Traditional Abrahamic religious teaching states that it is wrong to kill the innocent. However, advances in medical care have created new situations The principle of double effect and the distinction between ordinary and extraordinary therapies have allowed religious ethicists a degree of latitude when it comes to thinking about euthanasia. Secular ethicists have also been challenged by these developments, and there are various opinions ranging from conservative to radical among these writers. In essence the principle of autonomy tends to trump all other issues, and this would mean that an autonomous decision to die by refusing treatment is to be respected. An autonomous request to be actively killed is more controversial, but there seems to be growing legal and ethical support for this under tightly controlled circumstances. Apart from theological objections, opponents of euthanasia raise practical concerns such as the slippery slope argument and the effect of active euthanasia on the doctor-patient relationship. When it comes to decision making in those patients who cannot function autonomously, such as neonates, patients in intensive care and patients in a persistent vegetative state, the issue is clouded. Health professionals must act in the patient’s best interests, but what these are may be difficult to define. In many cases there is no pre-existing decision of the patient that can be used as a basis for end-of-life decision making. Health care providers have to make use of surrogates to help reach a decision, and this is controversial. This paper attempts to place the current discussions around euthanasia in context and to highlight both areas of agreement and of contention.
Material submitted for publication in the South African Journal of Bioethics and Law (SAJBL) is accepted provided it has not been published elsewhere. The SAJBL reserves copyright of the material published.
The SAJBL does not hold itself responsible for statements made by the authors.