Societal Consequences Surrounding Euthanasia

The antiquity and general acceptance of an opinion is not assurance of its truth. ~ Pierre Bayle (1647 – 1706) 

When talking about euthanasia those in opposition often argue on the grounds of potential societal consequences. These consequences tend to focus on the potential for euthanasia to be abused and lead to the targeting of the vulnerable within society and the unnecessary loss of life within it. Although plausible these claims often do not have the numbers to support them. In this fourth post we look at how truthful such claims are, as well as shining a light on the often neglected societal consequences faced when euthanasia is absent.

Issues of Legalising Euthanasia

Excessive Abuse 

A slippery slope argument, opponents argue that the legalisation of euthanasia will result in its eventual excessive use once legalised. However numbers in the Netherlands tell a different story, with euthanasia only accounting for 1.7 percent of all deaths with the application to be euthanised being no guarantee of acceptance with around ⅔ of applicants being refused.1 Instead of death becoming cheap assisted dying applications in the Netherlands has become a complex process making it difficult to achieve.

Targeting of the Vulnerable 

Others argue that legal euthanasia will lead to pressure on vulnerable members of society such as the old and disabled to end their lives. However similar to the argument for excessive abuse, this is also not based on the numbers, with a 2007 Oregon state study finding that vulnerable individuals were represented as infrequently as everyone else2. This study was able to go in depth on individual backgrounds due to euthanasia accounting for only 0.2% of deaths for the decade (341 individuals in total).3

Unnecessary Loss of Life 

Finally there is the cost to human life as euthanasia dashes any chance of a full or partial recovery. However in nations where euthanasia is legal, in almost all cases it’s reserved for the terminally ill and despite wishful thinking a terminal illness is almost always that, terminal. In 1993, a Dutch paper supported this showing that in 86 percent of cases, euthanasia shortened life by a maximum of a week and usually only a few hours4. This shows that in reality euthanasia performs its purpose of ending suffering without loss of quality life.

Issues When Euthanasia is Absent 

Loss of Life 

Surprisingly when legal euthanasia is absent the rates of non voluntary euthanasia may indeed rise. A 2005 Netherlands study found that only 0.4 percent of all euthanasia procedures were carried out without the patient’s explicit permission compared to 0.8 percent in 1991 this shows a halving in unwanted deaths only 4 years after euthanasia laws came into effect5. It is possible that the laws and regulations that come with the legalisation of euthanasia helps to check such abuses.

Limited Options To Die 

When dying most of us imagine passing away peacefully however death is usually not like this and is more often a slow, painful, and undignified process. By blocking access to euthanasia as a painless option, it forces people to go to drastic measures to end their suffering. Some consequences include individuals traveling to countries such as Sweden to end their life, which along with significant financial costs ($10800 USD) can often drastically shorten life as they must arrive in the country while they are still physically fit to do so as in the case of Peter Smedly6. However there are only a few unpleasant options left for those that can’t make this journey. Tony Nicklinson a sufferer of locked in syndrome after having his request to die rejected in 2010 and 2012 by the British High Court had to make such a decision. Being unable to speak or move any part of his body except head and eyes he was unable to commit suicide or to do the final act of drinking the fluid himself in Sweden either. In the end, the only way Nicklinson had to escape his condition which he called “a living nightmare” was to starve himself to death, after a week with no food he died in misery from pneumonia.

Although it is human nature to fear death, a large part of that fear comes from the anticipation of pain in the final stages of dying. If people choose how and when they die, it is likely they would become free of the anxiety brought on by pain and be able to live their remaining life to the fullest. Recently passed author Terry Pratchett, who suffered progressive visuospatial processing damage had a similar perspective9 saying:

“If I knew that I could die at any time I wanted, then suddenly every day would be as precious as a million pounds. If I knew that I could die, I would live. My life, my death, my choice.”                                      ~ Terry Pratchett (1948 – 2015)

Resources 

1. Cable News Network (US). Dutch euthanasia clinic offers mobile service [Internet]. (United States of America): Ben Brumfield (US); 2012 [cited 2015 Apr 8]. Available from:   http://edition.cnn.com/2012/03/07/world/europe/netherlands-euthanasia-clinic

2.  Battin M, Heide A, Ganzini L, Wal G, Onwuteaka‐Philipsen B.  Legal physician‐assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups. J Med Ethics [Internet]. 2007 [cited 2015 Apr 8];33(10):591-7. Available from: PubMed Central

3.The Guardian (AU). Q&A: Assisted suicide [Internet]. (Australia): David Batty (AU); 2008  [cited 2015 Apr 8]. Available from: http://www.theguardian.com/society/2008/dec/10/assisted-suicide-law

4. Pijnenborg L, Maas P, Looman C, Delden J. Life-terminating acts without explicit request of patient. The Lancet  [Internet]. 1993 [cited 2015 Apr 8];341(8854):1196-9. Available from: Science Direct

5.The Washington Post (US). Euthanasia in the Netherlands: Rick Santorum’s bogus statistics [Internet]. (United States of America): Glen Kessler (US); 2012 [cited 2015 Apr 8]. Available from:  http://www.washingtonpost.com/blogs/fact-checker/post/euthanasia-in-the-netherlands-rick-santorums-bogus-statistics/2012/02/21/gIQAJaRbSR_blog.html

6. The Telegraph (GB). Millionaire hotelier Peter Smedley named as man whose Dignitas assisted suicide was filmed by BBC [Internet]. (United Kingdom): Gordon Rayner (GB); 2011 [cited 2015 Apr 8]. Available from:  http://www.telegraph.co.uk/culture/tvandradio/bbc/8562266/Millionaire-hotelier-Peter-Smedley-named-as-man-whose-Dignitas-assisted-suicide-was-filmed-by-BBC.html

7. Fact sheet: DIGNITAS To live with dignity – To die with dignity [Internet]. Dignitas (CH); 2013 [cited 2015 Apr 8]. Available from: http://www.dignitas.ch/images/stories/pdf/informations-broschuere-dignitas-e.pdf

8. The Telegraph (GB). Tony Nicklinson: A father’s fight for right to die is carried on after his death [Internet]. (United Kingdom): Sarah Rainey (GB); 2014 [cited 2015 Apr 8]. Available from: http://www.telegraph.co.uk/news/health/10914782/Tony-Nicklinson-A-fathers-fight-for-right-to-die-is-carried-on-after-his-death.html

9. The Guardian (AU). Terry Pratchett: my case for a euthanasia tribunal [Internet]. (Australia): Terry Pratchett (GB); 2010 [cited 2015 Apr 8]. Available from:  http://www.theguardian.com/society/2010/feb/02/terry-pratchett-assisted-suicide-tribunal

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