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Fight to the Death; The Global Ethics of Euthanasia

Abby Roberti
May 10, 2019
Global Perspectives
Mr. Torlée

Table of Contents
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Intro………………………………………………………………………………………………..1
Definition…………………………………………………………………….………………….2-4
Significance……………………………………………………………………………………..4-6
Background……………………………………………………………………………………...6-9
Expert…………………………………………………………………………………………..9-13
Role of Control……………………………………………………………………………….14-15
International Organizations…………………………………………………………………..15-17
Case Studies
Belgium………………………………………………………………………………18-20
Oregon, United States………………………………………………………...………20-22
India………………………………………………………………………………..…22-24
Canadian Connection…………………………………………………...…………………….24-27
Logic of Evil………………………………………………………………………………….27-28
Politics………………………………………………………………………………………..28-30
Religion……………………………………………………………………………...……….30-31
Solutions…………………………………………………………………………….………..31-35
References…………………………………………………………………………………....35-44
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Intro

Murder or mercy?

“Euthanasia is a controversial topic for legislatures around the world. Legal and
normalised in some countries while totally taboo in others, it remains one of the key
ethical debates at the juncture where politics meets philosophy” (The Week, 2018, n.p).

So, where to start?

Euthanasia. Mercy killing. Medical assistance in dying (MAID). The fine line between
life and death. The issue is often referred to as ‘eliminating the invalid’- “the act of putting to
death painlessly or allowing to die, as by withholding extreme medical measures, a person or
animal suffering from an incurable, especially a painful, disease or condition”
(dictionaryreference.com, 2019, n.p). This controversial act simply allows one to die with
dignity. The pain threshold; one can only undergo considerable hardship before euthanasia
becomes the alternative.

This paper will be approached by the following: the issue’s significance, the great debate
between ethical relativism and how active euthanasia was and still is a ceaseless global stigma.
The aid of various​ ​experts and international organizations will allow me to provide a more
extensive insight on the discussion of active euthanasia and subsequently, the world’s reaction.
Sources of control, such as politics and religion, will contribute to how certain factors play a role
in regards to this issue; all of which will present a potential solution towards the global ethics of
euthanasia. This report will discuss all angles of the controversial debate surrounding the act of
euthanasia, however it will transition from a neutral discussion to assisting the pro-euthanasia
argument.

The debate, has already begun.

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Definition

“Life is precious, you only pass this way once, and is worth a fight. It is when the fight is
clearly hopeless and the agony, physical and mental, is unbearable that a final exit is an
option” (Derek Humphry, 2005, pg. 88).

​ heartbeat.
Life: A

​ he condition of a person who is beyond medical help and will die shortly.
“Terminal illness: T
Right-to-die: ​Choice in the manner of dying.
Choices in dying: ​Making a commonsense decision on the options for how you will die.
​ elp with a good death” (Derek Humphry, 2005).
Euthanasia: H

Prolonging of Life:​ Extending a life with an incurable illness.

​ xtracorporeal life support.
ECLS: E
​ o not resuscitate.
DNR: D
Dysthanasia: ​Life is a privilege.​ ​“The ​undue​ ​prolongation​ of ​life​ by ​artificial​ means” (Your
Dictionary, 2019, n.p).

​ o heartbeat.
Death: N

Let the debate begin.

Everyone will die eventually. Without the intention to kill, euthanasia would not exist. As
to why the question stands, murder or mercy?

Euthanasia completely contradicts a doctor’s code of ethics. For centuries on end, doctors
have followed the original Hippocratic Oath encouraging them to maintain and improve the
quality of life for their patients. Some argue this oath and believe that a doctor’s role should be to
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act in the best interest of their patient, even if it means death. This being the primary reason as to
why the legality of euthanasia is so varied in the world today. Governments are the sovereignty
when pertaining to the laws and regulations of euthanasia in different regions of the world. As of
2018, active euthanasia is only legal in the Netherlands, Belgium, Columbia, Luxembourg and
Canada. Physician-assisted suicide (PAS), is legal in Switzerland, Germany, Finland, the
Netherlands, South Korea, and in a few US states such as Oregon, Colorado, Hawaii, Vermont,
Montana, Washington, D.C and California. As proposed, the Australian state of Victoria will be
legalizing euthanasia in mid-2019 (Health Line, 2018, n.p). Moving forward from the legality of
this issue, the next step is digging deeper into the discussions surrounding this complex topic.
S​ome say the only controversy is knowing the difference between euthanasia and assisted suicide
because the two terms are so interrelated. So, what is the difference?

“It’s like giving someone a loaded gun. The patient pulls the trigger, not the doctor. If the doctor
sets up the needle and syringe but let’s the patient push the plunger, that’s assisted suicide. If the
doctor pushes the plunger, it would be euthanasia.”
- Dr. Jack Kevorkian

Another common uncertainty lies between the two terms: euthanasia and palliative care.
They are not the same. Again, “euthanasia is the act of deliberately ending the life of a person
with an incurable condition or illness.” Whereas “palliative care can help a person maintain
comfort and quality of life throughout the advanced stages of their illness. Palliative care does
not attempt to hasten death” (Cancer Council, 2017, n.p).

Accordingly, there are various types of euthanasia hence one's medical state and level of
consciousness is what determines what method is conducted.​ ​The focus of this paper- active
euthanasia, commonly known as medical assistance in dying, (MAID), is when a medical
professional deliberately uses a form of drug to end a patient’s life. Active euthanasia is
prohibited in several developed countries, such as Canada before it’s legalization in 2016.
Passive euthanasia however, occurs when a patient withholds any medical treatment necessary to
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keep themselves alive and is granted in most countries around the world. If all requirements are
met and a patient is able to make a conscious decision to seek help with ending their life, it is
considered to be voluntary euthanasia. In contrast, involuntary euthanasia is when someone else,
typically a family member, makes the decision to end the patient’s life. With involuntary
euthanasia, the patient is generally completely unconscious and passive euthanasia is therefore
conducted, such as withdrawing life support. Euthanasia, in its many forms, is ultimately ‘the
good death’; a personal end of life choice and the right to die with dignity.

Significance

The snowball effect: beginning in an initial small state and quickly building upon itself,
becoming larger and potentially groundbreaking- the debate, whether that is good or bad
(Cambridge Dictionary, 2019, n.p). Euthanasia is evidently becoming more prominent and
influential in the 21st century. As a result, euthanasia has become one of the most contentious
and debatable issues in the world today.

Without legislation, euthanasia would be a synonym for murder. Do we have the

right-to-die? What happens if you lose all motion, mobility or simply the sense of feeling? What
happens when you can no longer move your arms or your legs and all that is left is your brain
telling you enough is enough- now do we have the right-to-die?

The great euthanasia debate continues - are you for or against?

“One should die proudly when it is no longer possible to live proudly.”

- Friedrich Nietzsche

Those in favour of euthanasia have reasons to why they advocate. People who support the
pro-euthanasia argument believe that if we’re going to die eventually, why not bypass the pain
and suffering while we still have the chance? “Every sixth death in the world is due to cancer”
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(Our World in Data, 2018, n.p). “Someone in the world develops dementia every 3 seconds”
(World Alzheimer Report, 2015, n.p). The National MS Society “estimates that 2.3 million
people live with multiple sclerosis globally” (Health Line, 2019, n.p). Millions of people
worldwide watch themselves deteriorate, both mentally and physically, from such debilitating
diseases. In this vulnerable state, a person's autonomy is compromised. People deserve the
“ability and right to make their own decisions about those things which are of fundamental
importance to them” (Dr. Syme, n.d, n.p). And in several areas of the world, this is jeopardized.

