Euthanasia: A Legal and Ethical Analysis of Healthcare Practices

This essay provides a comprehensive analysis of euthanasia, encompassing its legal and ethical dimensions. It begins by defining euthanasia and its various forms, including active, passive, voluntary, and involuntary euthanasia. The essay then delves into the legal status of euthanasia in Australia, highlighting the relevant laws, including the Voluntary Assisted Dying Act 2017 in Victoria and the historical Rights of the Terminally Ill Act in the Northern Territory. The arguments for and against euthanasia are explored, including the right to self-determination, the potential for suffering, and the concerns about weakening societal values and the role of doctors. The legal doctrine of necessity and its application to end-of-life care are discussed, as are relevant court cases such as Director of Public Prosecutions v Nestorowycz and R v Cox. The ethical considerations, including rights-based arguments and the principle of beneficence, are also examined, along with the growing public acceptance of euthanasia. The essay concludes by emphasizing the importance of considering all perspectives before making decisions on the legalization of euthanasia and advocating for free and fair democratic processes to determine the issue's outcome.

“The word euthanasia, originated in Greece means a good death. Euthanasia encompasses
various dimensions, from active (introducing something to cause death) to passive (withholding
treatment or supportive measures); voluntary (consent) to involuntary (consent from guardian)
and physician assisted (where physician's prescribe the medicine and patient or the third party
administers the medication to cause death). Request for premature ending of life has contributed
to the debate about the role of such practices in contemporary health care. This debate cuts
across complex and dynamic aspects such as, legal, ethical, human rights, health, religious,
economic, spiritual, social and cultural aspects of the civilised society.” (Math, S. B., &
Chaturvedi, S. K., 2012)
“Euthanasia and assisted dying are topical issues around the world. In Australia, attempts to
reform the law occur regularly, while in Europe and North America there is a trend towards the
legalisation (or decriminalisation) of voluntary euthanasia and physician-assisted dying.
Euthanasia is a deliberate, intentional act of one person to end the life of another person in order
to relieve that person’s suffering. Three of the most common are:
• Voluntary euthanasia: Euthanasia is performed at the request of the person whose life is ended,
and that person is competent.
• Non-voluntary euthanasia: Euthanasia is performed and the person is not competent. For
example, a doctor injects a patient in a post-coma unresponsive state (sometimes referred to as a
persistent vegetative state) with a lethal substance.
• Involuntary euthanasia: Euthanasia is performed and the person is competent but has not
expressed the wish to die or has expressed a wish that he or she does not die.” (Euthanasia and
Assisted Dying, n.d.)
“Euthanasia is illegal in all Australian States and Territories, and may result in a person being
charged with murder, manslaughter or assisting suicide. Assisted suicide is illegal in all
Australian States and Territories except for Victoria. On 29 November 2017 the Victorian
Legislative Assembly passed the Voluntary Assisted Dying Act 2017 ('the Act'), which will
legalise voluntary assisted dying (physician-assisted suicide) in Victoria from 19 June 2019. The
Act is discussed further below. Between March 1996 and March 1997, voluntary euthanasia and
physician-assisted suicide were legal in the Northern Territory under the Rights of the
Terminally Ill Act (NT). However, in 1997 the Australian Government intervened, using the
Territories power in the Australian Constitution to pass legislation abolishing the Act. Physician-
assisted suicide and euthanasia are now illegal in the Northern Territory. There have been many
attempts to legalise euthanasia in Australian States and Territories, with an increasing number of
Bills on this topic being introduced into State and Territory Parliaments. However, apart from the
Northern Territory, none of these bills have become law.” (Euthanasia and Assisted Dying, n.d.)
FOR:

