euthanasia pro essay

158 Euthanasia Topics & Essay Examples

If you’re writing a euthanasia essay, questions and topics on the subject can be tricky to find. Not with our list!

• 📑 Aspects to Cover in a Euthanasia Essay

🏆 Best Euthanasia Essay Examples & Topics

💡 clever euthanasia titles, 🎓 simple & easy euthanasia essay titles, ✅ most interesting euthanasia topics to write about, ❓ euthanasia essay questions.

Our experts have prepared a variety of ideas for your paper or speech. In the article below, find original euthanasia research questions and essay titles. And good luck with your assignment!

📑 Aspects to Cover in an Euthanasia Essay

Euthanasia is the process of intentional life ending. Its goal is to stop patients’ suffering and pain. In today’s world, euthanasia is a debatable topic, and there are many questions about it.

Euthanasia essays can help students to raise awareness of the process and its aspects. That is why it is crucial to research this issue and write papers on it.

You can discuss various problems in your essay on euthanasia, as there is a broad variety of related issues. You can choose the one you are the most concerned about, search for euthanasia essay questions online or consult your professor.

Here are some examples of euthanasia essay topics and titles we can suggest:

• The benefits and disadvantages of a physician-assisted suicide
• Ethical dilemmas associated with euthanasia
• An individual’s right to die
• Euthanasia as one of the most debatable topics in today’s society
• The ethical dilemma around euthanasia
• The ethics associated with voluntary euthanasia
• Can euthanasia be considered murder?
• Euthanasia debate: Should the government legalize this procedure?
• The legality of physician-assisted suicide in today’s society

Once you have selected one of the euthanasia essay titles, you can start working on your paper. Here are some important aspects to cover:

Start from developing a solid euthanasia essay thesis. You should state the main idea of your paper and your primary argument clearly. A thesis statement can look like this: Euthanasia is beneficial for patients because it prevents them from suffering. Euthanasia can be equal to murder.

• Remember to include a definition of euthanasia and related terms, such as physician-assisted suicide. Your audience should understand what you are talking about in the essay.
• Do not forget to include the existing evidence on the issue. For instance, you can research euthanasia in different countries, the debates around its legalization, and all other aspects related to the problem. Support your claims with facts and cite your sources correctly.
• Legal and ethical questions are some of the most significant aspects you should cover in the essay. Discuss the potential benefits and disadvantages of the procedure, as well as its impact on patients’ families and medical professionals.
• If you are writing an opinion paper, do not forget to state your opinion clearly. Include relevant experience, if possible (for example, if you work at a hospital and patients have asked you about the procedure). Have you met people who could have benefited from euthanasia? Include their stories, if applicable.
• Do not forget to cover the legal aspects of euthanasia in your state. Is it legal to perform some form of euthanasia where you live or work? Do you think it is beneficial for the patients?
• Remember to look at the grading rubric to see what other aspects you should cover in your paper. For example, your professor may want you to state a counter-argument and include a refutation paragraph. Make sure that you follow all of your instructor’s requirements.
• If you are not sure that you have covered all the necessary questions related to your issue, check out related articles and analyze the authors’ arguments. Avoid copying other people’s work and only use it as an inspiration.

Please find our free samples below with the best ideas for your work!

• Euthanasia: Advantages and Disadvantages The most heavily criticized of all such similar actions is involuntary euthanasia which bears the brunt of all severe protests against the issue, with involuntary euthanasia being dubbed as the deprivation of an individual of […]
• Arguments in Favor of Euthanasia Due to the sensitivity of the issue, laws that will protect the rights of both the patient and the physicians who practice euthanasia should be put in place.
• Consequentialism: Euthanasia and Physician-Assisted Suicide People against euthanasia view the consequences of legalization as a gateway to other unethical practices being accepted, which is a slippery slope that could lead to adverse consequences to the fundamental principles and values of […]
• The Morality of Euthanasia In the meantime the medication and the doctors are not trivial anymore in stopping the pain and the victim despite all the sufferings, he or she is in a vegetative state and there is nothing […]
• Euthanasia as Self-Termination Velleman believes that a person should not have the right to end their life as it can make other people suffer, but there is an objection to his opinion related to that person’s own pain.
• David Velleman’s Views on Euthanasia Velleman is correct in his conviction that in this case, the patient’s decision will be the outcome of a federal right to die; the situation with euthanasia is common to that of abortion with the […]
• Euthanasia: Right to Live or Right to Die Euthanasia or mercy killing as it is informally referred is the act of ending a person life if it is deemed to be the only way to help a person get out of their suffering.
• Why Active Euthanasia is Morally Wrong The issue of active euthanasia has come to the attention of the public over the past decades as more people demand for the right to be assisted to die.
• Euthanasia for Terminally Ill People: Pros & Cons Despite the fact that euthanasia causes a lot of controversy, every person should have the right to end suffering. Permission of euthanasia is the realization of a person’s right to dispose of their body.
• Euthanasia in Christian Spirituality and Ethics By examining Christian’s views on the fallenness of the world, the hope of resurrection, and the value of a person’s life, one can see that euthanasia is not a morally acceptable option for a Christian […]
• An Argument Against Euthanasia 5 Generally, it is contrary to the duty of the subject of euthanasia and that of those who intend to perform the mercy killing to take one’s life based on their own assessment of the […]
• The Problem of Euthanasia in Animal Shelters Animal shelters are forced to euthanize animals for a number of reasons which includes: Lack of funds to treat sick animals, overcrowding as a result of the increased number of animals brought in by owners […]
• Advantages and Disadvantages of Euthanasia in Modern Society In its turn, this points out to the fact that, in the field of health care, the notion of medicinal compassion organically derives out of the notion of scientific progress, and not out of the […]
• Euthanasia and Assisted Suicide The final act that results in the death of the person is however usually performed by the person intending to die after the provision of information, advice and even the ways through which he or […]
• The Death Definition and the Need for Euthanasia If the concept of the soul is to be believed in, then one’s death is simply a process that detaches the soul from the body.
• Euthanasia as a Polarizing Issue The example of a plethora of countries shows that the inclusion of assisted suicide is not detrimental to the broad society.
• Rachel’s Stance on Euthanasia: Passive and Active Killing Despite the appealing nature of Rachel’s argument, his claims of equity of killing and letting a person die are not ethically right. A major distinction between killing and witnessing death is the level of responsibility […]
• Analysis of Ethical Dilemma: Euthanasia One of these is the right to live, which includes much more than the ability to simply exist, and suggests an adherence to a minimum of quality and self-determination.
• Euthanasia-Related Ethical and Legal Issues There are no discussions about whether the person has the right to commit suicide or not because most individuals agree that it is the decision of the adult person who can dispose of their life.
• Euthanasia: Legal Prohibitions and Permits In addition, it is necessary to take into account the right of a suffering person to get rid of the suffering of loved ones.
• Euthanasia: Why Is It Such a Big Problem? Thus, according to the utilitarian viewpoint, there is no problem with euthanasia as along as it is better for the patient. Who is it to decide what is better for the patient?
• Euthanasia and Assisted Suicide as a Current Issue in Nursing Nowadays, even in nations where the procedure of euthanasia and assisted suicide has been legal for decades, this topic continues to be controversial due to ethical and policy issues. However, in the light of the […]
• Euthanasia and Its Main Advantages However, after realizing the condition is untreatable and having the consent of both the sick person and the relatives, undertaking assisted suicide will enable the patient to evade extreme suffering.
• Euthanasia: Nurses’ Attitudes Towards Death The weakest part of the article is that most of the participants did not clearly define the concept of euthanasia, which casts doubt on the reliability of the sampled data.
• Right to Die With Euthanasia Methods The possible answer is to develop the functionality of both ordinary public hospitals and hospices that are located in their departments. In addition, it is critical to specify the desirable methods of euthanasia.
• “Active and Passive Euthanasia” by James Rachels The second issue about euthanasia that Rachels raises is the difference between killing and allowing one to die. For Rachels, it is necessary to emphasize that killing is sometimes even more humane than allowing one […]
• Arguments Against Legalization of Euthanasia Although the PAS/E should be offered voluntarily to a patient, in some cases it is offered in secret by physicians to patients who are perceived to be dying.
• Euthanasia: The Terri Schiavo Case Analysis The long-term judicial resolution of the Terri Schiavo case was related to the bioethical problem of the humanity of euthanasia, which had many opponents and supporters.
• Can Euthanasia Be Considered Ethical Consequently, from this perspective, the act of euthanasia would be regarded as violence to someone else’s life. As a result, euthanasia is likely to be considered unethical from the point of view of any of […]
• “Active and Passive Euthanasia” and “Sexual Morality” According to Scruton, morality is a constraint upon reasons for action and a normal consequence of the possession of a first-person perspective. For Scruton, sexual morality includes the condemnation of lust and perversion that is, […]
• Nursing Role in Euthanasia Decision and Procedures The weakest point is the lack of analysis of other factors’ influence on the process of euthanasia. The researchers discovered that the role of nurses in euthanasia is underestimated.
• Aspects of Nursing and Euthanasia The subject of the research by Monteverde was to ask people who work in the medical sphere and face the necessity for euthanasia, whether they are for or against it, and why.
• Pros and Cons of Euthanasia from an Ethical Perspective Primarily, this is apparent on American soil, in which some states decriminalized euthanasia, although the supreme court maintained that there is no law that legalized the practice nor the ban of the mentioned act.
• Euthanasia in the Context of Christianity The questions addressed in the paper include the notions of fall and resurrection as means of interpreting suffering, the Christian stance on the value of human life and euthanasia, and the discussion of possible solutions […]
• Nursing Practice and Euthanasia’s Ethical Issues Effective healthcare management is the involvement of all stakeholders, such as CMS, and the federal government in the decision-making process to improve the sustainable growth in the effectiveness of Medicaid.
• Counseling on Euthanasia and End-of-Life Decision The immediate dynamic killing is a clinical demonstration coordinated to the hardship of life, while a doctor helped self-destruction is a demonstration of the doctor where he gives the patient a medicament for taking life.
• Euthanasia and Physician-Assisted Suicide Articles According to the methods of application, there are two main types of euthanasia: “active”, which consists in performing certain actions to accelerate the death of a hopelessly ill person, and “passive”, the meaning of which […]
• Legal and Ethical Issues of Euthanasia Davis argues that there exists a challenge on how to establish a consensus in the competing views regarding the desire for patients to have the choice to die with dignity while under pain and distress […]
• Debates on Euthanasia – Opposes the Use Therefore, the legal system should work hand in hand with healthcare shareholders in distinguishing the limits between the patients’ rights and the physicians’ accountability based on the possible life-limiting treatment choices.
• Active Euthanasia: Ethical Dilema In case of active euthanasia, it is the patient who requests the medical practitioner to end his or her life and the former abides by the wish.
• Euthanasia: Every For and Against Jane L Givens and Susan L Mitchell “Concerns about End-of-Life Care and Support for Euthanasia” Journal of Pain and Symptom Management Article in Press FOR The authors state socio-demographic characteristics of the people are the […]
• Pro Euthanasia in the United States The discussions of euthanasia implementation in the United States began in the early 19th century after the development of ether, which was applied to pain-relieving.
• Human Euthanasia Should Be Allowed It is stated that there is a shift in a social attitude towards human euthanasia, where people are beginning to realize that people’s lives are their rights.
• The Euthanasia in Humans The moral and ethical aspects of medical practice include not only the features of interaction with patients and other interested parties but also deeper nuances. In particular, one of the controversial and acute topics is euthanasia and its acceptability from different perspectives, including both patients’ and healthcare employees’ positions. In addition, religious issues are involved, […]
• Euthanasia: Philosophical Issues at Stake in Rodriguez I will argue that the prohibition of euthanasia contradicts utilitarianism and the principle of quality of life in particular, and can hardly be supported by paternalism since the ban does not benefit an individual’s life.
• “Euthanasia Reconsidered” by Deagle In more detail, there is a clearly discernible introduction that provides the background to the topic, introduces the thesis statement, and state the opinion of the author of the topic discussed.
• Euthanasia Movement in Modern America Euthanasia movements in modern America perfected the art of rhetoric in their communication and this worked for them in terms of winning the heart of the public.
• Euthanasia: The Issue of Medical Ethics In this respect, the position of a physician under the strain of extreme circumstances should be weighed about the value of compassion.
• The Dilemma of Euthanasia It is at this point, when it becomes a contention of professional ethics and moral considerations on the part of Jack and his wife on the one hand, and personal choice on the part of […]
• Euthanasia: Ethical Debates When a patient is in the final stage of life, sometimes, the disease or the conditions of the patient, cause a lot of physical and psychological suffering.
• Euthanasia Moral and Ethical Agitation If grandma were a dog, most all would agree that the only humane option would be to ‘put her to sleep.’ U.S.citizens are guaranteed certain rights but not the right to wouldie with dignity.’ This […]
• Life-Span Development: Terri Schiavo’s Euthanasia Case Euthanasia is the process of stopping the medical maintenance of a patient’s life when the patient/herself does not want to suffer anymore and the doctors are sure that no improvements in the patient’s condition are […]
• Euthanasia and Other Life Termination Options However, there is a strong case for helping terminally ill patients spend the remainder of their lives with care provided by the medical fraternity and with support from the state and insurance companies. And in […]
• The Problem of Euthanasia Nevertheless, we must recognize that the interruption of life, alone or with the help of doctors, is contrary to one of the basic tenets of Christianity: the more people suffer on earth, the easier it […]
• Euthanasia: Allow Them to Be Free From Body Euthanasia, the practice of deliberately bring about an easy, painless, and moderate death to a person who is in the last days of his life and can no more bear the pain of living, has […]
• Palliative Medicine Replacement for Euthanasia Euthanasia is not about helping ill and dying people to end their pain and bring comfort. Euthanasia undermines the core values of life and decreases the motivation to provide care for the dying.
• Euthanasia: A Legalized Right to Die Nothing could be further from the intent of those who favor a limited reconsideration of public policy in the areas of assisted suicide and voluntary active euthanasia.
• Euthanasia and Suicide Issues in Christian Ethics Based on the two perceptions of euthanasia, theological and professional, it is valid to say that assisted suicide is probably not the best way out.
• Euthanasia: Morals, Ethics, and the Value of Life James Rachels however disagrees with the position taken by doctors when it comes to active Euthanasia and argues that, given a case where the patient is in intolerable pain and is certain to die in […]
• Euthanasia. Arguments of Opponents The request of the patient to relieve them from Karma and sufferings that is clarification and healing, nobody gives the right to break life of a physical body.
• Attitudes Related to Euthanasia and Physician-Assisted Suicide Among Terminally Ill Patients Consequently, the outlined safeguard becomes the first line of defense in making sure that only the right individuals with chronic and incurable medical conditions benefit from assisted death.
• Active Euthanasia Legalization Controversy While many people present the notions of medical ethics, the right to life, and the availability of palliative care to oppose active euthanasia, there are those who support it since it is evidence-based in nature […]
• Dying With Dignity: Euthanasia Debate On the other hand, the supporters of the law claim that assisted death is not a suicide, and it allows more end-of-life options for terminally ill patients. The majority of people are concerned with control […]
• Euthanasia Legalization as an Unethical Practice The decision to legalize euthanasia is an idea that societies should ignore since it places many global citizens at risk, fails to provide adequate safeguards, diminishes social values, and undermines the teachings of Islam.
• The Ethics of Euthanasia In the analysis of the claims in favor and against euthanasia, the cause and effect relationships between the factors affecting the choice of euthanasia should be established.
• Today’s Moral Issues: Euthanasia To ensure that the right to life is respect, the law was amended to include assisted or aided suicide as a criminal offense.
• Controversial Issues of Euthanasia Decision We now had to make this difficult decision to end his life and relieve him of all the pain that he was undergoing.
• Confronting Physician-Assisted Suicide and Euthanasia It was because of that pain that led my mother and I to bring her to a Chinese holistic healer who treated her with some sort of secret Chinese medical injection.
• Assisted Suicide and Euthanasia Rights in Canada The article asserts that in the year 1993, Rodriquez petitioned in vain to the Supreme Court of Canada to allow her to undertake euthanasia. In the article, the author asserts that, in the year 1993, […]
• Euthanasia: “Being a Burden” by Martin Gunderson As it was implied in the Introduction, in his article, Gunderson argues in favor of the idea that it is utterly inappropriate to even consider the legalization of voluntary euthanasia, due to a number of […]
• Euthanasia: Fighting for the Right Cause Sommerville is a renowned Samuel Gale Professor of Law at the McGill University in Montreal, the Professor in the Faculty of Medicine, and the Founding Director of the Center for Medicine, Ethics, and Law. The […]
• Euthanasia as a Way of Painless Termination of Life The introduction of the Hippocratic School led to the abolishment of the practice. According to the approach, taking human life is unethical and violation of the core right to life.
• Euthanasia and Other Life-Destroying Procedures From this perspective, it is unethical to decide in favor of an end-of-life procedure on the condition that there are at least minimal chances for a patient’s survival.
• Ethics of Euthanasia and Pain-Relieving This leads to the historical argument that voluntary euthanasia is often the beginning of a slippery slope that gives rise to unintentional euthanasia and the murder of people who are unwanted in society.
• Euthanasia Legalization: Public Policy Debates The requirements of physicians to perform euthanasia and consideration of the second opinion eliminate the violation of legal and ethical stipulations, and thus, control the performance of euthanasia in health care environment. Opponents of euthanasia […]
• Euthanasia: Moral Rationalist View Human beings rely on the available evidence to generate beliefs about life and goals that should be attained, and thus the use of reason leads to success in these objectives.
• Euthanasia: Is It Worth the Fuss? In order to grasp the gist of the deliberations in this essay, it is important to first apprehend what the term euthanasia means and bring this meaning in the context of this essay.
• Active and Passive Euthanasia Analysis and Its Concept The issue of morality is one of the things that have to be mentioned when discussing the concept of euthanasia. In this instance, both the patient and the doctor know that there is no cure […]
• Euthanasia: Legalisation of a Mercy Killing The fact that the minority of countries and only several states in the US accept euthanasia proves that today people are still not ready to accept it as a mercy.
• Euthanasia in Today’s Society Euthanasia is the deliberate termination of life with the intention of relieving a patient from pain and suffering. If the prognosis of a patient is gloomy, medical care providers may find it more compassionate to […]
• When Ethics and Euthanasia Conflict? The main aim is to reduce the lifetime of a patient who is terminally ill. There is a deep mistrust of the motivations that fuel euthanasia.
• Religions Views on Euthanasia This essay highlights religious thoughts with regard to the whole issue of euthanasia, bringing into focus the extent to which our society has been influenced by courtesy of the Dr.
• Euthanasia as the Key Controversy of the XXI Century The fact that in the present-day society, human life is put at the top of the entire list of values is a major achievement of the civilization and the fact that the current society is […]
• Euthanasia: Is It the Best Solution? In twentieth century, various agencies erupted to address the practice of euthanasia such as Voluntary Euthanasia Legislation Society in 1935, which was advocating for its legalization in London and the National Society for the Legalization […]
• Legalizing Euthanasia The are supporters of the idea that only God has the right to take human’s life, on the other hand, the sufferings of the person may be unbearable and they may ask for euthanasia to […]
• A New Fight to Legalize Euthanasia Before settling down on the conclusion of the need to adopt the practice of euthanasia in our state, it is important to visit some basic aspects that are very key in the issue of euthanasia.
• The Ethics of Active Euthanasia In support of the euthanasia action, the argument is that there are circumstances when the rule of natural life can be violated.
• Is Euthanasia a Morally Wrong Choice for Terminal Patients? It is imperative to note that for both the opponents and proponents of euthanasia, the quality of life is usually the focal point, even though there is no agreement on the criteria of defining quality […]
• The Right to Life and Active Euthanasia The god of every individual should be the only one to bring death to a person and no person should have the authority to accept dying no matter the situation he/she is in.
• Singer’s Views on Voluntary Euthanasia, Non-voluntary Euthanasia, and Involuntary Euthanasia Hence, if a person consciously consents to die, there are no chances for recovery, and killing is the only way to deprive a patient from pain and suffering, euthanasia can be regarded as voluntary.
• Euthanasia Authorization Debate Euthanasia, which is equivalent to the termination of life, can be equated to a total breach of the principle of the sacredness of life, as well as the breach of the legal right of human […]
• Moral and Ethical Concerns of Euthanasia in Healthcare In the matter of euthanasia, professionals ought to decide between the overall good of the dying patient and that of other stakeholders.
• Good and Harm to Humanity of the Use a Euthanasia An Overview of Euthanasia The meaning of euthanasia has changed over the years from how it was originally construed to what it means to the contemporary world.
• Euthanasia and Meaning of Life The meaning of life is the most general aspect of judging about the requirements that must be set out by laws and people’s morals in regarding to the voluntary or involuntary taking of that life.
• Euthanasia: Your Right to Die? Although both positions can be supported with a lot of arguments, people should change their absolutely negative vision of euthanasia because the right to die with the help of physicians can be considered as one […]
• Euthanasia and Human’s Right to Die Trying to support human life with the help of modern equipment is a good idea, however, not in case there are no chances for a person to live without that equipment.
• Euthanasia Moral Permissibility Secondly, the application of voluntary euthanasia should not be regarded as the only way of reducing the pain that a patient can experience.
• Euthanasia (Mercy Killing) In some circumstances, the family and friends of the patient might request the hospital to terminate the life of the patient without necessarily informing the patient.
• Euthanasian Issues in Modern Society Is it possible to find the relief in the life which is full of pain and agony for those people who suffer from serious diseases and have only a little chance to get rid of […]
• Euthanasia From a Disciple of Jesus Christ in Today’s World Another form of euthanasia is that of Assisted Suicide where the person intending to end his/her life is provided with the necessary guidance, means as well as information as to how to go about the […]
• Euthanasia and Modern Society Towards this end Battin asserts that “the relief of pain of a patient is the least disputed and of the highest priority to the physician” in direct reference to sole and major reason of carrying […]
• Euthanasia: Moral Issues and Clinical Challenges Therefore, any law that rejects euthanasia is a bad one because it denies the patients the right and the liberty to die peacefully.
• Ethical Issues Surrounding the Choice of Euthanasia in the United States
• The Advantages and Disadvantages of the Legalization of Euthanasia
• Confronting Physician-Assisted Suicide and Euthanasia
• The Difference Between Active and Passive Euthanasia
• Euthanasia: Current Policy, Problems, and Solution
• The Permit and Legalization of Euthanasia for the Terminally Ill Patients
• Moral and Religious Differences Between Euthanasia and Suicide
• The Criticisms and Opposition of Euthanasia in Australia
• Assisted Suicide and Euthanasia It Is Not Murder, It Is Mercy
• The Factors That Influence the Legalization of Active and Passive Euthanasia in the United States
• Roman Catholic Church’s Teachings on Abortion and Euthanasia
• The Different Reasons Why People Are Against Euthanasia
• Religious and Ethical Arguments in Favour of Euthanasia
• The Moral and Ethical Views on the Goal of Euthanasia
• Euthanasia and the Role of Politics and Religion
• The Philosophical, Legal, and Medical Issues on Euthanasia
• General Information About Euthanasia and the Legality of Suicide in Australia
• The Nazi Euthanasia Programme Based on Racial Purity Theories
• Dr. Jack Kevorkian’s Role in Physician-Assisted Suicide and Euthanasia
• Utilitarian and Libertarian Views on Euthanasia
• The Moral and Religious Differences, if Any, Between Euthanasia and Suicide
• Biblical World View About the Euthanasia, Suicide, and Capital Punishment
• The Truth About Euthanasia and Assisted Suicide
• Tracing Back the Origins of the Practice of Euthanasia During the Greeks and Roman Times
• The Causes and Effects of Euthanasia and the Moral Right To Die
• The Arguments Against Euthanasia From a Standpoint of a Catholic Christian in the United States of America?
• Why Should Active Euthanasia and Physician-Assisted Suicide Be Legalized?
• What Are the Good and Bad Sides of Euthanasia?
• Do People Have To Commit Suicide by Euthanasia (Suicide by a Doctor)?
• What Is the Difference Between Passive and Active Euthanasia?
• What Are the Social Issues and Ethical Values of Euthanasia?
• What Is the Current Legal Situation Regarding Euthanasia?
• How Does Prohibition of Euthanasia Limit Our Rights?
• What Is the American Medical Association’s Attitude to Euthanasia?
• Can Hegelian Dialectics Justify Euthanasia?
• What Are the Viewpoints and Studies of the Legalization of Euthanasia in the United States?
• Why Does Parenting Make Euthanasia More Acceptable?
• What Are the Negative Arguments Against Euthanasia?
• Voluntary Euthanasia: What’s Right and Wrong?
• Why Can Christians not Accept Euthanasia?
• Can Euthanasia Help the Terminally Ill?
• What Are the Top Ten Reasons for Legalizing Euthanasia?
• Should Non Voluntary Euthanasia Be Legal?
• What Is the Difference Between Doctor-Assisted Suicide and Euthanasia?
• Why Should Euthanasia and Assisted Suicide Be Legalized?
• What’s Wrong With Involuntary Euthanasia?
• Why Are There So Different Views on Abortion and Euthanasia?
• How Would Christians Respond to the Issue of Abortion and Euthanasia?
• What Are the Objections To Legalizing Euthanasia in Hong Kong?
• How Does Euthanasia Devalue Human Life?
• What Are the Views and Arguments About Euthanasia?
• How May the Christian Faith Inform the Debate Over Euthanasia?
• What Does Euthanasia Mean to Society Today?
• What Are the Religious and Ethical Considerations to the Issue of Euthanasia?
• Euthanasia and Assisted Suicide – Who Wants It?
• Human Rights Essay Ideas
• Suffering Essay Topics
• Morality Research Ideas
• Death Penalty Questions
• Healthcare Questions
• Suicide Topics
• Constitution Research Ideas
• Social Justice Essay Ideas
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2024, February 28). 158 Euthanasia Topics & Essay Examples. https://ivypanda.com/essays/topic/euthanasia-essay-examples/