The opposition:

“Of all the arguments against voluntary euthanasia, the most influential is the ‘slippery slope’:
once we allow doctors to kill patients, we will not be able to limit the killing to those who want to
die.”
- Peter Singer

The logical fallacy of the slippery slope: “asserting that if we allow A to

happen, then Z will consequently happen too, therefore A should not happen” (Matt Torlée,
2019, n.p). One main argument for anti-euthanasia suggests that “euthanasia will weaken
society’s respect for the value of life and could result in a lower standard of care for people with
a terminal illness, and discourage people from finding cures for illnesses such as cancer”
(theMSAG, 2019, n.p). The intent of this statement goes further beyond words. People anticipate
that the increase of this practice will decrease societies will to live, similarly, when the going
gets tough, you quit. As previously mentioned, some people feel that there is value in suffering
and that all life has a purpose, disabled or sick; generally considered as ‘dysthanasia’. Many
agree that if proper palliative care is conducted then euthanasia really has no reason to exist.
Another popular discussion is dependant on that of religion. All religions have worldviews and
beliefs that differentiate from each other, some being completely averse to euthanasia. Overall,
the practice of euthanasia is neither ethical, practical or historically and religiously correct (BBC,
2014, n.p).
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The average life expectancy of a human was 40 years in 17th century, whereas now it is
approximately 80+, double the life span. This dramatic increase in life on earth is the dependant
variable of factors such as old age and eventually the exposure to fatal diseases (heart failure,
dementia, cancer or a combination). These independent variables are what is feeding our starving
generation the desire for an easy death. Hence, as the healthcare industry continues to grow so
will the debate of euthanasia due to the rapidly aging population. Some see the jurisdiction of
prolonging a person's life artificially degrading and inhumane, while others see it has a
subjective way to end a life with ease.

Background

“The more you know about the past, the better prepared you are for the future.”
- Theodore Roosevelt

“Discussion about euthanasia has spanned the entire panorama of human history”
(Cleveland Clinic Journal of Medicine, 1992, pg. 100).

Take a step back. What is evolution? In fact, what is the evolution of euthanasia? The
word ‘euthanasia’ originated in the early 17th century from the Greek words ‘eu’ meaning well
and ‘thanatos’ meaning death; in the sense ‘easy death’, while the original term was considered
to be ‘orthothanasia’, meaning ‘passive death’. The word euthanasia was first used in a medical
context by english philosopher, ​Francis Bacon​ in the 17th century.

Back in the 4th and 5th centuries, there was no medical advancement for euthanasia. “In
the aftermath of a battle, for example, people from a number of ancient cultures killed their
seriously injured comrades to give them, in their view, an honourable death” (Steve Wise, 2017,
pg. 19). The views on the ethics of the issue and what was considered to be euthanasia back then
was borderline. However, for some Ancient Greeks and Romans, it was considered acceptable.
“The Ancient Greek philosopher Socrates commited suicide in 399 BCE by drinking a cup of
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poison made from the hemlock plant. Others thought it was wrong, among them the Greek
physician Hippocrates (460-377 BCE). An oath attributed to him is still taken by many doctors
today. There are different versions, but the classic Hippocratic Oath includes concepts such as
putting the good of patients above the interests of doctors and emphasizes a doctor's role in
striving to preserve life” (Steve Wise, 2017, pg. 20).

The Christian and Jewish views on euthanasia essentially reinforced the Hippocratic
Oath. As Christians and Jews believe that life is given by God, churches began to emphasize the
importance of not interfering with the natural process of death (BBC Religions, 2009, n.p). This
opposition, to present day, “prevailed from the Middle Ages through the Renaissance and
Reformation” (When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context,
1994, n.p).

In the 17th century, the first US statute outlawing assisted suicide and euthanasia was
enacted in New York, 1828. People were not allowed to aid a suicide or, “furnish another person
with any deadly weapon or poisonous drug, knowing that such person intends to use such
weapon or drug in taking his own life” (Dr. Harold Glucksberg, 1997, n.p). With the Great
Depression right around the corner, Americans began to talk on terms of euthanasia once again.
“Public opinion polls indicated in 1937 that a full 45 percent of Americans had caught up with
Harry Haiselden’s belief that the mercy killing of 'infants born permanently deformed or
mentally handicapped' was permissible” (Ian Dowbiggin, 2003, n.p).

1940’s -​ ​The Euthanasia Program, the systematic mass murder of patients with mental
and physical disabilities. The German program was one of many which aimed to restore the
racial “integrity” of the German nation: “to eliminate what eugenicists and their supporters
considered "life unworthy of life": those individuals who—they believed—because of severe
psychiatric, neurological, or physical disabilities represented both a genetic and a financial
burden on German society and the state”. Presumably, at least 5,000 mentally and physically
disabled German children died in the Child Euthanasia program. From disabled children to
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adults, the Euthanasia Program wanted to extend its boundaries. In 1939, Germany’s leader,
Adolf Hitler, “signed a secret authorization in order to protect participating physicians, medical
staff, and administrators from prosecution. This authorization was backdated to September 1,
1939, to suggest that the effort was related to wartime measures” (Holocaust Encyclopedia,
2018, n.p).

In the past century, dozens of organizations have been founded, such as the World
Federation of Right to Die Societies in 1980. The euthanasia debate was on the rise, acts were
formed and laws were passed as this global issue continues to evolve.

Dr. Jack Kevorkian, 1928-2011, was one of the prominent euthanasia proponents in
history. Kevorkian spoke upon the right-to-die legislative movement throughout his time and has
claimed to have assisted a total of 130 patients. The formerly known American pathologist, Jack
Kevorkian had his hands full but still had passion for more; euthanasia became his subspeciality-
"But really, my number one reason was because it was interesting. And my second reason was
because it was a taboo subject” (Biography.com, 2015, n.p). In 1990, Dr. Kevorkian made
headlines when he assisted the suicide of 54 year old, Janet Adkins. It was Kevorkian’s invention
of a suicide machine, the Thanatron, that appealed to the Alzheimer's patient, Janet. Kevorkian
later assisted her inside his car at a public park in Michigan: first, attaching the IV, second, Janet
responsible of her own painkiller and third, the poison. With release to the media, Dr. Jack
Kevorkian was more than just a celebrity, he was a criminal. The State of Michigan charged
Kevorkian with the murder of Janet Adkins. The case was later dismissed due to Michigan’s
laws permitting to assisted suicide and euthanasia. A year later, a Michigan judge opposed the
use of Kevorkian’s suicide machine which resulted in the suspension of his medical license.
However, this didn't stop Kevorkian. “Unable to gather the medications needed to use the
Thanatron, Kevorkian assembled a new machine, called the Mercitron, which delivered carbon
monoxide through a gas mask”. The Michigan Legislature ended up passing a bill outlawing
assisted suicide, designed specifically to stop Kevorkian's campaign. This had Dr. Kevorkian
jailed twice that year. Bailed out by lawyer Geoffrey Fieger who helped Kevorkian “escape
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conviction by successfully arguing that a person may not be found guilty of criminally assisting a
suicide if they administered medication with the "intent to relieve pain and suffering," even it if
did increase the risk of death” (Biography.com, 2015, n.p). As a result, Dr. Jack Kevorkian
helped lay the groundwork for this euthanasia disharmony.

“Dying is not a crime.”

