Euthanasia as seen by Law, Morality and Religion

The terms meaning the killing of human beings, for their own good or that of others, have changed out of all recognition since the ancient Greeks coined the term “eu thanatos” meaning “a good death.”[2] Euthanasia, which is generally defined as the purposeful killing of a person for their benefit, provokes a number of moral, legal and religious questions. The questions and the contradictory arguments that arise largely depend on the types of euthanasia: active and passive. Ambiguous difference between active and passive euthanasia requires analytical consideration. The conventional doctrine is that there is such an important moral and religious difference between the two that, although the latter is sometimes permissible, the former is always forbidden. The overall purpose of this paper is to have an in depth look into the religious norms, legal regulations and moral principles concerning the issue of euthanasia and in the example of euthanasia find the one that suits society, the one that does not leave aside the people that are vulnerable to any kind of changes and the one that eliminates opportunities for abuse of power by officials, religious leaders and doctors.

Throughout the history of the humanity there have been so many various beliefs and each one had their own principals and norms regarding the end of life. Taking away the life of a person, no matter how hopeless the situation is, is believed to be the greatest sin in most religions, whilst some of them openly accept and even encourage this practice. The sources of religious principles, in the usual course of events, prohibit intentional termination of the life of a human being, while leaving various loopholes to practice euthanasia. When considering euthanasia from religious position; it is also vital to note that in contrast to countries which have secular governments in most Islamic countries the laws and regulations regarding such issues as euthanasia are founded on Islamic Views. In most beliefs, including Islam, the life of a human being is sacred and no one has the right to take it away except in the cases specified by Shari’ a and the law [3]. As stated in Holy Quran: “When their time comes they cannot delay it for a single hour nor can they bring it forward by a single hour.”[4] This piece of direction (sur’a) was received and written by Muhammad (Peace be upon him), the prophet of Muslims, as if 14 centuries ago it was already known that “bringing the death time forward” would be the issue of our times. Buddhists, in their turn, oppose the idea of euthanasia taking more complex position that willful termination of someone’s life disrupts the natural sequence and thereby produces religious regression on the way to logical explanation[5]. While Buddhists admit that euthanasia is allowed on altruistic basis, the people who accepted active voluntary euthanasia (AVE) in response to selfish ambitions or fear are regarded as offenders of self harm[6]. Not all the beliefs regard euthanasia as prohibited. Christianity, for instance, created the moral grounds for the governments of some European countries to legalize euthanasia or at least Physician-Assisted Suicide (PAS)[7] by shaping the moral norms of people for many centuries. Diverging views to those of Islamic and Buddhism can be found in the history of Ancient Greece, when people who “deemed to have disrespected the Gods by acting out of irrational whim or without virtuous intent”[8] would be ‘punished’ by severing the right hand, forbidding enactment of traditional burial rituals and many other. Adults, children and even newborns with innate or earned health or appearance problems would be considered to be in “irremediable disgrace” and “excruciating and unavoidable misfortune”[9] and given death ‘penalty’. One of the most influential intellectual figures of Ancient Greece Socrates (469–399 BC) advised his students that life was no longer worth continuing if the body or mind is “worn out or ruined”.[10]

As time passed the world learned and implemented more civilized and commonly accepted rules, norms and suitable ways of punishment. History knows the cases when innocent physicians or just ordinary people, who could not bear watching their patient or relatives undertaking unbearable pains and helped them to “go on”, being penalized to death. Some support the right for an expression of autonomy, i.e. one’s right to make independent choices without any external influences, saying that a competent adult can refuse medical treatment or ask for a lethal injection. Law, in this case, can be the strongest tool of protecting the vulnerable layers of society, who sometimes may be considered to be “better off dead”[11], as long as it is in the right hands. In light of belief that life does not necessarily mean something of a sacred, Romans were able to adopt highly individualistic approach to suicide and euthanasia, that could be implemented not only for desperately ill but also for healthy citizens. That was the Romans who first touched the issue of today’s “dying with dignity”[12] concerns. Even then Marcus Tillius Cicero (106–43 BC) pointed that “life full of pain is the thing most to be avoided” and as the “wise man” insisted that it was unnecessary to “continue to the last curtain” when “the play grows wearisome”.[13] This perspective was later legalized by the initiative of the Emperor Marcus Aurelius (AD 121–180), who assured Romans that even if the Gods existed, citizens could make independent decisions concerning the end of their lives without the fear from the Divine Powers.[14] There might be circumstances when regulations get out of control, taking immoral positions or when rules work for the sake of the powerful minority. Although it does not concern every official in the power, it is unproved fact that authority corrupts. Absolute authority corrupts absolutely.

