This essay discusses the laws concerning euthanasia in the United Kingdom and in other countries of the world. It also discusses the meanings of and the differences between the terms euthanasia (sometimes called “mercy killing”), terminal sedation and assisted suicide. According to “Euthanasia Statistics (July 2012), over half of all doctors support euthanasia, as do about 86 percent of members of the public surveyed, yet there are so few places where it is legal.
As Rhodes (2013) states, such issues “are highly controversial and opinions on whether they should be legalised are split.” As she also states, there are those who in general support euthanasia, who believe that a person who is either terminally ill or has a severe injury that has resulted in a life of continuing pain should be given the right to decide for themselves whether they want to live or to die. Those who oppose it may believe absolutely in “the sanctity of life” or may be concerned about the possibility of abuse; e.g. about vulnerable people being persuaded to decide to prematurely end their life because they are considered to have become a burden.
According to Rhodes, the situation in the United Kingdom is that euthanasia (sometimes referred to as “mercy killing”) refers to the practice of ending someone else’s life, to end that person’s suffering from some incurable disease or condition. When the person concerned gives their informed consent, it is called voluntary euthanasia. If the sufferer is unable to give their consent (e.g. due to mental incapacity or in a long-term coma for example), then it is known as involuntary euthanasia. In either case, euthanasia is prohibited under law in England and Wales.
“Euthanasia and assisted suicide” (Aug 2012) is an article published by NHS Choices. That article classifies euthanasia in a subtly different way to Rhodes, adding “non-voluntary euthanasia” to the categories Rhodes defines. In this NHS article, involuntary euthanasia is defined as the situation where a person’s life is ended in direct contravention of their expressed wishes, and non-voluntary euthanasia as when the person is unable to give consent due to being in a coma or unconscious. In such cases it is likely that the person has previously indicated they would like to end their life in those circumstances.
Comparing “assisted suicide” with euthanasia, although it is indeed a form of euthanasia, the distinction according to Rhodes is that with assisted suicide the person wanting to bring their own life to an end is provided with the means (e.g. drugs or equipment) by another person, usually because they lack the ability or the wherewithal themselves. Terminal sedation is distinct from both euthanasia and assisted suicide because it is not specifically a process to end a life, but is instead a method of reducing the suffering of a person in pain in the final days / hours of their life. It generally involves administering sedatives on a continuous basis to the terminally-ill patient so that they do not feel pain; most likely remaining unconscious. The process is not against the law in England and Wales, although concern has been expressed in some quarters that it may effectively – in some cases – be euthanasia in another form.
Rhodes mentions that in the Netherlands euthanasia (also encompassing assisted suicide), when requested to a doctor by a patient, although still a criminal offence, can entitle the doctor to exemption from prosecution provided the doctor has satisfied certain “due care” criteria and has formally reported the act – as defined in the “Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2002.” Rhodes also notes that euthanasia is legal in Belgium, and that assisted suicide is legal in Switzerland “provided there is no selfish motive.”
As regards the laws in England and Wales, Rhodes reports that a person found guilty of euthanasia by action (as opposed to omitting to prevent it) can face prosecution for murder. However, in certain circumstances such as discontinuing life support, prosecution is unlikely. As regards assisted suicide, even though suicide itself is not a crime, assisting another to commit suicide can be punished by a term of imprisonment of up to 14 years. Rhodes cites the case of Debbie Purdy who was suffering from an incurable disease and wished to go abroad to a country where assisted suicide is permitted by the law, but needed the help of her husband to do that. Although she battled over a long period to obtain assurance from the UK Department of Public Prosecutions (DPP) that he would not be prosecuted for helping her in this way, they were not forthcoming. However, she did succeed in persuading them to issue guidance on the issue of assisted suicide, although the outcome is still one of uncertainty for any specific case, which can be most stressful for those involved. As a consequence, increasing numbers of UK citizens finding themselves in this dreadful situation are travelling abroad to countries like Belgium, Switzerland or the Netherlands where assisted suicide is not illegal per se.
Another particularly poignant example of the situation faced by someone when a loved one is incurably sick is published by Marantz Henig (July 2013), describing the situation facing Peggy Battin – a prolific writer on “end-of-life bioethics” – who was suddenly confronted with the real life situation when her husband had a bicycle accident which broke his spine and left him a quadriplegic. In the event, he continued to live, although in a severely limited manner, though it did not change his wife’s conviction that everyone has a right to die if they so choose.
Withnall (October 2013), reporting for the Independent (UK newspaper) discussed the current situation in Belgium where extension of the already legal right to euthanasia was being debated in the country’s parliament. It has been permitted in Belgium since 2002 to choose death by injection so long as two doctors formally confirm there is “unbearable psychological or physical suffering” involved. According to Withnall, around one percent of deaths in Belgium are by assisted suicide. The extension being considered is to allow under-18’s to have the same option, so long as their parents give consent and an expert psychologist certifies that the child fully understands the implications of such a decision. Also being debated under the same Bill is to allow Alzheimer’s patients to consent to assisted suicide while they still have mental capacity, the death to be actioned when doctors decide they are no longer “interacting with society.” Withnall notes that as far as European countries are concerned, whilst Belgium, Luxembourg and the Netherlands allow legal euthanasia “in extreme circumstances”, the laws in Germany and Switzerland require that the patient must actually administer the needed lethal injection themselves.
