Euthanasia, understood as the act of ending a person's life to alleviate their suffering in situations of terminal illness or extreme pain, is one of the most controversial issues in contemporary medical ethics and law. This concept, which arouses deep divisions between defenders of individual autonomy and those who advocate the sanctity of life, has generated a global debate that encompasses moral, legal, religious and cultural aspects. This article analyses what euthanasia is, the existing types, the arguments for and against it, and how it is addressed in different parts of the world.
Definition and types of euthanasia.
The word "euthanasia" comes from the Greek eu (good) and thanatos (death), which translates as "good death." In modern terms, it refers to a medical intervention that seeks to end the life of a person who is suffering unbearably due to an irreversible health condition.
Types of euthanasia.
- Active euthanasia: It consists of carrying out a direct action, such as administering a lethal injection, to cause the death of the patient.
- Passive euthanasia: Involves the suspension or withdrawal of life-prolonging medical treatments, allowing the patient to die naturally.
- Voluntary euthanasia: When the patient consciously and expressly requests that euthanasia be performed on him/her.
- Non-voluntary euthanasia: It is carried out without the express consent of the patient, for example, when he or she is unconscious or incapable of making decisions.
- Assisted suicide: Although not strictly euthanasia, it is related. In this case, the doctor provides the patient with the means to end his or her own life.
Arguments in favor of euthanasia.
Proponents of euthanasia often focus their arguments on individual autonomy, relief from suffering, and compassion for terminally ill patients.
Right to decide about one's own life.
Euthanasia is seen by many as an extension of the right to personal autonomy. Just as people can make decisions about their bodies in other areas, such as abortion or organ donation, they should have the freedom to decide when and how to die in situations of extreme suffering.
Relief from suffering.
For patients facing painful terminal illnesses or chronic conditions with no chance of improvement, euthanasia is presented as a way to end unbearable physical and emotional suffering.
Dignity in death.
Many advocate the right to a dignified death, free from agony and degradation. Euthanasia allows people to avoid prolonging their life in conditions they consider undignified or humiliating.
Efficiency in medical resources.
In a health care system with limited resources, opponents of therapeutic obstinacy argue that artificially prolonging the lives of patients with no hope of recovery consumes resources that could be allocated to other patients with a chance of improvement.
Arguments against euthanasia.
On the other hand, opponents of euthanasia focus on the intrinsic value of life, the risks of abuse and the importance of seeking alternatives to suffering, such as palliative care.
Value of human life.
For many, life has an intrinsic value that should not be deliberately interrupted. This argument is especially strong in religious communities, where life is seen as a divine gift that only God has the right to take away.
Possible abuses and risks.
Critics fear that legalising euthanasia could lead to abusive practices, where vulnerable people, such as the elderly or disabled, feel pressured to opt for euthanasia so as not to be a burden on their families or society.
Alternatives such as palliative care.
It is argued that instead of legalising euthanasia, health systems should invest more in palliative care, which relieves pain and improves the quality of life of terminally ill patients without resorting to assisted dying.
Moral dilemma for doctors.
For many health professionals, euthanasia contradicts the Hippocratic oath to "do no harm." Participating in the death of a patient can generate deep ethical and emotional conflicts.
Euthanasia in the global legal framework.
Regulation of euthanasia varies widely between countries, reflecting cultural, religious and ethical differences surrounding the issue. Some countries have legalised active euthanasia, while others prohibit it entirely.
Countries where euthanasia is legal.
- Netherlands: It was the first country to legalize active euthanasia and assisted suicide in 2002, under strict conditions.
- Belgium also legalized euthanasia in 2002 and allows its application even to minors under certain circumstances.
- Luxembourg: Euthanasia was approved in 2009.
- Canada: Euthanasia and assisted suicide have been legal since 2016 under the Medical Assistance in Dying (MAID) Act.
- Colombia: It is the only country in Latin America where euthanasia is permitted, recognized by the Constitutional Court in 1997.
Countries where it is prohibited.
In most countries around the world, euthanasia remains illegal and can carry criminal penalties. However, many allow passive euthanasia, such as the suspension of medical treatment at the request of the patient.
Controversial cases.
In countries such as the United States, where legislation varies by state, and in Spain, where euthanasia was legalized in 2021, the issue continues to generate intense debate among political, religious and social sectors.
Cultural and religious aspects.
Perspectives on euthanasia are deeply influenced by cultural and religious beliefs. In predominantly religious societies, such as Islamic or conservative Christian ones, euthanasia is seen as a violation of the fundamental principles of faith. On the other hand, in more secularized cultures, such as those in Western Europe, acceptance of euthanasia tends to be greater.
Emotional and social impact.
In addition to legal and ethical debates, euthanasia has a significant emotional impact on all parties involved: patients, their families and health professionals.
- For patients: The choice of euthanasia can give them a sense of control over a situation that would otherwise be perceived as hopeless.
- For families: Although many families support the patient's decision, the process can generate internal conflicts, guilt and complex grief.
- For physicians: Participating in a euthanasia process can be emotionally challenging and raise ethical dilemmas even in settings where it is legal.
The future of the euthanasia debate.
As societies evolve, the debate over euthanasia is likely to continue to grow, especially in contexts of ageing populations and life-extending medical advances. Some factors that will influence this debate include:
- Advances in palliative care: If these progress, they could reduce the perceived need for euthanasia.
- Greater acceptance of personal autonomy: In more liberal societies, pressure to legalize euthanasia could intensify.
- Impact of technology: Artificial intelligence and other technologies could influence medical decision-making and how end-of-life conditions are managed.
Euthanasia is a complex issue that addresses profound questions about the meaning of life, autonomy and compassion. While for some it represents an act of humanity and respect for the patient's will, for others it poses insurmountable ethical dilemmas. As societies and legal systems evolve, finding a balance between respecting individual decisions and protecting the fundamental values of humanity will be crucial. The debate is far from resolved, but its importance in medical and social ethics makes it a central issue of the 21st century.