This fact was “effectively” proved in the example of Nazi Germany, when the strictly utilitarian Tiergartenstrasse (T4) euthanasia program stressed the risk of state controlled termination. More specifically, the program aimed in termination of the nation’s so-called “useless eaters”[15] and by reducing the number of “human ballast”[16] it was objected to cut the costs for healthcare, thereby utilizing sources for more useful layers of society. The full magnitude of this immoral policy became noticeable only after the War, when it was estimated that roughly 275 000 innocent “incurable patients” were “released” from suffering[17]. Another unproved fact is that history does not teach anything, since society does the same mistakes that it has already gone through. In Netherlands, for instance, government together with the law on euthanasia adopted the law that protects physicians that are accused of incorrect practices of euthanasia. The Dutch authorities explained this loophole in law by telling that “the Criminal Code exempts doctors from criminal liability only if they report their actions and show that they have satisfied the due care criteria formulated in the Act”.[18] The stages that the Netherlands is encountering look pretty much the same as Germans did in the years of war.

By its nature, morality is an ambiguous concept that is generally based on the system of norms accepted by the majority of people[19]. Morality of euthanasia is based upon the factors that morality itself is usually affected by. Careful attention should be paid to the word the majority, since this is the concern that causes many heated and slippery slope debates. When looking at the euthanasia it is important to consider the both side of the argument. At a glance, the issue seems to affect only the minority, yet it’s the majority that has to decide what is morally right or wrong. Terminally ill people as well the elder are often qualified as people who think their life is “not worth continuing”, and mostly it does not considered whether they asked, or at least wanted, to be killed.[20] They are thought to support pro-euthanasia lobby and mostly thought to be direct beneficiaries of any kind of law allowing euthanasia.[21] It is somehow easy to make decisions if a person expressed his position about the end of his life, but totally another issue when somebody cannot express his opinion physically. Coming to the Dutch examples again, National Right to Life NEWS (25/03/97) reported that doctors usually interpret a patient’s removing a feeding tube as desire to die. The writer, however, argues that from his own experience naso-gastric tubes can be very uncomfortable and if one was unable to understand the necessity for the tube being in place; it would seem only common sense to get rid of the offending object.[22] Here lies the concept of greater good, i.e. utilitarianism[23] which aims the greatest happiness for the greatest number. In a nutshell, it puts the interest of the majority above the interest of those who even cannot express their opinion, except for removing their feeding tube. In the instance of Nazi Germany, it started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as “life is not worth” to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of that category was enlarged to the socially unproductive, the ideologically unwanted, and finally all non-Germans. In all cultures the world of medicine has had guidelines in the forms of codes, prayers, creeds, or oaths. The most popular and the one that remained and still used today is the Hippocratic Oath[24]. Based on the Hippocratic Oath, many doctors think that the idea of giving a lethal injection[25] to a patient is immoral and goes against the duties of practicing medicine. In addition to the duty to protect lives, however, a doctor has the duty to do the best for a patient, including relieving pain.[26] So, it’s clear that both sides of the ‘coin’ contravene moral obligations of the doctors towards their patients, no matter what type of euthanasia is taken as an instance.

The bottom line is clear: no matter what norms function within society, it ought to think over the issue in a multidimensional approach, considering every beneficiary and the people might get negatively affected by the decision made.

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