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Running Head: EUTHANASIA


Euthanasia: A Complex and Taboo Subject
Emmanuel Avila
University of Texas at El Paso


Euthanasia: A Complex and Taboo Subject

The subject of euthanasia is one most people are ill equipped to deal with or discuss. I
myself was little prepared for the headache I was about to embark on. There are many different
names and definitions for this subject: Active euthanasia, assisted suicide, physician assisted
suicide, passive euthanasia. However you choose to describe it, there is no mistaking that the
subject is very much controversial, especially in the United States. Most recently, the case of
Brittany Maynard was brought to the forefront, a 29 year old Oregon resident diagnosed with
terminal brain cancer who decided to end her own life. I myself am not strictly opposed to
euthanasia, depending on the circumstance, however the aim of this paper is not to persuade, but
merely to discuss. Mainly this paper will outline three of the most important aspects of
euthanasia, the legality, the ethical dilemma, and the aspect of quality of life.
Euthanasia has many different definitions, all which are considered controversial by most
authors. Euthanasia conducted with the consent of the patient is termed voluntary, when the
consent of the patient is unavailable it is termed non-voluntary, and euthanasia conducted against
the patients will is involuntary. Furthermore, all three can be divided into passive and active
euthanasia. Passive euthanasia is when common treatment is withheld from a patient necessary
for the continuance of life, and active euthanasia involves the use of lethal forces to end life.
Oregon became the first US state where an adult can hasten their death with the use of drugs
prescribed by a physician (Lopes, 2015, p. 1). This is dubbed physician assisted suicide, when



the drugs used by the patient to end his or her life are provided by anyone other than a physician
it is simply called assisted suicide. As Huxtable (2013) found “The country with the longest
history of permitting the practice is the Netherlands” (p. 88). Other states, such as Washington,
Vermont, and California, have followed Oregon’s lead in legalizing assisted euthanasia. Different
parts of Canada allow passive euthanasia, but assisted suicide is under legal review. According to
Huxtable (2013), “The Netherlands’ near neighbors have followed its lead, with Belgium and
Luxembourg also recently enacting laws that permit voluntary euthanasia” (p. 88). Below is a
map illustrating the different forms of euthanasia allowed around the world: Dark blue indicates
where active euthanasia is legal, light blue allows passive euthanasia, the laws in the black vary
depending on administrative district, euthanasia is illegal in the red, and gray is unknown.



The question of legality is not always as black and white as we believe it to be. Even countries
that do not allow euthanasia can allow for leniency. Huxtable (2013) states “In the UK, for
example, judges tend to respond leniently to any ‘mercy killer’ who has sought to end the
suffering of their loved one” (p. 89). This was due in part to reports that patients with terminal
illnesses were traveling to Switzerland to receive assistance in suicide (Huxtable, 2013, p. 89).
Switzerland, unlike Oregon and the Netherlands, does not have a “residents only” provision
(Tulloch, 2005, p. 65), which has given rise to the term “suicide tourism.” Even in the United
States complicated cases have arisen. Rudy Linares, a Chicago man, took a gun into the hospital
and disconnected his son from a respirator, after the boy had swallowed a balloon that lodged in
his windpipe causing him to be without oxygen for too long, the father was not charged with
murder (Tulloch, 2005, p. 16). This instance brings to question the legal definition of death. The
absence of heartbeat, or breath have long been the criterion for death, but the Harvard Medical
School recommended that irreversible coma, or brain death be taken as the new criterion
(Tulloch, 2005, p. 7). The case of Terri Schiavo is another of these instances. In 1990 Terri
collapsed in her Florida home, it was found that her brain had been deprived of oxygen. Terri
was diagnosed as being in a persistent vegetative state. Her husband, Michael, requested that she
not be resuscitated, and that her feeding tube be removed. Terri’s parents insisted that as a
Roman Catholic, their daughter would want treatment to continue. After a lengthy battle,
ultimately ending in the Supreme Court, the courts favored with Michael, and Terri’s feeding
tube was removed in March of 2005 (Huxtable, 2013, p. 50). Perhaps the most controversial law
to date has been a recent one passed in Belgium. According to Von Sydow (2014), “In 2014,
Belgium, which made euthanasia legal for adults in 2002, passed a bill allowing euthanasia for


terminally children. The choice is placed with the child and has to be supported by a parental
consent” (p. 246). This most recent law gives rise to the next issue with euthanasia, the problem
of ethics.
Most individuals believe that all life is precious and should be cherished. The United
States in particular has a large population of people who consider themselves to be religious. As
Yuill (2013) stated, “The most important argument against legalizing assisted suicide is based
upon the idea of the sanctity of life” (p. 30). So who ultimately decides when it is okay to take
life? The United States is no stranger to taking life, after all the death penalty has long been a
form of punishment sanctioned by the state. If we deem someone is far too evil to be allowed to
live in a civilized society, then why can’t the opposite be true? That a good person who is
suffering immensely be allowed to die with dignity. The argument for euthanasia relies on the
idea of our autonomy. According to Barbuzzi (2014), “autonomy is defined as the patient’s
ability to make a subjective decision regarding their treatment based on their understanding of
the relevant medical facts given by the doctor and on their assessment of their own personal
circumstances” (p. 17). Those who argue against euthanasia use the idea of the slippery slope and
the integrity of medicine. The slippery slope refers to euthanasia that gets out of hand. As
Barbuzzi (2014) states, “critics claim that if society legally accepts active killing for terminally
ill patients who request it due to extreme pain or disability, less serious cases will eventually be
accepted” (p. 18). There is an idea that voluntary euthanasia could slip into the realm of
involuntary euthanasia (Yuill, 2013, p. 32), akin to thinning the herd. Still another ethical
dilemma of euthanasia is the integrity of our medical system, and the idea of foreseen and


