I will try to discuss this highly controversial topic from the point of view of a clinician under the light of ethical principles. There are four ethical principles that govern the conduct of doctors in modern day medicine (Beauchamp and Childress 2001):
1. Respect for patient autonomy
2. Beneficence: promotion of what is best for the patient
3. Non-maleficence : avoiding harm to the patient
4. Justice: patients with similar conditions should receive similar level of care
When a patient is terminally ill and her suffering is intolerable, the patient may decide it is too painful to live and that she is better off dead to end her sufferings. Provided that the patient is mentally competent, should a doctor comply with her request to terminate her life? Proponents of euthanasia would argue that it is acceptable to end life in such a situation because euthanasia in this case satisfies the first ethical principle – Respect for patient autonomy. A mentally competent patient has the autonomy to decide what she wants to do with her life. In addition, euthanasia in this case complies with the second ethical principle – Beneficence. By ending her life, the doctor is relieving her from the suffering, which in this case, is in the best interest of the patient whose quality of life is unacceptably low. By conducting euthanasia, the doctor is helping the patient avoid the intolerable suffering and is doing no harm; hence it complies with the third principle – Non-maleficence. Here, the principle of justice is not applicable. Therefore, euthanasia is in accordance with the ethical principles which the doctors should adhere to.
However, the opponents of euthanasia would argue that a terminally ill patient is likely to be vulnerable to the pressure by the people surrounding her and the decision to end her life might be the result of the influence of the people around her. In other words, there may be an element of coercion or manipulation. And that would be against the principle of autonomy. In addition, some people may exploit euthanasia to their advantage e.g. in cases of inheritance. Moreover, some would argue that by legalizing euthanasia, the constraint of public towards killing will slip down and public will become more tolerant towards killing in general which will result in undesirable consequencs in the long run.
The debate over euthanasia is unlikely to be over soon. Both its opponents and proponents will keep on fighting fiercely for their conviction. Over the history, many practices, which were once illegal, are no longer considered crimes now. For example, abortion has now been legalized in many countries. In some countries, suicide is no longer a crime. Competent patients can refuse life saving treatment. So who knows if euthanasia will not follow suit.
