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Choice, Quality of Life and Self-Control: Summary Arguments in Support
of Euthanasia
Ian Ireland
Law and Public Administration Group
Introduction
The passage of the Northern Territory Rights of the Terminally Ill Act
1995 and introduction of the Euthanasia Laws Bill 1996 in the Australian
Parliament has ignited an often vociferous debate in Australia about euthanasia.
This Research Note outlines some of the arguments used by supporters of
euthanasia for the terminally ill. However, not all supporters would support
all the arguments outlined below.
It is strongly recommended that this Research Note be read in conjunction
with its counterpart, Research Note No. 13 1996-97, The Sanctity of Life:
Summary Arguments Opposing Euthanasia. Also recommended are Parliamentary
Research Service Research Papers No's 3 and 4 1996-97, Euthanasia-the
Australian Law in an International Context-Part 1: Passive Voluntary Euthanasia;
Euthanasia-the Australian Law in an International Context-Part 2: Active
Voluntary Euthanasia and the Bills Digest for the Euthanasia Laws Bill
1996.
Some Definitions
The term 'euthanasia' means a quiet and easy death. The term is often
divided into categories such as the following:
- passive voluntary euthanasia-where medical treatment is withdrawn
or withheld from a patient at that patient's request and death results.
- active voluntary euthanasia-where medical intervention is sought
by a patient in order to end their own life.
- passive involuntary euthanasia-where medical treatment is withheld
in order to cause death, but the withholding of treatment is not at
the patient's request.
- active involuntary euthanasia -where medical intervention brings
about a patient's death, and the intervention is not at the patient's
request.
Quality of Life
Quality of life is an issue faced by many people when making a decision
about dying. People faced with a terminal illness are faced with setting
standards about quality of life such as:
- how much physical pain they will have to endure;
- how much loss of physical and mental control they will have to endure;
and
- how much isolation they will have to endure.
For some, life has an inherent value. For others, it is being conscious
that is inherently valuable or having a life worth living. For the latter,
choosing a dignified death rather than an undignified existence is a matter
of individual freedom which, in its own way, shows a respect for life.
The question of quality of life has become particularly important because
advances in medical treatment and technology mean that patients may now
be kept alive much longer than in the past, although their quality of
life may be extremely poor.
Human Right
The denial of human rights is of the greatest concern in all liberal
democracies. Violations of human rights include imprisonment without trial,
torture and discrimination against women, racial, religious and political
groups. Not to recognise the right of competent terminally ill people
to die with dignity, to dictate to a competent terminally ill person that
they have to endure an often lingering painful death, is seen by some
to be a violation of human rights.
In a liberal democratic society it is argued that every person should
have the right to make choices in accordance with their own values as
long as those choices do not impinge on the liberties of others. The choice
of a terminally ill person to die does not impinge on the liberties of
anyone other than themselves. In a liberal democracy a terminally ill
person should be able to choose to die where the only alternative is dying
suffering.
It is also argued that to require a person die in a way that others
approve, but the dying person regards as a contradiction of their life,
is a form of tyranny.
Personal Autonomy
Like the decision of whether or not to have an abortion, the decision
of how and when to die is one the most intimate and personal choices a
person may make in a lifetime, a choice central to a person's autonomy
and dignity.
Active voluntary euthanasia is merely the response of a medical practitioner
to a request from a competent and autonomous person.
The Slippery Slope
One of the major arguments used by opponents of active euthanasia is
that it would lead to the lives of the poor or indigenous people being
devalued and coerced. Such rationale can be seen to be patronising and
racist. The argument assumes that the poor, indigenous people and the
elderly are incapable of decision making.
Providing a statutory regime for voluntary euthanasia will regulate
and provide safeguards for what at present, may be unregulated practice.
Some proponents of active voluntary euthanasia would argue that research
in the Netherlands shows that the practice can be properly regulated and
that there is no statistical evidence that involuntary euthanasia occurs
frequently, or more frequently, in the Netherlands than other Western
societies.
Palliative Care
While palliative care in terminal illness may reduce pain and distress,
it may not improve quality of life. Palliative care can give many terminally
ill patients the death they wish, but that death is not desired by everyone.
Palliative care may reduce pain and distress and improve the quality
of life in many terminally ill patients. However, even good palliative
care will fail to relieve pain for some patients. Proponents argue that
active voluntary euthanasia, in properly controlled circumstances, should
be available for such patients.
Public Opinion
Polls, including: an Australian National University nation wide survey
in February 1995; a National Church Life Survey of February 1995; a Roy
Morgan opinion poll in The Canberra Times of August 1995; an AGB McNair
AgePoll in The Age in June 1996; and a Newspoll Survey in The Australian
in July 1996; suggest that a majority of Australians are in favour of
euthanasia, as are the Doctors Reform Society and support groups for people
suffering from HIV/AIDS.
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