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    End of Life Choice ActArticle04 Sep, 2020
    Last edited: 14 Sep, 2020, 4:28 PM

    Dr. Simon Clarke: Voluntary Euthanasia - For And Against

    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.

    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.

    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

    Simon Clarke

    Simon Clarke

    @srclarke100

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    Luke B.

    Luke B.

    @coragus

    Commented 14 Sep, 2020

    Nicely written, I certainly think that people should focus on preventative reasons that people get into a state that they might need this. Afterall quite a lot of people I know support it, but for when life isn't living anymore, just surviving.
    There is also the issue that some people at the current moment, don't' have any solutions to get better, we simply don't have the technology to help people of various illnesses recover.
    John Monro

    John Monro

    @JohnMonro

    Commented 13 Sep, 2020

    Hi. I will be voting against euthanasia in the forthcoming referendum. I fear though I will be in a minority and that the "feeling" for euthanasia is now quite strong in the community. I believe, without I hope appearing too condescending, that the public have been just a bit misinformed about terminal illness and dying, and that distressing publicity about some individual instances is not the best way to make such a fundamental change to our relationship with each other or the profession charged with looking after us. . I am a recently retired GP and if euthanasia is approved, I will be eternally grateful I no longer work in a profession that is allowed to help people kill themselves. I believe I am right in saying that the professional medial bodies that act in most western democracies do not support euthanasia. I would ask the general public to think about this. I am an atheist, and my belief in the "sanctity of human life" is absolute because I believe a humanist can construct just a firm a moral and ethical life and principles as any religious person. I am not going to rehash all the arguments here, I have amassed quite a number, three of which are usefully put forward above, but whilst the "slippery slope" argument is a vexed one, it's the wrong metaphor. It's more a door that has always been closed and locked, and now has been unlocked and pushed ajar. There is a night and day difference between being allowed to do one thing, whatever the constraints, and never being allowed to, whatever the circumstances. I worked nearly 50 years in medical practice. My experience, and nothing else, tells me that we are complicated creatures, whose rationality is always subject to our manifestly more powerful emotional behaviour. The basic issue is this, I do not trust us. I do not trust common human behaviour, I do not trust the medical profession, I do not trust governments or communities to always do the right or reasoned thing. We are very fortunate to live in a moderately reasoning, benign society on the whole, where the rule of law is generally observed and for the most part society is run on humane and compassionate grounds. But the history of our species, our humanity, is replete with innumerable examples where this does not apply. I have a reasoned fear that we cannot guarantee our own society might not revert to something more primitive in the future, in the face of some of the existential threats now facing us, as a society or nation, and as members of a common humanity. If we cannot guarantee the sanctity of human life during the good times, how on earth are we going to be expected to do so in the bad? I won't go on, but I'd urge people to do a lot of reading and thinking about this issue, discussing with their families and loved ones. I would be very distressed to see the vote for yes, and the government to act on this, but I would accept it rather better if I felt the public were debating this issue on rational and informed debate, rather than emotional appeals to fear and unreason, including from at least one previously medically qualified person whose proselytising for euthanasia is nothing other than medical quackery. Thank you for your time. JKM

    David W. Scott

    David W. Scott

    @dwscott

    Commented 04 Sep, 2020

    I think the whole sanctity of life argument against the referendum, is often rather lacking in nuance. Their argument usually boils down to their "sanctity" just being the maintaining of a heartbeat, over the real sanctity of all aspects of life, as in it being actually physically or mentally bearable to continue in terrible circumstances. Death is after all the final chapter part of all our lives. By all means have checks and balances, but ultimately I will choose when my final page is written.


    Simon Clarke

    Simon Clarke

    @srclarke100

    Replied 07 Sep, 2020

    Yes, the view seems to be that life itself, regardless of its conditions or quality, is valuable and must never be intentionally taken. As I suggest in the article, that doesn't seem true. What would be the point of living in a permanent coma forever?


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