58. Euthanasia & Assisted Suicide [Part I]

When it comes to the contentious topics of euthanasia and assisted suicide I remained as bewildered as I was at university about the ill-defined divisions between church and state, and between religion and the law. The state maintains that it owns your body, as evidenced by the fact that it is a criminal offense to commit or attempt suicide. Possession aside, this would seem to be gross interference of the state in our freedom of action.

The subject, pro and con, remains immensely broad with numbers of religious groups opposing Euthanasia on the ground that we are all God’s creations and remain at his disposition. Because of the complexity of the subject, I have divided this blog into two parts: The first will focus on the secular, the second will focus on the religious.

Euthanasia was practiced by the ancient Greeks and Romans as evidenced by the support by Plato, Seneca, and most dramatically by Socrates who ended his life with poison hemlock. The doctrine of the “sanctity of human life” arose later with St Augustine and its adoption by Christianity, which held sway until the 19th Century. Problems started to arise when doctors began to use morphine to treat those suffering “the pains of death.” In 1870 an English school teacher, Samuel Williams, proposed the use of chloroform to deliberately end the suffering of terminally ill patients.1 The great outspoken reformer, Annie Besant, endorsed that position considering it a social duty to society to “die voluntarily and painlessly” when one reached the point of becoming “a burden.”2 At that time, however, the medical profession did not take part in the debates on euthanasia which followed as this was regarded as a philosophical proposal tied inextricably to objections from Christians citing the sanctity of human life.

Felix Adler was the first prominent American to contend in 1891 that suicide in certain chronic illnesses should be permitted. He argued from an Ethical Culture perspective that it should be permissible for a doctor to assist in such instances. Robert Ingersoll, rejecting religion, argued in 1894 in favor of Euthanasia and also agreed that patients suffering from a terminal illness, as in certain cancers, should have the right to end their pains. However, humane end-of-life practices were slow to be introduced. There was a reluctance to recognize that those who were dying should be given choices. Objections were raised that once such practices were accepted, terminally ill patients might feel it was their “duty to die” because of the enormous burden they were placing on their relatives as well as on society.

In Britain the Voluntary Euthanasia Legalization Society (now called Dignity in Dying) was founded in 1935. The death of George V in January 1936 coincided with the proposed legislation in the House of Lords to legalize euthanasia. However, the public was unaware at the time that the King had been given a fatal dose of morphine in order to hasten his death. It was kept secret for 50 years that the decision to end his life had been made by his physician, Lord Dawson. What was deemed acceptable for royalty was obviously not suitable for his subjects.

The introduction in Nazi Germany in 1939 of state sponsored euthanasia caused long term setbacks to Euthanasia groups in both the UK and the US. The killing of a severely disabled infant, endorsed by Hitler’s office and pseudo-scientific parties concerned with purifying the “Aryan” heritage in Germany, was described by a 1939 BBC radio program titled “Genocide Under the Nazi’s Timeline” as the first “state sponsored euthanasia.” Eventually this secret Nazi exercise led to “mercy killings” of almost 300,000 physically and mentally handicapped people including thousands of children forcibly taken from their parents. The horrors to which these human beings were submitted ended serious discussion of euthanasia for decades.

The “Death with Dignity Act” came into force in Oregon in December 1994 after “Measure 16”, a long debated proposition, had been narrowly passed in state elections. It allowed doctors to prescribe lethal drugs so that terminally ill patients, who were to be provided with certain rigid safeguards, could end their own lives. However, the doctor could not administer such lethal doses until the patient had requested it in writing at least once and two doctors had concluded that the patient was sane, acting voluntarily, and not suffering from depression. The doctor then had to wait at least 17 days before issuing the prescription and during the waiting period the patient had to be informed of all the possible options.

To some extent the legal argument for euthanasia was brought into the open in the US by Judge Stephen Reinhardt summing up for the majority of the 9th Circuit Court of Appeals when he said in March 1996 that there was constitutional protection “for determining the time and manner of one’s own death.” Reinhardt argued that “a mentally competent, terminally ill adult, having lived nearly the full measure of his life, has a strong liberty interest in choosing a dignified and humane death.”3 Five US states now have laws that allow assisted suicide whereby a mentally competent person who is terminally ill can legally be prescribed a lethal dose of medication. And three state legislatures — in Connecticut, Massachusetts, and New Jersey — are expected to give similar laws a full hearing this year.

In Europe, because of mounting demographic pressure, end-of-life care has become an increasingly contentious moral, legal, economic and medical issue. Because the costs of care for the elderly in the closing months of life rise sharply, governments are looking for ways to economize. Doctors in the Netherlands, Belgium, Luxembourg and France now are able to make end-of-life choices for patients in their care, which, by American standards, might be regarded as unthinkable.4 The New York Times reported that in 2012 about 130,000 of the 570,000 registered hospital deaths in France were preceded by a physician’s decision to raise the dosage of pain killers and sedatives, or to limit the treatment. In France, an overwhelming percentage of those polled agree that assisted suicide should be permitted for those with a terminal illness. A broad spectrum of the French believe that doctors are bound by their medical and legal principles; that they are free from economic or emotional considerations and can consequently make value free decisions on ending a patient’s life.

It is generally recognized that, motivated by compassion, doctors want to protect their patients, the families and the medical profession. However, at a trial of one French doctor who had prepared a lethal dose of sedatives for a comatose patient in his care, the state prosecutor charged that “To be too compassionate is to deem others disposable. It is to unburden them of a responsibility that, in fact, belongs to them.”5

In the final scenes of the superb French film, “Amour,” the actor ends the life of his suffering wife, suggesting that “what will survive us is love.” The inference is clear that euthanasia must be seen as an often difficult but kinder way of death for the terminally ill. Parts of the media, such as the tabloids, have been persistent in their pursuit and exposure of those terminally ill who fly to Switzerland to die with dignity and in a humane manner. Some governments have also been keen on pursuing those who accompany them on their journey as criminals abetting murder. I believe there eventually needs to be a binding international agreement on the legality of assisted suicide. The notion that a patient seeking to end suffering is committing a crime by going to another nation in order to end it seems obscene to me. Our free-will demands greater respect than that!

1Samuel Williams, Euthanasia, (1872)
2Ian Dowbiggin (March 2007). A Concise History of Euthanasia: Life, Death, God, and Medicine. Rowman & Littlefield. pp. 51,
3Yorick Blumenfeld, Towards the Millennium (1997) p.589
4Scott Sayare, “France asks why doctors get the last word to end a life,” The New York Times, August 1, 2014

2 thoughts on “58. Euthanasia & Assisted Suicide [Part I]

  1. Pingback: 60. Towards a New Economics | Yorick's Blog

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