"158 Euthanasia Topics & Essay Examples." IvyPanda , 28 Feb. 2024, ivypanda.com/essays/topic/euthanasia-essay-examples/.

IvyPanda . (2024) '158 Euthanasia Topics & Essay Examples'. 28 February.

IvyPanda . 2024. "158 Euthanasia Topics & Essay Examples." February 28, 2024. https://ivypanda.com/essays/topic/euthanasia-essay-examples/.

1. IvyPanda . "158 Euthanasia Topics & Essay Examples." February 28, 2024. https://ivypanda.com/essays/topic/euthanasia-essay-examples/.

Bibliography

IvyPanda . "158 Euthanasia Topics & Essay Examples." February 28, 2024. https://ivypanda.com/essays/topic/euthanasia-essay-examples/.

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• Diet & Nutrition
• Supplements
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

Arguments in Favor of Right-to-Die Legislation

There are many arguments about whether people should have the right to die when they choose, intentionally and by design, to end their own perceived pain and suffering .

Differences of Opinion

Most of the arguments for and against the right to die are ideological, based on many important aspects of civility: the law, religion or spiritual beliefs, ethics, and social mores. Opinions vary based on personal experiences, belief systems, age, culture, and other aspects of humankind that influence how we think about important aspects of life.

Where the Right to Die Is Legal

In the United States, with the exception of a small number of states which have passed right-to-die legislation, a doctor who injects a patient who wants to die with a lethal drug and kills him would technically have committed murder.   Proponents of right-to-die legislation desire a legal remedy for doctors who assist their suffering patients in ending their lives. Outside of the United States, euthanasia is the law of the land in Canada, the Netherlands, Colombia, Belgium, Luxembourg, and Switzerland.

Understanding Right-to-Die Laws

Right-to-Die legislation, also known as physician-assisted death or aid in dying, gives mentally competent adult patients with a terminal illness and a prognosis of six months or less to have the ability to request and receive a prescription medication to bring about their death. Most statutes under consideration at the state level are modeled after Oregon’s Death with Dignity Act, which requires two physicians to confirm the patient’s residence, diagnosis, prognosis, mental competence, and voluntariness of the request to die.   In addition, two waiting periods are required.

The Pros for Right-to-Die Laws

Here are some arguments in favor of giving patients the right to die and protecting healthcare providers who carry out those wishes. Compare these arguments in favor of death with dignity and the right to die against  the cons .

• A patient's death brings him or her the end of pain and suffering.
• Patients have an opportunity to die with dignity, without fear that they will lose their physical or mental capacities.
• The overall healthcare financial burden on the family is reduced.
• Patients can arrange for final goodbyes with loved ones.
• If planned for in advance, organs can be harvested and donated .
• With physician assistance , patients have a better chance of experiencing a painless and less traumatic death (death with dignity).
• Patients can end pain and suffering when there is no hope for relief.
• Some say assisted death with dignity is against the Hippocratic Oath; however, the statement “first do no harm” can also apply to helping a patient find the ultimate relief from pain through death.
• Medical advances have enabled life beyond what nature might have allowed, but that is not always in the best interest of the suffering patient with no hope of recovery.
• A living will, considered a guiding document for a patient's healthcare wishes, can provide clear evidence of a patient's decisions regarding end-of-life care.

Pereira J. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls . Curr Oncol . 2011;18(2):e38-45. doi:10.3747/co.v18i2.883

Battin MP, Van der heide A, Ganzini L, Van der wal G, Onwuteaka-philipsen BD. Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups . J Med Ethics . 2007;33(10):591-7. doi:10.1136/jme.2007.022335

By Trisha Torrey  Trisha Torrey is a patient empowerment and advocacy consultant. She has written several books about patient advocacy and how to best navigate the healthcare system. 

We have a right to die with dignity. The medical profession has a duty to assist

Distinguished Professor of Philosophy and Director: Centre for Applied Ethics, Stellenbosch University

Disclosure statement

Anton van Niekerk is director of the Centre for Applied Ethics and Head of the Unit for Bioethics in that Centre. The Unit receives an annual contribution from Mediclinic, but that is not for the exclusive use of Anton van Niekerk.

Stellenbosch University provides funding as a partner of The Conversation AFRICA.

View all partners

Euthanasia represents one of the oldest issues in medical ethics. It is forbidden in the original Hippocratic Oath, and has consistently been opposed by most religious traditions since antiquity – other than, incidentally, abortion, which has only been formally banned by the Catholic Church since the middle of the 19th century.

Euthanasia is a wide topic with many dimensions. I will limit myself in this article to the issue of assisted death, which seems to me to be one of the most pressing issues of our time.

Desmond Tutu, emeritus archbishop of Cape Town, raised it again on his 85th birthday in an article in the Washington Post. He wrote:

I have prepared for my death and have made it clear that I do not wish to be kept alive at all costs. I hope I am treated with compassion and allowed to pass onto the next phase of life’s journey in the manner of my choice.

Assisted death can take the form of physician assisted suicide (PAS) . Here a suffering and terminal patient is assisted by a physician to gain access to a lethal substance which the patient himself or herself takes or administers. If incapable of doing so, the physician – on request of the patient – administers the lethal substance which terminates the patient’s life.

The latter procedure is also referred to as “voluntary active euthanasia” (VAE). I will not deal with the issue of involuntary euthanasia –where the suffering patient’s life is terminated without their explicit consent -– a procedure which, to my mind, is ethically much more problematic.

Passive form of euthanasia

The term “voluntary active euthanasia” suggests that there also is a passive form of euthanasia. It is passive in the sense that nothing is “actively” done to kill the patient, but that nothing is done to deter the process of dying either, and that the termination of life-support which is clearly futile, is permitted.

However, the moral significance of the distinction between “active” and “passive” euthanasia is increasingly questioned by ethicists. The reason simply is the credibility of arguing that administering a lethal agent is “active”, but terminating life support (for example switching off a ventilator) is “passive”. Both clearly are observable and describable actions, and both are the direct causes of the patient’s death.

There are a number of reasons for the opposition to physician assisted suicide or voluntary active euthanasia. The value bestowed on human life in all religious traditions and almost all cultures, such as the prohibition on murder is so pervasive that it is an element of common, and not statutory, law.

Objections from the medical profession to being seen or utilised as “killers” rather than saviours of human life, as well as the sometimes well-founded fear of the possible abuse of physician assisted suicide or voluntary active euthanasia, is a further reason. The main victims of such possible abuse could well be the most vulnerable and indigent members of society: the poor, the disabled and the like. Those who cannot pay for prolonged accommodation in expensive health care facilities and intensive care units.

Death with dignity

In support of physician assisted suicide or voluntary active euthanasia, the argument is often made that, as people have the right to live with dignity, they also have the right to die with dignity. Some medical conditions are simply so painful and unnecessarily prolonged that the capability of the medical profession to alleviate suffering by means of palliative care is surpassed.

