Introduction

The deliberate taking of a life to eliminate suffering, usually as a result of a fatal illness or excruciating pain, is known as euthanasia. A doctor, another medical professional, or the patient themself may perform this action (in cases of assisted suicide). A person’s autonomy and freedom to choose their own end-of-life care, including whether to refuse life-sustaining treatment or ask for assistance in dying if they have a terminal illness or other irreversible condition, is the foundation of the right to die with dignity principle. The practice of euthanasia dates back to ancient civilizations, when it was occasionally employed to end pain or preserve social order. But when Christianity spread and Hippocratic medical ethics gained traction, euthanasia became mainly frowned upon in Western nations. And now, euthanasia laws vary throughout nations. 

Legal Framework

Around the world, euthanasia—also referred to as “mercy killing” or medically assisted suicide—is a hotly debated subject. While euthanasia is illegal in the majority of nations, it is permitted in several others under certain conditions. Australia is one of the countries where active euthanasia is legal (under certain conditions), with state-by-state variations in “voluntary assisted dying” regulations. Canada provides medical assistance in dying (MAID) for qualified patients, Belgium enables euthanasia for terminally ill individuals who meet certain requirements, Euthanasia for patients with terminal illnesses is lawful in Colombia; under tight guidelines, it is also permitted in Ecuador; other nations that allow this practice include Luxembourg, the Netherlands, New Zealand, Portugal, Spain, and others. Other nations practice “passive euthanasia,” or ending life-sustaining care: Finland, where it is permissible to perform passive euthanasia but not active euthanasia; France, where euthanasia is illegal but permits terminal patients to be deeply sedated until they pass away; and Germany, where active euthanasia is still illegal despite the legalization of passive euthanasia in 2014. Although euthanasia is rare worldwide, there are considerable differences in its legal status. problem. The fundamental principles of the Convention are the respect for human freedom and dignity. However, a number of arguments have been made in favor of a strict policy, including the need to safeguard the sanctity of all human life, shield weak and vulnerable individuals from sneaky influences, and maintain public confidence in the medical community.[1]. In the Nicklinson v. United Kingdom [2]case, the European Court ruled that it is up to each Member State to determine whether or not this kind of interference is appropriate. On this issue, Europeans cannot agree.

Ethical Considerations

Let’s discuss the ethical arguments surrounding euthanasia from various perspectives:

a. Legalization and Personal Choice:

• Pro: Proponents contend that an individual’s right to die ought to be up to them. The choice to end their life with assistance should be available to those who are elderly or suffering from a terminal illness.
  • Con: Some who oppose legalizing euthanasia say that doing so may encourage social pressure on weaker people to take their own lives. Instead, they stress the significance of protecting life and making sure that compassionate care is provided[3].

b. Medical Perspectives:

• Pro: A few medical experts are in favor of allowing terminally sick people to get physician assistance in dying. They contend that if all other measures are unsuccessful, it may be a kind method to put an end to suffering.
  • Con: Some argue that human life is sacred and warn against euthanasia. They think doctors should put more of an emphasis on healing than intentionally taking a patient’s life.

c. Palliative Care vs. Euthanasia:

• Pro: Euthanasia proponents contend that it offers a respectable means of ending suffering, particularly in situations where a patient has a terminal illness.
  • Con: Some who oppose palliative care argue that it is an effective way to treat pain and suffering without using euthanasia. Instead of approving assisted suicide, they support bettering end-of-life care.[4]

d. Sanctity of Life:

• Con: A major defense of euthanasia is the sanctity of human life. Some contend that societal respect for life itself is compromised by the acceptance of euthanasia.
  • Religious Beliefs: Euthanasia is opposed by many religious groups that view it as immoral and a threat to life’s sanctity.

The debate over euthanasia involves complex ethical considerations, touching on autonomy, compassion, and the value of life. Each perspective brings unique insights, and the discussion continues to evolve.[5]

Legal Challenges and Court Decisions

Euthanasia and the right to die with dignity have been the subject of intense global discussion and controversy due to legal challenges and court rulings. When it comes to end-of-life decisions, courts have struggled to interpret constitutional principles such as the right to privacy and the ban on cruel and unusual punishment. An examination of several significant court rulings and legal issues is provided below:

 A. Right to Privacy:

United States: The U.S. Supreme Court established a constitutional right to privacy in the seminal case of Griswold v. Connecticut (1965), which set the precedent for other issues pertaining to reproductive rights, contraception, and end-of-life decisions[6]. The Court concluded in Washington v. Glucksberg (1997) that there is no constitutional right to physician-assisted suicide, but it allowed states to pass laws addressing the matter[7].European Court of Human Rights (ECHR): In cases like Pretty v. United Kingdom (2002)[8] and Nicklinson v. United Kingdom (2015)[9], Article 8 of the European Convention on Human Rights (ECHR) addresses the right to respect for private and family life, which includes the right to die with dignity[10]. The court has emphasized the importance of striking a balance between individual autonomy and the protection of vulnerable individuals.

