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Muhammad Waseem Khan
Ms Bioethics Aga Khan University Hospital Karachi Pakistan
Lecturer Baluchistan University of Information Technology Engineering & Management Sciences Quetta Pakistan
Keywords: Autonomy, Euthanasia, Ethical, Proponents, Withhold.


Euthanasia and physician assisted suicide is considered to be in conflict with basic ethical principles of autonomy, justice, beneficence, non-maleficence and dignity in medical practice. Euthanasia being allowed in few states has raised certain ethical questions which are due to be given importance and need to be answered. Proponents of euthanasia argue in favor of passive euthanasia to be allowed and they consider it to be legal and permissible and need of the day. They tend to forget the importance of advancement being made
in the field of medical sciences and medical technology. Theses advancements are deemed to be used for the benefit of human beings rather than using for taking human beings most precious property.


The term euthanasia refers to the practice of ending some one’s life in a painless manner. Euthanasia is precisely defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering". The term euthanasia is derived from the Greek terms eu meaning good and thanatos meaning death
Euthanasia generally classified as active or passive, and classified as either voluntary or involuntary. In active euthanasia patient is served to death by injecting with poison, providing overdose medicine etc. In passive euthanasia patient is withdrawn of any medical treatment or facility which causes patient death.
The difference between active and passive euthanasia is that, in active euthanasia, something is done to end the patient's life; in passive euthanasia, something is not done that would have saved the patient’s life. Voluntary euthanasia and involuntary euthanasia is when the act of ending life is performed with and without the consent knowledge and request of patient respectively. In assisted suicide as the name describes, a physician provides a patient with the means to end his own life, but the doctor does not administer it.


It is commonly argued that passive euthanasia can be allowed as legal and permissible but in practice it can hardly be differentiated from active form of killing. The supporters of passive euthanasia argue that since in passive euthanasia the physician do nothing or some time just remove the useless and burdensome life support system that is why passive euthanasia is allowed. But, it is like about the child who says to his teacher, "Do you think it is right to punish someone for something that he did not do?" the teacher replies "Why, of course not,” the child says "Good,", "Because I did not do my homework”
The most common method of euthanasia in the United States today is withholding food and fluids. In other words, the patient is starved to death and it is classified as passive euthanasia. But we have many laws that penalize people for what they did not do as to decide not to pay income taxes, or not to send children to school, or not to obey rules and regulations and many many more. [3]
The arguments in favor of passive euthanasia is to relieve unbearable pain may not be valid and passive euthanasia should not be allowed due to unbearable pain to relieve the suffering of the patient as the justification for this doing so is that the patient is in terrible agony, and since he is going to die anyway, it would be wrong to prolong his suffering needlessly. But if one imply to withhold treatment, it may take the patient longer to die, and so he may suffer more than he would if noire direct action were taken and a lethal injection given. This fact provides strong reason for thinking that, once the initial decision not to prolong his agony has been made active euthanasia is actually preferable to passive euthanasia.
It is argued that not to resuscitate a 500 gram baby? Do the high mortality and the risk for disability make this unworthy? As in the last few years there has been major progress in the field of biomedical sciences and particularly in the field of neonatal care. Nowadays many babies can survive who would have died some years ago in the 80 the survival limit was about 30 weeks. Arguments made by those in favor of the legalization of physician-assisted suicide and euthanasia often rely upon the idea of the quality of life. This idea states that an individual’s life is not valuable as an intrinsic good, but is only good based upon the things which it allows us to do. It thus allows the argument that it is morally permissible to kill individuals whose lives have fallen below an acceptable ‘quality of life’.” When we say “quality of life” we should mean “acceptance of life”. But is that measurable? Who is going to decide that quality of life? And how? And is it right to measure it by proxy? We cannot put ourselves in the baby’s shoes without confusing life acceptance (what the baby feels) with life acceptability.
Proponents of euthanasia in favor argue that euthanasia should be allowed due to unbearable pain but what is unbearable to some people, is good to others, nowadays life is “unacceptable” in western countries without tap water or electricity in the houses, but this discomfort was commonly accepted only few years ago; life can be unacceptable after a heartbreak, but many people accept not to be married. A sure prognosis is impossible and it is not human to kill people because they are disabled, neither is pain a good reason, and pain is curable, non acceptance of life is often reversible or only supposed.
Advocates of euthanasia also argue that the process of death that is how we die is just a private matter. But it is not possible because each person’s death necessarily involves others as euthanasia is an act that requires two people to make it possible, including healthcare professionals, and societal values and symbols.
Proponents of euthanasia argue that euthanasia allows terminally ill people to die with dignity and without pain and state that society should permit people to opt for euthanasia if they so wish. Proponents also state that individuals should be free to dictate the time and place of their own death. They argue that forcing people to live against their wishes violates personal freedoms and human rights and that it is immoral to compel people to continue to live with unbearable pain and suffering. But who says that life is an individual’s property rather life is a gift from its creator (God) and only God has the power to take it away. As individuals do not decide when and how they are born, therefore, they should not be allowed to decide how and when they die. Allowing euthanasia for this purpose could lead to an abuse of power where people might be euthanized when they do not actually wish to die.
Proponents of euthanasia argue that the decision to end a life of pain and suffering is an expression of one’s right to personal autonomy, which should be respected by one’s family, healthcare providers and society at large. But we live in an interdependent society, where one’s decisions will impact on others physically, emotionally and financially, therefore limits should be placed on personal autonomy.
It is argued for euthanasia that it provides a way to relieve extreme pain but modern medicine has the ability to control pain. A person who seeks to kill him or herself to avoid pain does not need legalized assisted suicide but a doctor better trained in alleviating the pain.
It is commonly argued that euthanasia provides a way of relief when a person’s quality of life is low, Instead of relief and insuring quality of life Euthanasia devalues human life as the poor’s, handicapped individuals and aged people will be considered of low quality and they all will be killed to insure their quality of life and to provide relief to them. People who argue in favor of euthanasia often say that it is already considered permissible to take human life under some circumstances such as self defense, but they miss the point that when one kills for self defense they are saving innocent life either their own or someone else. With euthanasia no one’s life is being saved and life is only taken.


As secular ethics is based on freethinking, logic and reasoning by human beings, only these proponents though may not be contrasting to religion but they are not acceptable every time and in every situation. The idea of secular ethics may be valid for identifying problems but secular ethics fails to solve and answer many problems. Every time human beings pass any judgment it can be challenged and in fact every time it is challenged, which creates problems rather than solving the issue and only scriptural decisions and supernatural revelation is perfect which cannot be challenged by any other.


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2. Assisted suicide & death with dignity: past, present & Future (accessed 12 Feb 2010).
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4. Rachels J. Active and Passive Euthanasia. NEJM 1975 Jan; 292. (accessed 15 February 2011).
5. Bellieni C. Quality of life is a misnomer: the case for neonatal euthanasia. JM&P 2006 Sep; 4(3). (accessed 12 Jun 2011).
6. Somerville MA. Death talk: debating euthanasia and physician-assisted suicide in Australia. MJA 2003; 178. (accessed 3 Sep 2011).
7. Euthanasia: your body, your death, your choice? (accessed at February 08, 2010).
8. Euthanasia pros and cons (accessed at February 10, 2010).
9. Arguments against Euthanasia. (accessed at February 17, 2010).
10. Leff AA. Unspeakable ethics, Unnatural Law. DLJ 1979 Dec; 1229-1250. (accessed 08 August 2011).


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