Full Answer Section

• • Non-maleficence: The duty to do no harm (“primum non nocere”). This is a major point of contention, as active euthanasia directly violates the “do no harm” principle for many medical professionals and ethical frameworks.
  • Justice: Ensuring fair and equitable access to care and preventing potential abuses or pressures on vulnerable individuals.

Pain and Suffering within the Context of Faith

Most major faith traditions offer complex perspectives on pain and suffering, often seeing them as more than just physical sensations.

• Christianity: Suffering is often viewed through the lens of the Passion of Christ, suggesting that it can have redemptive meaning, build character, or draw individuals closer to God. While not glorified, it’s seen as an unavoidable part of the human condition that can be endured with faith and hope. Compassion for those suffering is a central tenet, leading to support for palliative care and efforts to alleviate pain, but usually not for intentionally ending life, which is seen as God’s prerogative.
• Islam: Muslims believe that suffering can be a test from Allah, a means of expiation for sins, or a path to spiritual growth. Patience (sabr) in the face of adversity is highly valued. While alleviating pain is encouraged, intentionally ending life is forbidden, as life and death are considered to be in Allah’s hands.
• Judaism: Jewish tradition emphasizes the sanctity of life (pikuach nefesh) and the imperative to preserve it. While there’s a strong tradition of not prolonging the dying process unnecessarily and allowing natural death, active hastening of death is prohibited. Suffering can be viewed as part of God’s mysterious plan, but also as something to be actively combated with medical intervention.
• Buddhism: Suffering (dukkha) is a core concept, and the goal is to alleviate it through understanding its causes and following the Eightfold Path. While compassion is paramount, the focus is on reducing suffering through spiritual and mental transformation, not through ending life. The act of causing death, even with good intentions, can have negative karmic implications.

Across these faiths, there’s a strong emphasis on providing comfort, companionship, and spiritual support to the dying, and a general prohibition against active euthanasia or suicide, as life is considered sacred and a gift from a higher power.

Physician-Assisted Suicide / Death (PAS / PAD)

• Definition: Physician-assisted suicide (PAS), increasingly referred to as Physician-Assisted Death (PAD), occurs when a physician provides a mentally competent, terminally ill patient with a prescription for a lethal dose of medication that the patient then self-administers to end their own life. The physician’s role is to provide the means, not directly administer the act. This differentiates it from active euthanasia, where the physician performs the final lethal act.

• Is it Ethical? The ethicality of PAS/PAD is a deeply divisive issue with strong arguments on both sides:

  • Arguments for Ethicality (Pro-PAD):

    • Autonomy: Patients have a right to self-determination, including the right to make choices about their own death when facing unbearable suffering in a terminal illness.
    • Compassion and Relief of Suffering: It offers a compassionate option for individuals experiencing intractable pain and suffering that cannot be alleviated by palliative care.
    • Dignity: Allows individuals to maintain control and agency over their dying process, choosing the timing and manner of their death, thereby preserving their dignity.
    • Transparency and Regulation: Legalizing it allows for strict safeguards and oversight, preventing abuses that might occur in an unregulated “underground” practice.

  • Arguments against Ethicality (Anti-PAD):

    • Sanctity of Life: Opponents, often from religious or moral standpoints, argue that all human life is inherently valuable and that intentionally ending it is morally wrong, regardless of suffering.
    • “Slippery Slope” Concerns: Fear that legalizing PAS/PAD could lead to its expansion to less clear-cut cases (e.g., non-terminal illness, depression, pressure from families), or to non-voluntary euthanasia, particularly for vulnerable populations.
    • Role of the Physician: Many in the medical profession believe a physician’s role is to heal and alleviate suffering, not to facilitate death, violating the “do no harm” principle.
    • Availability of Alternatives: Argue that with adequate palliative care and hospice services, most suffering can be managed, and the desire for PAS/PAD often stems from unmanaged pain or depression rather than an inherent wish to die.

• Should we have the right to end our lives? Why yes or why not?

  • Argument for “Yes” (Individual Autonomy): Proponents argue that a fundamental aspect of human liberty is the right to self-determination, particularly over one’s own body and life. When facing a terminal illness with unbearable suffering, denying an individual the right to choose the timing and manner of their death is seen as a violation of their autonomy and an imposition of suffering. This right is often framed as a “dignity in dying” argument, allowing individuals to avoid a prolonged, painful, or undignified dying process.
  • Argument for “No” (Societal Protection/Ethical Boundaries): Opponents argue that while individual autonomy is important, it is not absolute and must be balanced against societal values, the sanctity of life, and the protection of vulnerable individuals. They contend that society has an interest in preserving life and that legalizing the right to end one’s life, even under strict conditions, could devalue life, especially for the elderly, disabled, or those struggling with mental health issues. There are concerns about potential coercion, misdiagnosis, and whether truly informed consent can be given under extreme duress. Furthermore, some argue that society’s obligation is to provide comprehensive support to live well until natural death, not to facilitate suicide.

Better Alternatives to PAS; Compare and Contrast Each:

1. Hospice Care

• Definition: Hospice care is a philosophy and program of care that focuses on providing comfort, dignity, and quality of life for terminally ill patients who have a prognosis of six months or less to live, and who have decided to forgo curative treatments. It is typically provided at home, but also in dedicated hospice facilities, hospitals, or nursing homes.
• Key Features: Holistic approach (addresses physical, emotional, social, and spiritual needs); involves a multidisciplinary team (doctors, nurses, social workers, chaplains, volunteers); provides support to the patient’s family as well; focuses on pain and symptom management.