1. “that people have a right to self-determination, and thus should be allowed to choose their
own fate
2. assisting a subject to die might be a better choice than requiring that they continue to suffer
3. the distinction between passive euthanasia, which is often permitted, and active euthanasia,
which is not substantive (or that the underlying principle–the doctrine of double effect–is
unreasonable or unsound);
4. permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-
euthanasia activists often point to countries like the Netherlands and Belgium, and states
like Oregon, where euthanasia has been legalized, to argue that it is mostly unproblematic.”
(Euthanasia- Arguments in Favour and Against, 2016)
AGAINST:
 “euthanasia would weaken society's respect for the value and importance of human life
 proper palliative care is available which reduces or removes the need for people to be in pain
 it would lead to worse care for the terminally ill
 it would put too much power in the hands of doctors, and damage the trust between patient and
doctor
 some people may feel pressured to request euthanasia by family, friends or doctors, when it
isn't what they really want
 it would undermine the commitment of doctors and nurses to save lives
 it would discourage the search for new cures and treatments for the terminally ill” (Euthanasia
- Revision 3, n.d.)
“Euthanasia is fundamentally incompatible with the physician’s role as healer, would be difficult
or impossible to control, and would pose serious societal risks. Euthanasia could readily be
extended to incompetent patients and other vulnerable populations. The involvement of
physicians in euthanasia heightens the significance of its ethical prohibition. The physician who
performs euthanasia assumes unique responsibility for the act of ending the patient’s life.”
(Euthanasia, n.d.)
LAW:
“These charges of hypocrisy and reliance on damaging legal fictions might be deflected,
however, if the law acknowledged an alternative rationale for the 'exception' outlined in the
English case law. That rationale is the legal doctrine of 'necessity'. Applying this doctrine, the
administration of a potentially fatal dose of pain relieving drugs would be excused as necessary
if that was the only way for the doctor to relieve the patient's pain, and thus the doctor's only
other option would be to leave the patient without adequate pain relief.

The sophistication of modern methods of pain relief would mean, however, that explicit legal
recognition of a 'necessity' defence in these terms would only justify intentional administration of
life-shortening pain relief by a doctor in the most exceptional circumstances. If the law wished to
use the doctrine of necessity to legitimise such behaviour by doctors in a broader range of
circumstances, it would need to specify clearly and explicitly in which circumstances the
doctrine would apply.
In 1991 the Law Reform Commission of Western Australia expressed concern at the uncertainty
of the legal position when death is hastened by the administration of pain relieving drugs.
Accordingly it recommended that legislation be introduced to protect doctors from liability 'for
administering drugs or other treatment for the purpose of controlling pain, even though the drugs
or other treatment may incidentally shorten the patient's life, provided that the consent of the
patient is obtained and that the administration is reasonable in all the circumstances'. No such
legislation has been enacted in Western Australia.
Only South Australia has statutory provisions that clarify the law on this issue. Section 17(1) of
the new Consent to Medical Treatment and Palliative Care Act 1995 (SA) applies to the
situation where a doctor, or other health care professional acting under a doctor's supervision,
administers medical treatment 'with the intention of relieving pain or distress', even though 'an
incidental effect of the treatment is to hasten the death of the patient'. The Medical Treatment
Act 1988 (Vic) provides that its operation 'does not affect any right, power or duty which a
medical practitioner or any other person has in relation to palliative care'. In June 1995 the
Queensland Parliament passed the Criminal Code Act 1995 (Qld) to repeal the Criminal Code
Act 1899 (Qld) and thereby introduce a new Criminal Code. The amending legislation replaces
section 282 of the old Criminal Code with a new section 82.” (Natasha Cica, 2013)
CASES:
“Director of Public Prosecutions v Nestorowycz [2008] VSC 385:
Nestrowycz’s husband suffered from dementia and diabetes and was in a wheelchair. Although
her husband pleaded to be taken home from care, there was no clear evidence of his intent to die.
Nestrowycz stabbed her husband and then attempted suicide. She pleaded guilty to attempted
murder and received a suspended sentence of 2 years 9 months.
R v Cox (1992) 12 BMLR 38
Mrs Boyes, an elderly lady, was in agonising pain from rheumatoid arthritis. She had known Dr
Cox for 13 years and he said she would not suffer. After many unsuccessful attempts to control
her pain Mrs Boyes begged Dr Cox to kill her. Dr Cox administered a large dose of potassium
chloride and Boyes died shortly after. Cox was charged with attempted murder (the Crown was
unsure if they could prove the drugs killed Boyes or she died from her other conditions. Boyes’

