Open Access Journal of Science

Review Article Open Access

Investigation of the ethical and legal issues of

euthanasia and assisted suicide
Abstract Volume 7 Issue 1 - 2024
Euthanasia and assisted suicide are highly complex and ethically charged medical practices
that challenge societal norms and legal frameworks worldwide. This research investigates
Shakibapoor Amanda Petra
Department of Civil Law, University of Pécs, Hungary
the multifaceted ethical and legal dilemmas surrounding these end-of-life options. It
examines the core ethical arguments for and against euthanasia and assisted suicide, Correspondence: Shakibapoor Amanda Petra, Department of
including autonomy, beneficence, non-maleficence, and justice. The analysis explores Civil Law, University of Pécs, Hungary, Tel 0036302627661,
different legal approaches to these practices globally, comparing permissive, restrictive, and Email
prohibitive regimes. It delves into the legal complexities of informed consent, competency,
vulnerability, and the potential for abuse. Furthermore, the research examines the role Received: Ocotober 01, 2024 | Published: Ocober 18, 2024
of palliative care and the impact of social, cultural, and religious factors on the debate.
This investigation aims to provide a comprehensive understanding of the ethical and legal
landscape of euthanasia and assisted suicide, contributing to informed policy-making and
ethical medical practice.
Euthanasia and assisted suicide are topics that spark intense ethical, legal, and social debate.
Both are related to the right to die, but there are fundamental differences between them.

Keywords: ethical, legal, and social debate, consent, competency, vulnerability,

legalization, potential impact

Introduction and explore alternative approaches to end-of-life care that prioritize

comfort and dignity.
The intersection of life, death, and individual autonomy has long
been a source of profound ethical and legal debate. Euthanasia and By providing a comprehensive analysis of the ethical and legal
assisted suicide, practices aimed at intentionally ending a life to relieve complexities surrounding euthanasia and assisted suicide, this
suffering, sit at the heart of this complex discourse. This investigation investigation aims to contribute to a more informed and nuanced
delves into the multifaceted ethical and legal issues surrounding these public discourse on this highly sensitive and deeply personal issue.
practices, exploring the arguments for and against their legalization,
Euthanasia
the potential impact on vulnerable populations, and the challenges of
balancing individual rights with societal interests. Euthanasia is an act performed by a physician with the aim of
ending the life of a terminally ill patient, at the patient’s explicit
Historically and across cultures, attitudes towards euthanasia
request. There are two main types: active euthanasia and passive
and assisted suicide have varied significantly, reflecting diverse
euthanasia. In active euthanasia, the physician actively intervenes,
philosophical, religious, and cultural perspectives. In recent decades,
for example, by administering a lethal injection, while in passive
however, advancements in medical technology and a growing emphasis
euthanasia, the physician withdraws life-sustaining treatment, such as
on individual autonomy have reignited these debates, prompting legal
turning off a respirator.
challenges and legislative changes in several countries.
Regarding its legal status, euthanasia is illegal in most countries,
This investigation will examine the core ethical principles at play,
but it is permitted under strict conditions in a few countries, such as the
including autonomy, beneficence, non-maleficence, and justice. It will
Netherlands, Belgium, and Luxembourg. Its existence raises important
analyze the arguments for legalization, such as respect for individual
ethical questions such as the role of the physician: contradiction with
choice, alleviation of unbearable suffering, and the right to die with
the oath to preserve life and alleviate suffering; patient autonomy1:
dignity. Conversely, it will address the concerns raised by opponents,
the patient’s right to decide about their own life; and the potential for
including the sanctity of life, the potential for abuse and coercion,
abuse: coercion of vulnerable patients into euthanasia.
the slippery slope argument, and the impact on the doctor-patient
relationship. Assisted suicide
Furthermore, this investigation will analyze the current legal By definition, assisted suicide occurs when a physician provides
landscape surrounding euthanasia and assisted suicide, examining the a lethal drug to the patient, but the patient takes it themselves. In
diverse approaches adopted by different jurisdictions. It will explore terms of its legal status, it is permitted in a few countries, such as
the legal safeguards implemented in countries where these practices Switzerland and some states in the USA, but it is explicitly prohibited
are permitted, aiming to prevent abuse and ensure that decisions are and sanctioned in most countries. Ethical issues to be considered
made voluntarily and with full informed consent. include: the role of the physician: indirect participation in death;
Finally, this investigation will consider the broader societal patient autonomy: the patient’s right to choose the time and manner
implications of legalizing euthanasia and assisted suicide, including of their own death; and the potential for abuse: assisting mentally
the potential impact on vulnerable populations, such as the elderly, unstable patients with suicide.
disabled, and terminally ill. It will examine the role of palliative care 1
Voluntary Euthanasia- Timothy E. Quill

Submit Manuscript | http://medcraveonline.com Open Access J Sci. 2024;7(1):205‒212. 205

©2024 Petra. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and build upon your work non-commercially.
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 206

Comparison Euthanasia and assisted suicide are currently prohibited in Hungary.

