by a doctor at the request of a patient.”
Debate over Euthanasia
There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and sometimes involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient’s condition. In some experts’ opinion, consent on the part of the patient was not considered essential, although it may have been required to justify euthanasia. However, others see the consent of the patient as essential.
In the mid-1800s, the use of morphine to treat “the pains of death” emerged. John Warren recommended its use in 1848. A similar use of chloroform was revealed by Joseph Buller in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a school teacher, initiated the contemporary ‘euthanasia debate’ through a speech given at the Birmingham Speculative Club in England, which was subsequently published as ‘Essays of the Birmingham Speculative Club’—the collective works of a number of members of an amateur philosophical society. William’s proposal was to use chloroform to deliberately hasten the death of terminally ill patients :
“That in all cases of hopeless and painful illness, it should be the recognised duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anaesthetic, so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt” or question, that the remedy was applied at the express wish of the patient.
After 1996 the euthanasia debate reduced in intensity, resurfacing periodically, but not returning to the same level of debate until the 1930s in the United Kingdom.