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Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering. Different countries have different euthanasia laws. The British

House of Lords The House of Lords, also known as the House of Peers, is the upper house of the Parliament of the United Kingdom. Membership is by appointment, heredity or official function. Like the House of Commons, it meets in the Palace of Westminste ...

select committee on medical ethics defines euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering". In the

Netherlands ) , anthem = ( en, "William of Nassau") , image_map = , map_caption = , subdivision_type = Sovereign state , subdivision_name = Kingdom of the Netherlands , established_title = Before independence , established_date = Spanish Netherl ...

and

Belgium Belgium, ; french: Belgique ; german: Belgien officially the Kingdom of Belgium, is a country in Northwestern Europe. The country is bordered by the Netherlands to the north, Germany to the east, Luxembourg to the southeast, France to th ...

, euthanasia is understood as "termination of life by a doctor at the request of a patient". The Dutch law, however, does not use the term 'euthanasia' but includes the concept under the broader definition of "assisted suicide and termination of life on request". Euthanasia is categorized in different ways, which include

voluntary Voluntary may refer to: * Voluntary (music) * Voluntary or volunteer, person participating via volunteering/volunteerism * Voluntary muscle contraction See also

* Voluntary action * Voluntariness, in law and philosophy * Voluntaryism, reje ...

, non-voluntary, or

involuntary Involuntary means ''unintended''. An involuntary action is one that is unintentional, i.e. without volition or will; see volition (psychology) and will (philosophy). ''Involuntary'' may also refer to: * ''Involuntary'' (film), a 2008 Swedish film ...

.Voluntary and involuntary euthanasia
''

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'' Accessed 12 February 2012. Archived from the original Voluntary euthanasia is when a person wills to have their life ended and is legal in a growing number of countries. Non-voluntary euthanasia occurs when a patient's consent is unavailable and is legal in some countries under certain limited conditions, in both active and passive forms. Involuntary euthanasia, which is done without asking for consent or against the patient's will, is illegal in all countries and is usually considered murder. euthanasia had become the most active area of research in

bioethics Bioethics is both a field of study and professional practice, interested in ethical issues related to health (primarily focused on the human, but also increasingly includes animal ethics), including those emerging from advances in biology, m ...

. In some countries divisive public controversy occurs over the moral, ethical, and legal issues associated with euthanasia. Passive euthanasia (known as "pulling the plug") is legal under some circumstances in many countries. Active euthanasia, however, is legal or ''de facto'' legal in only a handful of countries (for example: Belgium, Canada and Switzerland), which limit it to specific circumstances and require the approval of counselors and doctors or other specialists. In some countries - such as Nigeria, Saudi Arabia and Pakistan - support for active euthanasia is almost non-existent.

Definition

Like other terms borrowed from history, "euthanasia" has had different meanings depending on usage. The first apparent usage of the term "euthanasia" belongs to the historian Suetonius, who described how the Emperor

Augustus Caesar Augustus (born Gaius Octavius; 23 September 63 BC – 19 August AD 14), also known as Octavian, was the first Roman emperor; he reigned from 27 BC until his death in AD 14. He is known for being the founder of the Roman Pr ...

, "dying quickly and without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished for." The word "euthanasia" was first used in a medical context by

Francis Bacon Francis Bacon, 1st Viscount St Alban (; 22 January 1561 – 9 April 1626), also known as Lord Verulam, was an English philosopher and statesman who served as Attorney General and Lord Chancellor of England. Bacon led the advancement of both ...

in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body." Bacon referred to an "outward euthanasia"—the term "outward" he used to distinguish from a spiritual concept—the euthanasia "which regards the preparation of the soul." In current usage, euthanasia has been defined as the "painless inducement of a quick death". However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional. Another approach incorporates the notion of suffering into the definition. The definition offered by the

Oxford English Dictionary The ''Oxford English Dictionary'' (''OED'') is the first and foundational historical dictionary of the English language, published by Oxford University Press (OUP). It traces the historical development of the English language, providing a co ...

incorporates suffering as a necessary condition, with "the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma", This approach is included in Marvin Khol and Paul Kurtz's definition of it as "a mode or act of inducing or permitting death painlessly as a relief from suffering". Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as

Tom Beauchamp Tom Lamar Beauchamp (born 1939) is an American philosopher specializing in the work of David Hume, moral philosophy, bioethics, and animal ethics. He is Professor Emeritus of Philosophy at Georgetown University, where he was Senior Research Schola ...

