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Overview of pro-euthanasia arguments

Arguments in favour of euthanasia can be broken down into a few main categories:

Arguments based on rights

• People have an explicit right to die
• A separate right to die is not necessary, because our other human rights imply the right to die
• Death is a private matter and if there is no harm to others, the state and other people have no right to interfere (a libertarian argument)

Practical arguments

• It is possible to regulate euthanasia
• Death is a private matter and if there is no harm to others, the state and other people have no right to interfere (a libertarian argument)
• Allowing people to die may free up scarce health resources (this is a possible argument, but no authority has seriously proposed it)
• Euthanasia happens anyway (a utilitarian or consequentialist argument)

Philosophical arguments

• Euthanasia satisfies the criterion that moral rules must be universalisable
• Euthanasia happens anyway (a utilitarian or consequentialist argument)
• Is death a bad thing?

Arguments about death itself

• Is death a bad thing?

Regulating euthanasia

Those in favour of euthanasia think that there is no reason why euthanasia can't be controlled by proper regulation, but they acknowledge that some problems will remain.

For example, it will be difficult to deal with people who want to implement euthanasia for selfish reasons or pressurise vulnerable patients into dying.

This is little different from the position with any crime. The law prohibits theft, but that doesn't stop bad people stealing things.

People have the right to die

Human beings have the right to die when and how they want to

Many people think that each person has the right to control his or her body and life and so should be able to determine at what time, in what way and by whose hand he or she will die.

Behind this lies the idea that human beings should be as free as possible - and that unnecessary restraints on human rights are a bad thing.

And behind that lies the idea that human beings are independent biological entities, with the right to take and carry out decisions about themselves, providing the greater good of society doesn't prohibit this. Allied to this is a firm belief that death is the end.

Religious objections

Religious opponents disagree because they believe that the right to decide when a person dies belongs to God.

Secular objections

Secular opponents argue that whatever rights we have are limited by our obligations. The decision to die by euthanasia will affect other people - our family and friends, and healthcare professionals - and we must balance the consequences for them (guilt, grief, anger) against our rights.

We should also take account of our obligations to society, and balance our individual right to die against any bad consequences that it might have for the community in general.

These bad consequences might be practical - such as making involuntary euthanasia easier and so putting vulnerable people at risk.

There is also a political and philosophical objection that says that our individual right to autonomy against the state must be balanced against the need to make the sanctity of life an important, intrinsic, abstract value of the state.

Secular philosophers put forward a number of technical arguments, mostly based on the duty to preserve life because it has value in itself, or the importance of regarding all human beings as ends rather than means.

Other human rights imply a right to die

Without creating (or acknowledging) a specific right to die, it is possible to argue that other human rights ought to be taken to include this right.

The right to life includes the right to die

• The right to life is not a right simply to exist
• The right to life is a right to life with a minimum quality and value
• Death is the opposite of life, but the process of dying is part of life
• Dying is one of the most important events in human life
• Dying can be good or bad
• People have the right to try and make the events in their lives as good as possible
• So they have the right to try to make their dying as good as possible
• If the dying process is unpleasant, people should have the right to shorten it, and thus reduce the unpleasantness
  • People also have obligations - to their friends and family, to their doctors and nurses, to society in general
  • These obligations limit their rights
  • These obligations do not outweigh a person's right to refuse medical treatment that they do not want
  • But they do prevent a patient having any right to be killed
• But even if there is a right to die, that doesn't mean that doctors have a duty to kill, so no doctor can be forced to help the patient who wants euthanasia.

The right not to be killed

The right to life gives a person the right not to be killed if they don't want to be.

Those in favour of euthanasia will argue that respect for this right not to be killed is sufficient to protect against misuse of euthanasia, as any doctor who kills a patient who doesn't want to die has violated that person's rights.

Opponents of euthanasia may disagree, and argue that allowing euthanasia will greatly increase the risk of people who want to live being killed. The danger of violating the right to life is so great that we should ban euthanasia even if it means violating the right to die.

The rights to privacy and freedom of belief include a right to die

This is the idea that the rights to privacy and freedom of belief give a person the right to decide how and when to die.

