Commentaire d'anglais : l’éthique de l'euthanasie

The Ethics of Euthanasia and Medically assisted Suicide

I. Introduction: euthanasia and physician-assisted suicide, what is it? The situation in today's world.

Is it possible to be in control of one's life until the last moment?

Switzerland is one of the countries that allows it, and this by having decriminalised assisted suicide. A person can therefore decide when he or she is going to end his or her life. To be more precise, a lethal product is injected into the patient's perfusion and the patient turns the valve himself, which will allow the perfusion to be reopened and the product to enter the bloodstream. In 2015, 965 cases of assisted suicide were recorded, three times more than in 2009. But assisted suicide is not the only way for a patient who wishes to die to shorten his or her life. When a person wishes to legally kill oneself, we speak of euthanasia. It is the act of deliberately and intentionally giving death to a person. A voluntary euthanasia is when the act is carried out at the request of the patient. It is also necessary that a distinction be made between passive and active euthanasia. In the first case, it refers to the act of a third party administering a lethal substance to a patient with the aim of causing immediate death. This type of euthanasia is the most extreme and is permitted in only a few countries: Colombia, Belgium, the Netherlands and Luxembourg. These countries have legally recognized active euthanasia in their legislation. It is a way of guaranteeing each patient total autonomy concerning the end of their life.

However, they are not the only countries to offer patients who wish to end their life a possibility to achieve their goals. Indeed, a greater number of countries recognise, or in some cases tolerate, passive euthanasia. Among them, there are Switzerland, Norway, Finland and some states in the United States. It means that they allow the cessation of life-sustaining medication, the interruption of food and/or hydration, or the taking of medication in a certain dose may cause death after a certain period of time. A distinction is therefore made between causing death and allowing a patient to die at his or her own request. It is necessary to understand that not only consent but also the will of the patient is essential. Finally, some countries have chosen another path, assisted suicide. In this way, a patient can shorten one’s life with the help of a third party who provides a lethal substance that the patient administers to oneself. This allows people who wish to end their lives but who are not able to do so directly because they are disabled, to go to the end of their will. It is called medically assisted suicide when the assistance comes from medical personnel. Nevertheless, while this practice allows each person to remain free to choose, many questions are raised, such as to what extent can a third party help the patient to commit suicide? Should he simply provide him with the substances to end his life, prepare them so that he ingests them on his own?

Self-administration, depending on the states, is one of the criteria required (as in California) but what are the limits? Similarly, is it possible to prosecute someone for murder if the will carried of seriously ill patient or relative who wishes to die with dignity has been carried out, but the protocol has not been respected? Overall, it is necessary to distinguish the line between murder, euthanasia and assisted suicide, because even if the aim is to satisfy a patient's wishes, abuses may occur.

Throughout the world, it can be observed that not all countries have the same opinion regarding the right to euthanasia. Some do indeed recognise it as a right, which allows patients to assert their freedom of choice, allowing them to choose the last moments of their life and offering them a dignified death. It should be mentioned, however, that some countries punish euthanasia criminally (Italy, United Kingdom, etc.), which leads to the migration of persons seeking the possibility of legally taking their own life. As for the United States, the country is against euthanasia, however, some legislation has evolved to allow patients who so wish to end their lives under certain conditions. Taking the case of Europe as an example, although there is a willingness to guarantee patients' self-determination, there is no consensus among all states on this issue. It is nevertheless possible to observe a development in the sense that techniques enabling a human being to legally end one’s life are being developed.

Broadly speaking, the more flexible the legislation is, the greater the gaps are. Several countries can testify that the development of euthanasia is certainly supported by many populations, but its development could be threatened by an insufficient legal framework which does not guarantee any security. It also happens that the rules laid down for the implementation of euthanasia are not respected, and what is most alarming is that the resulting offences are not, for the most part, punished.

This subject is therefore very controversial, and some ethical questions may be raised. If ethics can be defined as the study of what is morally right and what is not it remains a personnel thing. On the one hand, some consider that euthanasia is indeed part of the right to life (I), while on the other hand, some consider that euthanasia is unacceptable and cannot be justified (II). But in the end what is most important is to act in the patient's best interest (III). Here again, opinions diverge, and euthanasia is either seen as a way for the person to exercise free will or as a tool that will open the way to irreversible acts.

I. Overview of pro-euthanasia arguments:

Those who defend euthanasia and physician-assisted suicide as ethical and part of the right of any human being base their views on three main arguments:

At first, they think that all people have an explicit right to die, in fact our human rights imply the right to die. As a matter of fact, being a human implies being independent biological identities, with the right to take and carry out decisions about themselves, providing the greater good of society does not prohibit this. But not allowing physician-assisted suicide or euthanasia means depriving anyone who wants to have recourse to it of the possibility of legally carrying out his or her will. That is why many people think that the right to life is a right. It is the right to die or to say otherwise, it is the right to live with a minimum of quality and value. A person who thinks that life is no longer worth living, only commits himself. Not allowing the person the possibility to leave when they want, means restricting their freedom and forcing them to live in conditions that may seem unbearable to them.

That is why those who are pro-euthanasia also argue that death is a private matter and if there is no harm to others, the state and other, people have no right to interfere in it. Indeed, the process of dying is part of life and as dying is one of the most important events in human life, when and how to die should be a personal decision. Furthermore, if the dying process is unpleasant, people should have the right to shorten it, and thus reduce the unpleasantness. However, again, this decision should be a decision that everyone can make on their own, since when did people lose control of their own life.

And finally, what is important and what those who are pro-euthanasia say, is that even if there is a right to die that does not mean that doctors have the duty to kill. So, no doctor can be forced to help the patient who wants euthanasia. Making euthanasia or physician-assisted suicide legal is simply giving those who want to use this