This article addresses the ethical debate of euthanasia in the context of the natural truth of end-of-life. It analyzes the types of euthanasia based on the sanctity and autonomy of life, analyzes how modern medical advances affect the euthanasia debate, and considers the choice of euthanasia in light of human dignity.
Biological death is a truth of nature that no one can escape. We are born, live our lives to make them worthwhile and enriching, and then one day we fall ill and die. In other words, death can happen to anyone, anywhere, at any time during life. And people have come to accept such deaths as natural. While some people have taken it upon themselves to end their lives by committing suicide, this has been morally condemned by many religions and peoples throughout the ages. For centuries, we’ve believed that human life is sacred, and that it’s not something we should interfere with.
However, cracks are beginning to appear in this belief. This is the crack created by the issue of euthanasia. Modern medical advances have made life-sustaining medical treatments much more feasible than in the past, allowing people to overcome diseases that would have been fatal in the past. On the other hand, it has also made it possible to provide life-sustaining treatments that simply postpone the death of people with incurable and terminal illnesses. As a result, the question of whether it is right to allow a terminally ill patient to die painlessly or to leave his or her life in the hands of divine providence has become a difficult one for anyone to answer.
While medical advances have made it easier than ever to save a person’s life, they have also made it easier to kill them. Whereas dying used to be painful, today it can be as easy as injecting a simple drug. However, the value of human life is still important, and indiscriminate euthanasia should not be allowed.
However, not all euthanasia is an easy death, where the dignity of human life is abandoned. Scholars categorize euthanasia into different types of euthanasia, and depending on the type of euthanasia, some are in favor of it and some are against it. So, before we go any further, let’s take a look at the classification of euthanasia.
There are a few ways to categorize euthanasia, first of all, depending on what the doctor does: active or passive euthanasia. Active euthanasia is the intentional shortening of life by administering a lethal dose of medication to a terminally ill patient with no hope of recovery and no way to end their suffering other than death. Passive euthanasia, on the other hand, involves withdrawing artificial life-prolonging measures so that the patient will die naturally, sooner than if treatment were continued. This is the same as the natural death that most animals experience at the end of life. Euthanasia is also categorized into voluntary and involuntary euthanasia based on the wishes of the living subject. Voluntary euthanasia is when the patient wants to die and requests it, while involuntary euthanasia is when the patient hasn’t expressed their wishes. Euthanasia is also called involuntary if it is performed despite the patient’s objections.
One important ethical issue here is how well the communication between the doctor, patient, and family works. In particular, in the case of voluntary euthanasia, it can be controversial whether the patient’s true wishes are being honored. For example, when a patient is in extreme pain due to a terminal illness, there may be questions about whether the patient is being pressured into choosing euthanasia by a doctor or family member. In these situations, it is important to clearly distinguish whether the patient’s decision to choose euthanasia is truly voluntary, or whether the decision is the result of pressure from medical staff or society.
In this regard, the role of legal and social norms related to bioethics becomes even more important. For example, countries that allow euthanasia have set strict procedures and requirements to ensure that the patient’s decision is voluntary. When a patient requests euthanasia, it must not be a simple request, but a repeated request, and psychological counseling and legal advice must be available during the process. These procedures help ensure that patients have enough time to consider their decision and are free from outside pressure.
Of these, involuntary euthanasia and euthanasia against the patient’s wishes are the least controversial, as most people are against them. This is because it has nothing to do with the right to self-determination, which is at the center of the euthanasia debate. The main debate is about voluntary euthanasia: should we allow active euthanasia, passive euthanasia, or neither? In this article, we will focus on this point to guide our discussion.
In South Korea, the issue of euthanasia came to the forefront in December 1997 with the so-called Boramae Hospital case, in which the wife of a patient in the intensive care unit after brain surgery requested that he be discharged from the hospital because she could not afford to pay for his care, and the medical staff at Boramae Hospital in Seoul complied, removing him from the ventilator and discharging him, allowing him to die. The court found them guilty of “aiding and abetting death by discharging a patient in the recovery phase,” and the medical community responded by asking, “What is the standard of recovery?” This case became a major social controversy, and the debate on euthanasia began in earnest. So, why has euthanasia become so prevalent in modern society? There are three main reasons.
The first is the changing perception of human death. Up until the 19th and early 20th centuries, death was a natural part of life. As long as people lived, death could come at any time, and it was as natural to die as it was to live. But in the 20th century, as sanitation improved and medical technology advanced, many previously fatal diseases became curable, and death became unnatural. As death became something to be feared, overcome, and taboo, people facing imminent death reacted to it in two ways. One is to postpone death as far as possible through various technological means, and the other is to avoid confronting it. Euthanasia is the most appropriate means of avoiding the dreaded and taboo death.
The second reason is the entrenchment of individualism in modern society. With the establishment of modernity in Europe, individualism emerged, and it changed people’s lives. Individuals were able to assert all their rights as long as they didn’t threaten the very existence of society, and the spread of individualism led to sexual liberation, divorce and cohabitation, homosexuality, and more. In the same way, euthanasia is increasingly seen as a right to choose one’s own death, a right to self-determination over one’s own life. Rather than fight an incurable disease and prolong a meaningless life in pain, they believe they have the right to choose a morphine injection and a comfortable death. However, in a society where suicide is morally condemned for any reason, it is doubtful that euthanasia is the only right to die. On the other hand, it is possible that people who choose euthanasia are not simply trying to avoid suffering, but that they have no choice. According to a BBC documentary on euthanasia, it’s not uncommon in Europe for friends, lovers, and family to leave and cut off contact when a person is declared incurable. The longer the dying process, the more support is needed, but in the modern world, it is increasingly a solitary experience. At the threshold of death, a person should be able to talk to people about their life and death, organize their life, and be comforted, but if they don’t have the opportunity to do so and have to live a painful life of being treated like an object, isn’t it better to choose euthanasia than to prolong a meaningless life?
The third cause is the remarkable advances in medical technology. Anyone who has visited a hospital intensive care unit for the first time may be shocked by the coexistence of humans and machines. Humans are surrounded by machines – breathing machines, feeding machines, heart monitors, EKG machines, CPR machines, etc. The machines and humans work as one, and when the machines stop, so does the human life. If these medical procedures are performed against the patient’s will, it raises the question of whether it is humane and ethical to prolong life with the help of these machines when the patient is truly dying. To what extent should humans rely on machines to keep them alive? This extends beyond just biological life to issues related to human dignity. For example, if a patient is forced to rely on a machine to prolong their life against their will, when their life is in immediate danger without a life-support device such as a ventilator or dialysis machine, is that really “life”? This is where another issue related to medical ethics comes into play. Medical professionals, families, and society must deeply consider whether it is right to simply prolong life without considering the dignity of the patient.
These issues lead to the essence of the euthanasia debate. Technological advances can give humans more life, but if human dignity and autonomy are not fully taken into account in the process, there is a risk that technological advances can dehumanize us. Therefore, it is important to remember that when discussing the issue of euthanasia, it is not just a question of whether or not to prolong life, but rather a question of human dignity, autonomy, and quality of life.