- Dr. Jack Kevorkian

Experts

Dr. Brian Morris

Dr. Brian Morris, MD, is a palliative care physician, medical director of Hospice Simcoe
and an Associate Professor at the Department of Family and Community Medicine, University of
Toronto. Born in Halifax, raised in Barrie, Morris comes from a family of teachers. He studied at
U of T where he was rewarded Certification in the College of Family Physicians, (CCFP) as well
as the Fellowship designation, (FCPP). Now semi-retired, Dr. Morris had a full-time practice in
Barrie since 1980 focusing on palliative care and currently spends his time with his wife of 41
years, 2 children and 2 grandchildren. Triple threat; sailor, triathlete and musician, Dr. Brian
Morris discusses his expertise in the following interview via email:

Q- Where does the law stand for MAID? Why legislate?

A- “The answer to ‘why legislate?’ is pretty simple- without the legalisation, I would be
committing murder every time I did this!”

Q- What are your contributions to ensure that your patients die with dignity?
A-​ ​“To ensure a death with dignity, the most important factor is respecting patient autonomy,
that is what this is all about. The patient has total choice of what happens on the chosen day. This
includes where (bedroom? living room? backyard? hospice? hospital?), who (just spouse, or
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kids, or other family, or friends, or neighbours - I have heard of 40 people being in the room!),
music (hymns? rock and roll?), presence of a spiritual leader (very important for some people),
incense burning, candles, prayers, last words,.... All of these decisions are discussed ahead of
time, the patient is in control. In terms of what I do, I approach this procedure very carefully, lots
of discussion, lots of listening. During the procedure, I speak softly to the patient, maintain eye
contact, explain what I am doing.”

Q- As a medical professional, your job is to maintain and improve the quality of life
through medical interventions. How does this contradict your code of ethics?
A- “If by ‘code of ethics’ you mean the Hippocratic oath, I take the view that my job is to help
the patient IN WHATEVER WAY THEY WANT TO BE HELPED - that is the autonomy that I
mentioned earlier. I will do my best to provide really good palliative care, with best possible pain
control, management of other symptoms - but there are lots of symptoms that I can’t control,
nobody can, and if my patient requests MAID I feel that I must take the request very seriously,
and (if the patient is eligible) honour that request.”

Q- “People are worried euthanasia will weaken society’s respect for the value of life and
could result in a lower standard of care for people with a terminal illness, and discourage
people from finding cures for illnesses such as cancer” (theMSAG, 2019). What is your
stance on this?
A- “A MAID request requires that the patient be offered (really good) palliative care, so MAID
is not a substitute for palliative care. As for the possibility that availability of MAID would lead
to ‘discouraging people from finding the cure for cancer’ - sorry, but I fear that is a ludicrous
suggestion. If offered the choice between a cure for their cancer, and MAID, any rational person
would choose the cure.”

Q- With the aging population and the increase of fatal diseases, will MAID be the preferred
medical intervention in the future?
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A- “No, I cannot see MAID becoming ‘the preferred medical intervention in the future’. In
jurisdictions (Oregon, the Netherlands) where MAID has been available for decades, it accounts
for just a few percent of all deaths. Many deaths will always be sudden and unexpected, many
people will be ineligible for MAID, many people will decline it for personal reasons, so I feel
that in future it will also be a small percentage of all deaths.”

Q- Are there any active solutions you are taking in order to resolve this controversy? How
would you approach this? How would these solutions help?
A- “As for ‘active solutions that I am taking to resolve this controversy’ - I don’t see a
controversy! MAID, according to public opinion polls, is an option, the availability of which is
preferred by a majority of Canadians. The legislation is in place, the procedure (when done
according to protocol) is entirely legal - where is the controversy? Yes, there are Canadians
(including many physicians) who disagree with MAID from a personal/religious/ethical
perspective, just as there are those who do not feel that abortion should be legal. But the law of
the land is clear, and I feel that my actions are right.”

Christian Medical and Dental Society (CMDS)

“CMDS is a national association of Christian doctors and dentists who strive to integrate
their Christian faith with medical or dental practice. CMDS represents approximately 1600
medical doctors, dentists and medical and dental students, over 500 of which are located in
Ontario” (CMDS, 2019, n.p). Their mission as an organization:

● “Upholds an explicitly of Christian view of medicine and dentistry;

● Seeks to understand and minister to the spiritual needs of patients and colleagues;
● Creates educational materials that address issues of public policy and health;
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● Develops programs that promote a Christian view of medical ethics, address the health
and spiritual needs of the poor and needy, or encourage networking of like-minded
colleagues;
● Ministers to the needs of Christian physicians, dentists and students by supporting local
group activities, planning conferences and locating mentorship, elective or practice
opportunities” (CMDS, 2019).

Q- What is your stance on euthanasia?

A- “As Christians, we believe that euthanasia and assisted suicide prematurely ends the life of a
patient. Our Christian faith teaches us to not kill another person. Euthanasia/assisted suicide as
morally equal to killing our patient. As such, members of our organization and other like-minded
people cannot in good conscience be involved or be complicit in that act.”

Q- What is the role of religion in euthanasia? Specifically, your statement of faith towards
this act.
A- “Our membership includes Christians from many different denominations. That said, our
members agree that euthanasia is prematurely ending the life of a patient. Our deeply held
religious beliefs preclude us from being involved either by performing or referring a patient to
another physician for euthanasia/assisted suicide. Our religious beliefs are informed by a variety
of sources, including the Bible and the teachings of our individual denominations.”

Q- How would you say euthanasia is affected by politics?

A- “No comment.”

Q- As an ethical issue, are there any active solutions you are taking in order to resolve this
controversy? How would you approach this? How would these solutions help?
A- “Euthanasia and assisted suicide are both legal in Canada with some restrictions. We
advocated strongly against legalization, but now that it has been decriminalized, we are focusing
our efforts on protecting the conscience rights of physicians and other healthcare professionals
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and against the further expansion of the MAID (euthanasia/assisted suicide mandate). CMDS
Canada is a member of a group called the Coalition for HealthCARE and Conscience, which
works to advocate for the protection of conscience rights of all healthcare professionals.”

“The Coalition for HealthCARE and Conscience represents more than 110 healthcare
facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across
Canada. Our members come from diverse perspectives, but all agree that taking a patient’s life or
referring for this procedure violates at least one of the following:

● The Hippocratic Oath;

● Our religious convictions;
● Our mission and values;
● Our professional ethics;
● Our creed; or,
● Our deeply held conviction that healthcare should heal people, not hasten death.”
(Coalition Proposal SK, 2018, pg. 1).

“We are also involved with a court case which challenged the policies of the College of
Physicians and Surgeons of Ontario. The position of our case was that two of their policies
contravened the Canadian Charter of Rights and Religious Freedoms protections of religion and
conscience. We are awaiting the ruling from the Ontario Court of Appeal.”

“While our members cannot participate in euthanasia or assisted suicide, we acknowledge that
patients will sometimes seek it out. Our members are willing to discuss all options and give them
information about how they can directly access an assessment for euthanasia and assisted
suicide. This is already a compromise for us, but we recognize patients will make other decisions
with the information provided and we will continue to provide all other unrelated care within the
scope of our practice.”
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Role of Control

Control: jurisdiction, authority, dominance, sovereignty. “The power to influence or

directs people’s behaviour or the course of events” (dictionaryreference.com, 2019, n.p). Role of
control in euthanasia: the patient, physician, family, religion, government or politics. Each title
just mentioned essentially has the power over one's life or death.