and Arnold Davidson have argued that doing so would constitute "murder simpliciter" rather than euthanasia. The third element incorporated into many definitions is that of intentionality – the death must be intended, rather than being accidental, and the intent of the action must be a "merciful death". Michael Wreen argued that "the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned." Similarly, Heather Draper speaks to the importance of motive, arguing that "the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end." Definitions such as that offered by the

Select committee on Medical Ethics take this path, where euthanasia is defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering." Beauchamp and Davidson also highlight Baruch Brody's "an act of euthanasia is one in which one person ... (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed". Draper argued that any definition of euthanasia must incorporate four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Based on this, she offered a definition incorporating those elements, stating that euthanasia "must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies." Prior to Draper, Beauchamp and Davidson had also offered a definition that includes these elements. Their definition specifically discounts

fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal dev ...

es to distinguish between abortions and euthanasia: Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition: Wreen also considered a seventh requirement: "(7) The good specified in (6) is, or at least includes, the avoidance of evil", although as Wreen noted in the paper, he was not convinced that the restriction was required. In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject's " right to life". In response, Wreen argued that euthanasia has to be voluntary, and that "involuntary euthanasia is, as such, a great wrong". Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: "Medicalized killing of a person without the person's consent, whether nonvoluntary (where the person is unable to consent) or involuntary (against the person's will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only." Although the EPAC Ethics Task Force argued that both non-voluntary and

involuntary euthanasia Involuntary euthanasia occurs when euthanasia is performed on a person who would be able to provide informed consent, but does not, either because they do not want to die, or because they were not asked. Involuntary euthanasia is contrasted with ...

could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.

Classification

Euthanasia may be classified into three types, according to whether a person gives informed consent: voluntary, non-voluntary and involuntary. There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient's circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Wreen, consent on the part of the patient was not considered one of their criteria, although it may have been required to justify euthanasia. However, others see consent as essential.

Voluntary euthanasia

Voluntary euthanasia Voluntary euthanasia (VE) is the ending of a person's life at their request in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in recent years. Some forms of ...

is conducted with the consent of the patient. Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. Passive voluntary euthanasia is legal throughout the US per '' Cruzan v. Director, Missouri Department of Health''. When the patient brings about their own death with the assistance of a physician, the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont.

Non-voluntary euthanasia

Non-voluntary euthanasia Non-voluntary euthanasia is euthanasia conducted when the explicit consent of the individual concerned is unavailable, such as when the person is in a persistent vegetative state, or in the case of young children. It contrasts with ''involunt ...

is conducted when the consent of the patient is unavailable. Examples include

child euthanasia Child euthanasia is a form of euthanasia that is applied to children who are gravely ill or have significant birth defects. In 2005, the Netherlands became the first country to decriminalize euthanasia for infants with hopeless prognosis and int ...

, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol. Passive forms of non-voluntary euthanasia (i.e. withholding treatment) are legal in a number of countries under specified conditions.

Involuntary euthanasia

Involuntary euthanasia Involuntary euthanasia occurs when euthanasia is performed on a person who would be able to provide informed consent, but does not, either because they do not want to die, or because they were not asked. Involuntary euthanasia is contrasted with ...

is conducted against the will of the patient.

Passive and active euthanasia

Voluntary, non-voluntary and involuntary types can be further divided into passive or active variants. Passive euthanasia entails the withholding treatment necessary for the continuance of life. Active euthanasia entails the use of lethal substances or forces (such as administering a lethal injection), and is more controversial. While some authors consider these terms to be misleading and unhelpful, they are nonetheless commonly used. In some cases, such as the administration of increasingly necessary, but toxic doses of

painkillers An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It i ...

, there is a debate whether or not to regard the practice as active or passive.

History

Euthanasia was practiced in

Ancient Greece Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean Sea, Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of Classical Antiquity, classical antiquity ( AD 600), th ...

and

Rome , established_title = Founded , established_date = 753 BC , founder = King Romulus (legendary) , image_map = Map of comune of Rome (metropolitan city of Capital Rome, region Lazio, Italy).svg , map_caption ...

: for example, hemlock was employed as a means of hastening death on the island of

Kea The kea (; ; ''Nestor notabilis'') is a species of large parrot in the family Nestoridae found in the forested and alpine regions of the South Island of New Zealand. About long, it is mostly olive-green with a brilliant orange under its wing ...

, a technique also employed in Massalia. Euthanasia, in the sense of the deliberate hastening of a person's death, was supported by

Socrates Socrates (; ; –399 BC) was a Greek philosopher from Athens who is credited as the founder of Western philosophy and among the first moral philosophers of the ethical tradition of thought. An enigmatic figure, Socrates authored no te ...