B. Prohibition of Cruel and Unusual Punishment

United States: The Eighth Amendment to the U.S. Constitution prohibits cruel and unusual punishment[11]. In Cruzan v. Director[12], The right to decline life-sustaining treatment was a topic the U.S. Supreme Court addressed in Missouri Department of Health (1990). The Court avoided discussing euthanasia explicitly, ruling instead that competent people had a constitutional right to decline medical treatment, including life-sustaining care.

Canada: The Canadian Supreme Court held in Carter v. Canada (2015) that the ban on physician-assisted suicide was an infringement on the rights to life, liberty, and personal security guaranteed by the Canadian Charter of Rights and Freedoms. The court determined that people’s autonomy and dignity in making end-of-life decisions were violated by the general prohibition.[13]

C. Legislative Responses

Countries that have Legalized Euthanasia: Courts have upheld the constitutionality of euthanasia laws in countries like the Netherlands, Belgium, and Canada, but they have also imposed safeguards to protect vulnerable individuals and guarantee that end-of-life decisions are made voluntarily and with full awareness of the consequences.
Nations imposing limitations or prohibitions: Courts have had difficulty striking a balance between conflicting interests, including as societal values, public health and safety, and individual autonomy, in nations where euthanasia is regulated or outlawed. Certain courts have yielded authority to legislative authorities to resolve the matter via democratic procedures.

International Perspectives

Diverse legal systems and cultural perspectives exist about euthanasia. In Europe, euthanasia is legal in nations like the Netherlands and Belgium but illegal in Germany and Italy because of religious convictions. North America exhibits changing societal views, as evidenced by Canada’s legalization of medical help in dying (MAID). In Asia, Japan continues to forbid euthanasia, although India allows it under specific circumstances. National laws are influenced by international human rights standards, especially in Europe[14]. The right to respect for one’s private and family life is how the European Convention on Human Rights handles euthanasia. Meanwhile, through human rights agreements like the International Covenant on Civil and Political Rights and the Universal Declaration of Human Rights, the UN indirectly impacts state policies[15]. In summary, there are significant regional and national differences in the legal and cultural views around euthanasia, which are a reflection of the various ethical, religious, and cultural viewpoints. National euthanasia laws and policies have been impacted by international human rights treaties and conventions, especially in Europe. Courts have been essential in interpreting and applying human rights concepts concerning end-of-life decisions.

Conclusion

Global attitudes and practices around euthanasia are shaped by legal, cultural, and ethical factors, making it a highly complicated and contentious topic. While some nations, like the Netherlands and Belgium, have allowed assisted suicide, other nations, like Germany and Italy, continue to forbid it because of religious convictions. North America demonstrates changing cultural perspectives; Canada has legalized assisted suicide. In the meantime, India allows passive euthanasia under some circumstances, but Japan continues to forbid euthanasia. National laws are influenced by international human rights standards, especially in Europe. The European Convention on Human Rights addresses euthanasia through the right to respect for private and family life. Future legalization trends, medical ethics, palliative care developments, and demographic changes will all have an impact on euthanasia laws and the right to die with dignity. It is anticipated that conversations about euthanasia and other end-of-life care alternatives will grow more heated as medical technology progresses and the population ages. Enhancing the availability of top-notch palliative care services could present substitute methods for handling pain and offering comprehensive end-of-life assistance, hence reducing the need for euthanasia. Legal challenges, international human rights standards, and legalization tendencies in some countries may lead to a reexamination of euthanasia legislation in other places. Policy decisions will also be influenced by public opinion and lobbying initiatives, which will reflect shifting social views on human dignity, autonomy, and compassion. Overall, ongoing debates and societal changes will continue to shape the future landscape of euthanasia laws and end-of-life care practices.

[1] R (Pretty) v United Kingdom (2002) 35 EHRR 1, para 65

[2] ProCon.org, “Top 10 Pro & Con Arguments,” ProCon.org. last modified October 9, 2018.

[3]ProCon.org, “Top 10 Pro & Con Arguments,” ProCon.org. last modified October 9, 2018

[4] ClearIAS, ‘Euthanasia’ <https://www.clearias.com/euthanasia/> accessed 3 June 2024.

[5]BBC, ‘Euthanasia: Against Euthanasia’ (BBC Ethics), [2009] BBC Ethics

[6] Griswold v. Connecticut, 381 U.S. 479 (1965)

[7] Washington v. Glucksberg, 521 U.S. 702 (1997)

[8]Pretty v. United Kingdom, [2002] ECHR

[9] Thomas E. Webb, Essential Cases: Public Law (6th edn, OUP 2023) Ch 55

[10] European Convention on Human Rights (ECHR) art 8

[11] U.S. Const. amend. VIII

[12] Cruzan v. Director, Missouri Dept. of Health, [1990] 497 U.S. 261

[13] Carter v. Canada (Attorney General), 2015 SCC 5 (CanLII), [2015] 1 SCR 331

[14] European Convention on Human Rights (ECHR) art 8

[15] Universal Declaration of Human Rights, International Covenant on Civil and Political Rights.