Intractable terminal suffering robs the victims of most of their dignity. In addition, medical science and practice is currently capable of an unprecedented prolongation of human life. It can be a prolongation that too often results in a concomitant prolongation of unnecessary and pointless suffering.

Enormous pressure is placed upon both families and the health care system to spend time and very costly resources on patients that have little or no chance of recovery and are irrevocably destined to die. It is, so the argument goes, not inhumane or irreverent to assist such patients – particularly if they clearly and repeatedly so request – to bring their lives to an end.

I am personally much more in favour of the pro-PAS and pro-VAE positions, although the arguments against do raise issues that need to be addressed. Most of those issues (for example the danger of the exploitation of vulnerable patients) I believe, can be satisfactorily dealt with by regulation.

Argument in favour of assisted suicide

The most compelling argument in favour of physician assisted suicide or voluntary active euthanasia is the argument in support of committing suicide in a democracy. The right to commit suicide is, as far as I am concerned, simply one of the prices we have to be willing to pay as citizens of a democracy.

We do not have the right, and we play no discernible role, in coming into existence. But we do have the right to decide how long we remain in existence. The fact that we have the right to suicide, does not mean that it is always (morally) right to execute that right.

It is hard to deny the right of an 85-year-old with terminal cancer of the pancreas and almost no family and friends left, to commit suicide or ask for assisted death. In this case, he or she both has the right, and will be in the right if exercising that right.

Compare that with the situation of a 40-year-old man, a husband and father of three young children, who has embezzled company funds and now has to face the music in court. He, also, has the right to commit suicide. But, I would argue, it would not be morally right for him to do so, given the dire consequences for his family. To have a right, does not imply that it is always right to execute that right.

My argument in favour of physician assisted suicide or voluntary active euthanasia is thus grounded in the right to suicide, which I think is fundamental to a democracy.

Take the case of a competent person who is terminally ill, who will die within the next six months and has no prospect of relief or cure. This person suffers intolerably and/or intractably, often because of an irreversible dependence on life-support. This patient repeatedly, say at least twice a week, requests that his/her life be terminated. I am convinced that to perform physician assisted suicide or voluntary active euthanasia in this situation is not only the humane and respectful, but the morally justified way to go.

The primary task of the medical profession is not to prolong life or to promote health, but to relieve suffering. We have a right to die with dignity, and the medical profession has a duty to assist in that regard.

• Assisted suicide
• Voluntary euthanasia
• Desmond Tutu
• World Philosophy Day
• Philosophy2021

Chief Operating Officer (COO)

Technical Assistant - Metabolomics

Data Manager

Director, Social Policy

Head, School of Psychology

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Indian J Med Res
• v.136(6); 2012 Dec

Euthanasia: Right to life vs right to die

Suresh bada math.

Department of Psychiatry National Institute of Mental Health & Neuro Sciences (Deemed University) Bangalore 560 029, India

Santosh K. Chaturvedi

The word euthanasia, originated in Greece means a good death 1 . Euthanasia encompasses various dimensions, from active (introducing something to cause death) to passive (withholding treatment or supportive measures); voluntary (consent) to involuntary (consent from guardian) and physician assisted (where physician's prescribe the medicine and patient or the third party administers the medication to cause death) 2 , 3 . Request for premature ending of life has contributed to the debate about the role of such practices in contemporary health care. This debate cuts across complex and dynamic aspects such as, legal, ethical, human rights, health, religious, economic, spiritual, social and cultural aspects of the civilised society. Here we argue this complex issue from both the supporters and opponents’ perspectives, and also attempts to present the plight of the sufferers and their caregivers. The objective is to discuss the subject of euthanasia from the medical and human rights perspective given the background of the recent Supreme Court judgement 3 in this context.

In India abetment of suicide and attempt to suicide are both criminal offences. In 1994, constitutional validity of Indian Penal Code Section (IPC Sec) 309 was challenged in the Supreme Court 4 . The Supreme Court declared that IPC Sec 309 is unconstitutional, under Article 21 (Right to Life) of the constitution in a landmark judgement 4 . In 1996, an interesting case of abetment of commission of suicide (IPC Sec 306) came to Supreme Court 5 . The accused were convicted in the trial court and later the conviction was upheld by the High Court. They appealed to the Supreme Court and contended that ‘right to die’ be included in Article 21 of the Constitution and any person abetting the commission of suicide by anyone is merely assisting in the enforcement of the fundamental right under Article 21; hence their punishment is violation of Article 21. This made the Supreme Court to rethink and to reconsider the decision of right to die. Immediately the matter was referred to a Constitution Bench of the Indian Supreme Court. The Court held that the right to life under Article 21 of the Constitution does not include the right to die 5 .

Regarding suicide, the Supreme Court reconsidered its decision on suicide. Abetment of suicide (IPC Sec 306) and attempt to suicide (IPC Sec 309) are two distinct offences, hence Section 306 can survive independent of Section 309. It has also clearly stated that a person attempts suicide in a depression, and hence he needs help, rather than punishment. Therefore, the Supreme Court has recommended to Parliament to consider the feasibility of deleting Section 309 from the Indian Penal Code 3 .

Arguments against euthanasia

Eliminating the invalid : Euthanasia opposers argue that if we embrace ‘the right to death with dignity’, people with incurable and debilitating illnesses will be disposed from our civilised society. The practice of palliative care counters this view, as palliative care would provide relief from distressing symptoms and pain, and support to the patient as well as the care giver. Palliative care is an active, compassionate and creative care for the dying 6 .

Constitution of India : ‘Right to life’ is a natural right embodied in Article 21 but suicide is an unnatural termination or extinction of life and, therefore, incompatible and inconsistent with the concept of ‘right to life’. It is the duty of the State to protect life and the physician's duty to provide care and not to harm patients. If euthanasia is legalised, then there is a grave apprehension that the State may refuse to invest in health (working towards Right to life). Legalised euthanasia has led to a severe decline in the quality of care for terminally-ill patients in Holland 7 . Hence, in a welfare state there should not be any role of euthanasia in any form.

Symptom of mental illness : Attempts to suicide or completed suicide are commonly seen in patients suffering from depression 8 , schizophrenia 9 and substance users 10 . It is also documented in patients suffering from obsessive compulsive disorder 11 . Hence, it is essential to assess the mental status of the individual seeking for euthanasia. In classical teaching, attempt to suicide is a psychiatric emergency and it is considered as a desperate call for help or assistance. Several guidelines have been formulated for management of suicidal patients in psychiatry 12 . Hence, attempted suicide is considered as a sign of mental illness 13 .

Malafide intention : In the era of declining morality and justice, there is a possibility of misusing euthanasia by family members or relatives for inheriting the property of the patient. The Supreme Court has also raised this issue in the recent judgement 3 . ‘Mercy killing’ should not lead to ‘killing mercy’ in the hands of the noble medical professionals. Hence, to keep control over the medical professionals, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 discusses euthanasia briefly in Chapter 6, Section 6.7 and it is in accordance with the provisions of the Transplantation of Human Organ Act, 1994 14 . There is an urgent need to protect patients and also medical practitioners caring the terminally ill patients from unnecessary lawsuit. Law commission had submitted a report (no-196) to the government on this issue 15 .

Emphasis on care : Earlier majority of them died before they reached the hospital but now it is converse. Now sciences had advanced to the extent, life can be prolonged but not to that extent of bringing back the dead one. This phenomenon has raised a complex situation. Earlier diseases outcome was discussed in terms of ‘CURE’ but in the contemporary world of diseases such as cancer, Aids, diabetes, hypertension and mental illness are debated in terms best ‘CARE’, since cure is distant. The principle is to add life to years rather than years to life with a good quality palliative care. The intention is to provide care when cure is not possible by low cost methods. The expectation of society is, ‘cure’ from the health professionals, but the role of medical professionals is to provide ‘care’. Hence, euthanasia for no cure illness does not have a logical argument. Whenever, there is no cure, the society and medical professionals become frustrated and the fellow citizen take extreme measures such as suicide, euthanasia or substance use. In such situations, palliative and rehabilitative care comes to the rescue of the patient and the family. At times, doctors do suggest to the family members to have the patient discharged from the hospital wait for death to come, if the family or patient so desires. Various reasons are quoted for such decisions, such as poverty, non-availability of bed, futile intervention, resources can be utilised for other patients where cure is possible and unfortunately majority of our patient's family do accordingly. Many of the terminally ill patients prefer to die at home, with or without any proper terminal health care. The societal perception needs to be altered and also the medical professionals need to focus on care rather in addition to just cure. The motive for many euthanasia requests is unawareness of alternatives. Patients hear from their doctors that ‘nothing can be done anymore’. However, when patients hear that a lot can be done through palliative care, that the symptoms can be controlled, now and in the future, many do not want euthanasia anymore 16 .

Commercialisation of health care : Passive euthanasia occurs in majority of the hospitals across the county, where poor patients and their family members refuse or withdraw treatment because of the huge cost involved in keeping them alive. If euthanasia is legalised, then commercial health sector will serve death sentence to many disabled and elderly citizens of India for meagre amount of money. This has been highlighted in the Supreme Court Judgement 3 , 17 .

Research has revealed that many terminally ill patients requesting euthanasia, have major depression, and that the desire for death in terminal patients is correlated with the depression 18 . In Indian setting also, strong desire for death was reported by 3 of the 191 advanced cancer patients, and these had severe depression 19 . They need palliative and rehabilitative care. They want to be looked after by enthusiastic, compassionate and humanistic team of health professionals and the complete expenses need to be borne by the State so that ‘Right to life’ becomes a reality and succeeds before ‘Right to death with dignity’. Palliative care actually provides death with dignity and a death considered good by the patient and the care givers.

Counterargument of euthanasia supporters

Caregivers burden : ‘Right-to-die’ supporters argue that people who have an incurable, degenerative, disabling or debilitating condition should be allowed to die in dignity. This argument is further defended for those, who have chronic debilitating illness even though it is not terminal such as severe mental illness. Majority of such petitions are filed by the sufferers or family members or their caretakers. The caregiver's burden is huge and cuts across various domains such as financial, emotional, time, physical, mental and social. Hence, it is uncommon to hear requests from the family members of the person with psychiatric illness to give some poison either to patient or else to them. Coupled with the States inefficiency, apathy and no investment on health is mockery of the ‘Right to life’.

Refusing care : Right to refuse medical treatment is well recognised in law, including medical treatment that sustains or prolongs life. For example, a patient suffering from blood cancer can refuse treatment or deny feeds through nasogastric tube. Recognition of right to refuse treatment gives a way for passive euthanasia. Many do argue that allowing medical termination of pregnancy before 16 wk is also a form of active involuntary euthanasia. This issue of mercy killing of deformed babies has already been in discussion in Holland 20 .

Right to die : Many patients in a persistent vegetative state or else in chronic illness, do not want to be a burden on their family members. Euthanasia can be considered as a way to upheld the ‘Right to life’ by honouring ‘Right to die’ with dignity.

Encouraging the organ transplantation : Euthanasia in terminally ill patients provides an opportunity to advocate for organ donation. This in turn will help many patients with organ failure waiting for transplantation. Not only euthanasia gives ‘Right to die’ for the terminally ill, but also ‘Right to life’ for the organ needy patients.

Constitution of India reads ‘right to life’ is in positive direction of protecting life. Hence, there is an urgent need to fulfil this obligation of ‘Right to life’ by providing ‘food, safe drinking water and health care’. On the contrary, the state does not own the responsibility of promoting, protecting and fulfilling the socio-economic rights such as right to food, right to water, right to education and right to health care, which are basic essential ingredients of right to life. Till date, most of the States has not done anything to support the terminally ill people by providing for hospice care.

If the State takes the responsibility of providing reasonable degree of health care, then majority of the euthanasia supporters will definitely reconsider their argument. We do endorse the Supreme Court Judgement that our contemporary society and public health system is not matured enough to handle this sensitive issue, hence it needs to be withheld. However, this issue needs to be re-examined again after few years depending upon the evolution of the society with regard to providing health care to the disabled and public health sector with regard to providing health care to poor people.

The Supreme Court judgement to withhold decision on this sensitive issue is a first step towards a new era of health care in terminally ill patients. The Judgment laid down is to preserve harmony within a society, when faced with a complex medical, social and legal dilemma. There is a need to enact a legislation to protect terminally ill patients and also medical practitioners caring for them as per the recommendation of Law Commission Report-196 15 . There is also an urgent need to invest in our health care system, so that poor people suffering from ill health can access free health care. Investment in health care is not a charity; ‘Right to Health’ is bestowed under ‘Right to Life’ of our constitution.

• Open access
• Published: 21 May 2024

Ethical perspectives regarding Euthanasia, including in the context of adult psychiatry: a qualitative interview study among healthcare workers in Belgium

• Monica Verhofstadt 1 ,
• Loïc Moureau 2 ,
• Koen Pardon 1 &
• Axel Liégeois 2 , 3  

BMC Medical Ethics volume  25 , Article number:  60 ( 2024 ) Cite this article

644 Accesses

1 Altmetric

Metrics details

Introduction

Previous research has explored euthanasia’s ethical dimensions, primarily focusing on general practice and, to a lesser extent, psychiatry, mainly from the viewpoints of physicians and nurses. However, a gap exists in understanding the comprehensive value-based perspectives of other professionals involved in both somatic and psychiatric euthanasia. This paper aims to analyze the interplay among legal, medical, and ethical factors to clarify how foundational values shape the ethical discourse surrounding euthanasia in both somatic and psychiatric contexts. It seeks to explore these dynamics among all healthcare professionals and volunteers in Belgium.

Semi-structured interviews were conducted with 30 Dutch-speaking healthcare workers who had encountered patients requesting euthanasia for psychiatric conditions, in Belgium, from August 2019 to August 2020. Qualitative thematic analysis was applied to the interview transcripts.

Participants identified three pivotal values and virtues: religious values, professional values, and fundamental medical values encompassing autonomy, beneficence, and non-maleficence, linked to compassion, quality care, and justice. These values interwove across four tiers: the patient, the patient’s inner circle, the medical realm, and society at large. Irrespective of their euthanasia stance, participants generally displayed a blend of ethical values across these tiers. Their euthanasia perspective was primarily shaped by value interpretation, significance allocation to key components, and tier weighting. Explicit mention of varying ethical values, potentially indicating distinct stances in favor of or against euthanasia, was infrequent.

The study underscores ethical discourse’s central role in navigating euthanasia’s intricate landscape. Fostering inclusive dialogue, bridging diverse values, supports informed decision-making, nurturing justice, and empathy. Tailored end-of-life healthcare in psychiatry is essential, acknowledging all involved actors’ needs. The study calls for interdisciplinary research to comprehensively grasp euthanasia’s multifaceted dimensions, and guiding policy evolution. While contextualized in Belgium, the implications extend to the broader euthanasia discourse, suggesting avenues for further inquiry and cross-cultural exploration.

Peer Review reports

Medical assistance in dying is allowed in 27 jurisdictions in the world and if so, it is mainly restricted to the terminally ill (see BOX 1 in OSF) [ 1 ]. Medical assistance in dying entails that a patient’s death request can be granted via euthanasia , defined as the intentional termination of life by a physician at the patient’s explicit request, which is currently decriminalised in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, Spain, and New Zealand. In addition, it can be granted by means of assisted suicide , also defined as the intentional termination of life by a physician at the patient’s explicit request, but in these cases, the lethal drugs are provided by a physician and self-administered by the patient at a time of the latter’s own choosing (e.g., Australia, Austria, Switzerland, United States). In some countries, not only a physician, but also a nurse practitioner can be involved in the procedure (e.g., Canada, New Zealand).

Euthanasia has been legal in Belgium since 2002, positioning the country as a pioneer in this field with two decades of euthanasia practice [ 2 ]. According to Belgian legislation, individuals can be deemed eligible for euthanasia when they are, among other criteria, in a medically futile state characterized by constant and unbearable physical or psychological suffering resulting from a serious and incurable disorder caused by accident or illness [ 2 ]. Belgium is one of the few countries that does not exclude people from assisted dying who suffer predominantly from irremediable psychiatric conditions (see BOX 2 in OSF for all legal criteria in Belgium). As regards prevalence, euthanasia accounted for up to 3.1% of all registered deaths in 2023 in Belgium [ 3 ]. Whereas most registered euthanasia deaths concerned the terminally ill (approximately 84%), predominantly suffering from cancer, only 48 or 1.4% of euthanasia deaths concerned non-terminally ill adults predominantly suffering from psychiatric conditions. Since euthanasia was legalised, in total 457 such euthanasia cases have been reported, less than 1.5% of all registered euthanasia cases in Belgium [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ].