Plato Plato ( ; grc-gre, Πλάτων ; 428/427 or 424/423 – 348/347 BC) was a Greek philosopher born in Athens during the Classical period in Ancient Greece. He founded the Platonist school of thought and the Academy, the first institution ...

and Seneca the Elder in the ancient world, although

Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...

appears to have spoken against the practice, writing "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death" (noting there is some debate in the literature about whether or not this was intended to encompass euthanasia).

Early modern period

The term ''euthanasia'', in the earlier sense of supporting someone as they died, was used for the first time by

. In his work, ''Euthanasia medica'', he chose this ancient Greek word and, in doing so, distinguished between ''euthanasia interior'', the preparation of the soul for death, and ''euthanasia exterior'', which was intended to make the end of life easier and painless, in exceptional circumstances by shortening life. That the ancient meaning of an easy death came to the fore again in the early modern period can be seen from its definition in the 18th century ''Zedlers Universallexikon'':

Euthanasia: a very gentle and quiet death, which happens without painful convulsions. The word comes from ευ, ''bene'', well, and θανατος, ''mors'', death.

The concept of euthanasia in the sense of alleviating the process of death goes back to the medical historian, Karl Friedrich Heinrich Marx, who drew on Bacon's philosophical ideas. According to Marx, a doctor had a moral duty to ease the suffering of death through encouragement, support and mitigation using medication. Such an "alleviation of death" reflected the contemporary ''

zeitgeist In 18th- and 19th-century German philosophy, a ''Zeitgeist'' () ("spirit of the age") is an invisible agent, force or Daemon dominating the characteristics of a given epoch in world history. Now, the term is usually associated with Georg W. ...

'', but was brought into the medical canon of responsibility for the first time by Marx. Marx also stressed the distinction between the theological care of the soul of sick people from the physical care and medical treatment by doctors. Euthanasia in its modern sense has always been strongly opposed in the Judeo-Christian tradition.

Thomas Aquinas Thomas Aquinas, OP (; it, Tommaso d'Aquino, lit=Thomas of Aquino; 1225 – 7 March 1274) was an Italian Dominican friar and priest who was an influential philosopher, theologian and jurist in the tradition of scholasticism; he is known wit ...

opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival, as did Francois Ranchin (1565–1641), a French physician and professor of medicine, and Michael Boudewijns (1601–1681), a physician and teacher. Other voices argued for euthanasia, such as John Donne in 1624, and euthanasia continued to be practised. In 1678, the publication of Caspar Questel's ''De pulvinari morientibus non-subtrahend'', ("''On the pillow of which the dying should not be deprived''"), initiated debate on the topic. Questel described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was "against the laws of God and Nature". This view was shared by others who followed, including Philipp Jakob Spener, Veit Riedlin and

Johann Georg Krünitz Johann Georg Krünitz (20 March 1728 – 20 December 1796) was a German encyclopedist who started the 242-volume Oekonomische Encyklopädie and during his lifetime managed to complete its first 72 volumes. Life Krünitz was born in Berlin as th ...

. Despite opposition, euthanasia continued to be practised, involving techniques such as bleeding, suffocation, and removing people from their beds to be placed on the cold ground. Suicide and euthanasia became more accepted during the

Age of Enlightenment The Age of Enlightenment or the Enlightenment; german: Aufklärung, "Enlightenment"; it, L'Illuminismo, "Enlightenment"; pl, Oświecenie, "Enlightenment"; pt, Iluminismo, "Enlightenment"; es, La Ilustración, "Enlightenment" was an intel ...

Thomas More Sir Thomas More (7 February 1478 – 6 July 1535), venerated in the Catholic Church as Saint Thomas More, was an English lawyer, judge, social philosopher, author, statesman, and noted Renaissance humanist. He also served Henry VIII as Lord ...

wrote of euthanasia in ''

Utopia A utopia ( ) typically describes an imaginary community or society that possesses highly desirable or nearly perfect qualities for its members. It was coined by Sir Thomas More for his 1516 book '' Utopia'', describing a fictional island societ ...

'', although it is not clear if More was intending to endorse the practice. Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, as it is used in cases of honor, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.

Beginnings of the contemporary euthanasia debate

In the mid-1800s, the use of

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...

to treat "the pains of death" emerged, with

John Warren John Warren may refer to: Medicine * John Warren (surgeon) (1753–1815), American surgeon during the Revolutionary War * John Collins Warren (1778–1856), American surgeon * John Collins Warren Jr. (1842–1927), American surgeon, son of John C ...

recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a schoolteacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club in England, which was subsequently published in a one-off publication entitled ''Essays of the Birmingham Speculative Club'', the collected works of a number of members of an amateur philosophical society. Williams' proposal was to use chloroform to deliberately hasten the death of terminally ill patients: The essay was favourably reviewed in '' The Saturday Review'', but an editorial against the essay appeared in ''

The Spectator ''The Spectator'' is a weekly British magazine on politics, culture, and current affairs. It was first published in July 1828, making it the oldest surviving weekly magazine in the world. It is owned by Frederick Barclay, who also owns ''The ...

