The right to die: what is euthanasia and where is it allowed

In 2019, 51% of our countries supported euthanasia for terminally ill people who endure unbearable suffering. We tell you what euthanasia is, where it is allowed, and whether it is necessary to introduce this practice in our country

What is euthanasia?

Euthanasia is the deprivation of a person’s life as a way to end his suffering from old age or illness. Euthanasia is a rather controversial aspect of modern medicine, but it has recently gained popularity in Western society. For the first time, the term “euthanasia” was used by Francis Bacon back in the XNUMXth century, speaking of an easy, painless and happy death. He believed that the doctor’s task in this case was to exclude the patient’s physical pain and alleviate the suffering of the patient, allowing him to leave in peace.

In the middle of the 1906th century, the debate about euthanasia resumed with a vengeance. By that time, morphine and chloroform were already actively used in medicine as painkillers, and the question arose about the ethics of their use for dying patients, whose treatment was already meaningless. The rationalism and scientific nature of the industrial revolution era also contributed to the emergence of the beginnings of modern healthcare and medicine. In America, for example, a whole movement for euthanasia arose, which actively promoted the human right to a painless and peaceful death. As early as XNUMX, the Ohio state government attempted to legalize euthanasia, but such radical ideas were not accepted by society.

The concept of euthanasia was severely distorted when the National Socialist Party came to power in Germany. Concerns about the “purity” of the German race led to the launch of the T-4 program, which, in essence, was engaged in the destruction of people with mental and physical disabilities in order to “improve” the nation. At first, this program concerned only children with special needs, but after 1940 it turned into a state-sponsored extermination of the incapacitated population.

The popularizer of euthanasia in the modern world is Jack Kevorkian, an American doctor of Armenian origin. He was a supporter of the idea of ​​death as a relief from pain for patients with incurable diseases, and in 1989 he developed a drug that allowed him to quickly and painlessly end the patient’s life. However, for its use, a criminal case was opened against Kevorkyan for the murder of a 52-year-old patient with Charcot’s disease, whom the doctor helped to die.

Today it is quite difficult to establish how many people are euthanized in the world. In Switzerland, for example, approximately 2019 people were euthanized in 1. And in the Netherlands, 200 people died by euthanasia in 2020.

Types of euthanasia

Voluntary euthanasia is the termination of a patient’s life at his request and only after his active consent. This means that the patient is in a clear mind and sober memory and is firmly convinced that he wants to die. In order to undergo voluntary euthanasia, a person usually needs to meet certain criteria, which are carefully checked by several doctors. Intractable pain syndrome, which significantly reduces the quality of life of the patient, and severe disability are the key conditions for the procedure.

Active euthanasia

Any type of euthanasia necessarily includes several consultations with a doctor, but the presence of medical personnel during the procedure is not necessary. In the case of active euthanasia, the doctor himself administers the dose of the drug to the patient, but this type of euthanasia is not allowed everywhere. In the United States and Switzerland, for example, lethal injection by medical personnel is prohibited by law. Much more common is the so-called assisted suicide, when a doctor “allows” the death of a patient by prescribing a lethal dosage of a special drug. In this case, the patient, in the presence of a doctor, takes a medicine that puts him to sleep, and then “kills” the body.

Passive euthanasia

Passive euthanasia is the refusal of the patient from maintenance therapy. By refusing treatment, the patient deliberately hastens the onset of death, and the doctor has no right to refuse him this. The term passive euthanasia is controversial, and very often one can come across the opinion that stopping treatment at the request of the patient cannot be considered euthanasia at all. This is due to the fact that the patient always has the right to refuse medical care, regardless of the opinion of doctors. However, passive euthanasia is still an acceptable term to describe situations where a patient in the terminal stage of the disease decides to refuse treatment in order to hasten death and reduce the time of their suffering.

Also, some researchers direct и indirectly euthanasia. In direct euthanasia, the doctor performs actions that directly lead to death. Indirect euthanasia means that death occurs as a result of other actions, such as the introduction of an overdose of drugs or sleeping pills.

How is euthanasia performed?

The procedure for conducting euthanasia depends on the laws of the state in which it is carried out, however, there are a number of common features that do not change from country to country. When a patient decides to end his life, he should talk to his doctor or go to a special medical facility where the procedure is possible. Then a council of doctors, psychologists and lawyers meets to decide whether the patient fits the necessary criteria for euthanasia. If the patient’s agony is really unbearable and there is no way to alleviate it, then the patient signs the necessary documents and the date of the procedure is set. As a rule, the patient is given several months to reconsider his decision. During this period, he often communicates with his doctor – he must make sure that the patient is firmly convinced of his decision to die. On the day of the procedure, the patient arrives at a medical facility, where the doctor once again clarifies the patient’s intention before the injection. After obtaining active consent from the patient, the doctor proceeds with the procedure. First, he gives the patient an injection of sedatives and painkillers, and the patient falls asleep. The doctor then injects a lethal dose of a toxic substance that ends the patient’s life.