However, this is only the tip of the iceberg, as there is reason to believe that the total number of requests for euthanasia in Belgium (regardless of outcome), is at least 10 times higher. For instance, recent annual reports from Vonkel, an end-of-life consultation centre in Belgium, revealed around 100 unique patients per year applying for euthanasia for psychiatric reasons. Less than 10% of those euthanasia requests were reported to be carried out [ 10 , 11 , 12 ]. Moreover, a recent survey among psychiatrists working in Flanders, Belgium, revealed that 8 out of 10 respondents had been confronted at least once throughout their career with patients requesting euthanasia for psychiatric reasons [ 13 ]. The survey also showed that, although three-quarters are supportive of not excluding the option of euthanasia for this specific patient group [ 14 ], the majority is hesitant to be actively engaged in a euthanasia procedure [ 13 , 14 ]. The literature ascribed the reluctance to the complexity of euthanasia assessment in this patient group, inherently high in professional and emotional demands [ 15 , 16 , 17 , 18 , 19 ]. The complexity was for a large part described in terms of the practical considerations surrounding euthanasia requests and assessment, e.g., whether and when these patients can meet the legal criteria.

There is thus reason to believe that healthcare workers’ overarching ethical considerations influence their attitudes on euthanasia in general and in the context of psychiatry specifically, and their practice. As empirical in-depth studies are lacking, this area is largely understudied. To date, only two recent qualitative studies among Dutch physicians emphasised the value-based reasons for euthanasia decision-making, but did not [ 20 ] or only summarily [ 21 ] scratch the specific context of psychiatry. Another recent qualitative study among Dutch physicians, including psychiatrists, emphasized the value-based reasons for supportive attitudes towards euthanasia, e.g. the value of self-determination, compassion, fairness, and suicide prevention, versus the value-based reasons for not supporting euthanasia, e.g. the mission of medicine of hope and healing [ 22 ]. Furthermore, a recent systematic review described the main ethical challenges surrounding the euthanasia practice in the context of psychiatry [ 23 ]. However, this ethical debate was mainly concentrated on the permissibility and implementation of euthanasia from a practical-clinical point of view, e.g. whether euthanasia in the context of psychiatry should be permitted, and why the legal requirements can (not) be adequately embedded in the field of psychiatric medicine. How practically and juridically relevant these considerations may be, they remain the outcome of ethical values being weighed up, which means that no single consideration can be considered ethically irrelevant, neutral, or value-free. Moreover, the review was based on articles that have been selected in a timeframe in which sound empirical data regarding euthanasia in the context of psychiatry were largely lacking.

Also, the overarching value-based views of other professionals involved in psychiatric euthanasia practice have not yet been studied. This is striking, as a recent Belgian survey study revealed that that half of the psychiatric nurses (53%) are frequently and directly confronted with such euthanasia requests [ 24 ], but in-depth insights into their value-based views are lacking. Furthermore, there are many more formal caregivers, other than psychiatric nurses, involved in euthanasia assessment procedures. End-of-life centres employ e.g., paramedical personnel such as psychologists, psychiatric nurses for intake and registration purposes, and well-trained volunteer personnel such as buddies, entrusted with the task to help these patients to cope with the euthanasia procedure. In addition, rehabilitation-oriented support groups (REAKIRO) were established to help these patients (and their relatives) in walking the tightrope of life and death [ 25 ]. All of these caregivers may also have an unacknowledged but influential role in these euthanasia assessment procedures, and therefore, an interesting perspective to reflect on euthanasia legislation and practice. Gaining insight into healthcare workers’ ethical considerations related to euthanasia in psychiatry will lay bare the ethical foundations underlying current practice and is important to inform and spark further debate around this extremely thorny issue, and to promote sound ethical analysis.

Hence, the purpose of this research is to explore healthcare workers’ ethical considerations regarding euthanasia in general and euthanasia concerning adults suffering predominantly from psychiatric conditions in particular.

Theoretical research framework

Our research was guided by the framework of ‘critical social constructionism’ [ 26 ], providing a nuanced perspective that diverges from the acknowledgment of an objective reality. This approach intricately examines the interplay of personal, social, and societal dimensions within the phenomena under study. It necessitates an acknowledgment of the layered complexities influencing our understanding of phenomena such as euthanasia, a notion supported by both our prior research [ 27 ] and additional studies [ 23 , 28 ].

Our interpretation of the data was informed by social constructionism, which recognizes the role of internalized societal norms in shaping individuals’ perceptions of reality over time. Furthermore, we embraced a contextualist epistemology [ 29 ], acknowledging the contextual influence on knowledge formation among both researchers and participants. This methodological approach aimed to capture diverse lived experiences (e.g., diversity in clinical and euthanasia trajectories) and perspectives, including varied attitudes toward euthanasia based on specific relationships (e.g., professional healthcare worker or volunteer). Consequently, we maintained a reflexive stance regarding the potential impact of our individual experiences and identities on our analyses and interpretations, as elaborated in the Ethical Considerations section.

Study design

The qualitative research design consisted of semi-structured face-to-face interviews with healthcare workers in Flanders and Brussels, Belgium.

Participants

All participants were Dutch-speaking and had at least one concrete experience with euthanasia requests and procedures concerning adults with psychiatric conditions in the period 2016–2020, either as professional or volunteer healthcare workers. We adopted a broad recruitment approach, with a particular focus on all healthcare providers directly involved in medical practice rather than in managerial or policy-making roles. No further exclusion criteria were employed.

Recruitment and interview procedure

Purposive sampling was used to ensure diversity and heterogeneity in terms of: participants’ affiliation with institutions holding different stances on ‘euthanasia and psychiatry’; being to a different extent confronted with these euthanasia procedures as regards the amount of experiences (sporadically versus regularly); the nature of the experiences (e.g. confronted with or engaged in euthanasia procedures that were still under review or that had been rejected, granted, performed or withdrawn); and their specific role as professional or volunteer healthcare worker.

Participants were recruited via assistance of our contact persons at: (1) the end-of-life consultation centre Vonkel; (2) the Brothers of Charity; (3) the rehabilitation-oriented centre REAKIRO in Louvain; and (4) the Review Belgian Euthanasia Law for psychological suffering (REBEL) group, a group of Belgian physicians (e.g. psychiatrists), therapists (e.g. psychologists) as well as academics who express their concern on euthanasia in the context of psychiatry via the media. Participants were also recruited via a notice on the sites, newsflashes and/or in the online newsletters of LEIF (Life End Information Forum), Recht op Waardig Sterven (the Flemish Right to Die with Dignity Society) and Vlaamse Vereniging voor Psychiatrie (Flemish Psychiatric Association).

Potential participants contacted MV or a study assistant by phone or mail. The patients were then given an information letter and informed consent form that consisted of 2 main parts. All interviews were conducted by MV or a study assistant, who both have experience in conducting interviews on end-of-life topics. Interviews were held at the participant’s location of choice, except for five interviews which were held online via video call by Whereby 14 due to the Covid-19 crisis lockdown regulations. Interviews lasted between 55 min and 2 h, and were audio recorded (the online video interviews were recorded by Whereby’s software and immediately transferred in an mp.3 format).

Measurements

The interview guide (see OSF) contained the following consecutive questions of importance to the present report: (1) What is your personal stance regarding euthanasia as a legalised medical end-of-life option? and (2) What is your personal stance regarding euthanasia in the context of psychiatry?

Data management and analysis

We used a model of sampling-based saturation, namely inductive thematic saturation, that relates to the emergence of new themes (defined as 7 consecutive interviews without new themes) [ 30 ]. We continued to recruit and conduct interviews so that the sample would be heterogenous in terms of socio-demographics, clinical profile, and clinical setting. In particular, our focus was on recruiting individuals with the following profiles: psychologists, male psychiatric nurses and moral consultants/spiritual caregivers employed in residential psychiatric settings ( n  = 5).

All interviews were then transcribed verbatim and de-identified by the interviewers.

We made use of hybrid inductive and deductive coding and theme development by means of a 2-staged process. Stage 1 consisted of an inductive data-driven thematic coding procedure.

We made use of these four phases; (1) identification and coding of all transcripts; (2) the placing of the codes in subthemes, i.e., arguments in favour versus critical concerns; (3) the placing of these subthemes in overarching main themes, i.e., different stakeholders (patient/medicine/society); (4) the comparison and discussion of the findings (with all co-authors). In addition to the inductive approach, we also used a deductive, theory-driven template approach during stage 2. We made use of these four phases; 1) the development of an ethical interpretation framework (see OSF). The framework consists of four key concepts, each involving a multitude of ethical concepts: (a) ethical theories and methodologies, (b) ethical values, (c) basic ethical virtues, and (d) dialogue/decision making ethics; 2) the identification of codes that fit the ethical framework and the theory-driven renaming of these codes; 3) the placing of some of the subthemes in an additional main theme; and 4) the comparison and discussion of the findings (with all co-authors).

Ethical considerations

The research team comprised two experienced clinical psychologists, one specializing in euthanasia within the cancer patient population and the other skilled in conducting interviews on this sensitive topic within the adult psychiatric context. Additionally, two ethicists with expertise in assisted dying, including euthanasia, were part of the team. Some authors also have backgrounds in psychiatric practice, including outpatient and residential settings, while others bring expertise through personal experiences. Furthermore, all contributing authors have personal and/or professional connections with individuals navigating death ideation, offering diverse perspectives on euthanasia. Additionally, some authors hold religious beliefs, while others maintain a more agnostic stance. These perspectives vary depending on the predominant viewpoints adopted—whether that of the patient, a close relation, a clinician, an ethicist, or policy stances. To mitigate potential undue influence on data interpretation, three team assemblies were convened. These sessions served to share firsthand encounters from interviews and their outcomes, fostering reflection and deliberation among team members. This proactive measure was implemented to prevent both personal and professional biases from affecting the interpretation of the data.

The main characteristics of the 30 participants are listed in Table  1 . The sample consisted of 16 physicians, 7 other care professionals (ranging from psychiatric nurses to mobile support teams), and 7 volunteers, all of whom were engaged in one or more euthanasia procedures predominantly based on psychiatric conditions.

The participating physicians held various roles regarding the handling of euthanasia requests:

1 physician refused to discuss the request with the patient on principle grounds.

7 physicians managed the clarification of euthanasia requests from their own patients or referred them to colleagues for further clarification.

10 physicians provided one of the two legally required formal advices or an additional advice on the euthanasia request.

5 physicians performed the act of euthanasia.

3 physicians held a more normative, dissuasive stance against euthanasia in the context of psychiatry but were willing to explore and discuss the euthanasia request with the patient.

The sample further included 14 non-physicians, among them members holding one or more roles:

2 members were part of mobile teams providing psychiatric care and support in the patient’s home setting.

3 were psychiatric nurses working either in a general hospital or in a psychiatric residential setting.

2 were Experts by Experience, individuals with a history of mental distress trained to provide support for individuals new to the euthanasia procedure and/or rehabilitation approaches.

3 were buddies, individuals entrusted with assisting and supporting the patient throughout the euthanasia procedure.

3 were moral consultants/spiritual caregiver, tasked with offering various forms of existential guidance and support to patients considering euthanasia, including religious, moral, and/or other perspectives.

5 were consultants at end-of-life information and/or consultation centers responsible for patient intake.

Participants’ ethical considerations regarding euthanasia, in the broadest context of medicine

As can be seen from the coding structure in Table  2 , we ordered coding categories on the level of 1) the individual patient, 2) the patient’s social inner circle, 3) the (para)medical field, and 4) the society. Note that words used verbatim by the interviewees (often interview fragments instead of quotes, as to better illuminate the complexities and nuances of interviewees’ first-hand lived experiences) from the transcribed interviews are incorporated that provide both additional insightful details and reveal the at times interwoven nature of the analysed codes.”

The level of the individual patient

On the level of the individual patient, the following five ethical considerations were distinguished: (1) autonomy, (2) dignity, (3) quality of life, (4) compassion, and (5) the meaning and transformative value of suffering.

First, Autonomy was a recurrent theme in all the interviews. Some participants expressly valued individual autonomy , and more specifically its following two underpinning characteristics: (1) self-determination in terms of the fundamental right for each individual to direct the course of one’s own life, which also includes ‘taking control over the timing and circumstances of one’s end-of-life’, and (2) freedom of choice , as they strongly believed that individuals are free to choose what meaning and purpose they assign to their lives. According to them, as each individual should be enabled ‘to live according to one’s own value system’, so should the ending of one’s life also be congruent with one’s own value system. Hence, in their opinion, euthanasia should remain ‘one of the many options to die’.

Other participants called this individualistic approach of autonomy ‘unrealistic’ or even ‘delusional’, as it shies away from: (1) the relational account of autonomy, in which a true autonomous decision was seen as the outcome of a decision-making process which is shaped by individual, social and contextual components, and (2) the internalised downside of autonomy, as the feeling underpinning many euthanasia requests, namely ‘not wanting to be a burden to others’ may lead to ‘self-sacrifice’ and ‘the duty to die’ under the false pretence of autonomy. In addition, some pointed to the power of susceptibility and subliminality, as human beings are subliminal creatures whose behaviour is continuously influenced on both a subconscious and even conscious level. Consequently, internalised pressure cannot be excluded when a patient requests euthanasia. One psychiatrist even stated that ‘ there exists no such thing as a free will, as human beings are always manipulated in many areas of human life and functioning’ .

“I believe that that there should still be places in society where you could die without considering euthanasia. While many people today are facing dementia, and you almost must…. Interviewer: Yes. “Yes, like how should I deal with it? Should I exit life before it becomes inevitable dementia or something similar? Because I think that in a neo-liberal society, many people internalize the idea that at some point, it becomes a moral duty to step aside. They feel obliged to eliminate themselves. Self-elimination. In a neo-liberal model, as long as you can keep up and contribute, everything is fine. But if you can’t keep up, well, if you cannot fully exercise autonomy, then… Essentially, you should hold your honour and step aside.” (spiritual caregiver)

Second, participants mentioned euthanasia as an option to die with dignity . For those in favour of the Law, euthanasia is considered (1) a ‘dignified way of dying’ when everything that leads up to death, including individual, medical, and social needs and expectations, is consistent with one’s own sense of integrity, belief-system and lifestyle, and (2) a ‘good death’, when referring to the literal meaning of the concept ‘euthanasia’, namely ‘a soft and gentle passing’. Other participants raised concerns on the reference to euthanasia and dignified dying in the same breath, as if “ other ways of dying are not or less dignified ”.

Third, the value of quality of life underpinned the arguments made in favour of the Law on Euthanasia, as (1) life itself should not be prolonged unnecessarily, (2) meaningless suffering should be prevented, and (3) a good life should pertain to all stages in life, from the very beginning until the very end, which is feasible if quality of dying circumstances can be guaranteed. As one buddy stated: “ Living a full and good life implies dying a good death ”. Other participants made use of this value underpinning their argument against euthanasia, based on (1) the “protect-worthiness” of life itself and (2) the suffering that must be considered an inherent feature of the human condition.

Fourth, and seamlessly fitting with the former value, divergent courses also emerged regarding the aspect of how to deal with suffering . Some participants were in favour of euthanasia out of compassion in terms of (1) bringing a kind of relief to the patient when providing her the prospect of an end to the suffering and (2) ending the suffering once it has become ‘useless and meaningless’ and ‘disclosing the limits of the carrying capacity of the self’. Some participants referred to the insufficient degree of quality of life in some patients and valued euthanasia as sort of ‘ compensation for a life gone wrong’.

Others considered the option of euthanasia as compromising patients’ ability to accept, bear and cope with suffering experiences by offering the opportunity ‘to quickly resign from it’.

