When we hear the phrase voluntary euthanasia people generally think of
one of two things: the active termination of life at the patient’s request as it
occurs in the Netherlands (or similar proposals in other countries); or the
Nazi extermination program of murder. Many people have beliefs about
whether euthanasia is right or wrong, often without being able to define it
clearly. Some people take an extreme view, while many fall somewhere
between the two camps. Dictionary definitions avail us little, as there will
always be large groups of people that claim it means something else. The
apparent derivation a gentle and easy death (from the Greek, eu – thanatos)
hardly describes what we mean. Even extending the definition to include
bringing about of this, especially in the case of incurable and painful
disease (Oxford English Dictionary) hardly covers it – hospices often
succeed in bringing about a peaceful death, but they don’t perform
In the Netherlands, the only country where euthanasia is openly practised,
euthanasia is defined as the intentional termination of life by another at the
explicit request of the person who dies (Netherlands State Commission on
Euthanasia). The argument then often centres on the voluntariness of the
request. How can one be sure that it is voluntary? Supporters of the
voluntary euthanasia movement generally believe that it would be possible to
devise sufficient safeguards to ensure that the request was voluntary and that
people could never feel pressured.
The Dutch are critical of their own system and are continually refining and
testing it – though generally they feel that it respects human rights and is part
of good medicine. They get rid of the word voluntary since the explicit
request is part of their definition of euthanasia. An explicit request is
objectively observable, whereas voluntariness depends somewhat on
interpretation. (Some opponents of euthanasia suggest that the true will is
impaired if one is asking to die and that therefore there is no voluntariness.
Most people would agree if the person was emotionally distraught over, say,
being jilted by a lover, or if the person was psychiatrically of unsound mind,
but most of us view more considered statements as voluntary, especially if
we are unable to find any evidence to the contrary.
Obviously the Dutch definition needs careful implementation to ensure
voluntariness, and the Dutch attempt to do this by a series of safeguards
within a close doctor-patient relationship, a high standard and availability of
palliative care, and general public support. There is much debate over
whether we could have a similar system in, say, Britain, but we feel that the
present system is unsatisfactory and so we press for reform.
One of the few certainties of life is death, but in the twentieth century it is
still a taboo subject. The forbidden nature of death adds to the unnamed
fears and worries that most people feel when asked to confront the idea of
their own death. Yet once people can overcome their reluctance to discuss
the subject, most often what is revealed is not the fear of death itself, but the
manner of dying. The difficulty of thinking about death with dignity is that
it implies that one day you, or someone you love, may be in a position to
want that choice.
No one can prevent death finally, but we can and should ensure that the
dying process is a gentle and peaceful one. When life consists of a few
agonising, drugged weeks, many patients beg their doctors to help them die,
and many doctors, mindful of the ethics of their profession, feel forced to
refuse. Those who, out of compassion, accede to such a request, know they
are breaking the law and putting their careers at risk.
This is the dilemma which faces all of us now. Should we, as potential
patients, have the legal right to ask our doctors to help us die when the end
of life is in sight and our suffering severe?
Did Dr. Kevorkian go too far in portraying Youk’s death on national TV?
Dr. Kevorkian brought the issue of death into the homes of millions of Americans. Death has always
been a major taboo unless it is portrayed through Hollywood’s violent disregard for human life. Mr.
Youk’s death was a peaceful, and dignified one. Most Americans are not given the choice to have
such a gentle death. Many patients die slowly, extremely sedated, incompetent and incontinent or by
choosing to hasten their death by refusing food and hydration. Mr. Youk received quality hospice
care and chose a peaceful ending. The choice that Thomas Youk made should be a choice that
everyone has available to discuss with his or her families and make by their own accord