Debates about the moral status of euthanasia are based on the premise that human life is a good. Without this statement, the dispute loses its meaning and the argument ceases to be relevant. The issue of the fundamental justification of euthanasia has been discussed for several decades. Doctors, specialists in moral philosophy and medical ethics, representatives of the clergy and many other people take part in public discussions.

Ethical arguments for and against euthanasia

There are many arguments in favor of euthanasia, but there are also many arguments against it. If we leave aside specifics, we can highlight two main arguments in favor:

1. Life is a blessing, but only when pleasure prevails over suffering.

This is a strong and self-evident argument, which rests on common sense: “Life is good as long as we can enjoy it, actually live.” Accordingly, when a person suffers so much that he cannot enjoy life, and is able to unequivocally express his desire to end his life, there are grounds for ethically justifying euthanasia.

• Living in suffering is still a good thing if the alternative is no life. While experiencing pain, a person is able to experience feelings; experiencing negative emotions, he is still worried. After death there is no opportunity to worry. Therefore, life, even life in torment, is always a greater blessing than death.
• The patient's conscious desire to end his suffering is not a sufficient basis for euthanasia. By allowing euthanasia based solely on the will of the dying person, we thereby equate euthanasia with suicide and, moreover, begin to consider suicide a good thing.

The argument turns to what exactly makes a person's life good - the possibility of meaningful activity, receiving emotions, communication. If an illness has reduced a person to a vegetative state and deprived him of consciousness, then his life is no longer fully human, and therefore is not considered good. In this case, ending a person’s existence is the same as cutting down a dead plant.

There are two main objections to this argument:

• A person is determined not only by his “I”, but also by the attitude of others towards him. If a person had value only when he was alive and sane, then our culture would not have become what it is. From time immemorial, people treated the dead with trepidation and revered burials, despite the fact that the bodies of the deceased had long since turned to dust. Close person, who finds himself in a coma or vegetative state, deserves no less respect than the remains of a deceased relative.
• Life in a vegetative state is also life. Cutting it off just because of this is equivalent to cutting down a still living tree just because it is not human. A seriously ill person deserves no less reverent treatment than living nature.

Pragmatic arguments for and against euthanasia

The debate is not only about the fundamental moral justification of euthanasia, but also about practical side this procedure.

Pragmatic arguments for:

• Keeping a dying person alive is expensive for hospitals. The argument is built around a practical view of resource allocation. Keeping a person in a state of dying is not only painful for him and his loved ones, but also wastes resources medical institution. Medicines, equipment and doctors' efforts can instead be used to treat those people who can still be saved.
• Keeping a dying person alive wastes the energy and resources of his loved ones. The argument appeals to a pragmatic understanding of the good of the dying person's loved ones. As a rule, keeping a person during the dying stage costs big money. Relatives of a dying (or terminally ill) person spend large sums of money to keep him alive, despite the lack of possibility of recovery. For this, they often get into debt and loans, and the need to look after a dying loved one gives rise to psychological problems for relatives, up to clinical disorders.

Pragmatic arguments against:

• Possibility of abuse. The introduction of euthanasia threatens a large number abuse. Insufficient control over euthanasia, especially involuntary euthanasia, can lead to it being used in situations where it can be avoided. In addition, euthanasia, carried out not at the will of the dying person, can be used for selfish reasons on the part of his heirs or third parties.
• Requires a large-scale revision of legislation. The introduction of euthanasia will require significant work to create legislative framework. It will be necessary to develop legal and medical criteria when euthanasia is acceptable and when it is not. It will be necessary to formulate an exhaustive list medical tests to establish the possibility of euthanasia and conduct the necessary research for this.

Phenomenon

The meaning of the word “euthanasia” has changed greatly over time. And now few people understand what it really is. IN Ancient Greece euthanasia was a “dignified end to life,” a “good death” (on the battlefield or surrounded by close relatives). Then they began to call it “easy death,” that is, death without suffering, and then “the necessary cessation of life to avoid pain and suffering.” Now “euthanasia” is a rather narrow term that describes a specific medical procedure. Namely, the active murder of a terminally ill person, carried out at his request by administering medicines. If the drugs provided by the doctor are administered by the person who wants to die, this is not euthanasia. By modern ideas, such an act should be called “assisted suicide.” It will not be euthanasia if a doctor kills a patient if the patient has no desire to die. It's just murder. Refusal additional treatment a patient who is obviously dying is also not euthanasia.

On April 17, information appeared in the press that the Federation Council was preparing a bill allowing euthanasia in Russia. The senators stated that “such a bill has not been developed, its text does not exist,” but admitted that requests were sent to the medical community to find out how pressing this problem is for our country.

Euthanasia, the "good death" * or "legalized murder", has supporters and opponents. Politicians, doctors and seriously ill people give their arguments for and against.