Some participants referred to the dynamic features and hence, the potential enriching value of suffering. They believed that one can and must revolt against the perception of pointless suffering, as suffering may offer unique opportunities to achieve personal growth through the realisation of self-actualising tendencies amidst the suffering and though all kinds of hardship and adversity in life. Therefore, the real challenge is to support the sufferer to (re)gain the ability to transform the suffering by means of redefining, accepting, and making sense of it. One psychiatrist referred to the Myth of Sisyphus and stated:

A rock that must be pushed up the mountain, which is terrible, and then Sisyphus lets the rock fall back down, and he must start all over again. And what is the purpose of that suffering? Pushing the rock up? It’s absurd, really, but still. I find it so vital, human, uh, yes. That is something that inspires me enormously and often makes me, well, yes, vitality and suffering, suffering is inherent to being, of course, and one can suffer, of course, that is very serious suffering, terrible suffering. I know that. But well, accept suffering, right? I’m not glorifying suffering, no, I don’t belong to that category. Some Catholics do that; the suffering of Christ, we must… No, not at all. Suffering is inherent to life. Interviewer: It’s just more bearable for some than for others. Interviewee: Then it’s our task to make it more bearable. Yes. (…) Look, that sets a dynamic in motion. By dynamic, I also mean movement. A euthanasia request is often rigid. I am for movement. That’s what Eastern philosophy teaches us too, that everything moves, and we must keep that movement and that the question may change or that people may also discover things. Or indeed, a suffering that is even more exposed, but on which one can then work. There is still much to do, yes, before the ultimate and final act of euthanasia, by a doctor for all sakes, should be considered. (psychiatrist)

The level of the patient’s inner circle

On the level of the social inner circle, the following three ethical considerations were distinguished: (1) involvement, (2) connectedness, and (3) attentiveness.

Some participants stressed that euthanasia can only be a soft and thus ‘good’ way of dying, if the patient’s social inner circle can be involved in the euthanasia procedure and if sufficient support to them can be provided. All participants in favour of the legal framework on euthanasia echoed the importance of the social circle being involved in an early stage of the euthanasia procedure, as the prospect of the end of life may challenge a patient’s ability of staying and feeling connected . If the euthanasia request is to be carried out, it offers a unique opportunity for both the patient and her social inner circle of consciously being present and sharing goodbyes. Other participants considered this reasoning as potentially deceiving, as concern was raised regarding the trap of false assumptions, in terms of words being left unspoken and the bottling up of one’s own needs for the sake of the other.

As the third doctor, I was asked to provide advice about someone, and the [adult child] was present, a charming [adult child]. The [adult child] was also very friendly but didn’t say much. The man explained why he himself wanted euthanasia and so on. To be honest, at first, I thought, “Well, this won’t take long,” because there were many arguments and reports I had received, but as the conversation went on, I started to feel something different. It turned into a very long conversation, during which the [adult child] also had their say. In short, the father believed that he couldn’t burden his children. He was a kind man who knew what he wanted, and his children were inclined to follow his idea, to follow his vision. However, the children thought, “Yes, we are actually going to agree with our father, and we’ll allow it,” but deep down, they still wanted to take good care of him. The father didn’t want them to take care of him, and there were many other things, but after that long conversation with the [adult child] and the father, and everything else, like, “We’ll still celebrate Christmas together,” there was a complete turnaround. The other physicians involved accepted this very well, and they said, “Okay, for us, it wasn’t clear. (physician)

In addition, concern was raised regarding the inner circle’s respect of individual patient autonomy and freedom of choice outweighing their r esponsibility and accountabilit y to take care for one another and to act according to all these subjects’ best interest.

Consequently, divergent discourses on the virtue of attentiveness emerged. Whereas for some, the euthanasia procedure may offer a unique opportunity for both the patient and her relatives to be better prepared for death and for the bereaved to better cope with grief, others pointed to the inner circle’s continued grappling with unresolved feelings and perceived helplessness after such a fast-track to death.

Yes, and sometimes I also see people, family members after such euthanasia, yeah, I’ve experienced it several times. They say things like, “Yes, I supported it, but I didn’t know it would affect me like this,” you know? They try to convince themselves, saying, “It was good, it was good, and I stand behind it.” Yeah, you are hardly allowed to do otherwise, but you feel that inner struggle in them, you know? Like, “Was it really okay?” But you can’t question it because you think, “Poor them,” but you still feel it, like, “How sad, how sad. (psychiatrist)

The level of medicine

The following five ethical considerations were distinguished: (1) professional duties, (2) responsibility to alleviate suffering, (3) subsidiarity, (4) professional integrity, and (5) monologic versus dialogic approaches.

First and as regards professional duties, it was (only) reported by some physicians that the physician’s duty is “ to provide good care, which includes good end-of-life care ”. Hence, physicians are the ones who should have euthanasia “as a tool in their end-of-life toolbox”. Others held a different stance and referred to Hippocrates’ Oath when stating that the physician’s duty is to save life at all costs.

Second, all the participants agreed that clinicians have the responsibility to alleviate the patient’s suffering . Whereas some welcomed the option of euthanasia due to the experienced limits of palliative care, that in some cases is deemed an insufficient response to intractable suffering, others stated that euthanasia is not needed as physicians have proper palliative care in their toolbox to alleviate all kinds and degrees of suffering.

Third and as regards the subsidiarity principle , opinions differed on the use of a palliative filter, i.e., whether a consultation with specialist palliative care units should precede euthanasia.

Fourth and as regards professional integrity , some participants relativized the physicians’ executive autonomy. As one psychiatrist stated “because in the end, we do not decide whether someone might die or not. We only decide whether we want to be of help and assist in it.” All the ones in favour of the current legal framework echoed that as physicians are the ones that have better access to the lethal drugs and the technical expertise to end the patient’s life in more efficacious ways than non-physicians, they should remain entrusted with euthanasia assessment procedures. Others (only physicians) criticized the Belgian legislator for placing too much power in the physicians’ hands so that the latter “ can play for God instead of using their pharmacological and technical know-how to save lives ”.

Fifth, and as regards the decision-making process, most participants valued the ethical principle of shared decision-making between the patient and her physicians, and some even preferred a triadic dialogue in which the patient, her relevant health carers and her social inner circle is involved in euthanasia assessment procedures. For most of them, this type of extended or relational autonomy is considered as best clinical euthanasia practice, especially when death is not foreseeable. According to some non-physicians, a strict dyadic patient-physician approach is to be preferred when death is reasonably foreseeable in a patient with sufficient mental competence. In this event, no intermediary should be tolerated as the medical secret is considered ‘sacred’. One participant elaborated further on this strict dyadic approach and said:

“ But actually, in my opinion, the request for euthanasia is something between two people. So…. Interviewer: The singular dialogue? “So, a relationship between the patient and the doctor, yes. That’s what I think. And I do understand that the legislation exists, primarily to protect the doctor against misuse or accusations, because euthanasia used to happen before too, but in secret. But for me as a doctor, it would be enough if a patient whom I’ve known for years, followed for years, maybe 20 years, 30 years, 40 years, and who is terminally ill, asks me in private, ‘I want it.’ For me, it doesn’t need to be more than that for me to say, ‘yes.’ So, there’s no need for a whole set of legislation, except of course to protect myself, maybe from the heirs who might have a different idea about it, yes, but I find it beautiful. And they say, you know, our legislation is such that you can write your euthanasia request on the back of a beer coaster and that’s enough, you know? But how it used to be, euthanasia happened just as well, that’s what I heard from my older colleagues. But it was done in private. Actually, that is the most beautiful sign of trust between a doctor and a patient. ” (Physician and consultant)

Others, all physicians without a favourable stance on euthanasia, considered medical paternalism morally justified in the end-of-life context, as (1) physicians have more intimate knowledge of the patient and are thus best placed to act in the patient’s best interests, (2) only the independent evaluation from well-trained and experienced physicians may rule out external or internalized pressure from the patient’s social inner circle, and (3) some patients may show impaired decision-making capacity when confronted with the end of life.

The level of society

As regards the origins and impact of euthanasia legislation on the level of society, the following four ethical themes emerged: (1) protection, (2) dignified dying, (3) solidarity, and (4) distributive justice.

First and as regards protection , some participants valued the existence of a legal framework for an ‘underground’ practice before 2002. According to them, this framework was highly needed to protect the patient against malicious practices and the physician against being charged for murder when ensuring herself that all the legal requirements are met.

So, I believe that it should be well-regulated in a state. In a country, it should be well-regulated. You can either be in favour of it, have reservations, or question it, but when it happens and many people want it or think it’s okay, then it should be regulated. And those, like me, who may be against it, have doubts about it, or wonder, “Is this really necessary?” I would say, or “Does it align with our purpose?” the existential comments that you can make about it, we must accept it because it would be terrible if it, well, it would be even worse if it happened in the underground, like before those laws were established, that’s, yeah. So, I think the laws should exist. Whether I would have made those laws is a different question, or whether I would vote for the parties in parliament that, you know, that support it, that’s another question, but apparently, here in North-western Europe, the need for those practices exists, and it should be regulated properly. And yes, it shouldn’t be left to amateurs or something like that, that’s not the intention. Yes, well, it serves to protect, both in terms of health and to ensure that it doesn’t become a business, of course. I’d prefer it to be integrated into the healthcare system rather than turning it into a profit-driven and exploitative affair for some others. So, that’s…. (psychiatric nurse)

Critical concerns were raised on the lack of protection of the most vulnerable people, i.e., the mentally ill and the elderly. Some of them referred to the amended Law in 2014, that also allowed minors to die by means of euthanasia – be it under more strict circumstances, inter alia, when based on unbearable physical suffering resulting from a medically terminal condition – and feared that the Law will be amended again, so it would no longer exclude the people suffering from dementia or for groups without serious incurable illness, e.g., the elderly with a perceived ‘completed life’.

Second, a major societal shift in thoughts regarding what constitutes dignified dying was reported. For some, the Law on Euthanasia reflects a nascent movement of death revivalism, in terms of people reclaiming control over their dying process. In this respect, euthanasia is deemed a counterreaction to the former dominant paternalistic attitude in Western society to systematically marginalise conversations on death and dying, e.g., due to the mechanisms of denial, avoidance, and postponement, and with the line between life and death increasingly held in physician’s hands, which has left many people ill-equipped to deal with dying and death. The current broad public support for euthanasia is seen as the individual patient taking back the decision-making process of dying and death in her own hands. They further considered euthanasia as a logical consequence of living an artificially prolonged life due to e.g., advances in medicine, that have not necessarily enhanced the quality of life.

“ One thing I also consider is that a part of our lives is artificially prolonged, you know. We don’t live longer because we are healthier, but because we have good pills or better surgical procedures, so we can afford to buy our health. So that part of life is still valuable to me, it’s not less valuable, but it’s artificially extended. So, I think we should keep that in mind, that we can prolong something artificially and maybe even go beyond a point where it no longer works. Interviewer: Beyond the expiration date? That’s what I was looking for (laughs). So, in that sense, I believe we should keep in mind that we can artificially extend something and then maybe, even if it’s just that artificial part, stop or be allowed to stop when the person no longer wants to, I think that makes perfect sense. ” (psychiatrist)

Others provided arguments against the increased death revivalism, referring to euthanasia as a ‘fast-track to death’ resulting in ‘the trivialisation of death’ in the face of formerly known and experienced Art of Dying. For instance, the current societal tendency to avoid suffering and the fear of dying may lead to patients (too quickly) resigning from a slow track to death, in which there is time to e.g., hold a wake.

But I won’t just grab a syringe, fill it up, and administer a lethal injection, you know? I follow the symptoms. And if they become uncomfortable, then I’ll increase the dosage so they can rest peacefully and not have to suffer. That’s what I call a dignified death. And if the family can be present, sometimes it takes a while for them to arrive, and they’ll say, “Come on, even a dog is not allowed to suffer that long.” Meanwhile, the person is just lying peacefully. But that too. Everything should, even that, should progress, and there isn’t much time left for vigil and, yes, I don’t want to romanticize it, but sometimes you see so much happening between families. There’re all kinds of things happening in those rooms, with the family, reconciliations being made. Memories being shared. “Oh, I didn’t know that about our father.“, an aunt walking in and telling a story. Well, so much still happens. I don’t want to romanticize it, but to say that all that time is useless, that’s not true either. And at the farewell, there’s always, the time, you think there’s time for it, but people are still taken aback when an infusion is given, that it can happen within a minute, even if they’re behind it and have been informed beforehand. Just a minute… and it’s done. The banality of death, it’s almost like that. (psychiatrist)

These and other participants also criticised ‘the romanticised image of euthanasia’, that masks the economics of the death system, taking financial advantage of ‘patients not wanting to be a burden to society’.

Third and consequently, divergent discourses on the value of solidarity emerged. For some, decades of civic engagement pointed to the need of death revivalism and patient empowerment, that resulted in the current legal framework. Others strongly criticised the lack of solidarity underpinning the legal framework on the following three counts: 1) the emphasis on patient autonomy is deemed a ’societal negligence in disguise’, as citizens are no longer urged to take care of others, 2) equating autonomy and dignity in euthanasia debates leads to the trap of viewing the ill or the elderly as having ‘undignified’ lives, and 3) wealth over health has become the credo of the current neoliberal society, as the Law on Euthanasia discourages further investments in health care but settles on the ‘commodification’ of health care.

“ I believe that we should take care of each other and especially care for the most vulnerable in our society. We shouldn’t just leave them to fend for themselves. I don’t think the motto should be all about autonomy, autonomy, and then the flip side, saying, “figure it out on your own.” That’s not acceptable. We have a responsibility to take care of each other. We are meant to care for one another. In biblical terms, we are each other’s keeper, right? “Am I my brother’s keeper?” Yes, I am my brother’s keeper. I must take care of each other, take care of others. So, I think in the long term, speaking maybe 100 years from now, people might say, “Sorry, that was a real mistake in the way they approached things.” I don’t know, but that’s looking at it from a meta-level, as historians call it, “longue durée,” and combining it with a neoliberal model, right? Neoliberalism and euthanasia thinking, it would be interesting to do a doctoral thesis on how they fit together perfectly. How they fit together perfectly… They are no longer patients, they are no longer clients, and I also don’t like the word ‘clients.’ They have become ‘users’. Sorry, but that’s our Dutch translation of the English word ‘consumers’ right? It’s like buying Dash detergent or a car; you buy care, just like the Personal Budget for people with disabilities. You buy your care, sorry, this goes against the very essence of what care fundamentally is. Care is a relationship between people; it’s not something you buy. It’s not something you say, “It’s a contract, and I want that.” It doesn’t work like that. [raising voice] The burden is on society. [end of raising voice] And when the money runs out, you have nothing left. If you can’t buy it, then it doesn’t come. “Here’s your little package,” that’s how it’s translated, and it’s always a hidden cost-cutting operation, let’s be very honest about it, a nice story, but it’s always a hidden cost-saving measure. I see right through that story, but well, big stories are always told, and they are always about saving money. [raising voice] It doesn’t bring anything, right? [end of raising voice] People’s self-reliance, they must stay at home, etc. How many people would benefit from going to a care centre, not at the end of their lives, but just because they feel totally lonely at home, but they can’t get in because nobody wants them there, as they don’t bring any profit. ” (spiritual caregiver)

Fourth, critical concerns were expressed concerning the lack of (distributive) justice due to the many existing misperceptions and misconceptions regarding medical end-of-life options that need to be uncovered. For instance, many people would be unaware of euthanasia and palliative sedation can both be dignified ways of dying, with euthanasia functioning as a fast-track and palliative sedation functioning as slow track to death. Also, the evolution of death literacy was contested: there was a sense that patients did not become more death literate, as many of them have insufficient knowledge of the content of the many end-of-life documents in circulation.

Yeah, I mean, you see, and I hear many people saying, “My papers are in order.” I won’t say every day, but I hear it almost every day, “My papers are in order.” That’s also something. It’s an illusion of control, right? Because what papers are they talking about? “My papers are in order.” When you ask them about it, they themselves don’t really know what that means, some kind of ‘living will’, ‘an advance care plan’, but yeah, with all… A living will or advance care plan is not that simple either, and then they think, “Oh, if I get dementia and I don’t recognize anyone anymore, they will give me an injection.” Ah yes, but then we are in a different domain, and that’s a whole other… But yeah, people are not well-informed, I find. They have totally wrong ideas and sometimes fear the wrong things, don’t know what is possible and what is not, and they also let themselves believe all kinds of things. Well, there are many misconceptions out there. (psychiatrist)

Participants’ ethical considerations regarding the additional procedural criteria for people with a non-terminal illness

As can be seen from the coding structure in Table  3 , participants made use of the principle justice to motivate their stance on additional (procedural) criteria that people with a non-terminal illness must meet before euthanasia can be carried out, in comparison with people with terminal illness. Those in favour of the additional procedural criteria referred to the differences between the terminally ill and the non-terminally ill regarding the aspect of content (i.e., the difference between general life expectancy and healthy life expectancy) and the aspect of time (i.e., the probability verging on certainty concerning the terminally ill versus the rough estimation concerning the non-terminally ill). Some of them also referred to the legal proceedings and stated that the Law was meant only for people with terminal illnesses to die by means of euthanasia. Others were of the opinion that it concerns only an arbitrary difference due to 1) the vagueness of the concept ‘naturally foreseeable’, i.e., suffering from a terminal illness, and the subjectivity of the calculated course and prognosis of e.g., degenerative somatic illnesses and dementia. A few participants said that this is beside the question, as one’s individual carrying capacity trumps the course and prognosis of an illness.

