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Voluntary Euthanasia - For And Against

On 17 October this year, New Zealanders will have the opportunity to vote for or against the legalisation of voluntary euthanasia. The proposed law will permit those with six months or less to live to request assistance from others to end their own lives, if approved by two doctors. Should voters approve the law? There are strong arguments on each side.

FOR

There are three main arguments in favour of legalising voluntary euthanasia. The first is mercy or relief of suffering. Some people have terminal illnesses that greatly compromise their quality of life. They may be suffering from cancer or another disease, with effective treatment no longer possible, and in severe pain and discomfort. Some readers may have seen loved ones go through this experience; their agony and distress is apparent. The current situation forces people to go through long lingering painful deaths and it is cruel to force people to suffer this way. It could be replied that good palliative care to relieve pain is the appropriate response, but some medical conditions are such that the pain and suffering is not completely relievable.

The second argument for legalising voluntary euthanasia is respect for personal autonomy. People generally have the right to make decisions about their own lives so long as they do not harm others. They may decide where to live, who to live with, their occupation, projects, and hobbies. Surely they should also have the right to decide the timing and manner of their own death too. The title of a film in which the main character who wishes to end his own life against the judgements of the medical authorities is Whose Life Is It Anyway? To this it might be responded that a person’s decision to end his or her life is not a self-regarding one; it affects others too such as family, friends, and perhaps society as a whole. True, but it is still fundamentally a decision about themselves that they are making. All decisions affect others in some way, but decisions fundamentally about ourselves such as who to marry, what occupation to pursue, and the timing and manner of one’s life and death, are decisions that people should be free to make for themselves.

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The third argument points to the fact that passive euthanasia is already practiced in society. A person is morally and legally permitted to refuse life-saving treatment if they wish. For example, some people out of religious belief may refuse a blood transfusion even if doing so risks their own death. Since this is already permitted, why not let people achieve the same ends by active intervention too, by permitting them to request a lethal injection from their doctor? There seems little moral difference between letting people refuse life-saving treatment and letting them request life-ending treatment. If the intentions and end results are the same, why not let people do the latter as well as the former?

AGAINST

There are also strong arguments against the legalisation of voluntary euthanasia. It is sometimes said that innocent human life is sacred, that it is a value that must be upheld and protected as much as possible. This may be based on a religious view but even secular humanists may believe that protecting human life is a bedrock value of any society. Permitting voluntary euthanasia, it is argued, would be incompatible with the sanctity of life. What does it mean to say that human life is sacred or has sanctity? It means that it is intrinsically valuable, good in itself rather than as a means to something else, and of absolute or near-absolute value, so that it is not outweighed by something else such as convenience or financial cost. Against this, it could be objected that innocent human life does not have intrinsic value, that it is valuable only when it contains other things of value such as enjoyment and relationships, and that in euthanasia cases, those other things are missing. And also it could be objected that life does not have absolute value, that sometimes its value outweighed by (for example) the amount of pain and suffering in it.

The second argument against voluntary euthanasia is less philosophical and more practical. How do we know that the decisions being made will really be voluntary and fully-informed? Perhaps the illness that the person is suffering from has undermined their decision-making capacities. The proposed law tries to deal with this difficulty by regulations such as that two independent doctors must verify that the patient is reasonably informed and is deciding freely, and with other checks to ensure this is the case. Such regulations are helpful and necessary of course, but there is no guarantee that they will be 100% effective. Some people might fall through the cracks, and choose euthanasia when they are not fully informed, not making a fully rational decision, or have been pressured by others. That possibility will probably never be completely eliminated and for some, that possibility outweighs whatever advantages legal voluntary euthanasia may have.

The third argument is the slippery slope objection against voluntary euthanasia. The objection is that if voluntary euthanasia is allowed, then society’s attitude towards killing might become weakened. Belief in the value of life may decrease generally. Once killing of the terminally ill with their consent is accepted, perhaps society will soon permit the killing of the ill without their consent or the killing of people thought undesirable. In other words, permitting voluntary euthanasia may cause society to slide down a slippery slope into accepting killing in other types of cases. There is some evidence that this has occurred in countries that have already legalised voluntary euthanasia such as the Netherlands and Belgium. At first, only people with terminal illness were permitted to request euthanasia but in recent years, policies in those countries have been changed so that anyone with an illness, whether terminal or not, that results in suffering and loss of quality of life may request assistance to die. It might be objected that perhaps such cases should be permitted too and so that sliding down the slope a little way is not such a bad thing. But the worry might be that further slides down the slope may occur.

There are other arguments for and against voluntary euthanasia but these are some of the main considerations on each side. Voters will have to decide for themselves come voting day.

Associate Professor Dr Simon Clarke

Political Science and International Affairs

American University of Armenia

Yerevan, Armenia

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