Title: The two slippery Slopes arguments of voluntary euthanasia

and physician-associated suicide

Euthanasia is also known as medical assistance in dying, medical assistance in legalized

in Canada in 2016 by the amendments to the criminal code. This prohibition allowed nurses to be
the assessor and providers of medical assistance in dying. two actions to medical assistance in
dying are permissible 1. administering a substance to a person at their request that causes their
death (commonly referred to as euthanasia). 2 prescribing or providing a substance to a person at
their request so that they may self-administer the substance and in so doing cause their own death
commonly known as assisted suicide. Seven countries around the world adopted assistance in
dying into law. Which are Belgium Colombia and some US states otherwise in Switzerland
Luxembourg medical procedures that aid in dying are allowed under predetermined
circumstances euthanasia is the term used mostly in an international context. Euthanasia is
defined as an active and intentional act of putting to death in a relatively painless way of persons
suffering severely from medical conditions that are incurable untreatable or irreversible at that
person’s explicit request. Assisted dying is a highly controversial moral issue incorporating both
physician-assisted dying and voluntary active euthanasia. End-of-life practices are debated in
many countries, with assisted lying receiving different considerations across various
jurisdictions. Voluntary active euthanasia includes a physician or third person intentionally
ending a person’s life normally through the administration of drugs, at the person’s voluntary
and competent request (Hartling, 2021). Facilitating a person’s death without their prior consent
incorporates both non-voluntary euthanasia (when the patient is not capable of providing
informed consent e.g. vegetative state, young child) and involuntary euthanasia (against the
patient’s will). Physician-assisted dying is defined as follows: a physician intentionally helping a
person to terminate their life by providing drugs for self-administration at the person’s voluntary
and competent request (Keown, 2021).

Discussion regarding withholding or withdrawing treatment and requesting assisted death has
emerged in association with the simultaneous expansion of palliative care across the world. The
World health organization defines palliative care is an approach that improves the quality of life
of patients and their families facing the problems associated with life-threatening illnesses,
through the prevention and relief of suffering by means of early identification and impeccable
assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Beauchamp and Childress developed a standard approach to bioethics and advocated for four
principles that lie at the heart of healthcare ethics underpin decision-making. Respect for
autonomy is one of the fundamental concepts, in combination with justice, beneficence, and non-
maleficence. In medical practice, autonomy describes the right of competent adults to make their
own medical care, prior to any investigation or treatment taking place. For physicians respect for
autonomy includes acknowledging and preserving a patient’s right to self-determination and
providing the necessary guidance, which would allow for informed consent and independent
choice free of coercion (Boer, 2021). However, autonomy is far from a straightforward
consideration. Onora O’Neill, in an attempt to scrutinize the context of autonomy in her Gifford
lectures, makes a clear and compelling distinction between the approach of John Stuart Mill and
Kant regarding the subject of autonomy. As O’Neil vividly describes, Mill stretches the bound of
choice and sees individuals not merely as choosing to implement whatever desires, but as
reflecting on and selecting among them in a distinctive way. The Kantian version of autonomy is
guided by a ‘Practical reason’. Kant views autonomy as a matter of acting on certain sort of
principles, and specifically on principles of obligation ‘rather than a form of self-expression and
supports that ‘there can be no possibility of freedom for any individual if this person acts without
reference to all other moral agents. O’Neil embraces the Kantian view and contextualizes it as
‘principled autonomy’ compared to ‘individualistic autonomy. The greatest expression of
autonomous self-determination is the right of ‘capacitous’ adults to refuse any proposed
intervention (irrespective of rationality), even if the decision could result in harm or death,
provided they are capable of freely reaching a decision in the above manner. For this reason,
obtaining informed consent from a patient after they have been offered all the relevant
information regarding their situation is of paramount importance. During past decades, the
development of liberal democrats has highlighted the significance of self-determination, with
health systems increasingly adopting more patient-centered approaches to care decisions.