A powerful body of opinion against euthanasia is manifested by religious opposition to it. Teahan (November 2013) reports in the Catholic Herald that the bishops in Belgium have issued a statement that the proposed extension of the euthanasia laws risk “destroying the functioning of society.” They do not accept that children are capable of making that life-or-death decision, and believe that euthanizing dementia sufferers is denying them their dignity and allowing others to make arbitrary judgments about their continuance or ending of life. The article notes that Alzheimer’s patients in the Netherlands can already be euthanized under Dutch legislation. Also noted in the article is that in an October survey conducted in Belgium, three quarters of Belgians surveyed approved of the euthanasia of children who are “in an irreversible coma or vegetative state” and 80 percent supported it for Alzheimer’s sufferers. The article reports that in Belgium some 75 percent of the population is Catholic, although only 10 percent go to church.
Regarding the position with respect to euthanasia laws around the world, the UK-based Care charity published an article entitled “Euthanasia: Country Comparison” comparing the situations prevailing at that time in various countries with respect to euthanasia and Physician Assisted Suicide (PAS). Summarizing:
- Australia: Euthanasia illegal; PAS illegal.
- Belgium: Euthanasia legal; although not specifically named, PAS is permitted under certain conditions, including what are called “advance directives.”
- Canada: Both illegal, although a 2013 Bill is planning to legalize euthanasia, though with only minority support from the population.
- France: Both could be made legal under proposed legislation.
- Germany: Active euthanasia illegal (maximum five years imprisonment). PAS is allowed though not legal as such.
- Italy: Both illegal.
- Luxembourg: Both are allowed under law.
- The Netherlands: Both are allowed under law.
- Switzerland: Active euthanasia is illegal, but PAS is lawful.
- USA: Active euthanasia is illegal in most states, but PAS is permitted in some states (e.g. Montana, Oregon, Washington).
The USA position referred to above was updated somewhat in May of 2013 by publication of a “State-by-State Guide to Physician-Assisted Suicide on the ProCon.org website, adding Vermont in 2013 to the list of states where PAS is permitted. The article also notes that although PAS legislation handled only at state level, all states prohibit euthanasia under federal laws of homicide.
A concern for many is that by giving the power of decision-making to doctors, the door is opened to abuse – perhaps on a large scale. One such case is reported by Schadenberg (2013), in which a doctor in Brazil is alleged to have euthanized (killed) as many as 300 patients in her care in order to free up more beds in her hospital. The article also mentions an incident some years ago when a Dutch doctor referred to terminally ill patients as “bed-blockers.” It seems that to him the solution was euthanasia. In the same article, it is reported that studies in Belgium have found that a number of nurses admitted to euthanizing patients, even though that is illegal; only doctors are permitted to do it under Belgian law. It is also alleged (again in Belgium) that not only are many euthanasia deaths not reported as such, but that about a third of euthanasia deaths are implemented without specific request. So it would appear from this article that where euthanasia and PAS are made legal, abuse is not just possible but probable, although it is to be hoped in only a minority of cases.
Although the “Euthanasia Country Comparison” article referenced earlier in this essay lists Australia as a country where both euthanasia and PAS are illegal, Winter (Nov 2013) reports for ABC News that a euthanasia clinic has just been opened by Exit International in Adelaide. However, according to Dr Philip Nitzschke the clinic will not be a “death clinic” but a place where people can obtain “information on end of life choices.” Many people are supportive of the facility, but some who are opposed to it plan to lobby the State Parliament about it.
Conclusions
Works Cited:
“Euthanasia and assisted suicide.” (Aug 2012). NHS Choices. Web. 16 November 2013.
“Euthanasia: Country Comparison.” (2010-2013). Care. Web. 18 November 2013.
“Euthanasia Statistics.” (2012). Statistic Brain. Web. 18 November 2013.
Marantz Henig, Robin. (July 2013). “A Life-or-Death Situation.” New York Times. Web. 17 November 2013.
Rhodes, L-A. (2013). “Euthanasia, Terminal Sedation and Assisted Suicide.” LegalCentre.co.uk. Web. 17 November 2013.
Schadenberg, Alex. (2013). “Doctor Killed 300 Patients in Euthanasia to “Free Up” Hospital Beds.” LifeNews.com. Web. 18 November 2013.
“State-by-State Guide to Physician-Assisted Suicide.” ProCon.org. Web. 18 November 2013.
Teahan, Madeleine. (November 2013). “Belgium bishops attack proposed euthanasia law extension.” The Catholic Herald. Web. 17 November 2013.
Winter, Caroline. (Nov 12 2013). “Euthanasia clinic opens in Adelaide.” ABC News. Web. 18 November 2013.
Withnall, Adam. (October 2013). “Belgian MPs to debate extending euthanasia laws to under-18s and Alzheimer’s patients.” The Independent. Web. 17 November 2013.