In set types of euthanasia, specifically active, passive, voluntary and physician-assisted,

the patient has full consciousness and control over their body. Assumably, most patients who are
wishing to undergo euthanasia are dealing with great amounts of pain, both mentally and
physically, or the fear of that same pain in the future. As to why these individuals insist on the
right of choice, the decision boils down to having full control over their life and the ability to die
with the utmost comfort in a dignified manner- yet some still fear the power of the terminally ill.
The doctor or physician ultimately has the control over the medication and drugs and
concludes whether or not the patient meets all eligibility criteria for euthanasia (see Dr. Brian
Morris’ interview for further context). Some doctors see it as death on demand, where the patient
has the ability to decide the time and manner of their death, and feel as if they have too much
power. As more people want to be euthanized and as it continues to be practiced, this process
might easily get out of hand- this being a doctor's greatest fear. In terms of both ethics and
religion, doctors have various outlooks and stances on euthanasia. A doctor has the ability to
decline a patient's wishes if they believe the practice is wrong or inhumane.

Family becomes an influential factor when involuntary and essentially passive euthanasia
are in process when required to make the final decision for their loved one/patient. As a whole,
families play a vital role in the patients end of life decision, whether for or against. A patient may
feel as if they are a burden to their family which can ultimately persuade their decision to reduce
the families emotional stress and expenses.
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The influence of religion is so powerful yet there is a large grey area which follows. As
with hundreds of religions existing in the world, it is harder to generalize belief systems and
laws, for example, euthanasia. As a result, conflict arises and begins to create the partition within
the euthanasia debate. Disagreement in religious beliefs and practices between the patient and the
family and/or the patient and the doctor are a very common occurrence concerning euthanasia.
Dependant on their beliefs and wishes, controversial debates can occur when multiple religions
are brought to the table.

Governments and politics set laws and regulations and law down the standards between
what is right and wrong. With the authority of several governments, euthanasia has only been
made legal in a few regions of the world. Reasons varying from the costs, the limitations, to the
population, governments ultimately have the control. The medical care required for euthanasia is
costly and proven to be more expensive than ordinary health care. With this, some governments
see it as a reason not to legislate. These limitations towards euthanasia enforced by the
government have sent people running to other countries in order to die with dignity. In a sense,
certain areas of the world are heavily religion based or specific to one culture. As some religions
and cultures do not concur with euthanasia there is patently no need for the government to
legalize the law there and in return, they would rather act in the best interest of their
demographics.

International Organizations

International organizations are organizations with global relations or presence; often

intergovernmental organizations, (IGOs) or non-governmental organizations, (NGOs). With the
intent to promote and use an established mechanism to unify the world in regards to peace and
security,​ ​the following international organizations abide a similar philosophy; to propose a
legislative change on the issues surrounding euthanasia.

Exit International
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Exit International, a pro-euthanasia organization, founded in 1997 by Dr. Philip Nitschke.

This non-profit Australian establishment has reached over 20,000 members worldwide to date
and is possibly one of the most progressive euthanasia groups in the world today. “It is
ceaselessly working for new ways in which dying people can self-deliver without a doctor and
without breaking the law” (Derek Humphry, 2005, n.p).

Exit’s aim:
“to ensure that all rational adults who desire choice over their death have access to the
best available information so that they may have absolute control over when and how
they die.”
“it is a fundamental human right for every adult of sound mind, to be able to plan for the
end of their life in a way that is reliable, peaceful & at a time of their choosing” (Exit
International, 2019, n.p).

In the process of their movement, Philip Nitschke and his former wife, Fiona Stewart,
co-wrote ​The Peaceful Pill Handbook,​ published 2006, allocating research on active euthanasia.
This book includes numerous strategies and options available when making the burdensome end
of life decision. Alongside the handbook, Exit International has taken several approaches geared
towards their goal: workshops, online forums, local meetings and research and development.
Exit’s workshops are the ‘cherry on top’ of their organization. These workshops are free and
include regular discussions with Dr. Nitschke on issues regarding euthanasia, “followed by an
interactive session featuring the practical aspects of end of life choices; including drugs, salts,
gases and more” (EI, 2019, n.p). Online forums are a second way Exit allows many to contribute.
These forums are essentially a way to stay connected as well as have the freedom to propose
questions and discuss information related to euthanasia. Subsequently, “local Exit chapter
meetings are held all around the place and include even smaller coffee & chat groups if you want
to meet folk of like mind & feel amongst friends” (EI, 2019, n.p). Exit’s research and
development aspect provides their members with the newest, most significant information and
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technology on the issues being faced, such as the 3D printed ‘Sarco’; the world’s first suicide
machine.

The World Federation of Right to Die Societies

Founded in 1980, The World Federation of Right to Die Societies (WFRtDS) is an

international non-governmental organization consisting of 49 right to die organizations from 26
different countries. “The Federation provides an international link for organizations working to
secure or protect the rights of individuals to self-determination at the end of their lives”
(WFRtDS,​ ​2019, n.p).

The World Federation of Right to Die Societies believes “in the rights and freedom of all
persons, we affirm this right to die with dignity, meaning in peace and without suffering. All
competent adults- regardless of their nationalities, professions, religious beliefs, and ethical and
political views - who are suffering unbearably from incurable illnesses should have the
possibility of various choices at the end of their life” (WFRtDS, 2019, n.p).

The Federation holds regular international conferences on right-to-die issues and

responds to suggestions and requests from scholars- essentially, they hope to act on any
proposals brought to their attention. Most importantly, the WFRtDS “provides assistance, where
requested, to groups and individuals interested in establishing similar societies in countries
where such societies do not currently exist” (WFRtDS, 2019, n.p).

With driven efforts, The World Federation of Right to Die Societies has achieved many
successes and awards, such as the ​Marilynne Seguin Award, SABA medal,​ ​ Tenrei Ohta Award,​
Health Professional Award​ and the​ WFRtDS Lifetime Achievement Award;​ all made out to
individuals contributing towards the international right-to-die movement.
 Roberti 20

Case Studies

Belgium

Founded in 1830, the Kingdom of Belgium is a country located in Western Europe,

population 11.56 million. Bordered by the Netherlands, Germany, Luxembourg, and France,
Belgium is known for its medieval towns, Renaissance architecture and the headquarters of the
European Union and NATO. Mere months behind the Netherlands, Belgium was the second
country to legalize euthanasia on May 28, 2002 as one of the highest countries ranking in state of
peace (Global Peace Index, 2017, pg. 10).

In support of the euthanasia controversy- Belgian officials are investigating whether three
doctors, in risk of facing serious charges, improperly euthanized a woman with autism, the first
criminal investigation in a euthanasia case since the practice was legalized (Cheng, 2018, n.p).
38 year old, Tine Nys was diagnosed with Asperger's syndrome, considerably on the “high
functioning” end of the spectrum, only two months before she was euthanized. With autism
being up for debate - that is whether it should be considered a valid reason to be a euthanasia
candidate. In 2017, The Associated Press reported that after the criminal complaint filed by the
Nys family, alleging numerous “irregularities” in her death, the doctors attempted to resist the
investigation. “‘We must try to stop these people,’ wrote Dr. Lieve Thienpont, the psychiatrist
who approved Nys’s request to die. [...] ‘It is a seriously dysfunctional, wounded, traumatized
family with very little empathy and respect for others.’” (Cheng, 2018, n.p). Due to these rather
“fumbling efforts”, the three doctors involved have been referred to the Court of Assize in
Ghent, Belgium. With due trial, the suspicion of allegedly poisoning Tine Nys has disrupted the
progression of euthanasia. If pleaded guilty, the three doctors will face charges possibly carrying
out a maximum penalty of a lifetime sentence. In addition to the controversy surrounding
euthanasia, “concerns have previously been raised in other cases about whether Thienpont, Nys’
psychiatrist, too easily approved euthanasia requests from patients with mental illnesses”,
furthering the already strict guidelines (Associated Press, 2018, n.p).
 Roberti 21

On February 13, 2014, Belgium was declared the first country to legalize euthanasia by
lethal injection for children, an extension of their pre-existing law which was established in
2002. This was enabled by a vote of 86 to 44 with 12 abstentions. The lower house of Parliament
then approved the law which had previously been passed by the country’s Senate. With no age
limit, young children are now allowed to end their lives with the help of a physician in the
world’s most radical extension of a euthanasia law. However, this creates a new concern for the
future legality of euthanasia; the pressure has already been placed on the parents and now their
children are asked to make the final decision. (Patients Rights Council, 2013).