The Criminal Code (Btk.) criminalizes aiding and abetting suicide.
Euthanasia and assisted suicide can be compared in several The issue of euthanasia and assisted suicide raises numerous ethical
respects. They can be distinguished based on who performs the act: and legal dilemmas, which are the subject of a broad social debate.
the physician in the case of euthanasia, and the patient in the case The development of palliative care, the more effective management
of assisted suicide. The physician’s role is active in euthanasia and of pain, and the strengthening of patients’ right to self-determination
passive in assisted suicide. In terms of legal status, euthanasia is illegal shed new light on these issues.7
in most countries, while assisted suicide is legal in a few countries.2
Numerous ethical issues can arise during palliative care, such
It is important to examine the patient’s motivations in both cases. as the extent of patient information, the limits of pain relief and
In both cases, the patient’s motivation may be unbearable suffering symptomatic treatment, making end-of-life decisions, and involving
caused by an incurable disease, loss of dignity, or deterioration in the relatives in care. The professional ethics of healthcare workers,
quality of life. Physicians must carefully consider the patient’s request guidelines on palliative care, and the individual values of patients and
in both cases and ensure that the decision is voluntary, informed, and their relatives play an important role in answering ethical questions.8
well-considered.
The legal regulation of palliative care is constantly evolving,
In terms of social impact, the legalization of euthanasia and and the legislator and the judiciary must face numerous challenges.
assisted suicide can affect society’s attitude towards death and raise Respecting patients’ right to self-determination, ensuring equal access
the possibility of abuse. to care, and answering ethical questions are all crucial to improving
It is important to note that euthanasia and assisted suicide are the quality of palliative care and preserving the dignity of patients.
complex and controversial topics, and there is no single correct Religious and cultural views: Different religions and cultures have
answer to the ethical questions raised. Decision-making should take different views on euthanasia and assisted suicide. It is important to
into account the patient’s individual circumstances, as well as the respect these views in discussions.
social and cultural context.3
The history of euthanasia
Further considerations
Throughout history, numerous cultures and philosophical schools
Palliative care: Palliative care aims to improve the quality of life of thought have addressed the issue of euthanasia, and its perception
of terminally ill patients by alleviating symptoms and providing has changed significantly over time.9
psychosocial support. The development of palliative care may offer
an alternative to euthanasia and assisted suicide. I. Ancient times: In ancient Greece and Rome, euthanasia was
considered acceptable in certain cases. Socrates, Plato, and the
Palliative care, which aims to improve the quality of life of people Stoic philosophers supported ending suffering when it became
with life-threatening illnesses by alleviating physical, psychosocial, unbearable.
and spiritual suffering, is increasingly emphasized in the healthcare
system. At the same time, there is a need to clarify legal regulations II. Middle ages: With the spread of Christianity, the perception
and answer ethical questions.4 of euthanasia took a negative turn. Due to the emphasis on the
sanctity of life, euthanasia became prohibited.
Act CLIV of 1997 on Health Care (Eütv.) states that the patient has
the right to refuse care, including life-sustaining treatment. According III. Modern era: The question of euthanasia arose again during the
to the interpretation of the Constitutional Court, this right also Enlightenment. Several philosophers, including David Hume
includes the right to palliative care (Decision 23/1990. (X. 31.) AB). and Immanuel Kant, argued for the importance of individual
In exercising the patient’s right to self-determination, an important autonomy, which includes the right to decide about death.
role is played by advance care planning, during which the patient can IV. 20th Century: Euthanasia movements gained new momentum
make advance directives about what treatments they want or refuse in the 20th century. The first euthanasia society was founded in
in case of incapacity. The Eütv. regulates the form and content of England in 1935. In Nazi Germany, the euthanasia program was
advance care planning in detail.5 distorted and used for mass murder. This tragic event cast a long
Access to palliative care is a fundamental human right, which is shadow over the perception of euthanasia.
also enshrined in several international documents. In Hungary, the V. Present day: Euthanasia remains a subject of serious ethical and
Eütv. guarantees the right to palliative care for patients, but there legal debate today. In some countries, such as the Netherlands,
are still significant inequalities in access to care. In order to improve Belgium, and Luxembourg, euthanasia is legal. In other
access, it is of paramount importance to develop the palliative care countries, including Hungary, euthanasia is prohibited.10
system, ensure geographical and financial access to services, and
inform the public about the possibilities of palliative care.6 7
János Bodnár, Zoltán Sümegi: Legal regulation of palliative care in Hungary.
Health Economic Review, 2014/4. issue, pp. 101-108.
2
Euthanasia and Assisted Suicide: A Physician's and Ethicist's Perspectives - 8
József Radnay: Legal regulation of end-of-life decisions in Hungary. Journal
Timothy E. Quill and Margaret P. Battin (The Annals of Internal Medicine) of Legal Studies, 2013/1. issue, pp. 1-12.
3
Euthanasia and Assisted Suicide: A Physician's and Ethicist's Perspectives - 9
The History of Euthanasia Debates in the United States and Britain - Ezekiel
Timothy E. Quill and Margaret P. Battin (The Annals of Internal Medicine ) Emanuel (1994): This article, available on PubMed (https://pubmed.ncbi.nlm.
4
The Oxford Textbook of Palliative Medicine - Nathan Cherny nih.gov/7944057/)
5
23/1990. (X. 31.) AB decision 10
The History of Euthanasia Debates in the United States and Britain - Ezekiel
6
Katalin Hegedűs: Ethical issues of palliative care. Lege Artis Medicinae, Emanuel (1994): This article, available on PubMed (https://pubmed.ncbi.nlm.
2012/1. issue, pp. 45-50. nih.gov/7944057/)