Where is euthanasia legal?

Switzerland

In Switzerland, in the canton of Zurich, euthanasia has been legal in the form of assisted suicide since 1941. The first companies performing this type of euthanasia appeared in the country in the 1980s. Organizations Dignitas and Exit are today the main institutions in the country offering euthanasia services for terminal patients.

Dignitas is the only company in the world that legally performs euthanasia for residents of other countries. Today, so-called “suicide tours” are even held in Switzerland, offering euthanasia services for foreigners. They tried to ban this practice in 2011: a referendum was held in Zurich to ban euthanasia for foreign citizens. However, 78% of residents voted to keep the practice.

In 2019, 1 people died by euthanasia in Switzerland. Of these, 176 are foreign citizens. Most foreigners came from Germany, Great Britain, France, Austria and Italy.

Netherlands

There has been talk of legalizing euthanasia in the Netherlands since 1973, when a Dutch physiologist helped her 95-year-old mother pass away. In the 1980s, the Dutch Supreme Court began developing criteria that a patient must meet in order to undergo euthanasia. The official law allowing euthanasia came out in 2001. In 2019, 6 people were euthanized in the Netherlands.

Belgium

The Belgian parliament authorized euthanasia in 2002. And in 2014, Belgium became the first country in the world to legalize euthanasia for underage children. In 2016, a 17-year-old teenager suffering from terminal cancer ended his life by euthanasia, becoming the first minor to exercise the right to die. Today, just over 2 people a year undergo euthanasia in Belgium.

Luxembourg

Luxembourg allowed euthanasia in 2009. Interestingly, in Luxembourg, as well as in Switzerland, euthanasia is de facto allowed for residents of other countries. However, in order to undergo the procedure, the patient must have been observed by a local doctor for a long time, which significantly reduces the chances of foreigners for euthanasia.

Spain

In Spain, euthanasia was legalized quite recently – in 2021. The prerequisites for this were several high-profile cases of suicide recorded on video. The patients explained their act by the unbearable suffering that the disease caused them. Therefore, in 2020, the Congress of Deputies raised the issue of legalizing active euthanasia, and in 2021 the procedure became available to citizens of the country.

USA

In the US, euthanasia is legal in 9 states. Oregon was the first state to legalize euthanasia in 1994. New Mexico is the latest to allow the procedure in 2021. The rules for euthanasia and the criteria that patients must meet vary from state to state. In Oregon, for example, only state residents can be euthanized. And in Montana, in general, a patient can receive euthanasia only by court order.

Euthanasia in our country

In our country, euthanasia is prohibited by the federal law “On the Fundamentals of Protecting the Health of Citizens of the Russian Federation.” In particular, art. 45 says that medical professionals do not have the right to perform euthanasia or hasten the death of a patient either at his request or at the request of his relatives. Moreover, from the point of view of the Criminal Code of the Russian Federation, euthanasia is equated with murder and is punishable by an appropriate term. On the other hand, passive euthanasia is legal in our country and is practiced by doctors when the patient refuses further treatment.

Interestingly, in our Soviet country in 1922, euthanasia was legalized for a short time. This makes Russia the first country in the world to legalize active euthanasia at the state level.

What do supporters and opponents of euthanasia say?

Philosopher Elena Bryzgalina notes that in every country that eventually legalized euthanasia, the decision was not made unambiguously: “There have always been movements from patient communities, doctors, civil society, who said that it is impossible to legalize euthanasia.” Among the arguments in support of euthanasia where it is allowed, the expert identifies five main ones:

Speaking about the arguments of the opponents of the legalization of euthanasia, Elena Bryzgalina notes the following:

Elena Bryzgalina also emphasizes the importance of psychological arguments: “In fact, a person who asks for help to die through euthanasia may not ask for this, but simply draw attention to himself. People who say that others should be allowed to die because they suffer, in fact, they may not be talking about the good for that person, but about their own selfishness (“I don’t want to take care of my neighbor”, “I don’t want to waste my spiritual strength” ). To draw a line and determine what people really think, saying that they want to die on their own or ask to legalize euthanasia, is actually psychologically very difficult.”

In addition, there is a philosophical “inclined plane” argument: “Something is allowed and conditions are stipulated, for example, “you can allow euthanasia for people who…”. But life is very complicated, and there will always be situations that do not fit into the set of these rules, and something will need to be resolved additionally. It is easier for humanity to hold on to a hard “yes” or “no” than to allow a “yes, but”.