''. From there it proved to be influential, and other writers came out in support of such views: Lionel Tollemache wrote in favour of euthanasia, as did Annie Besant, the essayist and reformer who later became involved with the

National Secular Society The National Secular Society (NSS) is a British campaigning organisation that promotes secularism and the separation of church and state. It holds that no one should gain advantage or disadvantage because of their religion or lack of it. It was ...

, considering it a duty to society to "die voluntarily and painlessly" when one reaches the point of becoming a 'burden'. ''Popular Science'' analyzed the issue in May 1873, assessing both sides of the argument. Kemp notes that at the time, medical doctors did not participate in the discussion; it was "essentially a philosophical enterprise ... tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life".

Early euthanasia movement in the United States

The rise of the euthanasia movement in the United States coincided with the so-called

Gilded Age In United States history, the Gilded Age was an era extending roughly from 1877 to 1900, which was sandwiched between the Reconstruction era and the Progressive Era. It was a time of rapid economic growth, especially in the Northern and Wes ...

, a time of social and technological change that encompassed an "individualistic conservatism that praised laissez-faire economics,

scientific method The scientific method is an empirical method for acquiring knowledge that has characterized the development of science since at least the 17th century (with notable practitioners in previous centuries; see the article history of scientific ...

, and

rationalism In philosophy, rationalism is the epistemological view that "regards reason as the chief source and test of knowledge" or "any view appealing to reason as a source of knowledge or justification".Lacey, A.R. (1996), ''A Dictionary of Philosophy ...

", along with major depressions, industrialisation and conflict between corporations and labour unions. It was also the period in which the modern hospital system was developed, which has been seen as a factor in the emergence of the euthanasia debate. Robert Ingersoll argued for euthanasia, stating in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. Felix Adler offered a similar approach, although, unlike Ingersoll, Adler did not reject religion. In fact, he argued from an

Ethical Culture The Ethical movement, also referred to as the Ethical Culture movement, Ethical Humanism or simply Ethical Culture, is an ethical, educational, and religious movement that is usually traced back to Felix Adler (1851–1933).

framework. In 1891, Adler argued that those suffering from overwhelming pain should have the right to commit suicide, and, furthermore, that it should be permissible for a doctor to assist – thus making Adler the first "prominent American" to argue for suicide in cases where people were suffering from chronic illness. Both Ingersoll and Adler argued for voluntary euthanasia of adults suffering from terminal ailments. Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler enabled others to stretch the definition of euthanasia. The first attempt to legalise euthanasia took place in the United States, when Henry Hunt introduced legislation into the

General Assembly A general assembly or general meeting is a meeting of all the members of an organization or shareholders of a company. Specific examples of general assembly include: Churches * General Assembly (presbyterian church), the highest court of presb ...

Ohio Ohio () is a state in the Midwestern region of the United States. Of the fifty U.S. states, it is the 34th-largest by area, and with a population of nearly 11.8 million, is the seventh-most populous and tenth-most densely populated. The sta ...

in 1906. Hunt did so at the behest of

Anna Sophina Hall Anna Sophina Hall (August 7, 1857 – December 17, 1924) was a leading figure in the movement to legalize euthanasia in the United States during the first decade of the 20th century. Early life Anna Sophina Hall was born to Charles F ...

, a wealthy heiress who was a major figure in the euthanasia movement during the early 20th century in the United States. Hall had watched her mother die after an extended battle with liver cancer, and had dedicated herself to ensuring that others would not have to endure the same suffering. Towards this end she engaged in an extensive letter writing campaign, recruited Lurana Sheldon and Maud Ballington Booth, and organised a debate on euthanasia at the annual meeting of the

American Humane Association American Humane (AH) is an organization founded in 1877 committed to ensuring the safety, welfare, and well-being of animals. It was previously called the International Humane Association before changing its name in 1878. In 1940, it became t ...

in 1905 – described by Jacob Appel as the first significant public debate on the topic in the 20th century. Hunt's bill called for the administration of an

anesthetic An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two ...

to bring about a patient's death, so long as the person is of lawful age and sound mind, and was suffering from a fatal injury, an irrevocable illness, or great physical pain. It also required that the case be heard by a physician, required informed consent in front of three witnesses, and required the attendance of three physicians who had to agree that the patient's recovery was impossible. A motion to reject the bill outright was voted down, but the bill failed to pass, 79 to 23. Along with the Ohio euthanasia proposal, in 1906 Assemblyman Ross Gregory introduced a proposal to permit euthanasia to the

Iowa legislature The Iowa General Assembly is the legislative branch of the state government of Iowa. Like the federal United States Congress, the General Assembly is a bicameral body, composed of the upper house Iowa Senate and the lower Iowa House of Repr ...