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 207

Historical aspects of euthanasia has been legal in Switzerland since 1942, and in recent decades
it has been legalized or decriminalized in several other countries.
I. Religious aspects: Religious views have significantly influenced
the perception of euthanasia. Christianity, Judaism, and Islam all Historical aspects of assisted suicide
condemn euthanasia.
I. Religious aspects: Most religions, including Christianity,
II. Philosophical aspects: Many philosophical schools of Judaism, and Islam, condemn suicide, including assisted suicide.
thought have addressed the issue of euthanasia. Utilitarianism,
II. Philosophical aspects: Philosophers have debated the
existentialism, and liberal philosophy consider euthanasia
moral permissibility of suicide for centuries. Utilitarianism,
acceptable in certain cases.
existentialism, and liberal philosophy may consider assisted
III. Legal aspects: The legal regulation of euthanasia varies from suicide acceptable in certain cases.
country to country. Those who argue for the legalization of
III. Legal aspects: The legal regulation of assisted suicide varies
euthanasia emphasize the individual’s right to self-determination
from country to country. Those arguing for its legalization cite
and the importance of ending suffering. Opponents of euthanasia
individual autonomy and the avoidance of suffering. Opponents
cite the sanctity of life, the potential for abuse, and the role of
emphasize the sanctity of life, the potential for abuse, and the
physicians.
role of physicians.12
Further important aspects of euthanasia
Further important aspects of assisted suicide
I. Euthanasia can be active (directly causing the patient’s death) or
I. Assisted suicide is generally permitted only under strict
passive (withholding life-sustaining treatment).
conditions. The person must be suffering from an incurable
II. It is generally only permitted under strict conditions. The patient disease, must be competent, and must voluntarily request
must be suffering from an incurable disease and must voluntarily assistance.
request euthanasia.
II. The difference between assisted suicide and euthanasia is that in
III. It raises numerous ethical dilemmas. The most important issues assisted suicide, the person performs the lethal act themselves,
include the sanctity of life, the right to self-determination, the whereas in euthanasia, another person (usually a physician)
elimination of suffering, and the avoidance of abuse. performs it.
Euthanasia is a complex and controversial topic. Throughout III. Assisted suicide raises numerous ethical dilemmas, including
history, many cultures and philosophical schools of thought have those related to the sanctity of life, self-determination, suffering,
addressed the issue, and its perception has changed significantly over and the potential for abuse.
time. Today, euthanasia is the subject of serious ethical and legal
IV. Assisted suicide requires further social dialogue. It is important
debate. Further social dialogue will be needed in the future to find the
to find the right balance between individual autonomy, the
right balance between the sanctity of life, individual autonomy, and
sanctity of life, and the interests of society.
the elimination of suffering.
Assisted suicide, in which a person intentionally ends their own life The legal status of euthanasia in the world
with the help of another person who provides the necessary means or The legal regulation of euthanasia is extremely complex and varies
information, has a long and complex history. As with euthanasia, the from country to country. In most countries, euthanasia is prohibited
perception of assisted suicide has varied throughout history, and today in some form, but there are also countries where it is permitted under
it is the subject of serious ethical and legal debate. certain conditions. The lack or inconsistency of legal regulation raises
numerous ethical and practical problems.13
The History of Assisted Suicide11
I. Ancient times: In ancient Greece and Rome, suicide was I. Prohibited: Euthanasia is prohibited in most countries and
accepted in certain cases, and sometimes others assisted in carries criminal penalties. This is also the case in Hungary,
this. However, the Hippocratic Oath prohibits physicians from where euthanasia is considered homicide.
administering lethal poison, even upon request. II. Permitted: In some countries, such as the Netherlands, Belgium,
II. Middle ages: With the spread of Christianity, suicide, including Luxembourg, Canada, and Colombia, euthanasia is permitted
assisted suicide, was considered a sin. under certain conditions.

III. Enlightenment: In the 18th century, Enlightenment III. Assisted suicide: Assisted suicide is legal under certain
philosophers, such as David Hume, raised the issues of conditions in Switzerland, some US states (Oregon, Washington,
individual autonomy and the right to die. Montana, Vermont, California, Colorado, Hawaii, New Jersey,
Maine, New Mexico), and Australia (Victoria, Western Australia,
IV. 19th and 20th Centuries: In the 19th century, advances in Tasmania, Queensland, South Australia).
medicine allowed for more effective pain management, which
reduced the demand for assisted suicide. However, in the 20th Key issues in the legal regulation of euthanasia
century, due to the horrors of the Nazi euthanasia program, the
issue of assisted suicide remained taboo for a long time. The first step in legal regulation is to precisely define euthanasia.
This includes distinguishing between active and passive euthanasia,
V. Present day: In the late 20th and early 21st centuries, assisted as well as voluntary, non-voluntary, and involuntary euthanasia. Strict
suicide movements gained momentum again. Assisted suicide 12
Ancient euthanasia: 'good death' and the doctor in the graeco-Roman world"
11
Ancient euthanasia: 'good death' and the doctor in the graeco-Roman world" - Anton J. L. Van Hooff (2004)
- Anton J. L. Van Hooff (2004) 13
Legality of euthanasia - Wikipedia