“The annual number of euthanasia cases across all age groups has multiplied almost
fivefold in ten years in Belgium. The practice was legalised in the country in 2003 – a year after
the Netherlands, where the minimum age is 12. In 2007, 495 Belgians chose to die this way.
Latest figures reveal there were 2,028 such deaths in the country in 2016 and 2,309 in 2017 – a
14 per cent year-on-year rise” (Doughty, 2018).

Belgium is home to the youngest cases of euthanasia to date. Three terminally ill
children, aged nine, eleven and seventeen were given lethal injections within a two year time
frame. Between 2016 and 2017, a nine year old, suffering from a brain tumor, and an eleven year
old, undergoing cystic fibrosis were the first children under the age of 12 to be euthanized
anywhere in the world (Embury-Dennis, 2018). Although, parental consent is mandatory and can
override the child’s desires, “supporters of the law say a child should not be made to suffer
against their will but opponents say children are too young to make the decision to die” (Samuel,
2018, n.p). Similar to the requirements of adult euthanasia, a child must be “in a hopeless
medical situation of constant and unbearable suffering that cannot be eased and which will cause
death in the short term”. If so, a child must express a wish for euthanasia in writing followed by
an examination from a child psychiatrist in order to determine that their level of judgement is
solely their own.

The concept of minor euthanasia has sparked a heavy ethical debate. A great portion of
the children that are being euthanized are not old enough to drive, drink or vote, so why should
 Roberti 22

we allow them to make decisions about their life or death? An ongoing argument maintains that
children are not capable of judging what is best for them so early in life. This leaves our
generation in suspicion, what does this mean for our future? Is this getting out of hand?

Oregon, United States

In 1994, Ballot Measure 16 was passed. On October 27, 1997, the US state of Oregon
enacted the Death with Dignity Act (DWDA), allowing terminally-ill patients to end their lives
through the process of prescribed lethal injections. With Oregon being one of very few states
where euthanasia is legal, it remains a favoured location to commit this supported practice. A
recent annual report from Oregon’s DWDA:

“In 2018, 103 Oregon physicians wrote 249 prescriptions to dying Oregonians who
qualified for the Act; 168 people died using the medications obtained under the law. Similar to
previous years, most patients:

● were 65 years or over (79.2 percent), with the median age of 74;
● had cancer (62.5 percent);
● were at hospice at the time of death (90.5 percent);
● died at home (88.6 percent);
● had some form of health insurance (99.3 percent).

Similarly, the most frequently reported end-of-life concerns were loss of autonomy (91.7%),
decreasing ability to participate in activities that made life enjoyable (90.5%), and loss of dignity
(66.7%). During 2018, the estimated rate of deaths under the law was 45.9 per 10,000 total
deaths in the state. Since the first Oregonian took medication under the law in 1998, a total of
2,216 people have received prescriptions under the Act, of whom 1,459, or 65.8 percent, have
died from ingesting the medications” (Death with Dignity, n.d). As of January, 2019, Oregon’s
Death with Dignity Act previewed statistics that between 1998 and 2018, their DWDA had more
prescriptions written for patients than deaths that had occurred. Ten years after this act was
 Roberti 23

enacted, the number of physician-assisted suicides stood at 341 per decade, equaling to about 0.2
percent of all patient deaths - an exceedingly low number.

In January of 2014, Brittany Maynard was diagnosed with glioblastoma multiforme

(GBM), the most aggressive form of brain cancer. At the age of 29, she was given a prognosis of
six months left to live. Brittany Maynard faced many challenges as euthanasia was prohibited in
the state of California, in which Maynard lived. Accordingly, Brittany Maynard and her family
moved to Oregon where she could die a peaceful death under their Death with Dignity Act.
Maynard met all requirements and later received the medication that would take her life if and
when she chose to ingest it. Brittany Maynard felt relief knowing she would not have to die the
way it has been described how brain cancer would take her on it’s own. Dan Diaz, Brittany’s
husband says, “Death with Dignity allows for people who are in the predicament of facing a lot
of suffering that they can decide when enough is enough”. November 1, 2014, Brittany Maynard
died in Portland, Oregon, United States, comforted by her loved ones (Hoffman, 2014).
Brittany’s story transformed the conversation about death with dignity and legislators responded.
Compassion and Choices is a non-profit organization in the United States working to improve
patient care and end of life rights. “Compassion & Choices advocates to make aid in dying an
open, accessible medical practice in states across the country. Every American should have the
sense of peace that Brittany sought. The Brittany Maynard Fund, an initiative of Compassion &
Choices, will be used to advance this effort” (Compassion and Choice, 2019).

“A cautionary tale”. Jeanette Hall, resident of Oregon, voted for their assisted suicide
law, the Death with Dignity Act in 1997. Three years later in 2000, Jeanette Hall was diagnosed
with colon cancer, being told the only chance she had at surviving was if she underwent
chemotherapy and radiation - without it, she was given six months to live. Determined not to
have chemo or radiation, Hall met the eligibility criteria necessary for euthanasia and was
prepared to go through with what she had voted for. Her mind was made up. However, Jeanette’s
doctor, Dr. Kenneth Stevens did not believe in assisted suicide. He eventually encouraged Hall to
not give up as this cancer was worth the fight if it meant she could see her son graduate and get
married. “If Stevens had believed in assisted suicide, I would be dead”. “I looked for the easy
 Roberti 24

way out. That’s why I relate to Brittany Maynard. I said “I’m not gonna suffer, forget this”.”
Jeanette Hall was known as the woman who chose to die, then survived - and went on to live for
decades later.

India

In 1947, the country of India was founded in the South of Asia, bordering Pakistan,
China, Nepal, Bhutan, Bangladesh, and Myanmar. As the seventh largest country in the world,
their population is a mass total of 1.3 billion people, making India the second most populous
country in the world today, with over a dozen dialects. India; a characterized country by its
diverse religious beliefs and practices has surpassed a momentous accomplishment, the
legalization of euthanasia:

Judicial history has been made in India- In 1981, 39 year old, Mumbai police constable,
Maruti Shripati Dubal was involved in a car crash suffering severe head injuries, consequently
becoming mentally ill. One year later, Dubal was diagnosed with schizophrenia following a
combination of auditory and visual hallucinations as well as depression. As a result, Maruti
Shripati Dubal was treated with electric shocking and doses of tranquilizers. The pain was
inevitable, gradually becoming so intolerable that enough was enough. There was no other
option and there was no euthanasia law. On April 27, 1985, Maruti Shripati Dubal attempted
suicide outside the office of the Municipal Commissioner by pouring kerosene and trying to set
himself on fire. Abetting or committing suicide is a crime in India. Two Mumbai High Court
judges upheld Dubal's right to kill himself in violation of Section 309 of the Indian Penal Code.
With great violation of the Indian Penal Code, Dubal’s life was directly affected. For example,
immediately after the suicide attempt, his wife’s application for a market licence was delayed
and privileges were lost. Dubal admits he does not remember the incident itself, only the events
that occured before and after the attempt to end his life. However, “his mental condition
provided no protection and Dubal was prosecuted under Section 309” (Singh, 1986, n.p).
Fortunately, criminal lawyer, Shrikant Bhat stood by Maruti Shripati Dubal. Describing how
Dubal was unable to articulate the incident, Bhat filed a petition to the high court challenging
 Roberti 25