. However, the Iowa legislation was broader in scope than that offered in Ohio. It allowed for the death of any person of at least ten years of age who suffered from an ailment that would prove fatal and cause extreme pain, should they be of sound mind and express a desire to artificially hasten their death. In addition, it allowed for infants to be euthanised if they were sufficiently deformed, and permitted guardians to request euthanasia on behalf of their wards. The proposed legislation also imposed penalties on physicians who refused to perform euthanasia when requested: a 6–12-month prison term and a fine of between $200 and $1,000. The proposal proved to be controversial. It engendered considerable debate and failed to pass, having been withdrawn from consideration after being passed to the Committee on Public Health. After 1906 the euthanasia debate reduced in intensity, resurfacing periodically, but not returning to the same level of debate until the 1930s in the United Kingdom. Euthanasia opponent

Ian Dowbiggin Ian Robert Dowbiggin (born 1952) is a professor in the Department of History at the University of Prince Edward Island and writer on the history of medicine, in particular topics such as euthanasia and physician-assisted suicide. His research and ...

argues that the early membership of the

Euthanasia Society of America The Euthanasia Society of America was founded in 1938 to promote euthanasia. It was co-founded by Charles Francis Potter and Ann Mitchell. Alice Naumberg (mother of Ruth P. Smith) also helped to found the group. The group initially supported bo ...

(ESA) reflected how many perceived euthanasia at the time, often seeing it as a eugenics matter rather than an issue concerning individual rights. Dowbiggin argues that not every eugenist joined the ESA "solely for eugenic reasons", but he postulates that there were clear ideological connections between the eugenics and euthanasia movements.

1930s in Britain

The

Voluntary Euthanasia Legalisation Society Dignity in Dying (originally The Voluntary Euthanasia Legalisation Society) is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to hav ...

was founded in 1935 by Charles Killick Millard (now called Dignity in Dying). The movement campaigned for the legalisation of euthanasia in Great Britain. In January 1936,

King George V George V (George Frederick Ernest Albert; 3 June 1865 – 20 January 1936) was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 until his death in 1936. Born during the reign of his grandmother Qu ...

was given a fatal dose of morphine and

cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Ameri ...

to hasten his death. At the time he was suffering from cardio-respiratory failure, and the decision to end his life was made by his physician, Lord Dawson. Although this event was kept a secret for over 50 years, the death of George V coincided with proposed legislation in the

to legalise euthanasia.

Nazi Euthanasia Program

Alkoven Schloss Hartheim 2005-08-18 3589

A 24 July 1939 killing of a severely disabled infant in

Nazi Germany Nazi Germany (lit. "National Socialist State"), ' (lit. "Nazi State") for short; also ' (lit. "National Socialist Germany") (officially known as the German Reich from 1933 until 1943, and the Greater German Reich from 1943 to 1945) was ...

was described in a

...
"Genocide Under the Nazis Timeline" as the first "state-sponsored euthanasia". Parties that consented to the killing included Hitler's office, the parents, and the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses.Genocide Under the Nazis Timeline: 24 July 1939
''

...
'' Accessed 23 July 2011. Quotation: "The first state-sanctioned euthanasia is carried out, after Hitler receives a petition from a child's parents, asking for the life of their severely disabled infant to be ended. This happens after the case has been considered by Hitler's office and by the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses, whose 'experts' have laid down the basis for the removal of disabled children to special 'paediatric clinics'. Here they can be either starved to death or given lethal injections. At least 5,200 infants will eventually be killed through this programme". ''

The Telegraph ''The Telegraph'', ''Daily Telegraph'', ''Sunday Telegraph'' and other variant names are popular names for newspapers. Newspapers with these titles include: Australia * ''The Telegraph'' (Adelaide), a newspaper in Adelaide, South Australia, publ ...

'' noted that the killing of the disabled infant—whose name was

Gerhard Kretschmar Gerhard Herbert Kretschmar (20 February 1939 – 25 July 1939) was a German child born with severe disabilities. After receiving a petition from the child's parents, the German Führer Adolf Hitler authorized one of his personal physicians, Karl Br ...