body had been cremated and therefore there was no scientific evidence the potassium chloride
killed her).
During the trial the jury was instructed on the doctrine of double effect: Cox could only be
convicted if his primary intention was to cause her death. Significantly in this case, the
potassium chloride did not have any curative or pain-relieving properties and was estimated to be
twice the legal dose. The jury convicted Cox of attempted murder (Cox received a suspended
sentence of one year imprisonment and was allowed to return to his medical duties under
supervision).
R v Justins [2011] NSWSC 568
Justins was the long term partner of Wylie. Jennings was their friend. Wylie suffered from
Alzheimer’s disease and six months prior to his death he had attempted suicide by cutting his
wrists. He stated he wanted to go to Switzerland to have assistance in committing suicide
through an organization called Dignitas. However Dignitas rejected Wylie’s application on the
grounds Wylie may not have the capacity to make the decision to end his own life. Wylie then
attempted suicide again.
Jennings then travelled to Mexico to source the drug Nembutal (which is illegal in Australia) for
the purpose of ending Wylie’s life. Wylie was provided with the Nembutal, drank it voluntarily
and died. Justins and Jennings then concocted alibis and denied any connection with Wylie’s
death. Prior to Wylie’s death, and with Justins’ assistance, Wylie had changed his will to provide
Justins with a much greater benefit, to the exclusion of Wylie’s daughters.
The jury must have been satisfied that Wylie lacked capacity to make an informed decision to
end his life and found Justins guilty of manslaughter. She received a sentence of 2.5 years
imprisonment with a non-parole period of 22 months to be served by periodic detention. Justins’
conviction was overturned on appeal and she pleaded guilty to the lesser offence of aiding and
abetting suicide. She received no further punishment as, by that time; she had served 22 months
in prison. Jennings committed suicide prior to being sentenced.” (Euthanasia and Assisted
Dying, n.d.)

ETHICS AND EUTHANASIA:
“Rights-based argument
Advocates of euthanasia argue that a patient has the right to make the decision about when and
how they should die, based on the principles of autonomy and self-determination. Furthermore, it
is argued that as part of our human rights, there is a right to make our own decisions and a right
to a dignified death.
Beneficence
It is said that relieving a patient from their pain and suffering by performing euthanasia will do
more good than harm. Advocates of euthanasia express the view that the fundamental moral
values of society, compassion and mercy, require that no patient be allowed to suffer unbearably,
and mercy killing should be permissible.” (The ethics of euthanasia, n.d.)
Thus the ethics of empathy and right makes me support euthanasia.
“The question as to where to place euthanasia along moral lines is divided with those who
support it arguing that it is an act of mercy, kindness and compassion. Those in opposition
primarily and finally judge euthanasia as murder (Cavan & Dolan, 2000). It therefore would not
be conclusive to argue that everybody has accepted euthanasia regardless of whether it is ethical
or not. According to a survey done in respect to acceptance of euthanasia by the general public
the results show a growing level of acceptance (Top News, 2011). These results in comparison
with previous data indicate that there is a growing support for euthanasia as well as individual
rights to such matters. Overall in a number of western countries, there has been a notable
increase in euthanasia acceptance as the study showed and it further proved that pressure is still
building up for euthanasia to be legalized all over (Oxford, web).” (Law Teacher, 2013)
Taking everything into account, it might be vital for all voices to be heard before a rushed choice
is made on whether to legitimize willful extermination or not. Since every individual has a
privilege of articulation I figure the most ideal approach to respond to the topic of whether
willful extermination ought to be lawful be exposed to free and reasonable democratic and the
result be maintained.

REFERENCES:
Cica, Natasha. (2013, February 19). Euthanasia - the Australian Law in an International Context.
Retrieved from https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/
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(n.d.). Euthanasia. Retrieved from https://www.ama-assn.org/delivering-care/ethics/euthanasia
(2016, February 9). Euthanasia – Arguments in Favour and Against. Retrieved from
https://www.clearias.com/euthanasia/
(n.d.). Euthanasia - Revision 3 - GCSE Religious Studies - BBC Bitesize. Retrieved from
https://www.bbc.co.uk/bitesize/guides/z3fbwmn/revision/3
(n.d.). Euthanasia and Assisted Dying. Retrieved from https://end-of-life.qut.edu.au/euthanasia
(November 2013). Euthanasia is Ethical and Should Be Legal. Law Teacher. Retrieved from
https://www.lawteacher.net/free-law-essays/medical-law/euthanasia-is-ethical-and-should-be-
legal-law-medical-essay.php?vref
Math, S. B., & Chaturvedi, S. K. (2012, December). Euthanasia: right to life vs right to die. Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612319/
(n.d.). The ethics of euthanasia. Retrieved from https://www.amsj.org/archives/2066