Participants’ ethical considerations regarding adults with psychiatric conditions

As can be seen from the coding structure in Table  4 , when asked about participants’ stances on euthanasia in the context of psychiatry, we distinguished value-based themes at the level of (1) the patient, (2) the field of psychiatry, and (3) society in general.

The level of the patient

Justice was the main value-based principle that emerged at the level of the patient. Participants in favour of not legally amending additional procedural criteria in the context of psychiatry stated that every patient with a non-terminal illness should receive equal end-of-life care options. The main counterargument given concerned the differences in patient profile, as some questioned whether the mentally ill can meet the legal criteria or stated that extreme caution is needed and thus additional criteria are in place due to the factor of e.g., ambiguity, impulsivity, and manipulation in the mentally ill.

“I find, the way the procedure is conducted for psychiatric suffering, I find it only natural that they handle it more cautiously because it’s indeed less… It’s not so easy to determine everything, is there really no other option left? And then I understand somewhere that time must be taken to investigate all of that. Because some of these people can be very impulsive, and that impulsivity needs to be addressed somewhere, of course. You also have people who can use their setbacks in the sense of, ‘I’ve been through all that, so I deserve euthanasia.’ And those are the people you need to single out because that’s just… I think those are also people who, with the necessary guidance, can still get out of it. Do you understand? It’s a form of self-pity, in a way. I think there might be resilience there, but they haven’t tapped into it themselves yet; it’s a kind of deflection or something. People with a history of, who say ‘I’ve experienced this and that, so I don’t need it anymore, just give me euthanasia, I deserve that. I’ve been through all that.’ While maybe, if they see, that’s still worth something to me, who knows, maybe that can still happen. They’re people who give up a little too quickly.” (Moral consultant)

Regarding the field of medicine, the following four value-based considerations emerged: (1) justice, (2) responsiveness to suffering, (3) protection, and (4) proportionality.

First, and as regards the principle of justice , participants in favour of equal procedural criteria for all non-terminally ill pointed to the indissociable unity of soma and psyche. A few physicians went one step further and reported that some psychiatric conditions can be considered terminal, e.g., suicidality, or predominantly of somatic nature, e.g., anorexia. The main counterarguments in this respect were (1) the firm belief in the inexistence of irremediableness in psychiatry (only mentioned by some physicians) or (2) that more caution is needed due to the higher level of subjectivity in terms of diagnostics, prognosis, and outcome.

Second, arguments against the distinction between the somatically versus the mentally ill were based on the attitude of responsiveness to the extreme extent and duration of mental suffering that can also render the mentally ill in a medically futile situation and the field of psychiatry empty-handed.

And many of the psychiatric patients I see suffer more than the average ALS patient who has to endure it for three years. In my experience, we’re less advanced in psychiatry compared to most other medical fields. You can easily say “we don’t know” in other areas of medicine and people will understand, but when it comes to psychiatric conditions, it’s different. Doctors might admit “it’s not working” or “there’s no trust,” and they might refer patients elsewhere or even refuse further appointments. I’ve even told a judge during a forced admission, “There’s simply no treatment available.” Yes, sometimes it’s just over and society must accept that there’s no solution. I’m not saying euthanasia is the solution for everyone, but I think it can be an option for some people. (Psychiatrist)

Other participants were not blind to the deep suffering, but strongly believed in the ground principle and core strength of psychiatry, namely the beneficial effect of hope. In addition, they pointed to the differences in the nature and course of somatic versus psychiatric illnesses when stating that considerably more time is needed in psychiatry, with inclusion of the therapeutic effect of hope to become effective.

“And I also believe that collectively, within psychiatry, we can and must provide additional support to endure profound despair. So, even in the face of seemingly endless hopelessness, we must maintain hope, look towards the future with trust, and continuously offer encouragement to those who feel hopeless. Our unwavering optimism and support convey the message that together, we can overcome. Because individuals who suffer from severe mental illness are treatable, I consider myself to be a genuinely optimistic psychiatrist. I have witnessed individuals who have harbored feelings of hopelessness and despair for extended periods, sometimes even decades, undergo profound transformations and experience significant improvement, and in some cases, complete recovery.” (Psychiatrist)

Third, participants in favour of the current legal framework reported that allowing euthanasia for the mentally ill was needed in the light of protection , as it might protect the patient against brutal suicides and also against therapeutic tenacity that more often occurs in psychiatry. Other participants in favour of, as well as participants against the current framework held a different stance on the following two counts: (1) allowing euthanasia conflicts with the aim of psychiatry to prevent suicide at all costs, and (2) the mentally ill are insufficiently protected by the Law as there are insufficient built-in safeguards against therapeutic negligence.

But usually with a psychiatric condition, death isn’t imminent. That’s the tricky part, you know? How many suicides do we have here? But anyway, I have an issue with that, using euthanasia as a kind of antidote against, well, against suicide, that’s a completely different matter. But death and psychiatry, why do we have all those government programs against suicide then? Isn’t that dying as a result of a psychiatric condition? (Psychiatrist, supportive of maintaining euthanasia option in psychiatric settings)

Fourth and as regards proportionality , a few participants with a normative stance against euthanasia in the context of psychiatry argued that psychiatric patients may not be allowed to die by means of euthanasia for as long as the field of psychiatry is under-resourced. They pointed to e.g., the lack of sufficient crisis shelters with a 24/7 availability and the lack of palliative approaches in the field of psychiatry. Instead of allowing euthanasia, they argue ‘to jolt the Belgian government’s conscience on mental health policies’. As a revolution to defeat the built-up inequalities in the field of medicine and knowing that palliative and rehabilitation initiatives in psychiatry require time.

“I oppose euthanasia in psychiatry. Compared to somatic medicine, psychiatry lags behind by 50 years. While physical pain can be managed with medication, there’s insufficient research on treatments for psychological suffering. Promising options like psilocybin and ketamine show potential in easing existential mental struggles. Magnetic stimulation can also alleviate depression, yet access remains limited. Unfortunately, these treatments are underused and under-researched. Many patients aren’t informed about these alternatives to euthanasia. It’s frustrating to see reluctance in exploring these options, especially when they offer hope to long-suffering patients. Utilizing these methods in psychiatric settings carries no risk of addiction. However, current restrictions impede access to these treatments, depriving patients of viable alternatives.” (Shortened excerpt from an interview with a psychiatrist)

When taking a societal perspective, no new arguments emerged from the respondents strongly in favour of the current euthanasia legislation, other than the main value of justice described in the subsection above. According to some, the current Law on Euthanasia busts some myths on the malleability of life and medical omnipotence, and even on psychiatric illnesses as a ‘Western phenomenon’, with e.g., depression and suicidality as a consequence of material wealth instead of a neurologic issue in the brain (only reported by some non-physicians).

There are quite a few people who consider the whole issue of the unbearable nature of psychological suffering a luxury problem, you know? They say something like, “Yeah, where are the suicide rates, to put it in equivalent terms, the lowest in the world? In Africa, because they obviously don’t have the luxury to concern themselves with that. They are already happy if they have a potato on their plate every day.” This is a viewpoint held by many, right? They call it a luxury problem, a modern, typical Western luxury problem. And perhaps there is some truth to it, right? But there are other causes of mortality there, which are much higher, such as child mortality, for example. (non-physician)

Counterarguments were also given and pointed to the value of (distributive) Justice. First, euthanasia was considered as ‘a logical but perverse consequence of systemic societal inequities’ on the one hand and the ‘further evolution towards the commodification or commercialisation of health care in individualised Western societies’ on the other. This would then lead to another vicious circle, with a rapidly growing ‘perception of vulnerable patient groups as irremediable’ and hence less likely to receive potentially beneficial treatment or other interventions. Some took a more radical stance against euthanasia in psychiatry, as they were convinced that euthanasia is nothing but ‘a perverse means to cover societal failures’. In addition, some participants with permissive stances on euthanasia in the context of psychiatry pointed to gender disparities in euthanasia requestors. This was based on the evidence that in the context of psychiatry, many more females request and die by means of euthanasia than males, and proportionally more female patient suffering from psychiatric disorders request and die by means of euthanasia compared to their fellow peers suffering from life-limiting or predominantly somatic conditions.

Finally, some respondents said that they could understand and, in some cases, even support euthanasia in some individual cases, but felt uncomfortable with its impact on the societal level. They pointed to the vicious circle of stigma and self-stigma that may impede the mentally ill to fully participate in societal encounters. In the long run, this type of societal disability may lead to vulnerable patients no longer wanting to perceive themselves a burden to society or to remain ‘socially dead’.

While considering their ethical perspectives towards euthanasia, participants weigh up various values related to and intertwining with the following levels: (1) the patient, (2) the patient’s inner circle, (3) the field of medicine, and (4) society in general. Overall, the participants shared an amalgam of ethical values on each of these four levels, regardless of their stance on euthanasia. It was mainly the interpretation of some values, the emphasis they placed on the key components underpinning each value and the importance they attach to each of the four levels, that determined their stance towards euthanasia. It was uncommon for different ethical values to be explicitly mentioned, which could distinguish distinct stances for or against euthanasia.

As regards euthanasia in the context of psychiatry, the focus has primarily been on arguments for and against euthanasia [ 23 ]. However, our study takes a more comprehensive approach, exploring the issue from a wider range of perspectives. This approach allowed us to uncover more complex insights that may have been overlooked if we had only considered it as a black-and-white issue.

Both the systematic review of Nicolini et al. [ 23 ] and our study emphasized fundamental ethical domains such as autonomy, professional duties, and the broader implications of euthanasia on mental healthcare. While our findings aligned with those of the systematic review, our inquiry delved deeper into psychiatry-specific considerations, including the influence of sudden impulses and feelings of hopelessness. This underscores the importance of healthcare professionals carefully assessing the timing and contextual aspects of such decisions within psychiatric contexts, ensuring individuals receive timely and tailored support and interventions.

Furthermore, our study extended beyond the boundaries of medical discourse, addressing broader societal ramifications. Participants engaged in discussions about ‘social death,’ a phenomenon that describes the marginalization of individuals despite their physical existence. This discussion highlighted entrenched structural inequities and societal attitudes perpetuating social alienation, particularly affecting marginalized demographics, including individuals grappling with mental health issues. Advocating for societal inclusivity and supportive measures, our study strongly emphasized the need to foster a sense of unity and respect for everyone’s worth, regardless of their circumstances.

Interpretation of the main findings

We make explicit and discuss the values corresponding to the four classical principles of biomedical ethics, in particular beneficence, non-maleficence, respect for autonomy and justice [ 31 ]. We place these values in the context of different ethical approaches, such as religious, professional, emancipatory, social, societal, and virtue-oriented approaches (see the ethical interpretation framework in OSF).

In the discussion section, therefore, the following main values and virtues are addressed: (1) the values of beneficence and non-maleficence in a religious perspective, (2) those same values in the professional context, (3) the value of autonomy in the contemporary emancipation paradigm, (4) the virtue of compassion stemming from virtue ethics theory, (5) the value of quality care in a social approach, and (6) the value of justice in societal policy contexts.

Beneficence and non-maleficence: religious perspective

In the realm of euthanasia debates, the interplay of religious beliefs and the values of ‘beneficence’ (the act of doing good) and ‘non-maleficence’ (do no harm) has emerged as a pivotal point of contention, often giving rise to divergent perspectives on this complex ethical issue [ 32 , 33 ]. Some religious traditions staunchly oppose medical end-of-life decisions, including euthanasia and abortion, viewing them as morally wrong and as disruptive to the natural order of life and death. The principle of ‘sanctity of life’ forms the bedrock of their belief system, underscoring the significance they attach to preserving life at all costs, as an embodiment of beneficence [ 34 , 35 ]. Conversely, those who argue for the ethical consideration of euthanasia emphasize the concept of beneficence in alleviating suffering and granting autonomy to individuals in their final moments. However, intriguingly, our examination of the topic has revealed a nuanced relationship between religious beliefs and attitudes toward euthanasia. While some individuals in our sample expressed strong religious convictions ( n  = 5) and even considered themselves as practicing Catholics, they did not necessarily adopt a firm normative stance against euthanasia, signifying a complex balancing of beneficence and possible maleficence within their belief system. Conversely, certain participants who held steadfastly against euthanasia ( n  = 3) did not identify with any religious belief system, yet their position was firmly grounded in their perception of potential maleficence associated with medical intervention in life and death decisions. This observation aligns with recent studies highlighting the intricate and multifaceted nature of religiosity, where individuals within various religious frameworks may hold diverse beliefs and values surrounding beneficence and non-maleficence [ 36 , 37 ]. Moreover, it underscores the powerful influence of societal culture on shaping personal perspectives on euthanasia, and how these views are entwined with the values of beneficence and non-maleficence [ 36 , 37 ].

Beneficence and non-maleficence: professional values

Second, a profound division arises between proponents and opponents, particularly in the field of medicine, where interpretations of the Oath of Hippocrates play a central role. At its core, the Oath emphasizes the deontological values of beneficence and non-maleficence, as physicians are bound by a prohibition against administering a deadly drug to ‘anyone,’ even at their explicit request, highlighting the reverence for the sanctity of life inherent in medical practice. This interpretation has led some to perceive active euthanasia as contrary to these sacred principles of preserving life. The notion of beneficence, understood as promoting the well-being of patients, appears to be in tension with the act of intentionally ending a life. Critics argue that euthanasia undermines the fundamental duty of physicians to protect and preserve life. Additionally, the principle of ‘non-maleficence,’ which entails not harming the patient or their life, is seen by some as being in accordance with the ‘sanctity of life’. However, the Oath also recognizes the significance of alleviating relentless suffering, opening the door to a nuanced debate on how these timeless principles align with the modern concept of euthanasia. As the discourse unfolds, perspectives emerge, with some viewing euthanasia as a compassionate form of care, that respects the autonomy and dignity of patients facing terminal illness or unbearable suffering. Advocates argue that euthanasia can be an act of beneficence, providing relief from pain and allowing individuals to die with dignity and control over their own fate. On the other hand, opponents of euthanasia steadfastly uphold the sanctity of life principle, viewing it as an ethical imperative that must not be compromised. They argue that intentionally ending a life, even in the context of relieving suffering, undermines the fundamental values of medical ethics and the intrinsic worth of every human life. For these individuals, euthanasia represents a profound ethical dilemma that conflicts with the near sanctity of medical ethics and the value of preserving life [ 38 , 39 , 40 ].

Autonomy: contemporary emancipation paradigm

The principle of autonomy emerges as one of the most prominent and contentious values in our contemporary emancipation paradigm. Autonomy, grounded in the belief in individual self-governance, is often cited as a foundational ethical principle in euthanasia legislation, emphasizing the significance of an individual’s capacity to make choices aligned with their own personal values and desires [ 31 ]. However, the discussion on autonomy extends beyond pure individualism, with considerations for relational autonomy, recognizing that individuals are not isolated entities but are shaped by their relationships, communities, and broader societal structures [ 41 ]. Within the context of euthanasia, the complexities of autonomy become evident as participants in the debate strived to find a delicate balance. On one hand, they stress the importance of respecting a patient’s individual autonomy in end-of-life decisions, ensuring that their choices are honoured and upheld. Simultaneously, they acknowledge the necessity of accounting for the patient’s social context and broader community when considering euthanasia as a compassionate option. Nevertheless, concerns are raised by some about the potential risks posed by euthanasia legislation, particularly for the most vulnerable individuals, such as the elderly and the mentally ill. These concerns centre on the negative consequences that may arise when individual autonomy is exercised without consideration for others or for societal well-being, and the concept of “social death,” which refers to the marginalization and exclusion of individuals from social relationships and networks due to illness or disability [ 42 , 43 ].

Amidst these complexities, the ethical value of autonomy stands as a paramount consideration. However, its application necessitates thoughtful consideration and balance with other values, including justice, equality, and societal responsibility. Recent reflections on “relational autonomy” have prompted critical evaluations of the idea of pure autonomy, emphasizing the need to delve deeper into the micro, meso, and macro levels that underpin autonomy and address potential conflicts between individual and relational autonomy [ 44 ]. Further, it highlights the imperative to take the broader societal context into account when grappling with the ethical challenges associated with euthanasia [ 45 ].