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 208

conditions must generally be met to permit euthanasia. The patient III. Diane Pretty case (United Kingdom, 2002): Diane Pretty
must be suffering from an incurable illness, experiencing unbearable suffered from motor neurone disease and asked her husband to
pain, and must voluntarily request euthanasia. The legal regulation help her commit suicide. The court denied the request because
must also address the detailed rules of the euthanasia procedure. This assisted suicide was illegal in the UK. This case highlighted the
includes the role of physicians, informing the patient, the decision- legal differences between euthanasia and assisted suicide.18
making process, and record keeping. The legal regulation must
IV. Terri Schiavo case (USA, 2005): Terri Schiavo was in a
ensure the prevention of abuse. This includes strict control, obtaining
persistent vegetative state following a heart attack. Her husband
independent expert opinions, and protecting the patient’s rights.14
requested the withdrawal of artificial nutrition, while her parents
Challenges of legal regulation opposed it. The case led to a long legal battle involving the
Florida governor and the US Congress. Ultimately, the court
I. The legalization of euthanasia may contradict religious and ruled in favor of the husband and allowed the feeding to be
moral beliefs about the sanctity of life. stopped.19
II. Those who argue for the legalization of euthanasia cite the V. Lambert case (France, 2019): Vincent Lambert suffered severe
individual’s right to self-determination, which includes the right brain damage in a car accident and was in a persistent vegetative
to decide about death. state. A dispute arose within his family about the continuation
III. Legalizing euthanasia raises the possibility of abuse, especially of life-sustaining treatment. The case went all the way to the
in the case of vulnerable patients. European Court of Human Rights, which ultimately ruled that
France had not violated Lambert’s rights by withdrawing life-
IV. Legalizing euthanasia could change the role of physicians, sustaining treatment.20
whose primary responsibility is to preserve life.
Lessons from relevant legal cases
The legal regulation of euthanasia is constantly evolving. Social
and technological changes, as well as advances in medicine, pose new The legal cases highlight the importance of patient autonomy in
challenges for lawmakers. In the future, more countries are expected the matter of euthanasia. Courts generally respect the patient’s wishes,
to legalize euthanasia, and legal regulation will become increasingly as long as they can be clearly established. Advance directives, such
detailed and comprehensive. It is important to note that the legal as a living will, can help enforce the patient’s wishes when they
regulation of euthanasia raises not only legal, but also ethical, social, are no longer able to make decisions. Physicians play an important
and philosophical issues. Lawmakers must proceed with the utmost role in the euthanasia process. They are responsible for informing
caution and consider the interests of all parties involved.15 the patient, making the diagnosis, and explaining treatment options.
The legal cases highlight the importance of clear and comprehensive
Legal cases and court decisions have shaped the legal regulation of legal regulation in the area of euthanasia. Legal regulation must
euthanasia. These cases highlight the complexities of euthanasia and ensure the rights of patients while preventing abuse. Legal cases and
help to understand the ethical and legal dilemmas faced by lawmakers court decisions related to euthanasia are constantly shaping the legal
and courts. environment. As society and medicine evolve, new ethical and legal
questions arise that lawmakers and courts must answer.
Some important legal cases and court decisions
regarding euthanasia Comparing the situation in Hungary and the
Netherlands regarding euthanasia, the following
I. Karen Ann Quinlan case (USA, 1976): This case was one
of the first to receive widespread publicity on the issue of conclusions can be drawn21
euthanasia. Karen Ann Quinlan was in a persistent vegetative I. Legality: Euthanasia is prohibited in Hungary, while it is
state, and her parents requested the withdrawal of life-sustaining permitted in the Netherlands under strict conditions.
treatment. The court eventually allowed the respirator to be
II. Age limit: There is no age limit specified for euthanasia in
turned off, setting a precedent for allowing passive euthanasia
Hungary, as it is not permitted. In the Netherlands, it is permitted
in similar cases.16
for those over 18 years of age.
II. Nancy Cruzan case (USA, 1990): Nancy Cruzan suffered severe
III. Eligible conditions: In Hungary, euthanasia is only considered
brain damage in a car accident and was in a persistent vegetative
for terminal illnesses. In the Netherlands, it applies to those with
state. Her parents requested the withdrawal of artificial nutrition,
serious and incurable diseases.
but the court initially denied the request because there was no
evidence that Nancy would have wanted this. Later, after further IV. Decision-making capacity: Hungary requires full legal capacity
evidence was presented about Nancy’s previous wishes, the for decision-making. The Netherlands accepts limited capacity
court allowed the feeding to be stopped. This case emphasized for this purpose.
the importance of the patient’s advance directives in the matter V. Procedure: In Hungary, a strict medical committee review is
of euthanasia.17 required. In the Netherlands, this is replaced by a judicial review.
14
Euthanasia and Assisted Suicide: A Physician's and Ethicist's Perspectives
- Timothy E. Quill and Margaret P. Battin (The Annals of Internal Medicine) VI. Abuse: Hungary has strict penalties for abuse. The Netherlands
15
Assisted Suicide: The Liberal, Humanist Case Against Legalization - Julian has independent oversight.
Savulescu (2014) 18
Diane Pretty's Case: Assisted Suicide, Euthanasia and the Human Rights
16
In re Quinlan (70 N.J. 10, 355 A.2d 647 (N.J. 1976) (https://law.justia.com/
Convention" by Sheila McLean and Alison Britton (2003)
cases/new-jersey/supreme-court/1976/70-n-j-10-0.html) 19
The Terri Schiavo Case: Legal, Ethical, and Medical Perspectives" edited by
17
Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990) Arthur L. Caplan, James J. McCartney, and Dominic A. Sisti (2006)
(https://supreme.justia.com/cases/federal/us/497/261/), LexisNexis, or Oyez 20
Lambert and Others v. France (Application no. 46043/14)
(https://www.oyez.org/cases/1989/88-1503) 21
Euthanasia and Law in Europe" by Elspeth Guild (2004)