Section 309. The judges remarked: "Those who make the suicide attempt on account of mental
disorders require psychiatric treatment and not confinement in prison cells, where their condition
is bound to worsen.... Those who attempt suicide because of acute physical ailment, incurable
disease, torture or a decrepit physical state induced by old age or disablement, need a nursing
home and not prison to prevent them from making the attempt again. No deterrence is going to
hold back those who want to die for a social or political cause...loss of interest in life or for
self-deliverance" (Singh, 1986, n.p). Pleas similar to Bhat’s are what ignited the discussion in
India surrounding euthanasia. The dozens of remarkable suicide cases challenged the Indian
government. Consequently, in 2014, Section 309 of the Indian Penal Code had been
decriminalized effectively by the Mental Healthcare Act in 2017; “an Act to provide for mental
healthcare and services for persons with mental illness and to protect, promote and fulfill the
rights of such persons during delivery of mental healthcare and services and for matters
connected therewith or incidental thereto” (The Mental Healthcare Act, 2017, pg. 1). The
juridical boundaries had been pushed…

On March 9, 2018 the Supreme Court of India legalized passive euthanasia in which
there is withdrawal of ​life support​ to patients in a permanent vegetative state. The decision was
made after hard fought battles through cases such as Maruti Shripati Dubal and the appalling
case of Aruna Shanbaug. “The Supreme Court specified two irreversible conditions to permit
Passive Euthanasia Law in its 2011 Law: (I) The brain-dead for whom the ventilator can be
switched off (II) Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered
out and pain-managing palliatives be added, according to laid-down international specifications”
(Singh, 2015). However, on February 25, 2014, the case was brought to the attention of a
three-judge bench of the Supreme Court of India who had determined Aruna Shanbaug’s case to
be inconclusive, therefore passed onto a five-judge bench which did not transpire until 2018. “It
was then that it was declared if strict guidelines are followed, the government would honor
“living wills” allowing consenting patients to be passively euthanized if the patient suffers from
a terminal illness or is in a vegetative state” (BBC Living Wills, 2018).
 Roberti 26

November 27, 1973, Aruna Shanbaug was attacked and sodomized by Sohanlal Walmiki,
a custodian at King Edward Memorial Hospital, Mumbai, India, where she had been working as
a nurse. She was strangled by a dog chain, cutting off all oxygen to her head and brutally
sexually assaulted. The next morning, a cleaner found her unconscious and lying on the floor
covered in blood, suffering from severe brain damage. With complete immobility of her hands
and legs, Aruna Shanbaug was left in a vegetative-state, attached to a feeding tube and in a
prolonged coma of 42 years, later dying from pneumonia in 2015 at age 66 (Kasturi, 2015).

On behalf of Aruna Shanbaug, her friend Pinki Virani filed a petition to the Supreme
Court in December, 2009 arguing that the "continued existence of Aruna is in violation of her
right to live in dignity" (Vartak, 2018). Virani caught legal and public attention for Aruna
Shanbaug’s case and in March 2018, the Supreme Court finally decided to legalize passive
euthanasia in India (Venkatesan, 2016).

Canadian Connection

Between the years of 1892 and 2016, euthanasia was illegal in Canada under section
241(b) of the Criminal Code. However in 2015, after decades of several legal challenges,
including the consequential case of Sue Rodriguez, the Supreme Court of Canada decided to
authorize medical assistance in dying (MAID). In June 2016, the federal government passed Bill
C-14, the Medical Assistance in Dying Act, outlining the requirements necessary to undergo
medical assistance in dying and the obligatory safeguards for MAID (Marshall, 2016). Before
legalization, affected Canadians were forced to make their own end of life decisions illegally.
With the legalization of MAID in Canada, Canadian citizen’s rights are now respected. Having
this legal option can make their final days less despairing, possibly improving their quality of life
as the end approaches.

At the centre of Canada’s euthanasia controversy lies Sue Rodriguez:

 Roberti 27

“I would rather end it now while I’m able to speak and be clear about what I want. I know it’s
right for me and I feel I’ve done all I can to contribute to life and it’s time for me to move on.”
- ​Sue Rodriguez

Sue Rodriguez was a Canadian right-to-die activist living until 44 years of age. In August
of 1991, three years before she died, Rodriguez was diagnosed with amyotrophic lateral sclerosis
(ALS), a degenerative disease, gradually deteriorating her body and mind, given anywhere from
two to five years to live. After challenging the Supreme Court of British Columbia and the
British Columbia Court of Appeal, Rodriguez took her case to the ​Supreme Court of Canada​.
Sue Rodriguez had committed suicide in February 1994, assisted by her anonymous doctor,
peacefully and on her own terms; meanwhile, accompanied by a close friend, NDP MP Svend
Robinson, who continued to fight for her case. Sue Rodriguez ultimately, defied the law.
Although, Rodriguez never lived to see the law change in Canada, she accomplished more in her
death than she realized - putting the issue on the public agenda. “I would like to go down in
history knowing I had something to do with the laws being changed and creating a more
compassionate society as a result”, and she did (The Story of Sue Rodriguez, 2016).

"If I cannot give consent to my own death, whose body is this? Who owns my life?"
- Sue Rodriguez

As previously stated, if a patient is willing to undergo MAID in Canada, they must meet
the established eligibility criteria created by the federal legislation.

“The eligibility requirements are that the patient must:

● be 18 years or older,
● be capable of making health care decisions,
● have a grievous and irremediable medical condition, which means:
○ the patient has a serious and incurable illness, disease or disability, and
○ the patient is in an advanced state of irreversible decline in capabilities, and
 Roberti 28

○ the patient is enduring physical or psychological suffering, caused by the

medical condition or the state of decline, that is intolerable to the person, and
○ the patient's natural death has become reasonably foreseeable;
● be making a voluntary request;
● provide informed consent to medical assistance in dying after having been informed of
the means that are available to relieve their suffering, including palliative care” (Ontario
Ministry of Health, 2018).

This criteria ensures that all expected safeguards are met before the final decision is
made. With no exceptions, a patient must fulfill each section of the requirements. This allows for
a much more guarded and controlled act of euthanasia, leaving less room for error.

To the right of Ontario lies Quebec - a large slice of the pie for Canada’s MAID
advancement. In June, 2014, a free vote at the National Assembly in Quebec passed Bill 52,
commonly known as the Dying with Dignity Law which respectfully allows terminally ill
patients to encounter MAID. However, this change in law was controversial. Prior to
legalization, Quebec doctors began speaking out against medical aid in dying. A group of 500
doctors joined together under the Physicians’ Alliance for Total Refusal of Euthanasia. After
signing a declaration calling on the province to stop the legislation, they argued that assisting
death is not medical care and rather contradictory to a doctor’s code of ethics. Some appointed
physicians said euthanasia makes it necessary for a society to legalize killing, giving the message
that the lives of people with disabilities are not worth fighting for and therefore, less valuable.
However, the disapproval was not enough to maintain the illegal act of euthanasia. Statistics in
Quebec present that within the first year of legalization, they were offered “a hundred or so
requests [...] the final result shows that 469 people died by euthanasia in 2015-2016, and 638 in
the following year. [...] In comparing our numbers to those of Belgium, we observe that the first
year in Quebec corresponds to the sixth year in Belgium, [...]. This is to say that Quebec threw
itself headlong into death as a solution of suffering” (Martin, 2017). As it is expressed, Quebec
 Roberti 29

now stands behind their change in law and consequently, the high acceptance for MAID in the
province.