Doctor, Head of the Department of Faculty Surgery, Moscow State Medical and Dental University, Eduard Abdulkhaevich Gallyamov:
"Majority world scientists came to the conclusion that euthanasia does not contradict universal human principles, but the final decision should belong to the patient himself, and in case of the latter’s incompetence, to his relatives. It seems to me that this point of view is more humane. But I repeat, euthanasia belongs to the tense dilemmas of bioethics, when compelling arguments for and against are confronted in their own way.”

Professor medical ethics retired and former member British Medical Association Ethics Committee Len Doyal:
“Doctors may not admit this and pass off their actions as “relieving the suffering of patients,” but refusing to further support the biological existence of unconscious patients is morally equivalent active euthanasia"
... "If doctors are able to decide that it is inappropriate to continue to support the life of incapacitated patients, because they believe that they have no reason to live, Why delay their death without any reason?”

Executive Director of the English public organization"For Dignity in Dying" Deborah Ennets:
“The organization “For Dignified Death” believes that decisions to end life and treatment must be based on the conscious will of terminally ill people. ...People who fear losing their legal capacity in the future can ensure that their will is carried out by leaving a will.”

Russian pediatric surgeon Stanislav Doletsky:
"Euthanasia, painless death is mercy, it is good. Have you ever seen the terrible torment and pain that many cancer patients, stroke sufferers, and paralytics have to endure? Have you seen, have you felt the pain of mothers who gave birth to a deformed child, and a deformed child with an incurable pathology? If yes, you will understand me"...

Chairman of the Moscow City Duma Commission on Legislation Alexander Semennikov:
“We define euthanasia as the killing of a terminally ill person at his request, committed out of compassion in order to relieve the patient from painful suffering caused by the disease. And we believe that such an act cannot be qualified as intentional murder".

Sociologist and public figure of the People's Republic of China Zhao Gongmin
“I believe that euthanasia is “merciful killing” - may be allowed in certain areas of our country to generalize experience."

"Against"

German physician and theologian Manfred Lutz:
... "The fact that today people in surveys speak out for euthanasia can only be explained by their fear of depending on tubes and IVs in the future. Of course, they can be understood, but still It is necessary to maintain the taboo on killing. Eliminating taboos can have dire consequences for society."
... "The fear of being alone before death and the fear of pain is very great, but with the help of professional pain therapy you can cope with almost any pain."

German Minister of Justice Brigitte Zypries:
"Last the patient must take the step towards death only himself".

Deputy Speaker State Duma RF V.V. Zhirinovsky:
“We will not be able to control the implementation of even the most impeccable law on euthanasia. Murders related to inheritance, real estate, and any gain will receive legal cover. We will only achieve what the number of murders will increase".

Head physician of the First Moscow Hospice Vera Millionshchikova:
"The media can present any solution to any problem in such a way that people become supporters of it. But if this problem affects you personally, you are unlikely to want to accept a “good death” at the hands of your neighbor. I believe that a person is born to live, so I have a categorically negative attitude towards euthanasia.”

Archpriest Alexander Makarov
“From the point of view of the church, euthanasia is suicide, and therefore an unforgivable sin. For a believer, even suffering before death is good, because it is atonement for sins. Suicide is a step of despair, a renunciation of faith and God. But there should always be hope for a miracle, that medicine will suddenly make a breakthrough and a person will be saved.”

Specialist in palliative** medicine, doctor Elizaveta Glinka
“My personal opinion is expressed in three words: I am against euthanasia. There can be no certainty that any patient needs to be “turned off.” There are cases when patients, before pain relief, before admission to the hospice, asked for euthanasia. And when the pain retreated - the patient stopped suffering from depression and wanted to live. In general, requests for euthanasia are extremely rare, and as a rule they are simply a disguised request for help. No two patients are alike, and it is impossible to develop one law for everyone.”

Opinions of patients at one of the hospices:

Sasha, 42 years old. Moscow. Cancer of the left kidney, metastases to the liver. “I know about my diagnosis, I was informed about the prognosis. All that remains in this life is mine. Don't kill me."

Kirill, 19 years old, Kyiv. Sarcoma of the thigh, multiple metastases. "When I don't have pain, I think about not being discharged from the hospice. I will say that I have pain because I'm calm and not scared here".

Mom of an eight year old: " WE LIVE, YOU UNDERSTAND?"

Mom and dad of a four-year-old child, the child has a brain tumor and coma. They are aware of the forecast. " We are grateful for every minute with Masha. If they introduce a law on euthanasia, then let them come and kill us all at once."

Andrey, 36 years old, businessman, Moscow. Stomach cancer. " Death penalty cancelled, and kill us according to the law? Hide me. I want to live."

* Translated from Greek, “euthanasia” means “good death.” The term was first used in the 16th century by the English philosopher Francis Bacon to denote an “easy” death, not associated with excruciating pain and suffering, which can occur naturally. In the 19th century, euthanasia came to mean “killing a patient out of pity.”

**Palliative medicine - symptomatic care terminally ill, achievement best quality their lives.