, born blind, with missing limbs, subject to convulsions, and reportedly "an idiot"— provided "the rationale for a secret Nazi decree that led to 'mercy killings' of almost 300,000 mentally and physically handicapped people". While Kretchmar's killing received parental consent, most of the 5,000 to 8,000 children killed afterwards were forcibly taken from their parents. The "euthanasia campaign" of mass murder gathered momentum on 14 January 1940 when the "handicapped" were killed with gas vans and at killing centres, eventually leading to the deaths of 70,000 adult Germans.Genocide Under the Nazis Timeline: 14 January 1940
''

...
'' Accessed 23 July 2011. Quotation: "The 'euthanasia campaign' gathers momentum in Germany, as six special killing centres and gas vans, under an organisation code-named T4, are used in the murder of 'handicapped' adults. Over 70,000 Germans will eventually be killed in this act of mass murder – it is the first time poison bas will be used for such a purpose". Professor Robert Jay Lifton, author of ''The Nazi Doctors'' and a leading authority on the T4 program, contrasts this program with what he considers to be a genuine euthanasia. He explains that the Nazi version of "euthanasia" was based on the work of

Adolf Jost Adolf (also spelt Adolph or Adolphe, Adolfo and when Latinised Adolphus) is a given name used in German-speaking countries, Scandinavia, the Netherlands and Flanders, France, Italy, Spain, Portugal, Latin America and to a lesser extent in vari ...

, who published ''The Right to Death'' (Das Recht auf den Tod) in 1895. Lifton writes:

Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the ''individual's'' 'right to die' or 'right to death' or 'right to his or her own death,' as the ultimate human claim. In contrast, Jost was pointing to the state's right to kill. ... Ultimately the argument was biological: 'The rights to death rethe key to the fitness of life.' The state must own death—must kill—in order to keep the social organism alive and healthy.

In modern terms, the use of "euthanasia" in the context of Action T4 is seen to be a euphemism to disguise a program of

genocide Genocide is the intentional destruction of a people—usually defined as an ethnic, national, racial, or religious group—in whole or in part. Raphael Lemkin coined the term in 1944, combining the Greek word (, "race, people") with the Lat ...

, in which people were killed on the grounds of "disabilities, religious beliefs, and discordant individual values". Compared to the discussions of euthanasia that emerged post-war, the Nazi program may have been worded in terms that appear similar to the modern use of "euthanasia", but there was no "mercy" and the patients were not necessarily terminally ill. Despite these differences, historian and euthanasia opponent

writes that "the origins of Nazi euthanasia, like those of the American euthanasia movement, predate the Third Reich and were intertwined with the history of eugenics and Social Darwinism, and with efforts to discredit traditional morality and ethics."

1949 New York State Petition for Euthanasia and Catholic opposition

On 6 January 1949, the Euthanasia Society of America presented to the

New York State Legislature The New York State Legislature consists of the two houses that act as the state legislature of the U.S. state of New York: The New York State Senate and the New York State Assembly. The Constitution of New York does not designate an officia ...

a petition to legalize euthanasia, signed by 379 leading Protestant and Jewish ministers, the largest group of religious leaders ever to have taken this stance. A similar petition had been sent to the New York Legislature in 1947, signed by approximately 1,000 New York physicians.

Roman Catholic Roman or Romans most often refers to: *Rome, the capital city of Italy * Ancient Rome, Roman civilization from 8th century BC to 5th century AD * Roman people, the people of ancient Rome *'' Epistle to the Romans'', shortened to ''Romans'', a let ...

religious leaders criticized the petition, saying that such a bill would "legalize a suicide-murder pact" and a "rationalization of the fifth commandment of God, 'Thou Shalt Not Kill.'"

The Moncton Transcript The ''Times & Transcript'' is a newspaper from Moncton, New Brunswick. It serves Greater Moncton and eastern New Brunswick. Its offices and printing facilities are located on Main Street in Downtown Moncton. The paper is published by Brunswick N ...

. "Ministers Ask Mercy Killing." 6 January 1949. The Right Reverend Robert E. McCormick stated that The petition brought tensions between the American Euthanasia Society and the Catholic Church to a head that contributed to a climate of anti-Catholic sentiment generally, regarding issues such as birth control, eugenics, and population control. However, the petition did not result in any legal changes.

Debate

Historically, the euthanasia debate has tended to focus on a number of key concerns. According to euthanasia opponent

Ezekiel Emanuel Ezekiel Jonathan "Zeke" Emanuel (born September 6, 1957) is an American oncologist, bioethicist and senior fellow at the Center for American Progress. He is the current Vice Provost for Global Initiatives at the University of Pennsylvania and chai ...