Logic of Evil

To have logic means to have science behind reasoning, inductive or rational judgement,
critical thinking or common sense - wearing a lifejacket if you cannot swim, going to bed if you
are tired or eating if you are hungry. Logic is “a particular way of thinking, especially one that is
reasonable and based on good judgment” (Cambridge, 2019). On the contrary, the word “evil”
describes anything as diabolical or immoral. The world has and always will be plagued by vile
people who lack compassion and care, whose actions are considered to be “moral evils”,
subsequently resulting from the intentions or negligence of moral agents (Calder, 2013). The two
terms logic and evil are polar opposites. So, how do they relate? Similar to the euthanasia debate,
the Ying Yang effect, stating that “all things exist as inseparable and contradictory opposites”
(Cartwright, 2018), relates to the partition between logic and evil, specifically the reason behind
the anti-euthanasia argument.

Daunting to say, there is logic behind the anti-euthanasia argument. As an ethical issue
and a perpetual global stigma there are people, governments and countries that coexist with this
side of the dispute:

An experienced family physician, prominent member of the board and an executive of

both the British Columbia Medical Association and the Canadian Medical Association, Dr. Jim
Lane took part in a contentious debate before the Senate Special Committee on Euthanasia
holding a remarkable argument posing as a great example of the opposing side. This presentation
had taken place on September 26, 1994 by Canadian Physicians for Life; “a Canada-wide
organization of physicians who are committed to maintaining respect for the dignity and inherent
goodness of human life at all stages” (CPL, 2019). Dr. Jim Lane voices his opinion:
 Roberti 30

“I’m aware of what legislation would mean to my profession and the expectations that
would be placed on my profession if legalization of this act occurs”. However, Dr. Jim Lane
remains consistent with his words throughout the presentation, stating the lack of understanding
many have, therefore unable to realize the profound implications euthanasia would have on our
society. As an ethical issue, doctors such as Lane recognize their level of trust with patients and
how that can easily be undermined when not acting in the best interest of their patients. Thus,
entirely jeopardizing the necessary and intimate doctor-patient relationship.

“Patients must know that doctors are there to help them, not hurt them. [...] I, along with
most doctors, recognize the importance of educating doctors, patients and the public as to what
palliative care can accomplish and the need to make this care available to all. If my profession
can accomplish this task of education, much of the fear of pain and suffering can be eliminated,
and patients should not feel the need to ask for euthanasia”. A clear example: “Britain, which is
recognized as having one of the best hospice and palliative care programs in the world, had to
reject euthanasia. The Netherlands, on the other hand, not known for its palliative care, has opted
for euthanasia” (Lane, 1994).

In association with the Canadian Medical Association, Dr. Lane is in accordance with
this burdensome topic; opposing euthanasia​. ​Doctors are proud of what their governing body
represents. Doctors are not murderers, they chose this profession to save lives, not to end them.
Seemingly, euthanasia would weaken society’s respect for both the value and importance of
human life (BBC Bitesize, 2019, n.p), therefore it is at utmost transparency that Dr. Jim Lane is
against the act of euthanasia. Although, his speech is the reason why euthanasia continues to be a
controversial global issue. As dated, this presentation transpired almost 25 years ago yet the
arguments made remain relevant present-day. As a result, Dr. Lane held such a strong argument
that it could have resulted in one changing their perspective on this persistent issue - a never
ending debate.

Politics
 Roberti 31

Politics impact our daily lives and is beginning to take a toll on our death too.

The political discretion and governing potency over actions of individuals in a society
sovereign all measures of life and death. The mass media shapes an umbrella-like figure over the
world of politics. The media dictates what we interpret and how we interpret it. The influence of
the media skyrockets as it begins to directly blame the government. As previously stated, many
recognize the act of euthanasia as an immoral implementation. Within the low number of
countries that conduct euthanasia, the laws remain severe and do not allow much justice. There is
constant media coverage about cases where people are being denied the right to die. As
discussed, cases such as Brittany Maynard’s demanded a new governing law. With this, the
Maynard’s moved their home with the intent to pursue euthanasia. The media often refers back
to the legal status of euthanasia in that country, which can often spark a conversation about
whether the current laws in that country are effective enough. In several cases, there have been
stories so courageous and influential that the government then decided to implement a new law
as a result of their suffering, hardship and advocacy.

As mentioned in the role of control, governments have great power in which they
strategically use to their advantage. With this authority, governments are able to persuade the
political opinions and judgement of their population to better fit their demographics. For
example, Vatican City is the smallest country in the world, approximate population of 1,000, just
outside of Rome, Italy. At the center of the Roman Catholic Church, Vatican City is heavily
influenced by the Catholic religion (Encyclopedia.com, 2007). The legalization of euthanasia by
the government is therefore not necessary because of their demography, hence the Catholic
population. As recognized, many religions including Christianity do not correspond with this act
but instead side with the pro-life ideals. So, if there is not a demand for euthanasia in a specific
region, then why legislate?

What is the price of life?

 Roberti 32

From an economical standpoint, active euthanasia is not generally a concern for

governments. Rationale reasoning for euthanasia includes the thought of burden and financial
deficit that the patient forces onto the family. Cost is an intervention of palliative care.
Depending on the terminal illness the patient is living with, palliative care costs thousands and
thousands of dollars to keep one alive in a vegetative-state, whereas the lethal dose ingested in
euthanasia is at a much lower expense. According to a report published in the Canadian Medical
Association Journal, euthanasia “could reduce annual health-care spending across the country by
between $34.7 million and $136.8 million” (Malone, 2017). Countries such as Canada who are
alloted socialized medical care are able to sustain the dramatic difference in cost. However,
smaller countries or even the United States do not have free medical care, therefore being forced
to rely on medical expenses for government income; losing money due to the low cost of
euthanasia.

Religion

What is the meaning of life?

Religious philosophy is the study of the fundamental nature of both religious and spiritual
existence. Whether it is displayed objectively or done through persuasion by believers of a faith,
religion is frankly a way of life and as a result, one of the most powerful subjects in the world.
Religion is the basis of how to generate meaning in life and is strictly followed by a set of
beliefs. These beliefs are what steer one’s mindset in a given direction, ultimately gaining full
control over opinions and reliance. As previously mentioned in the role of control, religion
continues to be the extreme leverage behind the euthanasia argument.

A great number of religions believe that life is a privilege meaning absolutely nothing
should intervene, ultimately, the sanctity of life. Primarily in Christianity and Muslim, there is
quality to human life and therefore, it should be prolonged. Whether that life is full of pain and
suffering or it consists of love and laughter, the Christian religion believes nothing should
 Roberti 33

interfere with the natural occurence of death. In effect, majority of Christians have proven
themselves to be against the act of euthanasia. Euthanasia is called into effect when one meets
the requirements to end their life when it is the only option left; these religions prohibit that.
Christians believe that birth and death constitutes the fundamental basics of life that were created
by God. The Christian religion also claims that life is a sacred gift from God which has to be
treated with utmost dignity, therefore being in complete contradiction with this practice. Muslims
also believe that life is a sacred gift from Allah and therefore, human beings do not have the right
to decide their birth and death (BBC, 2014). Additionally, religions such as Buddhism and
Judaism do not follow euthanasia either. Buddhist’s place great stress on how life shall not
include any sense of self-harm especially any that will contribute to karma in the after-life. With
Buddhism, fear, hate or pain at the end of one's life will follow them into their next life as to why
euthanasia is not a common practice in this religion. Similarly, the Judaism religion shares great
value towards their morals which certainly forbid the act of euthanasia; an early, chosen death.
Generally, the majority of the world’s religions are anti-euthanasia as it infringes against all
fundamental religious doctrines.

