Is there truly such a thing as ‘the right to die’ or ‘dying with dignity’ as euthanasia advocates claim?
Few issues cut to the heart of human dignity and ethics, like (voluntary and involuntary) euthanasia and physician-assisted suicide. Both continue to ignite intense global debate, raising critical ethical, legal, and societal questions that we must address.
While there’s a technical distinction—assisted suicide involves the patient self-administering a lethal substance rather than a medical practitioner—the outcome is the same. For simplicity, this article uses the terms interchangeably.
At its core, assisted suicide involves the killing of a human being, mostly under the banner of “compassion” and relief from suffering. However, as this article explores, the line between compassion and callousness in euthanasia is perilously thin.
Back in 1826, physician Carl Friedrich Marx asserted that a doctor should never intentionally hasten a patient’s death, whether out of compassion or external pressure. This view mirrored long-standing beliefs, particularly in Christian and Western societies, where assisted suicide was equated with murder and strictly forbidden.
This view shifted in the late 19th century as euthanasia movements gained traction. Fast forward to 2001 and 2002, when the Netherlands and Belgium became the first countries to legalise euthanasia, spurring a growing list of countries to follow suit. The UK, however, remains deeply divided, with a contentious assisted suicide bill currently under parliamentary debate.
The UK Assisted Suicide Bill
UK parliamentarians are set to vote on a new assisted suicide bill at the end of November. If passed, this catastrophic proposal—the Terminally Ill Adults (End of Life) Bill—would allow terminally ill people with an estimated prognosis of 6 months or less to end their own lives.
This bill inevitably raises a plethora of problems. While Kim Leadbeater MP, who proposed the legislation, has told the public that the bill includes strict safeguards, the reality is far more ambiguous. These safeguards can still contain flaws. Take the criteria that the patient must be within 6 months of the end of their life. How can that be reconciled with the copious research showing that doctors very often get this prognosis wrong?
The bill marks the first time that UK law would allow medical practitioners to actively end their patient’s life, redefining the boundaries of medical ethics and healthcare.
While two medical practitioners must sign off on allowing the patient to end their life—the second, “independent” practitioner is chosen by the first. If they refuse, the first may ask a second choice.
Notably, 90% of palliative care specialists in the UK oppose legalising euthanasia. This reflects the broader commitment among medical professionals to provide unwavering support and reassurance to patients rather than helping them to end their lives.
These specialists have seen that when patients receive compassionate, high-quality care, the desire to end their lives almost always fades. The concerns voiced by palliative care experts remind us that euthanasia, despite intentions, is not the compassionate solution it’s made out to be.
Historical Intellectual Reasoning for Euthanasia
The early euthanasia movement was shaped by several trains of thought.
One driving force was Utilitarianism, a philosophy that prioritises pleasure and the minimisation of pain. In this view, ending lives could be justified if it relieved suffering or contributed to a perceived greater good.
Another was Neo-Lockeanism, which posited that only those capable of rational thought should be considered full people. This perspective devalued the lives of those with mental health disorders or cognitive disabilities.
Then came Social Darwinism, a controversial offshoot of Darwin’s theory of evolution. It argued that humanity could be “improved” by selecting desirable traits and eliminating “undesirable” ones from the gene pool. This meant encouraging the procreation of the “fit” and preventing or ending the lives of those deemed “unfit”.
Charles Goddard, an early advocate of euthanasia, echoed these views. He suggested euthanasia for people he described as “idiots” lacking the capacity for joy or purpose. This was not a fringe idea in the early euthanasia movement—it was a foundational one, closely tied to the eugenics movement. Both saw Social Darwinism as justification for selecting which lives were worth living.
The most infamous application of these ideas was Nazi Germany’s eugenics program, which fully implemented euthanasia as a state policy. The program required the reporting of any disabled child under the age of three, many of whom were euthanised. By 1945, around 250,000 people were killed as part of this program, a troubling reality where ideological justifications for “purity” and “utility” led to these atrocities.
Euthanasia and the Nuremberg Trials
Reflecting on the roots of the Nazi euthanasia program, psychiatrist Leo Alexander noted in the New England Journal of Medicine that it all started with one troubling idea: the notion that certain lives were “not worthy of being lived”.
Initially, this idea was applied to the severely and chronically ill. But gradually, the net widened to include anyone deemed “socially unproductive”, ideologically undesirable, or racially “unwanted”. Alexander highlighted how this “infinitely small lever” of thinking—dismissing the value of certain lives—ultimately set the stage for the horrors that followed. Combined with a lack of respect for human dignity and compounded by economic pressures, this perspective enabled one of the 20th century’s darkest chapters.
Thankfully, the aftermath of World War II cast a long and damning shadow over the euthanasia movement. Public outrage surged, and rightfully so, as the world grappled with the reality of how easily the notion of “mercy” could be weaponised. What began as an ostensibly compassionate act for the incurably ill had devolved into a horrifying eugenics agenda, exposing the fragility of moral boundaries when life-and-death decisions are placed in human hands.
By the end of the war, the so-called pursuit of alleviating suffering had instead led to unspeakable suffering itself. The movement’s association with such widespread and calculated brutality revealed its susceptibility to abuse, eroding public trust. This highlighted the inherent dangers of presuming authority over the value of individual lives, leading to a sharp decline in the movement’s credibility and support.