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 209

Comparing ethical considerations III. Societal Impact: Legalizing euthanasia can have an impact on
society as a whole. Some believe that legalization could lead to
I. Hungary: Emphasizes the absolute value of life, individual a decrease in the protection of the weak and vulnerable. Others
decision-making regarding their own life, avoidance of suffering, believe it could lead to an increase in solidarity and compassion.
family involvement, and elimination of potential abuse.
The legal and ethical issues of euthanasia are complex and
II. Netherlands: Focuses on preserving quality of life, limited interrelated. Legal regulation must take into account ethical dilemmas
self-determination, avoidance of suffering, and consideration of and find a balance between individual autonomy and the interests of
family wishes. society. The issue of euthanasia is not merely a legal or medical issue,
Euthanasia: legal and ethical dilemmas but fundamentally a human issue that touches on our deepest values.
Social dialogue and continuous reflection are essential to find the right
Euthanasia, the intentional shortening of the life of a terminally path in this complex issue.
ill patient with medical assistance, has been at the center of heated
debate for decades. The complexity of the topic lies in the fact that it Karsai Dániel and the Right to Die:A Legal Perspective
simultaneously raises complex legal and profound ethical questions. on Euthanasia in Hungary
The aim of this essay is to explore the dilemmas of euthanasia by
analyzing and comparing these issues in detail.22 Dr. Karsai Dániel, a renowned Hungarian lawyer and constitutional
expert, has brought the debate surrounding euthanasia to the forefront
Legal issues of public discourse in Hungary. Diagnosed with Amyotrophic
Lateral Sclerosis (ALS) in 2022, Karsai has publicly advocated for
The legality of euthanasia varies from country to country. While it the legalization of euthanasia, arguing that the current blanket ban
is permitted in the Netherlands and Belgium under strictly regulated in Hungary violates fundamental human rights. This paper examines
frameworks, it is a criminal offense in Hungary. This difference can be Karsai’s legal arguments, the specifics of his illness, and the broader
attributed to fundamental legal questions. Opponents of euthanasia, context of euthanasia legislation in Hungary and Europe, with relevant
citing the absolute value of life, emphasize that taking a human life legal references.25
is not permissible under any circumstances. The role of legislation
is to protect life, and legalizing euthanasia would contradict this Amyotrophic Lateral Sclerosis (ALS)
fundamental principle. Supporters of euthanasia, on the other hand,
highlight the individual’s right to self-determination. According to ALS is a progressive neurodegenerative disease with no known
this view, everyone has the right to decide about their own body and cure. It leads to the gradual loss of voluntary muscle control due to
life, including intervention in death. Prohibiting euthanasia restricts the degeneration of motor neurons. In its final stages, ALS results
individual autonomy and deprives individuals of the possibility of in paralysis, loss of speech, and the inability to breathe or swallow,
relief from suffering.23 One of the most important issues in legal ultimately leading to death, often through respiratory failure. Crucially,
regulation is the prevention of abuse. If euthanasia is legalized, there ALS does not impair cognitive function, leaving the individual fully
is a risk that patients may be pressured or even have their lives ended aware of their deteriorating condition and the inevitable outcome.26
against their will. Strict procedural rules and independent oversight This aspect of the disease is central to Karsai’s argument for the right
are essential to prevent abuse. to choose euthanasia.