The European Convention on Human Rights gives a person the right to die

• Not according to Britain's highest court.
• It concluded that the right to life did not give any right to self-determination over life and death, since the provisions of the convention were aimed at protecting and preserving life.

English law already acknowledges that people have the right to die

This argument is based on the fact that the Suicide Act (1961) made it legal for people to take their own lives.

Opponents of euthanasia may disagree:

• The Suicide Act doesn't necessarily acknowledge a right to die;
• it could simply acknowledge that you can't punish someone for succeeding at suicide
• and that it's inappropriate to punish someone so distressed that they want to take their own life.

Euthanasia opponents further point out that there is a moral difference between decriminalising something, often for practical reasons like those mentioned above, and encouraging it.

They can quite reasonably argue that the purpose of the Suicide Act is not to allow euthanasia, and support this argument by pointing out that the Act makes it a crime to help someone commit suicide. This is true, but that provision is really there to make it impossible to escape a murder charge by dressing the crime up as an assisted suicide.

Libertarian argument

This is a variation of the individual rights argument.

• If an action promotes the best interests of everyone concerned and violates no one's rights then that action is morally acceptable
• In some cases, euthanasia promotes the best interests of everyone involved and violates no one's rights
• It is therefore morally acceptable

Objections to this argument

Opponents attack the libertarian argument specifically by claiming that there are no cases that fit the conditions above:

• people sometimes think things are in their best interests that are not morally acceptable
  • The arguments that euthanasia is intrinsically wrong fit in here
• people are sometimes wrong about what's in their best interests
• people may not realise that committing euthanasia may harm other people
• euthanasia may deprive both the person who dies and others of benefits
• euthanasia is not a private act - we cannot ignore any bad effects it may have on society in general

Medical resources

Euthanasia may be necessary for the fair distribution of health resources

This argument has not been put forward publicly or seriously by any government or health authority. It is included here for completeness.

In most countries there is a shortage of health resources.

As a result, some people who are ill and could be cured are not able to get speedy access to the facilities they need for treatment.

At the same time health resources are being used on people who cannot be cured, and who, for their own reasons, would prefer not to continue living.

Allowing such people to commit euthanasia would not only let them have what they want, it would free valuable resources to treat people who want to live.

Abuse of this would be prevented by only allowing the person who wanted to die to intitiate the process, and by regulations that rigorously prevented abuse.

Objections to this argument

This proposal is an entirely pragmatic one; it says that we should allow euthanasia because it will allow more people to be happy. Such arguments will not convince anyone who believes that euthanasia is wrong in principle.

Others will object because they believe that such a proposal is wide-open to abuse, and would ultimately lead to involuntary euthanasia because of shortage of health resources.

In the end, they fear, people will be expected to commit euthanasia as soon as they become an unreasonable burden on society.

Moral rules must be universalisable

One of the commonly accepted principles in ethics, put forward by Immanuel Kant, is that only those ethical principles that could be accepted as a universal rule (i.e. one that applied to everybody) should be accepted.

So you should only do something if you're willing for anybody to do exactly the same thing in exactly similar circumstances, regardless of who they are.

The justification for this rule is hard to find - many people think it's just an obvious truth (philosophers call such truths self-evident). You find variations of this idea in many faiths; for example "do unto others as you would have them do unto you".

To put it more formally:

The person in favour of euthanasia argues that giving everybody the right to have a good death through euthanasia is acceptable as a universal principle, and that euthanasia is therefore morally acceptable.

This alone does not justify euthanasia

This is sound, but is not a full justification.

If a person wants to be allowed to commit euthanasia, it would clearly be inconsistent for them to say that they didn't think it should be allowed for other people.

But the principle of universalisability doesn't actually provide any positive justification for anything - genuine moral rules must be universalisable, but universalisability is not enough to say that a rule is a satisfactory moral rule.

Universalisability is therefore only a necessary condition, not a sufficient condition for a rule to be a morally good rule.

So, other than showing that one pre-condition is met, universalisibility doesn't advance the case for euthanasia at all.

How similar can situations be?

Every case is different in some respect, so anyone who is inclined to argue about it can argue about whether the particular differences are sufficent to make this case an exception to the rule.