Today’s Arguments for Assisted Suicide
Economic Factors
Historically, some proponents have openly linked euthanasia to economic concerns. Jacques Attali, a prominent European statesman, once argued that as people age beyond their productive years, they become costly for society, suggesting that euthanasia could be a necessary tool for future economies.
Similarly, Baroness Mary Warnock, a major figure in British politics, framed euthanasia as a rational choice for those who feel they are a burden on their families or the state, even suggesting a moral obligation to consider it.
Today, explicit economic arguments are rare and mostly hidden. However, we must stay aware that economic concerns remain a powerful factor. While most advocates of euthanasia are motivated by supposed compassion, the practice can still be influenced by economic interests. As the taxpayer base shrinks and the elderly population continues to grow, the financial pressures to offer or even encourage euthanasia will likely intensify.
In fact, economic influences on euthanasia are already visible. In Oregon, for instance, financial constraints have been cited as a reason for choosing euthanasia. In some jurisdictions, the practice has even created a pathway for organ harvesting.
As these trends develop, the risk of economic pressures overtaking compassionate motives in the practice of euthanasia is a very real and pressing concern.
Compassion as Motivation
Another angle, and probably the most supported one, is compassion. But compassion doesn’t involve supporting someone’s decision to end their life. If a healthy friend were contemplating suicide, we wouldn’t consider it compassionate to assist them. Instead, we would do everything possible to remind them of their worth, showing them that their life has dignity and purpose. True compassion involves guiding someone back from the edge, not pushing them over it.
Even if someone accepts the flawed premise that euthanasia can be “compassionate”, legalised euthanasia brings broader consequences. Thousands of people may feel pressured to end their lives—not out of personal choice, but because they feel they are a burden or because the state finds it less costly than providing care.
What may appear compassionate to some can, in practice, result in far-reaching and profoundly uncompassionate consequences for many.
And if we use compassion to justify euthanasia, where does that rationale end? Why should it only apply to those who request it? Shouldn’t it also include involuntary euthanasia for children or disabled individuals who are suffering, as permitted under regulations in the Netherlands?
This slippery slope shows that once euthanasia is allowed, limiting or strictly regulating it becomes increasingly difficult. What begins as compassion risks becoming a doorway to decisions that erode the very dignity and respect for life that compassion aims to uphold.
Autonomy as an Argument
We must first ask: why is autonomy important, and is it the ultimate value, outweighing all others? If autonomy were absolute, euthanasia would need to be permitted in all cases—for anyone, at any time, in any condition—simply because they choose it. Yet, most people reasonably feel troubled with such an unrestricted approach.
Even strong advocates of euthanasia usually argue for limits—no euthanasia for children, healthy people, or people with certain mental disorders, for instance. Yet, if autonomy is the sole justification, these boundaries become difficult to defend. Moreover, increasing one person’s autonomy can, in some cases, restrict the autonomy of others.
Evidence from Oregon shows that over half of euthanasia requests cite feelings of being a burden as a primary reason. This highlights how legalised euthanasia can undermine the authority of those who are vulnerable to outside pressure. Assisted suicide risks creating subtle (or explicit) pressure on people, especially those with serious illnesses, to choose death over costly care, effectively diminishing autonomy rather than preserving it. There is a high risk that the “right to die” could evolve into a perceived duty to.
Furthermore, we often limit autonomy in areas where it might lead to exploitation or where vulnerable people might feel forced into choices they wouldn’t otherwise make. We restrict autonomy to prevent self-harm or degradation; we never permit people to randomly amputate their limbs, even if they choose or want to.
A Look Around the World
In countries where assisted suicide is legal, there’s a suggestion that not all lives are equal—some lives are seen as “worthy” while others, particularly those of the vulnerable, are seen as expendable, building on the early intellectual bases for euthanasia. Let’s look at the Netherlands and Belgium, for example.
The Netherlands faces criticism for insufficient palliative care. In contrast, the UK, which has resisted euthanasia for many years, has significantly improved the quality of life for patients who, in other countries, might instead have been steered toward euthanasia.
In these countries, the boundaries of assisted suicide have expanded over time. People suffering from mental health disorders such as depression, schizophrenia and anorexia nervosa are now eligible for euthanasia.
The age criteria for euthanasia have also broadened. In Belgium, children of any age can request euthanasia if they are deemed capable of understanding their decision. Similarly, the Netherlands allows euthanasia for children aged 12 and older and is discussing the possibility of lowering this age threshold further. In the Netherlands, the ‘Groningen Protocol’ allows for the euthanasia of ill newborns. And there is now momentum toward allowing euthanasia for anyone over a certain age who feels their life is “complete”.
This shift in the Netherlands suggests a growing acceptance of euthanasia based not on medical need, but on subjective quality-of-life judgments that devalue the natural aging process and erode respect for the sanctity of life. There have also been cases where transgender people were granted euthanasia due to psychological distress, either before or after “transitioning”. This shows how the criteria of these laws can quickly expand to include anyone.
Conclusion: Euthanasia Should Never Be Legalised
As these trends illustrate, the logic of assisted suicide opens the door to a progression of ever-widening boundaries, which puts many at risk, regardless of age, gender, or ability. While supporters of euthanasia argue for the compassionate choice, the real-world consequences reveal a troubling trajectory that risks prioritising economic and social interests over inherent human dignity, equality, and life.
Will you write to your MP to ask them to say NO to assisted suicide and support the lives of the vulnerable?
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