Controversy and discord hides the etymology of the term: “a good death”. And using the proper term will always prompt deeper reflection.
Despite being in the 21st century, this concept continues to infuriate people and accumulate defenders and opposition, generating a debate that still hasn’t reached its final conclusion, as it revolves around two clearly incompatible principles: to live or to die.
But the debate is not a recent phenomenon, quite the contrary.
The meaning of euthanasia, in etymological terms, is directly related to the idea of a good death. Nowadays the term is linked to the idea of reducing pain for someone who is inevitably dying or due to a chronic illness, has lost their hope of a cure.
As with every good controversy, there are various components. There is a distinction between Passive Euthanasia, which lets a sick person die and Active Euthanasia, when, due to the inability of the patient, there is a second person who helps the patient to die.
Even in ancient times, this practice provoked a debate in which controversy was raised. Defenders and critics of this concept already existed in Ancient Greece and whilst the Pythagoreans did not accept it, it was supported by the Stoics, in situations where terminal illness made life itself bad and therefore not worth living. So, historically people have shown themselves to support euthanasia, as Plato said “let people die who are not healthy of body”.
Types and their importance
There are many practices related to ending a life. All of them are different.
Direct Euthanasia is when the death of a terminally ill patient is brought forward.
This practice is also divided into two types: there is Active Euthanasia, ending the life of a terminally ill patient on his or her wishes (for example, by the administration of a lethal dose). There is also Passive Euthanasia, this is the stopping of treatment for a patient with a terminal illness, with the intention that such neglect will cause their death.
Indirect Euthanasia, also known as “the double effect”, is the act of providing the patient with treatment to alleviate his or her suffering. However, as its name suggests, “the double effect” can result in the death of the patient.
There are a number of additional aspects related to euthanasia. Among them is the use of the word ‘suicide‘. It is called Assisted Suicide when the necessary means for a patient to end their life are provided for them.
The practice of euthanasia without the consent of the patient is called Cacotanasia, and in other situations it can be called Ortotanasia, when a terminally ill patient is allowed to die once their time has come, without using means that might prolong their life.
The opposite of this is Dysthanasia where every possible method is used to prolong the life of a terminally ill person.
It is crucial to understand that although the outcome of all these concepts is the same – death – they are all completely different in practice. It is precisely this distinction that is linked to the possible sentence of the person who carried out the action.
On the 1st of April, euthanasia celebrated ten years since it was first legalised in the Netherlands. However, there were many cases that preceded this legislation, long before this act became legal. In 1971, Doctor Postma, in what she called an act of mercy, administered a lethal injection of morphine to her mother. The patient, who after suffering a brain haemorrhage was admitted to a nursing home, and had asked her daughter on multiple occasions to help her end her life. Finally, these wishes were fulfilled.
The doctor was found guilty of mercy killing and sentenced to parole for a year as well as being given a one week suspension from work.
This case, not only controversial because it involved a mother and daughter, but also because the doctor confessed on her own judgement whilst being questioned, that her mother was not suffering unbearable physical pain. Thus this story passed as one of the first cases that marked the prelude of the legalisation of euthanasia in the Netherlands.
However this initiative has always been linked to information that calls the new law into question and contradicts the benefits of the legalisation of euthanasia. In 1990 the Remmelink Commission carried out a survey in the Netherlands where the results revealed that more than 10,000 people died because medical treatment was denied them without their consent.
In surveys carried out later, the results were no more encouraging, although euthanasia is only allowed in cases of terminal illness, there are more and more cases of euthanasia for patients who are not suffering from incurable illnesses. It has even been reported in cases of depression.
Currently the global situation concerning euthanasia varies considerably. On the list of countries that have legalised it are Belgium, Luxembourg and three US states: Oregon, Montana and Washington.
In Germany, France, Israel and Sweden only Passive Euthanasia in terminal cases is allowed. In Spain, patients in the terminal stage where there is no possibility of recovery have the right to be able to reject whatever treatment destined to prolong their life through the adoption of the Law “Palliative care and good death”
However, while euthanasia continues to be rejected legally by almost every country and international bodies, it has not prevented cases of euthanasia occurring.
In January 2010 Frances Inglis was involved in a story that shocked Great Britain and the whole world when she injected a lethal dose of heroin into her son. The youth, after finding himself embroiled in a fight leaving a pub, fell out of the ambulance that was taking him to hospital and suffered irreversible brain damage that left him in a coma. The verdict of 10 votes against and only 2 in favour meant the judge sentenced her to life imprisonment.
No less discussed was the case of the BBC journalist. In 2010 he confessed to having been directly involved in the death of his partner, ill with Aids, smothering him with a cushion, “We had this agreement. If he got to this state, I would end his life. And that is what I did.”, Ray Gosling told the BBC. The police investigations have not finished, but the journalist could face a sentence of up to 14 years in prison.
One year before, in 2009, the family of the Italian Eluana Englaro who was in a coma for 17 years, put the Supreme Court in a difficult position when they requested that the machine keeping her alive be switched off. Despite euthanasia not being legal in Italy, the family’s wishes were granted.
In Spain where the Civil Code does not support euthanasia, Ramón San Pedro was the first Spaniard to turn to the courts. He requested an act of mercy to grant his wish to end his life through assisted suicide. His disability prohibited him carrying it out on his own. He was quadriplegic for 30 years after a near fatal sea accident which left him lying in a bed only able to move his head. His request was rejected.
On the 12th January 1988, he died from poisoning, helped by his friend Ramona Maneiro who was never tried because of a lack of evidence. Years later and when the statute of limitations had elapsed, Ramona admitted on television to having been the person who gave the poison to Ramón.
Arguments for and against
For those who defend this law, human dignity is based on the right of whoever is suffering from an illness to choose when they die whereas its opposition think that this directly contradicts human morals.
Religion in general and the Catholic Church in particular are the most staunch defenders of life and consider that ending life is an attack against it. Specifically the most important representative of the Catholic Church, Pope Benedict XVI, expressed it in one of his last visits to Spain said “Man’s life is not a disposable good, from the moment of its beginning to its ultimate and natural fulfilment.”
Those opposed to euthanasia also consider that it rules out any possibility of improvement in the patient and in cases of Active Euthanasia carried out by a doctor, would contradict the oath made by doctors, which is based on healing.
Finding protection in the concept of freedom, the defenders of euthanasia argue that the individual is the only one who can decide on the quality of their life and evaluate whether or not it is worth living. They argue that life is a right, not a duty and as such if someone has a terminal illness, prolonging their suffering is no more than suppressing their human dignity and subjecting them to unnecessary torture.
When we talk about ideas as conflicting as living or dying, the probabilities of finding any common ground between prolonging the life of someone who is dying by any means possible and the opposite of accelerating their death to cure their suffering, are practically nonexistent. This leaves the debate always open, but ever more entrenched in society.
(Translate by Harriet Payne – Email: firstname.lastname@example.org)