As a distinguishing factor, religion often dictates whether or not an individual undergoes

euthanasia. As without question, religion continues to play a substantial and influential role in
this practice. Overall, it is no surprise as to why almost all religions have such specific, strong
views towards euthanasia.

Solutions

“Dignity is our inherent value and worth as human beings; everyone is born with it”
(Hicks, 2013, n.p). Therefore, everyone should die with it. It is deemed necessary for the act of
euthanasia to be present in a civilized society. It is morally acceptable for an individual to
request euthanasia as an expression of autonomy if their own body, mind or heart is deteriorating
and death is inevitable. If we knew exactly when we were going to die, the fear of death would
be atypical because there is no conventional way to die. It is known that human beings tend to
 Roberti 34

fancy a life unaccompanied by grievous pain but also free from the pain of anxiety of an
undignified death. After being diagnosed with a rare form of Alzheimer’s, former author, Terry
Pratchett became an advocate for assisted suicide: “As I have said, I would like to die peacefully
with Thomas Tallis on my iPod before the disease takes me over and I hope that will not be for
quite some time to come, because if I knew that I could die at any time I wanted, then suddenly
every day would be as precious as a million pounds. If I knew that I could die, I would live. My
life, my death, my choice.” (Morris, 2013, n.p). People are fleeing their own homes for the
primal reason of accessing euthanasia because their right to die with dignity is a crime in
particular countries. Criminalizing euthanasia is an immoral act in itself. Why should someone
who is suffering mental and/or physical agony be subjected to such an inhumane way of life?
These vulnerable individuals need a voice. With hope that they have lived a happy and healthy
life, they deserve to die in the same manner - with uttermost dignity.

Some solutions have been addressed, however necessary, none have changed the
ceaseless discussion of euthanasia as the opposition between the two positions remains intact.
Continuous efforts have been made by various international organizations, specifically ​Exit
International​ and ​The World Federation of Right to Die Societies,​ advocating for all individuals
wishing to die with dignity. These two organizations focus on making change by acting against
the law, without breaking it - targeting every aspect from individuals to societies around the
world as a progressive movement in favour of the pro-euthanasia discussion. ​Exit International
and ​The World Federation of Right to Die Societies h​ ave aimed at influencing public policy by
lobbying ideas and providing information to politicians. By promoting social and political
change, these international organizations have played a critical part in the progression of the
euthanasia debate; promoting citizen participation, improving communities, and developing
educated societies. ​These NGOs are addressing the issue that governments are currently
avoiding; euthanasia.

In addition, the euthanasia laws are changing and the progress continues to part
international borders. Direct manifestations of polarization, in particular, the cases of Brittany
 Roberti 35

Maynard, Maruti Shripati Dubal, and Aruna Shanbaug are playing an integral role in the history
of euthanasia. Terminally ill, Brittany Maynard fought to her death. Maynard challenged
California’s government, urging for legislation for a peaceful death. Openly denied, Brittany
Maynard fled to Oregon, United States where she could die on her own terms. Putting her life on
the line, Maynard ignited conversation. In response, “The Brittany Maynard Fund” was created
to advance her judicial efforts and assisted suicide has now been made legal in the US state of
California. Maruti Shripati Dubal, the terminally ill police officer from Mumbai, India made
advancements in the euthanasia laws. The suffering became inevitable and Dubal was ready to
end his life. With no law in play, Dubal was forced to commit a painful suicide. Breaking one
law, helped to create a new one. Aruna Shanbaug, brutally tortured, suffered in a vegetative-state
and a coma for more than half her life. Not until she died a painful death, euthanasia was
decriminalized. Maruti Shripati Dubal and Aruna Shanbaug played with the law and are the
reason for the change in legislation.

In the bigger picture, governments have authority over the public and dictate all
legislative solutions. The division that has been made by the varied legality of euthanasia
throughout the world should be interrupted. More governments need to advocate for an easy
death instead of watching their population suffer or at worst, flea their own country for proper
health rights. Euthanasia needs to become a more controlled and manageable practice, not
chaotic confusion. Governments need to implement strict guidelines so that the individual
wishing to foresee euthanasia is entitled to such literal life or death, instead of popularizing
euthanasia - as to why meeting all eligibility criteria for a patient is of great purpose. Beginning
with these actions, individuals will not need to fight a losing battle against the law, forcing them
to evacuate their country to be euthanized elsewhere. Ultimately, if a government is concerned
about losing control over their people, then establishing safeguards is the safest option. If a
government can find a balance between maintaining control and successfully allowing the
terminally ill to be euthanized, then this will affect the world’s population in a positive, safe, and
peaceful way.
 Roberti 36

One year ago, a legal challenge made on assisted suicide sparked a heavy London protest
involving 68 year old, terminally ill, Noel Conway. This all started when Conway was diagnosed
with motor neurone disease in 2014; his life attached to a ventilator and remaining movement in
his right hand, head and neck. Noel Conway has challenged the law for when his prognosis of six
months left to live is declared - at this time he will be granted the option to die with dignity, in a
sound and painless state, all while comprehensive of the situation in order to make his final
decision. Too ill to attend court, Conway’s case has been brought to the attention of the Supreme
Court. Losing his legal challenge, Noel Conway’s case was rejected by three senior judges.
Noted as “barbaric”, “his current options are to ‘effectively suffocate’ by removing his
ventilator, or spend thousands travelling to Switzerland to end his life and have his family risk
prosecution” (BBC News, 2018, n.p). This ignited a political protest. Supporters of Noel Conway
and other cases like his staged an opposition outside the Royal Courts of Justice in London.
Conway is not alone in this fight - the campaign is being supported by ​Dignity in Dying;​ a United
Kingdom nationwide campaigning organization. ​Dignity in Dying ​believes “assisted dying for
terminally ill, mentally competent adults should be legal in the UK. [...] the right law for the UK
is one that allows dying people, with six months or less to live the option to control their death.
We do not support a wider law” (Dignity in Dying, n.d). The #ImWithNoel campaign included
signs such as “GIVE ME CHOICE OVER MY DEATH”, “THE LAW NEEDS TO CHANGE”,
and “DYING PEOPLE SHOULD NOT HAVE TO SUFFER AGAINST THEIR WISHES”.
Unfortunately, this is what the law has forced the public to do. Protests in favour of euthanasia
are expressions against governments who are choosing to criminalize euthanasia and prevent a
human’s right to die.

Euthanasia should not be a law worth discussing. Regardless of all fundamental

legislative principles, it boils down to an individual's human rights and their choice. Euthanasia
is the partition between life and death and should be considered in a solemn manner. The desired
practice “should be institutionalized in a way that minimizes the hardship of both those ending
their lives on their own terms and the loved ones they intend to leave behind” (Ruiz, 2017). Our
world is constantly evolving and our laws must transform with it. The act of euthanasia must
 Roberti 37

further its existence so the law is available to anyone facing a terminal illness and those that are
suffering from immense pain - because after all, whose life is it?

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