unintended consequences. According to Tulloch (2005), “For example, the directly intended
effect of dropping the atom bomb on Nagasaki was to bring the Second World War to a close by
bringing about the surrender of the Japanese; the foreseen but not but not directly intended effect
was that 74,000 people were killed” (p. 30). To relate it to medicine, a doctor may prescribe and
elevate levels of morphine to a patient to relieve pain, however the elevated level of morphine
may repress the respiratory system to the point where the patient dies (Tulloch, 2005, p. 30). It is
certainly ethical for the doctor to provide the patient with drugs to alleviate pain. When does it
turn from alleviating pain to killing the patient? Those who argue against legalizing euthanasia
worry that it poses a threat to the integrity of the profession (Jeffrey, 2009, p. 40). Tulloch (2005)
found “In the end, the issue comes to the adherence to the Hippocratic Oath and a fear of the
abyss that yawns at the bottom of the slippery slope” (p. 32). Ethical questions are not so easily
solved, in most cases it depends on the individual to whom you relay the question. Let us discuss
the case of Michaelangelo and Rina Attard, the couple moved from Maltese to Manchester,
England. They were expecting conjoined twins, Gracie and Rosie were born with their own arms
and legs, but were joined at the pelvis, with a fused spine. Each girl had their own vital organs,
but they shared a liver, bladder, and also a circulatory system, as they were joined at the main
artery. Rosie’s heart and lungs were malformed and did not function. Gracie’s heart and lungs
were doing all the work for both girls, essentially pumping oxygenated blood throughout their
shared body. The doctors believed that if the girls remained joined Gracie’s heart would fail and
both girls would die. They believed that Rosie could not live without Gracie, but if separated
Gracie could live a relatively normal life. The separation would therefore cost Rosie her life,
being devout Roman Catholic the parents would not consent to the separation. The doctors


sought the assistance of the courts, and eventually it was ruled that it would be in the best interest
of Gracie for the girls to be separated. One judge saw Rosie’s dependence of Gracie as similar to
that of a patient needing the support of life-prolonging treatment that might be provided by tubes
and machines (Huxtable, 2013, 15). The story of Gracie and Rosie leads us to our final topic on
the subject.
Quality of Life
Quality of life is one of the most important aspects every individual holds near and dear.
The idea of dying slowly and painfully is a truly terrifying one. It is this argument that most
people use to justify the legalization of euthanasia. Take the above story of Gracie and Rosie,
their quality of life if they had remained joined was judged to be basically non-existent, therefore
they were separated so that Gracie could maintain some measure of quality. Barbuzzi (2014)
found, “If a patient’s quality of life is poor due to extreme pain, and she has no hope for
improvement of health, then if she wishes to die, the law states that wish should be respected” (p.
18). In 1996 Bob Dent became the first to die under a law that allowed assisted suicide in
Australia, Mr. Dent had terminal prostate cancer and had determined that it was time to put an
end to his existence (Tulloch, 2013, p. 86). Some people might argue that Dents actions were
cowardly, and that he should have fought to the bitter end. One controversial death that recently
took place at Dignitas, a Swiss euthanasia advocacy group, was that of 89 year old Anne, she
ended her life because she could no longer take modern living, having no terminal illness or
physical pain (Von Sydow, 2014, p. 246). For every case of Bob Dent there is a case of Anne. We
may not agree with either decision, but it is not ours to make, at least not yet


As stated from the onset the purpose of this paper was not to persuade, but merely to
discuss. I feel I should be candid at this moment, I am no closer to making my mind up about the
subject than when I first began my research. We all hope to die peacefully in our beds, but what
would we do if faced with a battle that was impossible to win. It is true that people miraculously
beat cancer, and that individuals who have been in comas for years suddenly wake up. Most
people believe that truly almost anything is possible, but that is not the reality. Maybe rather than
judging those who decide to take their lives when faced with grave illness, we should quietly
respect their wishes and move on with our lives. Admittedly the title to this segment is both true
and false, euthanasia is the ultimate conclusion to life, however I believe the story of euthanasia
in society has no real conclusion.



Barbuzzi, M. (2014). Who owns the right to die?: An argument about the legal status of
euthanasia and assisted suicide in Canada. Penn Bioethics Journal, 10(1), 16-19.
Huxtable, R. (2013). All that matters: Euthanasia. Great Britain, UK: Hodder & Stoughton.
Jeffrey, D. (2009). Against physician assisted suicide: A palliative care perspective. Oxford, NY:
Lopes, G. (2015). Dying with dignity: A legal approach to assisted death. Santa Barbara, CA:
Tulloch, G. (2005). Euthanasia: Choice and death. Edinburgh, UK: Edinburgh University Press.
Von Sydow, R. F. (2014). A life in need of “neither protection nor preservation”: Joseph
Fletcher, Down’s syndrome and euthanasia. Ecumenical Review Sibiu, 6, 246-258.
Yuill, K. (2013). Assisted suicide: The liberal, humanist case against legalization. Sunderland,
UK: University of Sunderland.