Ethical issues Karsai’s Legal Challenge

In addition to legal issues, euthanasia also raises numerous ethical Karsai contends that the current Hungarian legal framework, which
dilemmas. These dilemmas relate to the meaning of life, suffering, the completely prohibits euthanasia and assisted suicide, infringes upon
role of the physician, and social responsibility.24 several fundamental human rights. He argues that denying individuals
the right to choose a dignified death in the face of unbearable suffering
I. Sanctity of Life: The main ethical problem of euthanasia is violates:
related to the question of the sanctity of life. According to most
religions and moral teachings, human life is sacred and inviolable. The right to self-determination and human dignity: This right
Euthanasia, even if voluntary, contradicts this principle and stems from the inherent dignity of the human person and encompasses
questions the value of life. Supporters of euthanasia argue that the freedom to make fundamental choices about one’s life and death.27
avoiding suffering is a moral obligation. Terminally ill patients
The right to self-determination and human dignity are fundamental
have the right to die with dignity rather than endure unbearable
principles enshrined in international human rights law and domestic
pain. Opponents, on the other hand, argue that suffering can
legal systems worldwide. They underpin the very concept of
have meaning and contribute to human development.
individual autonomy and freedom, allowing individuals to make
II. Role of Physicians: The traditional role of physicians is to choices about their lives and destinies free from undue interference.
preserve life and heal patients. Euthanasia changes this role and This paper explores the legal foundations of these rights, their
makes the physician the cause of death. This can lead to ethical interconnectedness, and their implications in various contexts, with
conflict for physicians, who must grapple with the Hippocratic relevant legal references.
Oath and their own conscience.
22
Euthanasia and Assisted Suicide (Contemporary Issues in Bioethics) - Dan 25
The Right To Die Like The Trees: Standing (<https://verfassungsblog.de/the-
W. Brock and Steven G. Holtzman right-to-die-like-the-trees-standing/>).
23
Euthanasia and Law in Europe - Elspeth Guild (2004) 26
National Institute of Neurological Disorders and Stroke. (n.d.). Amyotrophic
24
Assisted Suicide: The Liberal, Humanist Case Against Legalization - Julian lateral sclerosis (ALS) fact sheet. Retrieved from NINDS website
Savulescu (2014) 27
Right to life (Article 2, European Convention on Human Rights)

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 210

Legal foundations I. Medical Law: In the context of medical treatment, these rights
underpin informed consent and patient autonomy, allowing
International Law individuals to make decisions about their own healthcare.34
I. Universal Declaration of Human Rights (UDHR): The II. End-of-Life Decisions: The debate surrounding euthanasia and
UDHR, though not a legally binding treaty, proclaims the assisted suicide centers on the right to self-determination, with
inherent dignity and the equal and inalienable rights of all proponents arguing that individuals should have the right to
members of the human family as the foundation of freedom, choose a dignified death.35
justice, and peace in the world.28
III. Reproductive Rights: The right to self-determination is central
II. International Covenant on Civil and Political Rights to debates about abortion and contraception, with arguments
(ICCPR): Article 1 of the ICCPR recognizes that all peoples focusing on the individual’s right to control their own body and
have the right of self-determination. By virtue of that right they reproductive choices.36
freely determine their political status and freely pursue their
economic, social and cultural development.29 IV. Disability Rights: Respect for human dignity requires ensuring
that persons with disabilities have equal opportunities and are
III. International Covenant on Economic, Social and Cultural not discriminated against.37
Rights (ICESCR): The ICESCR, while not explicitly
mentioning „self-determination,” recognizes the right of V. Indigenous Rights: The right to self-determination is crucial
everyone to self-determination in relation to their economic, for indigenous peoples, allowing them to exercise control over
social, and cultural development.30 their lands, resources, and cultural development.38
Regional Law Challenges
I. European Convention on Human Rights (ECHR): While I. Balancing competing rights: The exercise of self-determination
not explicitly mentioning „self-determination,” the ECHR may sometimes conflict with other rights or societal interests.
protects the right to respect for private and family life (Article Balancing these competing rights is a complex legal and ethical
8), which encompasses aspects of personal autonomy and self- challenge.39
determination.31 II. Vulnerable groups: Protecting the self-determination and
II. African Charter on Human and Peoples’ Rights: Article 20 dignity of vulnerable groups, such as children, persons with
of the African Charter recognizes the right of all peoples to self- disabilities, and the elderly, requires special legal and social
determination.32 safeguards.40