Universal exceptions to universal rules

Oddly enough, the law of universalisability allows for there to be exceptions - as long as the exceptions are themselves universalisable. So you could have a universal rule allowing voluntary euthanasia and universalise an exception for people who were less than 18 years old.

Euthanasia happens anyway

Euthanasia happens - better to make it legal and regulate it properly

Sounds a bit like "murder happens - better to make it legal and regulate it properly".

When you put it like that, the argument sounds very feeble indeed.

But it is one that is used a lot in discussion, and particularly in politics or round the table in the pub or the canteen.

People say things like "we can't control drugs so we'd better legalise them", or "if we don't make abortion legal so that people can have it done in hospital, people will die from backstreet abortions".

What lies behind it is Utilitarianism: the belief that moral rules should be designed to produce the greatest happiness of the greatest number of people.

If you accept this as the basis for your ethical code (and it's the basis of many people's ethics), then the arguments above are perfectly sensible.

If you don't accept this principle, but believe that certain things are wrong regardless of what effect they have on total human happiness, then you will probably regard this argument as cynical and wrong.

A utilitarian argument for euthanasia

From a utilitarian viewpoint, justifying euthanasia is a question of showing that allowing people to have a good death, at a time of their own choosing, will make them happier than the pain from their illness, the loss of dignity and the distress of anticipating a slow, painful death. Someone who wants euthanasia will have already made this comparison for themselves.

But utilitarianism deals with the total human happiness, not just that of the patient, so that even euthanasia opponents who agree with utilitarianism in principle can claim that the negative effects on those around the patient - family, friends and medical staff - would outweigh the benefit to the patient.

It is hard to measure happiness objectively, but one way to test this argument would be to speak to the families and carers of people who had committed assisted suicide.

Opponents can also argue that the net effect on the whole of society will be a decrease in happiness. The only way to approach this would be to look at countries where euthanasia is legal. However, as no two countries are alike, it seems impossible to extricate the happiness or unhappiness resulting from legal assisted suicide, from any happiness or unhappiness from other sources.

Even if you agree with the utilitarian argument, you then have to deal with the arguments that suggest that euthanasia can't be properly regulated.

Is death a bad thing?

Why ask this question?

If death is not a bad thing then many of the objections to euthanasia vanish.

If we put aside the idea that death is always a bad thing, we are able to consider whether death may actually sometimes be a good thing.

This makes it much easier to consider the issue of euthanasia from the viewpoint of someone who wants euthanasia.

Why is death a bad thing?

We tend to regard death as a bad thing for one or more of these reasons:

• because human life is intrinsically valuable
• because life and death are God's business with which we shouldn't interfere
• because most people don't want to die
• because it violates our autonomy in a drastic way

The first two reasons form key points in the arguments against euthanasia, but only if you accept that they are true.

The last two reasons why death is a bad thing are not absolute; if a person wants to die, then neither of those reasons can be used to say that they would be wrong to undergo euthanasia.

People don't usually want to die

People are usually eager to avoid death because they value being alive, because they have many things they wish to do, and experiences they wish to have.

Obviously, this is not the case with a patient who wishes to die - and proper regulation will weed out people who do not really want to die, but are asking for other reasons.

Violation of autonomy

Another reason why death is seen as a bad thing is that it's the worst possible violation of the the wishes of the person who does not want to die (or, to use philosophical language, a violation of their autonomy).

In the case of someone who does want to die, this objection disappears.

Being dead, versus not having been born

Some people say that being dead is no different from not having been born yet, and nobody makes a fuss about the bad time they had before they were born.

There is a big difference - even though being dead will be no different as an experience from the experience of not having yet been born.

The idea is that death hurts people because it stops them having more of the things that they want, and could have if they continued to live.

Someone who makes a request for euthanasia is likely to have a bad quality of life (or a bad prognosis, even if they are not yet suffering much) and the knowledge that this will only get worse. If that is the case, death will not deprive them of an otherwise pleasant existence.

Of course, most patients will still be leaving behind some things that are good: for example, loved ones and things they enjoy. Asking for death does not necessarily mean that they have nothing to live for: only that the patient has decided that after a certain point, the pain outweighs the good things.