Euthanasia - A Right to Die with Dignity

Assisted dying can encompass what's been called "physician-assisted death," wherein a doctor provides the lethal means for a patient to end their own life, and "voluntary euthanasia" wherein a physician performs an intervention to carry out the patient's request to end their life.

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To better understand the debate on euthanasia, we must draw a distinction between four main types of euthanasia, i.e.: active, passive, indirect and assisted suicide.

Passive euthanasia entails termination or withholding of medical treatment necessary to sustaining life. This can happen when doctors switch off machines and let the disease progress, which would inevitably lead to death or not provide a sick person with a necessary surgery. Indirect euthanasia means giving a patient such a treatment, which would reduce the pain and suffering at the cost of shortening life.

Active euthanasia occurs when doctors or other people intentionally give a person a lethal substance, which cause death.

Assisted suicide, on the contrary, is providing a person wishing to end life with necessary means, usually sedatives, but the act of using them remains with the one wishing to die. 

Such a distinction also indicates another crucial factor, i.e. it stands in direct relationship with a right to life which is protected by numerous international treaties on human rights as well as constitutions. There are 3 obligations a state has to fulfil when it comes to human rights: obligation to respect, protect and prevent. Ensuring a right to life - for instance as spelled out in Art. 2 of European Convention on Human Rights (ECHR) and Art. 6 International Covenant on Civil and Political Rights (ICCPR), clearly falls under the duty to prevent (the violation of human rights by third parties) and duty to protect (a right to life itself).

Furthermore, euthanasia also deals with the duty to respect. The duty to respect requires States to refrain from infringing on human rights. A lot of people who cannot be easily granted with a permit, namely a medical prescription, to end life try to appeal the court’s decision in the European Court of Human Rights.

They refer to Article 8 in ECHR (corresponds with Art. 17 in ICCPR) which guarantees a right to respect for private and family life, correspondence and home which is also sometimes called a right to identity, self-determination and physical and psychological integrity. This Article is mainly a negative obligation of States meaning they should not interfere with the enjoyment of the right unless it is in accordance with the law, in pursuit of a legitimate aim, and necessary in a democratic society (Art. 8.2 ECHR).

With reference to Article 8, a person has also a right to determine when to end his or her life. Yet, it is Article 2 (a right to life) which is the main sticking point. It is also an absolute right (non-derogable) and essentially means it is the State’s responsibility to take up all measures to ensure this right (positive obligation).

Fully legal

The Netherlands, Belgium, Luxembourg, New Zealand and Colombia are among those that have legalized voluntary euthanasia. Several U.S. states have enacted "death with dignity" laws that allow a physician to prescribe a lethal medication which the patient administers him or herself.

- The Netherlands has legalised active and direct euthanasia since April 2002. Requested administration of a drug in lethal doses is authorised if patients make the request while lucid.

They must also be experiencing unbearable suffering from a condition diagnosed as incurable by at least two doctors.

The Netherlands has also authorised euthanasia for children younger than 12 under strict conditions.

- Belgium lifted restrictions on euthanasia in September 2002 for patients facing constant, unbearable and untreatable physical or psychological suffering.

They must be aged 18 or over and request termination of life in a voluntary, deliberated and repeated manner free from coercion.

In February 2014, Belgium became the first country to authorise children to request euthanasia if they suffer a terminal disease and understand the consequences of the act.

- In Luxembourg, a text legalising euthanasia in certain terminal cases was approved in March 2009. It excludes minors.

-New Zealanders have voted to allow assisted dying for the terminally ill in October 2020.

With most votes counted, New Zealanders emphatically endorsed the right to assisted dying, with 65% saying "Yes."

The End of Life Choice Act allows terminally ill adults with less than six months to live and enduring "unbearable suffering" the opportunity to choose assisted dying if approved by two doctors.

Mai Nguyen