Abstract
This week has been an interesting week in medical law. It has been reported that courts in Belgium have allowed a healthy woman to access euthanasia because she has had ' suicidal thoughts since childhood' meanwhile in the Netherlands there has been a push to allow children under the age of 12 with terminal illnesses or illnesses that make life unbearable to access euthanasia. Back in the UK Lord Falconer's Bill is on its way through parliament and if it is passed into law it would allow people who have capacity, a terminal illness and less than 6 months to live to access euthanasia legally as long as they are domicile in the UK. These stories prompted me to look at whether or not euthanasia should ever be an option for a healthy person. For the sake of space I will assume that we are only considering adults over the age of 18 in situations where there is a genuine desire to die and no malice on the part of the physician. In this essay I am going to explore, firstly, the reasons why euthanasia has been legalised in some European countries and the main arguments for its legalisation. Secondly, why healthy people may choose euthanasia over suicide and whether this should be a lawful choice and finally whether it is consistent with the aims of medical law for the euthanasization of healthy people to be lawful.
Reasons why euthanaisa should be legal in some cases
Autonomy- one of the main reasons behind the push to legalise euthanasia in Europe has been the desire to respect people's right to die and not continue a life that they consider not worth living. In the case of healthy people this argument still holds strong. If what makes the England a modern and civil state is our desire to allow citizens to make their own choices for their own reasons then we should allow healthy people to have access to euthanasia simply because this is what they want. This would of course be subject to the conditions that the Doctor would not gain for the euthanasia and that the patient had a certain, capacitated and long held desire to die.
Non-discrimination- another argument that frequently features in the euthanasia debate is the need for people who physically cannot commit suicide due to paralysis or disability to have the same right to suicide as able bodied people. This is where we run into problems if we allow healthy people to have access to euthanasia,Suicide was made legal by the Suicide Act 1967 but assisted suicide and euthanasia remain illegal. If a healthy person wants to die then suicide is still an option for them, assuming that paralysis and disability take you out of the category of 'healthy persons'. Therefore it seems to go to far to say that not only should healthy people be allowed to kill themselves but they should also be allowed to ask a medical professional to help them. There is no discrimination in the case of a healthy adult who wants to die, they can commit suicide and the law cannot step in.
Prevention of harm- finally in most right to die cases the issue arises that the person wants to die and is currently in pain or mental distress to such an extent that doctors should help them die in order to prevent their suffering continuing. In the case of a healthy person seeking euthanasia this may be an issue because there may be no harm being prevented. It is of course arguable that the woman in Belgium, known only as 'Laura' was in such mental distress by her suicidal thoughts that allowing her to die prevented this suffering. However it is also clear that in many cases counselling, mental health treatments and other medical treatments may help to relieve this mental distress and so letting someone die would actually take away the chance of recovery rather than cure them.
Why would a healthy adult choose euthanasia?
I accept that I have limited space and knowledge in this area to really explain and analyse all the reasons why someone may want to be euthanized despite being physically able to commit suicide themselves. For now I shall look at 2 reasons. First, a fear that another suicide attempt may fail and second an inability to go through the process of suicide alone.
If a healthy adult wishes to die and wants a physician to help because they have attempted suicide before and failed then euthanasia may seem like the best option. The healthy person may believe that a doctor will be able to ensure that they are given drugs that will be sure to work and that death will be as peaceful and painless as possible. Whilst this seems rational and logical it misses out the fact that another person, the physician will be complicit in the euthanasia and so would have to consent to effectively killing a healthy person. In law consent is no defence to harm and so if the euthanasia of healthy people was legalised this really would be an extraordinary anomaly in English Law. It is possible that doctors would be given a right to conscientious objection which is fair and reasonable however my question would be what kind of doctor would agree to kill a healthy patient and go against all they have learnt at medical school about how the doctor's duty is to protect and care for their patients?
Secondly, if a healthy person wishes to access euthanasia because they feel they have not got the ability to go through the process alone then it should be asked whether they really do want to die. Part of the reason suicide is lawful is because the person themselves is ending their own life and right up until the last moment they can choose to remain alive. If doctors could assist a healthy person's suicide then the doctor will be taking the final steps of actually killing the patient and so the patient's autonomy in those last few seconds of life is surrendered to the Doctor. Therefore giving healthy people access to euthanasia is not protecting their autonomy as the law should.
Conclusion: would allowing healthy people to be euthanized be consistent with English medical law?
In short, no. Euthansia would not protect the healthy person's autonomy in the same way suicide does. The healthy person could not withdraw his consent once the lethal dose has been administered but he could choose not to jump from a bridge. This is why suicide is legal and euthanasia is not. English medical law has foundations in patient autonomy. Allowing healthy people to be euthanized also goes against the foundations of the medical profession as it effectively allows a doctor to end a patient's life and it offends the principle of the prevention of harm. Therefore overall I feel that the legalization of euthanasia for healthy people is unacceptable on medical and ethical grounds and although it is unlikely a judgement like the one in Belgium will ever happen in England judges should be slow to follow the Belgian model