Domestic Law III. Globalization and technology: Rapid technological

advancements and globalization raise new challenges to self-
Many countries have incorporated the right to self-determination determination and dignity, such as data privacy concerns and the
and human dignity into their constitutions or other domestic potential for AI to undermine human autonomy.
legislation. For instance, the German Basic Law explicitly protects The right to self-determination and human dignity are essential
human dignity in Article 1.33 for a just and equitable society. They empower individuals to live
Interconnectedness of SELF-DETERMINATION AND their lives with autonomy and freedom, shaping their destinies in
accordance with their own values and beliefs. Upholding these rights
HUMAN DIGNITY
requires constant vigilance and adaptation in the face of evolving
The right to self-determination is closely linked to the concept of social, technological, and legal challenges.
human dignity. Dignity implies that every human being has intrinsic The prohibition of inhuman and degrading treatment: Forcing
worth and should be treated with respect. Self-determination enables an individual to endure the final stages of ALS, with its attendant
individuals to exercise agency and make choices that shape their lives suffering and loss of bodily functions, could be considered inhuman
in accordance with their own values and beliefs, thus preserving their and degrading treatment. The prohibition of inhuman and degrading
dignity. Denying individuals the ability to exercise self-determination treatment is a cornerstone of international human rights law and a
undermines their inherent dignity. fundamental principle enshrined in numerous legal instruments. This
Implications and challenges principle reflects the inherent dignity of the human person and the
absolute imperative to protect individuals from cruel, inhuman, or
The right to self-determination and human dignity has implications degrading treatment or punishment, regardless of any circumstance.
in various contexts: This paper examines the legal foundations of this prohibition, its
scope, and its application in various contexts, with relevant legal
28
United Nations General Assembly. (1948). Universal Declaration of Human references.
Rights. Retrieved from UN website 34
Informed Consent: Legal Theory and Clinical Practice - Jessica Wilen Berg
29
United Nations General Assembly. (1966). International Covenant on Civil (2001)
and Political Rights. Retrieved from UN website 35
Euthanasia and Assisted Suicide (Contemporary Issues in Bioethics) - Dan
30
United Nations General Assembly. (1966). International Covenant on W. Brock and Steven G. Holtzman
Economic, Social and Cultural Rights. Retrieved from UN website 36
Abortion and the Law - Laurence H. Tribe (1992)
31
Council of Europe. (1950). European Convention on Human Rights. 37
Disability Rights Law and Policy - Ruth Colker and Adam Milani (2013)
Retrieved from Council of Europe website 38
United Nations Declaration on the Rights of Indigenous Peoples" (2007)
32
African Union. (1981). African Charter on Human and Peoples' Rights. 39
Balancing Human Rights" by Conor Gearty (2013
Retrieved from African Union website 40
Vulnerable Populations and the Law" edited by Michael Ashley Stein,
33
Basic Law for the Federal Republic of Germany (Grundgesetz) Penelope J. Phillips, and Michael Perlin (2011)

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 211

Legal foundations II. Cruel treatment: Acts that inflict severe physical or mental
pain or suffering, even if not intentional.
International Law
III. Degrading treatment: Treatment that humiliates or debases an
I. Universal Declaration of Human Rights (UDHR): Article 5 individual, even if it does not cause severe pain or suffering.
of the UDHR states, „No one shall be subjected to torture or to
cruel, inhuman or degrading treatment or punishment.”41 This prohibition applies in various contexts, including:
II. International Covenant on Civil and Political Rights I. Law enforcement: Prohibition of torture and ill-treatment by
(ICCPR): Article 7 of the ICCPR echoes the UDHR, stating, police, prison officials, and other law enforcement agents.
„No one shall be subjected to torture or to cruel, inhuman or
II. Armed conflict: Protection of civilians and combatants from
degrading treatment or punishment. In particular, no one shall
torture and inhuman treatment during armed conflict.
be subjected without his free consent to medical or scientific
experimentation.”42 III. Medical context: Prohibition of medical experimentation
without consent and protection of patients from inhuman or
III. Convention against Torture and Other Cruel, Inhuman or
degrading treatment in healthcare settings.
Degrading Treatment or Punishment (CAT): The CAT defines
torture and provides for international cooperation in preventing IV. Migration and asylum: Protection of refugees and migrants
and punishing acts of torture. It also establishes an absolute from inhuman or degrading treatment during immigration
prohibition on torture, meaning no exceptional circumstances detention and deportation procedures.
whatsoever can justify its use.43
V. Disability rights: Protection of persons with disabilities from
IV. Geneva Conventions: The Geneva Conventions and their inhuman or degrading treatment in institutions and in the
Additional Protocols provide extensive protections for civilians community.
and combatants during armed conflict, including the prohibition
of torture, cruel treatment, and outrages upon personal dignity.44 Challenges and Future Directions
Regional Law Despite the widespread legal recognition of this prohibition,
challenges remain:
I. European Convention on Human Rights (ECHR): Article 3
of the ECHR states, „No one shall be subjected to torture or to I. Defining the threshold: Determining the precise threshold
inhuman or degrading treatment or punishment.” This provision for what constitutes inhuman or degrading treatment can be
has been interpreted broadly by the European Court of Human challenging, as it involves subjective assessments of pain and
Rights to encompass a wide range of acts that inflict severe suffering.
physical or mental suffering.45
II. Evidence gathering: Obtaining evidence of inhuman or
II. African Charter on Human and Peoples’ Rights: Article 5 degrading treatment can be difficult, especially in closed
of the African Charter prohibits torture and cruel, inhuman or environments such as prisons or detention centers.
degrading treatment.46
III. State accountability: Holding states accountable for violations
III. Inter-American Convention to Prevent and Punish Torture:
of this prohibition can be challenging, especially in cases of
This convention defines torture and establishes obligations for
impunity or lack of cooperation with international mechanisms.
states to prevent and punish acts of torture.47
Domestic Law IV. Evolving forms of ill-treatment: New technologies and
social developments may give rise to new forms of inhuman or
Many countries have incorporated the prohibition of inhuman and degrading treatment that require legal and ethical responses.
degrading treatment into their constitutions or domestic legislation.
The prohibition of inhuman and degrading treatment is a
Scope and Application fundamental principle of human rights law that reflects the inherent
The prohibition of inhuman and degrading treatment encompasses dignity of the human person. Ensuring its effective implementation
a broad range of acts, including: requires ongoing efforts to strengthen legal frameworks, enhance
monitoring mechanisms, and promote a culture of respect for human
I. Torture: The intentional infliction of severe pain or suffering, rights in all contexts.
physical or mental, for a specific purpose.
41
United Nations General Assembly. (1948). Universal Declaration of Human The right to freedom of conscience and religion: This includes the
Rights. Retrieved from UN website right to hold beliefs about the meaning of life and death and to act in
42
United Nations General Assembly. (1966). International Covenant on Civil accordance with those beliefs.
and Political Rights. Retrieved from UN website
43
United Nations General Assembly. (1984). Convention against Torture and Karsai has taken his case to the European Court of Human Rights
Other Cruel, Inhuman or Degrading Treatment or Punishment. (ECHR), arguing that the Hungarian legal framework contradicts
44
International Committee of the Red Cross. (n.d.). Geneva Conventions and the European Convention on Human Rights (ECHR). Specifically,
their Additional Protocols. he argues that the blanket ban violates Articles 3 (prohibition of
45
Council of Europe. (1950). European Convention on Human Rights.
torture), 8 (right to respect for private life), and 9 (freedom of thought,
Retrieved from Council of Europe website
46
African Union. (1981). African Charter on Human and Peoples' Rights.
conscience and religion) of the Convention.48
Retrieved from African Union website
47
Organization of American States. (1985). Inter-American Convention to Council of Europe. (1950). European Convention on Human Rights.
48