, proponents of euthanasia have presented four main arguments: a) that people have a right to self-determination, and thus should be allowed to choose their own fate; b) assisting a subject to die might be a better choice than requiring that they continue to suffer; c) the distinction between passive euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that the underlying principle–the

doctrine of double effect The principle of double effect – also known as the rule of double effect; the doctrine of double effect, often abbreviated as DDE or PDE, double-effect reasoning; or simply double effect – is a set of ethical criteria which Christian philosop ...

–is unreasonable or unsound); and d) permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia activists often point to countries like the

and

, and states like

Oregon Oregon () is a state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. T ...

, where euthanasia has been legalized, to argue that it is mostly unproblematic. Similarly, Emanuel argues that there are four major arguments presented by opponents of euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment, combined with the use of effective pain relief, are available; c) the distinction between active and passive euthanasia is morally significant; and d) legalising euthanasia will place society on a

slippery slope A slippery slope argument (SSA), in logic, critical thinking, political rhetoric, and caselaw, is an argument in which a party asserts that a relatively small first step leads to a chain of related events culminating in some significant (usually ...

, which will lead to unacceptable consequences. In fact, in

, in 2013, pain wasn't one of the top five reasons people sought euthanasia. Top reasons were a loss of dignity, and a fear of burdening others. In the United States in 2013, 47% nationwide supported doctor-assisted suicide. This included 32% of Latinos, 29% of African-Americans, and almost nobody with disabilities. A 2015 Populus poll in the United Kingdom found broad public support for assisted dying. 82% of people supported the introduction of assisted dying laws, including 86% of people with disabilities. An alternative approach to the question is seen in the hospice movement which promotes

palliative care Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...

for the dying and terminally ill. This has pioneered the use of pain-relieving drugs in a holistic atmosphere in which the patient's spiritual care ranks alongside physical care. It 'intends neither to hasten nor postpone death'.

Legal status

West's ''Encyclopedia of American Law'' states that "a 'mercy killing' or euthanasia is generally considered to be a criminal homicide" and is normally used as a synonym of homicide committed at a request made by the patient. The judicial sense of the term " homicide" includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering.Carmen Tomás Y Valiente, La regulación de la eutanasia en Holanda, Anuario de Derecho Penal y Ciencias Penales – Núm. L, Enero 1997 Not all homicide is unlawful. Two designations of homicide that carry no criminal punishment are justifiable and excusable homicide. In most countries this is not the status of euthanasia. The term "euthanasia" is usually confined to the active variety; the University of Washington website states that "euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life".

Physician-assisted suicide Assisted suicide is suicide undertaken with the aid of another person. The term usually refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the p ...

is thus not classified as euthanasia by the US State of Oregon, where it is legal under the

Oregon Death with Dignity Act Measure 16 of 1994 established the U.S. state of Oregon's Death with Dignity Act (ORS 127.800–995), which legalizes medical aid in dying (commonly referred to as physician-assisted suicide) with certain restrictions. Passage of this initiativ ...

, and despite its name, it is not legally classified as suicide either. Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal. The use of pain medication to relieve suffering, even if it hastens death, has been held as legal in several court decisions. Some governments around the world have legalized voluntary euthanasia but most commonly it is still considered to be criminal homicide. In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal conditions. In a historic judgment, the Supreme court of India legalized passive euthanasia. The apex court remarked in the judgment that the Constitution of India values liberty, dignity, autonomy, and privacy. A bench headed by Chief Justice Dipak Misra delivered a unanimous judgment.

Health professionals' sentiment

A 2010 survey in the United States of more than 10,000 physicians found that 16.3% of physicians would consider halting life-sustaining therapy because the family demanded it, even if they believed that it was premature. Approximately 54.5% would not, and the remaining 29.2% responded "it depends". The study also found that 45.8% of physicians agreed that physician-assisted suicide should be allowed in some cases; 40.7% did not, and the remaining 13.5% felt it depended. In the United Kingdom, the assisted dying campaign group

Dignity in Dying Dignity in Dying (originally The Voluntary Euthanasia Legalisation Society) is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to hav ...

cites research in which 54% of general practitioners support or are neutral towards a law change on assisted dying. Similarly, a 2017 Doctors.net.uk poll reported in the British Medical Journal stated that 55% of doctors believe assisted dying, in defined circumstances, should be legalised in the UK.

Religious views

Christianity

Broadly against

The Roman Catholic Church condemns euthanasia and assisted suicide as morally wrong. It states that, "intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator". Because of this, the practice is unacceptable within the Church. The

Orthodox Church in America The Orthodox Church in America (OCA) is an Eastern Orthodox Christian church based in North America. The OCA is partly recognized as autocephalous and consists of more than 700 parishes, missions, communities, monasteries and institutions ...