Compassion: virtue ethics

Our study confirms that while the value of autonomy holds importance, it is not the sole determinant in the ethical considerations surrounding euthanasia [ 46 ]. In this complex discourse, numerous other ethical values and virtues come to the fore, including the significance of compassion towards suffering individuals and the imperative of alleviating their distress. Notably, compassion is not merely a singular principle, but rather a profound ground attitude or virtue that motivates individuals to empathize with the pain of others and take actions to provide relief.

As revealed in our research, participants who opposed euthanasia did not invoke religious frameworks; instead, they explored diverse philosophical approaches to comprehend suffering and compassion. Among these, non-Western philosophies emphasized embracing suffering as an intrinsic aspect of life, acknowledging the impermanence of all things, including suffering. Additionally, the existentialist perspective of Albert Camus underscored suffering’s innate connection to human existence, leading to deeper self-understanding and comprehension of the world.

These philosophical viewpoints find relevance in the realm of ethics as well. Virtue ethics, in particular, highlights the significance of cultivating virtues such as courage and resilience, while narrative ethics emphasizes storytelling as a means to gain profound insight and reflection on experiences of suffering [ 47 , 48 ]. Such narratives foster empathy and create a shared sense of experience and community.

Our results show that, for some, suffering may hold positive value in various ways. The nature and intensity of suffering, alongside an individual’s values and virtues, beliefs, and coping capacity, significantly influence the ethics of euthanasia decision-making. An intricate approach that recognizes the multifaceted impacts of suffering becomes essential, acknowledging that various factors could potentially influence the experience of suffering as well as the interpretation of the consequences of the suffering experience. It’s possible that this approach doesn’t solely depend on the quantity of suffering or even its nature. Instead, it could be related to the delicate balance between one’s ability to endure suffering, the burden it places on them, and the (ir)remediableness of this burden, which can vary greatly among individuals as well as it might change over time. Such an approach aims to alleviate relentless suffering and, in certain cases, relieve unnecessary and enduring distress without consistently imposing interpretations upon it. Thus, acknowledging that, experiences of suffering are inherent to life and might act as drivers for personal development, fostering resilience, empathy, and a deeper apprehension of life’s essence, while it also might represent something irremediable, underscores the significance of a broader meaning of the concept of compassion as guiding principle in euthanasia discussions. These discussions further extend to the recognition of the dynamic trajectory inherent to the burden of suffering, as well as its potential for temporal evolution within the individual experiences of the afflicted. Such recognition not only fosters a more intricate understanding of the complex interplay between suffering and resilience but also highlights the acknowledgment that there may be moments when suffering becomes unendurable, surpassing the individual’s capacity to cope. This dimension introduces a layer of intricacy to the ethical considerations inherent in these discussions, thus necessitating a nuanced approach that contemplates the potentialities as well as the constraints of human endurance and the associated ethical ramifications.

Quality care: social approach

Examining euthanasia debates from a sociological perspective sheds light on the influence of societal inequalities in healthcare access and quality on the practice of euthanasia, and how it can shape personal, relational, and societal values, leading to the normalization or culturalization of euthanasia [ 49 ]. A noteworthy finding in this context is the contrasting perspectives on the evolving process of dying, transitioning from being perceived as in God’s hands to a more medical realm, where proponents of euthanasia view medicine as a catalyst for granting individuals greater control over the timing, manner, and circumstances of their own deaths. They envision the opportunity to be surrounded by loved ones and maintain consciousness while embracing the option of euthanasia, which they believe improves the quality of life at the end.

Proponents also emphasize additional benefits, such as enhanced transparency and regulation, ensuring ethical conduct through regulatory measures. They express concerns about a cultural environment where certain physicians adopt paternalistic attitudes and resist accepting death, prioritizing the extension of life as a moral imperative. In contrast, critical voices argue that death and dying have become increasingly medicalized, leading to their institutionalization. Some critics further contend that this medicalization has devalued the dying process and commodified life itself, leading patients, and families to increasingly rely on medical interventions at life’s end.

Moreover, as shared by some of the interviewees, the growing acceptance of medical assistance in dying may raise concerns. It’s conceivable that this evolving attitude could contribute to a perception of death undergoing a shift in seriousness, resulting in decisions about one’s life conclusion being made with less comprehensive thought and insufficient reflection. Consequently, this scenario could potentially lead individuals who are more susceptible to experiencing feelings of life’s insignificance, weariness, or sense of being ‘through with life’, to lean towards considering euthanasia. However, this inclination might also be driven by a lack of sufficient access to the necessary, long-term quality mental health care that would otherwise facilitate the pursuit of a life imbued with adequate significance, comfort, and dignity, achievable through appropriate (mental) healthcare.

Earlier research indicates that Belgium’s psychiatric care system has been grappling with underfunding and fragmentation, leading to individuals falling through the gaps in the mental health safety net [ 50 ]. One critical aspect is, e.g., the inadequate investment in long-term, intensive care, which is precisely the kind of support that individuals grappling with such existential questions may require.

Hence, in the context of euthanasia debates, the value of quality care emerges, encompassing the principle of beneficence, which emphasizes the obligation to provide good care and enhance the overall well-being of individuals. Ethical considerations go beyond the individual’s right to autonomy, extending to societal factors that influence healthcare practices and attitudes towards euthanasia. Addressing the impact of healthcare disparities and the medicalization of dying becomes imperative to ensure ethical and compassionate decision-making that upholds the true value of quality care and respect for human dignity.

Justice: societal policy contexts

In the context of euthanasia in somatic versus psychiatric medicine, ethical considerations regarding euthanasia often revolve around the fundamental value of justice [ 23 , 51 , 52 ]. Some respondents in our study emphasized the need for parity between somatic and psychiatric illnesses, recognizing that there should be no distinction between patients suffering from either. They argued that upholding the principle of justice demands equal treatment and recognition of the suffering experienced by individuals with psychiatric illnesses.

However, for others, achieving justice requires acknowledging and addressing the unique challenges faced by patients predominantly suffering from psychiatric illnesses. A comprehensive and integrated healthcare approach is proposed, where mental health is regarded as an integral part of overall health. This approach involves allocating the same level of attention and resources to psychiatric medicine as given to somatic illnesses, aiming to combat stigma and discrimination towards individuals with psychiatric conditions. Equitable treatment during life and at the end of life becomes the focus.

Yet, the Belgian context of psychiatry presents significant challenges. The field is characterized by underfunding and fragmented care, particularly for individuals with longstanding and complex psychiatric problems [ 53 ]. Additionally, the end-of-life care for psychiatric patients is still underdeveloped, and palliative psychiatry is in its early stages, lacking a uniformly agreed-upon definition or clear implementation guidelines [ 54 ]. In response, Belgium is exploring the “Oyster Care” model, designed to provide flexible, personalized care for individuals with severe and persistent mental illness who may be at risk of neglect or overburdened by psychiatric services [ 55 ]. This model aims to create a safe “exoskeleton” or supportive environment for patients, recognizing that recovery, reintegration, and resocialization might not be attainable for everyone with certain psychiatric conditions [ 55 ].

However, the integration of Oyster Care in today’s psychiatric practice is still limited and requires further development. Emphasizing the value of justice calls for continued efforts to enhance and refine psychiatric care, ensuring that individuals with psychiatric illnesses receive equitable treatment throughout their lives, including end-of-life care decisions [ 55 , 56 ].

Implications for future research, policy, and practice

In terms of policy and practice, our findings indicate that the discourse surrounding euthanasia extends beyond legal or medical considerations and encompasses fundamental ethical values that underpin our society. These values may not always be aligned and can create ethical dilemmas that are challenging to address. A value-centred approach to the euthanasia debate necessitates a constructive ethical dialogue among various actors involved, including patients, healthcare practitioners, and the wider community. This conversation should strive to comprehend the diverse values involved and endeavour to achieve a balance between these values. Additionally, ethical dialogue might encourage individuals to reflect on their own assumptions and beliefs, leading to more informed and thoughtful decision-making on ethical and moral issues. Ultimately, ethical dialogue can promote a more just and equitable society that prioritizes empathy, understanding, and mutual respect.

It is also crucial to acknowledge that patients with somatic illnesses and those with psychiatric illnesses may have different needs and expectations regarding the end of life. Hence, end-of life healthcare must be sensitive to the unique needs of each group. This recognition of differences does not justify unequal treatment or discrimination based on the type of illness. Instead, it involves addressing the different needs and expectations of each patient group while ensuring equitable and high-quality care for all.

As regards research, most articles on euthanasia legislation to date placed the emphasis on what other countries and states can learn from the Belgian and Dutch euthanasia practice. In addition, what can be learned is mainly restricted to the evidence and reflections on factual issues from a global practical-clinical perspective. Consequently, one of the main ethical, clinical, and societal issues remains unrequited, namely the impact of legislation and its consequences on an intrapersonal, interpersonal, medical, social, and societal level. Although cultural diversity is recently put high on the research agenda concerning general health care and mental health care, it is largely understudied in the context of end-of-life decisions and largely ignored in the context of psychiatry. Fewer articles have focused on what the latter countries may learn from those not implementing or not considering euthanasia legislation. In an increasingly diverse society, rapidly evolving in terms of fluidity and multi-ethnicity, cross-cultural research can help us learn from one another. To address the many dimensions of euthanasia, there is a need for input from a variety of academic fields, including sociology, anthropology, communication studies, and history. Further interdisciplinary research in all these areas could help inform policy and practice related to euthanasia.

Strengths and limitations

This is the first empirical in-depth interview study that uncovered the underlying ethical considerations of a variety and relatively large sample of health care professionals and volunteers in Belgium, a country with one of the most permissive legislative frameworks regarding euthanasia, as – unlike in some other countries – it does not exclude adults with psychiatric conditions per definition. Belgium is also one of the pioneering countries with such a legislative framework and can boast on two decades of euthanasia legislation and implementation.

We succeeded in providing a unique and representative sample of participants, varying in gender, work setting and expertise, and stances regarding euthanasia. Finally, and unlike former scientific studies that focused on either the somatic or psychiatric context, we now gauged for participants’ ethical perspectives on euthanasia in both fields of medicine.

There are also several limitations to our study. We may have experienced selection bias, as our sample of non-physicians had varying ages, but the sample of physicians was mostly older than 60. In addition, some interviews had to be postponed or cancelled due to COVID-19 restrictions and, potentially, due to legal and emotional concerns surrounding a high-profile euthanasia case being brought to court. Additionally, our sample exhibited heterogeneity regarding worldview (religious or non-religious), but possibly not regarding other culture-sensitive aspects, like migration background. As our qualitative research focused on exploring themes, narratives, and shared experiences rather than on ensuring high participation rates for statistical generalizability, drawing definitive conclusions regarding the prevalence of each opinion (pro/ambivalent/critical/against), the level of experience, or perspective across the entire spectrum of euthanasia practice is beyond the scope of our study.

Finally, although there is a growing number of countries and states around the globe with a legislative framework on euthanasia, all the legal frameworks differ from one another, so the results of our study cannot be generalized to the specific euthanasia context in e.g., Switzerland or Canada.

Our study illuminates the foundational values guiding perceptions of euthanasia, including autonomy, compassion, quality care, and justice, which permeate through four interconnected tiers: the patient, their inner circle, the medical community, and society at large. Despite varied stances on euthanasia, participants demonstrated a convergence of ethical principles across these tiers, shaped by nuanced interpretations and considerations. While explicit discussions of distinct ethical values were infrequent, their profound impact on euthanasia perspectives underscores the importance of ethical discourse in navigating this complex issue. By fostering inclusive dialogue and reconciling diverse values, we can promote informed decision-making, justice, and empathy in end-of-life care, particularly in psychiatric settings. Interdisciplinary research is essential for a comprehensive understanding of euthanasia’s dimensions and to inform policy development. While our study is rooted in Belgium, its implications extend to the broader euthanasia discourse, suggesting avenues for further exploration and cross-cultural understanding.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due reasons of privacy and anonymity, but are available from the corresponding author on reasonable request, following procedures from all 3 Medical Ethics Committees involved. To access the supplementary materials, see the Open Science Framework repository at https://osf.io/26gez/?view_only=af42caddb2554acfb7d1d5aabd4dec7a . Upon publication of this paper, the repository will be made public, and a shorter link will be provided.

Mroz S, Dierickx S, Deliens L, Cohen J, Chambaere K. Assisted dying around the world: a status quaestionis. Ann Palliat Med. 2021;10(3):3540–53. https://apm.amegroups.com/article/view/50986/html

Belgian Official Gazette. Wet betreffende de Euthanasie (Law on Euthanasia) (in Dutch). 2002;2002/09590, 28515. http://www.ejustice.just.fgov.be/cgi_loi/change_lg.pl?language=nl&la=N&cn=2002052837&table_name=wet

FCECE (Federal Control- and Evaluation Committee on Euthanasia). Euthanasie - Cijfers van 2023 (Press release: Euthanasia - Figures for the year 2023). 2024; https://overlegorganen.gezondheid.belgie.be/nl/documenten/persbericht-fcee-euthanasie-cijfers-van-2023

Dierickx S, Deliens L, Cohen J, Chambaere K. Euthanasia for people with psychiatric disorders or dementia in Belgium: analysis of officially reported cases. BMC Psychiatry. 2017;17(1):203. http://bmcpsychiatry.biomedcentral.com/articles/ https://doi.org/10.1186/s12888-017-1369-0

Federal Control and Evaluation Committee for Euthanasia (FCECE). Ninth Report to the Belgian Parliament, 2018–2019. 2020.

Federal Control and Evaluation Committee for Euthanasia (FCECE). Eighth Report to the Parliament (2016–2017). Brussels, Belgium. 2018. https://leif.be/data/press-articles/FCEEC_-_8_euthanasie-verslag_2016-2017-nl.pdf

Federal Control and Evaluation Committee for Euthanasia (FCECE). Seventh Report to the Belgian Parliament. Vol. 001. Brussels, Belgium. 2016. https://leif.be/data/press-articles/FCEED_-_Verslag_Wetgevende_Kamers_-_periode_2014-2015_25-10-16.pdf

FCECE (Federal Control- and Evaluation Committee on Euthanasia). EUTHANASIE – Cijfers van 2020. Vol. 64. 2021. https://overlegorganen.gezondheid.belgie.be/sites/default/files/documents/fcee-cijfers-2020_persbericht.pdf

Federal Control and Evaluation Committee for Euthanasia (FCECE). Tenth Report to the Belgian Parliament. Brussels, Belgium. 2022. https://overlegorganen.gezondheid.belgie.be/nl/documenten

Vonkel JAARVERSLAGVONKEL. 2021 (Annual Report of the end-of-life consultation center Vonkel, 2021). Ghent; 2022. https://www.vonkeleenluisterendhuis.be/teksten/jaarverslag2021.pdf

Vonkel een luisterend huis. JAARVERSLAG VONKEL. 2020. 2021; https://www.vonkeleenluisterendhuis.be/teksten/jaarverslag2020.pdf

Vonkel. JAARVERSLAG VONKEL 2019 (Annual Report of the end-of-life consultation center Vonkel, 2019). 2020. http://vonkeleenluisterendhuis.be/teksten/jaarverslag2019.pdf

Verhofstadt M, Audenaert K, Van den Broeck K, Deliens L, Mortier F, Titeca K et al. The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study. BMC Psychiatry. 2020.

Verhofstadt M, Audenaert K, Van den Broeck K, Deliens L, Mortier F, Titeca K et al. Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions: a survey. BMC Psychiatry. 2020.

Dees MK, Vernooij-Dassen MJ, Dekkers WJ, Elwyn G, Vissers KC, van Weel C. Perspectives of decision-making in requests for euthanasia: A qualitative research among patients, relatives and treating physicians in the Netherlands. Palliat Med. 2013 Jan [cited 2012 Dec 26];27(1):27–37. http://www.ncbi.nlm.nih.gov/pubmed/23104511

Evenblij K, Pasman HRW, Pronk R, Onwuteaka-Philipsen BD. Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists. BMC Psychiatry. 2019;1–10. https://link.springer.com/article/10.1186/s12888-019-2053-3?utm_source=researcher_app&utm_medium=referral&utm_campaign=MKEF_USG_Researcher_inbound

Verhofstadt M, Audenaert K, Van den Broeck K, Deliens L, Mortier F, Titeca K et al. Flemish Psychiatrist’s Attitudes and Readiness to Engage in Euthanasia Assessment Procedures concerning Psychiatric Patients (forthcoming).