Prevent and Punish Torture. Retrieved from OAS website Retrieved from Council of Europe website

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234
 Copyright:
Investigation of the ethical and legal issues of euthanasia and assisted suicide ©2024 Petra. 212

Euthanasia Legislation in Hungary Closing thoughts

The Hungarian Criminal Code currently prohibits any form of As societies continue to grapple with these challenging issues,
euthanasia and assisted suicide. Article 161 criminalizes „taking the ongoing dialogue and reflection are essential. We must strive to create
life of another upon their express and earnest request,” while Article a compassionate and supportive environment for those facing end-of-
162 criminalizes „aiding suicide.”49 These provisions reflect a strong life decisions, ensuring access to high-quality palliative care and open
societal and legal emphasis on the sanctity of life. communication about all available options. While the legalization
of euthanasia and assisted suicide remains a contentious issue, this
The European Context investigation has highlighted the importance of approaching the
Euthanasia and assisted suicide are highly contentious issues debate with nuance, empathy, and a commitment to protecting the
across Europe. While a few countries, such as the Netherlands, dignity and autonomy of all individuals. The search for ethical and
Belgium, and Luxembourg, have legalized euthanasia under strict legal solutions that respect both the sanctity of life and the right to
conditions, most countries maintain legal prohibitions. 50The ECHR die with dignity is an ongoing challenge that demands our continued
has addressed the issue in several landmark cases, including Pretty v. attention and careful consideration.
United Kingdom (2002) and Haas v. Switzerland (2011), but has not
established a definitive right to euthanasia. 5152 However, the Court Acknowledgments
has emphasized the importance of individual autonomy in end-of-life None.
decisions and has called on states to carefully balance the protection
of life with respect for individual wishes. Conflcits of interest
Conclusion The author declares there is no conflcit of interest.

Karsai Dániel’s case has ignited a crucial debate about euthanasia

in Hungary. His legal challenge, rooted in fundamental human rights
arguments, compels a re-examination of the current legal framework.
The outcome of his case at the ECHR could have significant
implications for Hungarian law and societal attitudes towards end-
of-life choices. Regardless of the legal outcome, Karsai’s advocacy
has undeniably raised awareness and fostered a much-needed public
discourse on this complex and deeply personal issue.

Summary
This investigation has delved into the complex web of ethical
and legal considerations surrounding euthanasia and assisted suicide.
We have explored the core ethical principles at stake, analyzed
arguments for and against legalization, and examined the diverse legal
approaches adopted by different jurisdictions. It is clear that there are
no easy answers, and the debate is far from settled. The fundamental
tension lies in balancing individual autonomy and the right to choose
how one dies with society’s interest in protecting life and preventing
abuse. While proponents emphasize respect for individual choice
and the alleviation of suffering, opponents raise concerns about the
sanctity of life, the potential for coercion, and the slippery slope
towards devaluing life. The legal landscape reflects this complexity,
with a spectrum of approaches ranging from outright prohibition
to carefully regulated legalization. Where euthanasia and assisted
suicide are permitted, stringent safeguards are crucial to ensure
decisions are made voluntarily, with full informed consent, and only
after all other options have been exhausted. Ultimately, the debate
surrounding euthanasia and assisted suicide is not merely a legal or
medical one, but a deeply personal and societal one. It forces us to
confront fundamental questions about the meaning of life, the nature
of suffering, and the role of individual choice in the face of mortality.
49
Act C of 2012 on the Criminal Code (Hungary)
50
Euthanasia and assisted suicide laws around the world. (n.d.). BBC News.
Retrieved from BBC News website
51
Pretty v. United Kingdom, Application no. 2346/02 (ECHR 2002)
52
Haas v. Switzerland, Application no. 31322/07 (ECHR 2011)

Citation: Petra SA. Investigation of the ethical and legal issues of euthanasia and assisted suicide. Open Access J Sci. 2024;7(1):205‒212.
DOI: 10.15406/oajs.2024.07.00234