, along with other Eastern Orthodox Churches, also opposes euthanasia stating that "euthanasia is the deliberate cessation of human life, and, as such, must be condemned as murder." Many non-Catholic churches in the United States take a stance against euthanasia. Among Protestant denominations, the Episcopal Church passed a resolution in 1991 opposing euthanasia and assisted suicide stating that it is "morally wrong and unacceptable to take a human life to relieve the suffering caused by incurable illnesses." Protestant and other non-Catholic churches which oppose euthanasia include: * Assemblies of God *

The Church of Jesus Christ of Latter-day Saints The Church of Jesus Christ of Latter-day Saints, informally known as the LDS Church or Mormon Church, is a nontrinitarian Christian church that considers itself to be the restoration of the original church founded by Jesus Christ. The ch ...

Church of the Nazarene The Church of the Nazarene is an evangelicalism, evangelical Christian denomination that emerged in North America from the 19th-century Wesleyan-Holiness movement within Methodism. It is headquartered in Lenexa, Kansas, Lenexa within Johnson Cou ...

* Evangelical Lutheran Church in America *

Presbyterian Church in America The Presbyterian Church in America (PCA) is the second-largest Presbyterian church body, behind the Presbyterian Church (USA), and the largest conservative Calvinist denomination in the United States. The PCA is Reformed in theology and presb ...

* Lutheran Church–Missouri Synod * Reformed Church in America * Salvation Army * Seventh-day Adventist Church * Southern Baptist Convention *

United Methodist Church The United Methodist Church (UMC) is a worldwide mainline Protestant denomination based in the United States, and a major part of Methodism. In the 19th century, its main predecessor, the Methodist Episcopal Church, was a leader in evangelic ...

Partially in favor of

The

Church of England The Church of England (C of E) is the established Christian church in England and the mother church of the international Anglican Communion. It traces its history to the Christian church recorded as existing in the Roman province of Britai ...

accepts passive euthanasia under some circumstances, but is strongly against active euthanasia, and has led opposition against recent attempts to legalise it. The

United Church of Canada The United Church of Canada (french: link=no, Église unie du Canada) is a mainline Protestant denomination that is the largest Protestant Christian denomination in Canada and the second largest Canadian Christian denomination after the Catholi ...

accepts passive euthanasia under some circumstances, but is in general against active euthanasia, with growing acceptance now that active euthanasia has been partly legalised in Canada.

Islam

Euthanasia is a complex issue in Islamic theology; however, in general it is considered contrary to

Islamic law Sharia (; ar, شريعة, sharīʿa ) is a body of religious law that forms a part of the Islamic tradition. It is derived from the religious precepts of Islam and is based on the sacred scriptures of Islam, particularly the Quran and the ...

and holy texts. Among interpretations of the

Qur'an The Quran (, ; Standard Arabic: , Quranic Arabic: , , 'the recitation'), also romanized Qur'an or Koran, is the central religious text of Islam, believed by Muslims to be a revelation from God. It is organized in 114 chapters (pl.: , s ...

and

Hadith Ḥadīth ( or ; ar, حديث, , , , , , , literally "talk" or "discourse") or Athar ( ar, أثر, , literally "remnant"/"effect") refers to what the majority of Muslims believe to be a record of the words, actions, and the silent approva ...

, the early termination of life is a crime, be it by suicide or helping one commit suicide. The various positions on the cessation of medical treatment are mixed and considered a different class of action than direct termination of life, especially if the patient is suffering. Suicide and euthanasia are both crimes in almost all

Muslim majority countries The terms Muslim world and Islamic world commonly refer to the Islamic community, which is also known as the Ummah. This consists of all those who adhere to the religious beliefs and laws of Islam or to societies in which Islam is practiced. In ...

Judaism

There is much debate on the topic of euthanasia in Judaic theology, ethics, and general opinion (especially in Israel and the United States). Passive euthanasia was declared legal by Israel's highest court under certain conditions and has reached some level of acceptance. Active euthanasia remains illegal, however the topic is actively under debate with no clear consensus through legal, ethical, theological and spiritual perspectives.Death and Euthanasia in Jewish Law: Essays and Responses. W Jacob and M. Zemer. Pitsburg and Tel Aviv. Rodef Shalom Press. 1995

References

External links

* * *
Physician assisted death
from ''

The Hastings Center The Hastings Center is an independent, nonpartisan bioethics research institute and think tank based in Garrison, New York. It was instrumental in establishing the field of bioethics and is among the most prestigious bioethics and health policy ...

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