The right to bodily autonomy has also been enshrined under Article 8 of the European
Convention on Human Rights (ECHR). Taking this Article into consideration humans
encompasses inter alia the right to personal development. in a technical legal sense within the
jurisdiction of Swiss law, it includes a patient choice to avoid what they consider an undignified
and severe end to their life. Proponents of the highly contentious argument claim that seriously
ill patients should have a choice in whether or not they wish to continue living with a condition
that undermines their inherent dignity and personal identity, without violating the principle of the
sanctity of life (Greif, 2019). Therefore, it can be argued that respecting autonomy inherently
involves the prima facie right of a patient to control the circumstances and time of death by
requesting help in dying. This could minimize the suffering of an individual or their family and
improve the quality of an individual or their family and improve the quality of the end of the
patient’s life, as their wishes would be respected and dignity would be preserved (Fontalis,
Prousali & Kulkarni., 2018). The principle of beneficence and non-maleficence, plainly
described in the Hippocratic Oath, have been the foundation of medical ethics for many
centuries. Beneficence states that a doctor should act in the best interest of the patient. Non-
maleficence states ‘first, do no harm. Conformation of these fundamental principles is enshrined
within Hippocratic Oath, which involves aiming to benefit, or perhaps most importantly, not
doing any harm to a patient. Moreover, modern medical education is most countries follow legal
and cultural opposition to assisted death. Healthcare professionals are therefore currently not
adequately trained to participate in assisted dying. The professional opinion also remains divided
on whether further involvement would benefit or damage public perception, given the potential
conflict between these two ethical principles (Ley, 2020). The UK’s medical representative
body, the British Medical Association (BMA), has acknowledged this lack of consensus, but
clearly concludes with their view that assisted dying should not be made legal in the UK
(1Chakrabarty, 2022). Assisted dying, therefore, challenges the conflict faced between the
ultimate purpose of modern medical and social care and its founding ethical principles. Relief of
suffering through assisted death can be argued as a distinct entity to palliative care, with the
former –if safely and carefully considered –potentially an important way of fulfilling a
clinician’s duty to preserve autonomy and do good for a patient-for example, in cases where
alternatives are treatments which provide no benefit or do not prolong or improve the quality of
life of a terminally ill patient. A further consideration is that of an individual doctor’s ethical and
moral beliefs, which are also an important factor should a patient request an assisted death;
indeed, the British medical association has proposed that should a patient request an assisted
death; indeed, the British Medical Association has proposed that should have assisted dying
legislation be derived, then there should be a clear demarcation between those physicians who do
not offer this option.
Dating back to the past, euthanasia arguments has trolled great attention in order to raise ethical
and moral concern over the globe. Life is a profound human value and an extremely personal
choice. In a realistic world, it is virtually impossible to peruse all acts of euthanasia voluntarily.
Therefore, legal liberation is provided to physicians for terminally ill, lonely, elderly patients
who are suffering from vulnerable pain to ease the pain on the road of life. It is the moral,
ethical, and legal duty of the suicide-assisted authorized person to wisely use the legal power to
end the life of another person.
 References
Fontalis, A., Prousali, E., & Kulkarni, K. (2018). Euthanasia and assisted dying: what is
the current position and what are the key arguments informing the debate?. Journal of
the Royal Society of Medicine, 111(11), 407-413.

Hartling, O. (2021). Euthanasia and assisted dying: the illusion of autonomy—an essay
by Ole Hartling. bmj, 374.

Keown, J. (2021). Voluntary Euthanasia & Physician-assisted Suicide–The Two

‘Slippery Slope’Arguments. Anscombe Bioethics Centre.

Boer, T. A. (2021). Why Using Religious Arguments in the Euthanasia Discussion is

Problematic. Revista Latinoamericana de Bioética, 21(1), 127-136.Iberoamericana

Greif, A. (2019). The Morality of Euthanasia. Organon F: Medzinárodný Časopis Pre

Analytickú Filozofiu, 26(4).

Chakrabarty, I. (2022). Euthanasia around the World: The Ethical, Legal and Medical
Implications. Issue 1 Int'l JL Mgmt. & Human., 5, 1311.

Ley, A. (2020). Physician-Assisted Suicide and Euthanasia: Before, During, and After
the Holocaust. Lexington Books.