Pronk R, Evenblij K, Willems DL, van de Vathorst S. Considerations by Dutch Psychiatrists Regarding Euthanasia and Physician-Assisted Suicide in Psychiatry. J Clin Psychiatry. 2019;80(6). https://www.psychiatrist.com/JCP/article/Pages/2019/v80/19m12736.aspx

Bolt EE, Snijdewind MC, Willems DL, van der Heide A, Onwuteaka-Philipsen BD. Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living? J Med Ethics. 2015;41(8):592–8. http://jme.bmj.com/lookup/doi/ https://doi.org/10.1136/medethics-2014-102150

van Zwol M, de Boer F, Evans N, Widdershoven G. Moral values of Dutch physicians in relation to requests for euthanasia: a qualitative study. BMC Med Ethics. 2022;23(1):1–7. https://doi.org/10.1186/s12910-022-00834-4

Ten Cate K, van Tol DG, van de Vathorst S. Considerations on requests for euthanasia or assisted suicide; a qualitative study with Dutch general practitioners. Fam Pract. 2017;34(6):723–9.

Article   Google Scholar  

Pronk R, Sindram NP, van de Vathorst S, Willems DL. Experiences and views of Dutch general practitioners regarding physician-assisted death for patients suffering from severe mental illness: a mixed methods approach. Scand J Prim Health Care. 2021;39(2):166–73. https://www.tandfonline.com/doi/full/ https://doi.org/10.1080/02813432.2021.1913895

Nicolini ME, Kim SYH, Churchill ME, Gastmans C. Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons. Psychol Med. 2020;50(8):1241–56. https://www.cambridge.org/core/product/identifier/S0033291720001543/type/journal_article

Demedts D, Roelands M, Libbrecht J, Bilsen J. The attitudes, role & knowledge of mental health nurses towards euthanasia because of unbearable mental suffering in Belgium: a pilot study. J Psychiatr Ment Health Nurs. 2018;25(7):400–10.

Belgian Congregation of Brothers of Charity. Reakiro (in Dutch). 2020 [cited 2022 Mar 13]. https://reakiro.be/

Berger P, Luckmann T. The reality of everyday life. The social construction of reality: a treatise in the sociology of knowledge. New York: Doubleday & Company; 1966.

Google Scholar  

Verhofstadt M. Euthanasia in the Context of Adult Psychiatry: Walking the Tightrope Between Life and Death [PhD-Thesis]. Vrije Universiteit Brussel & Ghent University; 2022. https://cris.vub.be/ws/portalfiles/portal/86844133/Verhofstadt_Monica_PhD_thesis_23.05.2022.pdf

Pronk R. A dialogue on death: On mental illness and physician-assisted dying. [PHD Thesis]. Universiteit van Amsterdam; 2021. https://pure.uva.nl/ws/files/65781146/Thesis_complete_.pdf

Braun V, Clarke V. Is thematic analysis used well in health psychology? A critical review of published research, with recommendations for quality practice and reporting. Health Psychol Rev. 2023;17(4):695–718. https://www.tandfonline.com/doi/full/ https://doi.org/10.1080/17437199.2022.2161594

Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893–907.

Beauchamp, Childress TJ. Principles of Medical Ethics. Volume 459. Oxford Univ; 2009.

McCormack R, Clifford M, Conroy M. Attitudes of UK doctors towards euthanasia and physician-assisted suicide: A systematic literature review. Palliat Med. 2012;26(1):23–33. http://journals.sagepub.com/doi/10.1177/0269216310397688

Roelands M, Van den Block L, Geurts S, Deliens L, Cohen J. Attitudes of Belgian Students of Medicine, Philosophy, and Law Toward Euthanasia and the Conditions for Its Acceptance. Death Stud. 2015;39(3):139–50. http://www.tandfonline.com/doi/abs/ https://doi.org/10.1080/07481187.2014.920433

Baranzke H. Sanctity-of-Life—A Bioethical Principle for a Right to Life? Ethical Theory Moral Pract. 2012;15(3):295–308. http://link.springer.com/ https://doi.org/10.1007/s10677-012-9369-0

Lockhart C, Lee CHJ, Sibley CG, Osborne D. The sanctity of life: The role of purity in attitudes towards abortion and euthanasia. Int J Psychol. 2023;58(1):16–29. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1002/ijop.12877

Muishout G, van Laarhoven HWM, Wiegers G, Popp-Baier U. Muslim physicians and palliative care: attitudes towards the use of palliative sedation. Support Care Cancer. 2018;26(11):3701–10. http://link.springer.com/ https://doi.org/10.1007/s00520-018-4229-7

Sabriseilabi S, Williams J. Dimensions of religion and attitudes toward euthanasia. Death Stud. 2022;46(5):1149–56. https://www.tandfonline.com/doi/full/10.1080/07481187.2020.1800863

Baumgartner F, Flores G. Contemporary Medical Students’ Perceptions of the Hippocratic Oath. Linacre Q. 2018;85(1):63–73. http://journals.sagepub.com/doi/10.1177/0024363918756389

Schuklenk U. The ethical case against assisted euthanasia has not been made. J Thorac Cardiovasc Surg. 2015.

Hajar R. The physician’s oath: Historical perspectives. Hear Views. 2017;18(4):154. http://www.heartviews.org/text.asp?2017/18/4/154/221224

Igel LH, Lerner BH. Moving Past Individual and Pure Autonomy: The Rise of Family-Centered Patient Care. AMA J Ethics. 2016;18(1):56–62. http://www.ncbi.nlm.nih.gov/pubmed/18733507 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1650661

Borgstrom E. Social Death. QJM. 2017;110(1):5–7. https://academic.oup.com/qjmed/article-lookup/doi/ https://doi.org/10.1093/qjmed/hcw183

Králová J. What is social death? Contemp Soc Sci. 2015;10(3):235–48. http://www.tandfonline.com/doi/full/10.1080/21582041.2015.1114407

Ho A. Relational autonomy or undue pressure? Family’s role in medical decision-making. Scand J Caring Sci. 2008;22(1):128–35.

Gómez-Vírseda C, de Maeseneer Y, Gastmans C. Relational autonomy: what does it mean and how is it used in end-of-life care? A systematic review of argument-based ethics literature. BMC Med Ethics. 2019;20(1):76. https://bmcmedethics.biomedcentral.com/articles/ https://doi.org/10.1186/s12910-019-0417-3

Liégeois A. Values in dialogue: Ethics in Care. Peeters Publishing; 2016. p. 138.

Nussbaum M. Upheavals of Thought. The intelligence of emotions. In Cambridge: Cambridge University Press; 2001.

Book   Google Scholar  

MacIntyre A. After Virtue. A study in Moral Theory. 3rd ed. Notre Dame: University of Notre Dame.; 2007.

Campbell CS. Dying well, dying badly: ethical issues at the end of life. Death and religion in a changing world. Routledge. In; 2022. pp. 226–53.

Mistiaen P, Cornelis J, Detollenaere J, Devriese S, Farfan-Portet M, Ricour C. Organisation of mental health care for adults in Belgium. Health Services Research (HSR)Brussels: Belgian Health Care Knowledge Centre (KCE). 2019. KCE Reports 318. D/2019/10. 2019. https://kce.fgov.be/sites/default/files/atoms/files/KCE_318_Mental_Health_care_Report_0.pdf

Rooney W, Schuklenk U, van de Vathorst S. Are concerns about Irremediableness, vulnerability, or competence sufficient to Justify excluding all Psychiatric patients from Medical Aid in Dying? Heal Care Anal. 2018.

Dembo J, Schuklenk U, Reggler J. For Their Own Good: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness Is the Sole Underlying Condition. Can J Psychiatry. 2018;63(7):451–6. http://journals.sagepub.com/doi/ https://doi.org/10.1177/0706743718766055

Hermans MHM, de Witte N, Dom G. The state of psychiatry in Belgium. Int Rev Psychiatry. 2012;24(4):286–94. http://www.tandfonline.com/doi/full/ https://doi.org/10.3109/09540261.2012.690337

Lindblad A, Helgesson G, Sjöstrand M. Towards a palliative care approach in psychiatry: do we need a new definition? J Med Ethics. 2019;45(1):26–30. https://jme.bmj.com/lookup/doi/ https://doi.org/10.1136/medethics-2018-104944

Decorte I, Verfaillie F, Moureau L, Meynendonckx S, Van Ballaer K, De Geest I et al. Oyster Care: an innovative Palliative Approach towards SPMI patients. Front Psychiatry. 2020.

De Rycke R, Sabbe S. Psychiatrie. Wat Je Moet Weten (Psychiatry. What you need to know). 4th ed. Leuven (Louvain): Uitgeverij LannooCampus; 2019. p. 304.

Download references

Acknowledgements

The authors wish to thank prof. dr. Kenneth Chambaere and prof. dr. Kurt Audenaert for their preliminary advice regarding the ethics of the research methodology, dr. Steven Vanderstichelen for his help with the interviews (i.e., conducting and transcribing) and all the participants for sharing their professional and in some cases also personal experiences during the interview. We’d also like to thank prof. dr. Kenneth Chambaere for the supervision during the conducting of the interviews and his feedback on the ‘near to final’ draft.

MV is funded by the Research Foundation Flanders via research project (G017818N) and PhD fellowship (1162618 N).

Author information

Authors and affiliations.

End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, Brussels, 1090, Belgium

Monica Verhofstadt & Koen Pardon

Faculty of Theology and Religious Studies, KU Leuven, Louvain, Belgium

Loïc Moureau & Axel Liégeois

Organisation Brothers of Charity, Ghent, Belgium

Axel Liégeois

You can also search for this author in PubMed   Google Scholar

Contributions

The article has been developed with the following authors’ contributions: MV was responsible for the study methodology and managed ethical approval; MV conducted most of the interviews and wrote the main manuscript texts. AL drafted the ethical interpretation framework. MV, LM, KP and AL were responsible for the coding structure and data interpretation and performed a critical review and revision of the final manuscript.

Corresponding author

Correspondence to Monica Verhofstadt .

Ethics declarations

Ethics approval and consent to participate.

This research project was performed in accordance with the Declaration of Helsinki and the European rules of the General Data Protection Regulation. It received ethical approval from the Medical Ethics Committee of the Brussels University Hospital with reference BUN 143201939499, from the Medical Ethics Committee of Ghent University Hospital with reference 2019/0456, and from the Medical Ethics Committee of the Brothers of Charity with reference OG054-2019-20. The interviews were held after obtaining informed consent from all the participants.

Consent for publication

Not applicable.

Competing interests

MV has received research grants from the Research Foundation Flanders; no other relationships or activities that could appear to have influenced the submitted work were declared. All other authors declare that they do not have any competing interest.

Transparency declaration

MV is the guarantor of the manuscript and affirm that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancy from the study have been noted and explained in the manuscript.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Verhofstadt, M., Moureau, L., Pardon, K. et al. Ethical perspectives regarding Euthanasia, including in the context of adult psychiatry: a qualitative interview study among healthcare workers in Belgium. BMC Med Ethics 25 , 60 (2024). https://doi.org/10.1186/s12910-024-01063-7

Download citation

Received : 04 September 2023

Accepted : 15 May 2024

Published : 21 May 2024

DOI : https://doi.org/10.1186/s12910-024-01063-7

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• End-of-life
• Medical assistance in dying
• Mental disorders

BMC Medical Ethics

ISSN: 1472-6939

• General enquiries: [email protected]

The Ethical and Practical Failings of the Death Penalty

This essay about the death penalty argues that it is fundamentally wrong due to ethical, practical, and systemic issues. It highlights the violation of human rights, the risk of wrongful executions, and the failure of the death penalty to deter crime effectively. Additionally, it points out the significant economic burden it imposes on the judicial system and the deep-seated biases and inequalities in its application. The psychological impact on those involved in its administration is also discussed. The essay concludes that abolishing the death penalty in favor of more humane and effective approaches to justice would uphold the dignity of human life and contribute to a more equitable society.

How it works

One of the most contentious issues in the fields of criminal justice and human rights is still the death penalty. Many contemporary nations are debating the morality, effectiveness, and ramifications of the death penalty despite its historical roots. There are many reasons why the death sentence is inherently immoral, ranging from moral conundrums to pragmatic issues.

Human rights are inherently violated by the death sentence, which is one of the strongest grounds against it. The idea that each and every person has the right to life and dignity is the foundation of human rights.

By its inherent nature, the death penalty completely violates human rights. The state-approved, irreversible act of terminating a life creates a risky precedent that diminishes the value of human life. Furthermore, there is a serious possibility of erroneous executions. Since new information is frequently discovered too late, there is not always a guarantee that someone on death row will remain acquitted. This is evidence that legal systems are imperfect. Due to the death penalty’s irreversible nature, any errors made after an execution made cannot be corrected, leading to an unjust and tragic loss of life.

In addition to the moral arguments, the death penalty fails to serve as an effective deterrent to crime. Numerous studies have shown that the death penalty does not significantly reduce crime rates compared to life imprisonment. The assumption that harsher punishments lead to lower crime rates oversimplifies the complex social, economic, and psychological factors that drive criminal behavior. Instead, a more rehabilitative approach to justice, focusing on prevention, education, and social support, has proven to be more effective in reducing crime in the long term. By addressing the root causes of criminal behavior, society can foster an environment where crime is less likely to occur, rather than relying on the fear of capital punishment.

The economic burden of the death penalty also raises significant concerns. Contrary to popular belief, the process of prosecuting and executing a death sentence is far more costly than sentencing an individual to life imprisonment without parole. The extensive legal proceedings required to ensure a fair trial, including numerous appeals and lengthy trials, place a substantial financial strain on the judicial system. These funds could be better allocated to crime prevention programs, victim support services, and other areas that contribute to the overall well-being of society. By diverting resources away from the costly death penalty process, communities can invest in initiatives that have a more profound and positive impact on public safety and justice.

Furthermore, the application of the death penalty often reveals deep-seated biases and inequalities within the judicial system. Studies have shown that factors such as race, socioeconomic status, and geography can significantly influence who is sentenced to death. Minority groups and those from disadvantaged backgrounds are disproportionately represented on death row, highlighting systemic injustices. This disparity not only undermines the principle of equal justice under the law but also perpetuates cycles of discrimination and inequality. A justice system that claims to be fair and impartial cannot condone a practice that so blatantly reflects and reinforces social biases.

The psychological impact of the death penalty on those involved in its administration also warrants attention. Executioners, prison staff, and even judges and jurors can experience severe emotional and psychological distress as a result of their participation in the process. The act of taking a life, even in a legal context, can lead to long-term mental health issues and moral injury. These often-overlooked consequences further illustrate the pervasive harm caused by capital punishment, extending beyond the individuals directly affected by its implementation.

In conclusion, the death penalty is an inadequate form of punishment in contemporary society due to a number of ethical, practical, and structural problems. It infringes upon fundamental human rights, is a poor deterrent to crime, causes heavy financial costs, and exacerbates social injustices. It also causes psychological damage to those who carry out its implementation. Society may respect human life and strive toward a more just and equitable system for all by doing away with the death penalty and concentrating on more compassionate and successful methods to justice.

Cite this page

The Ethical and Practical Failings of the Death Penalty. (2024, Jun 01). Retrieved from https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/

"The Ethical and Practical Failings of the Death Penalty." PapersOwl.com , 1 Jun 2024, https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/

PapersOwl.com. (2024). The Ethical and Practical Failings of the Death Penalty . [Online]. Available at: https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/ [Accessed: 3 Jun. 2024]

"The Ethical and Practical Failings of the Death Penalty." PapersOwl.com, Jun 01, 2024. Accessed June 3, 2024. https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/

"The Ethical and Practical Failings of the Death Penalty," PapersOwl.com , 01-Jun-2024. [Online]. Available: https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/. [Accessed: 3-Jun-2024]

PapersOwl.com. (2024). The Ethical and Practical Failings of the Death Penalty . [Online]. Available at: https://papersowl.com/examples/the-ethical-and-practical-failings-of-the-death-penalty/ [Accessed: 3-Jun-2024]

Don't let plagiarism ruin your grade

Hire a writer to get a unique paper crafted to your needs.

Our writers will help you fix any mistakes and get an A+!

Please check your inbox.

You can order an original essay written according to your instructions.

Trusted by over 1 million students worldwide

1. Tell Us Your Requirements

2. Pick your perfect writer

3. Get Your Paper and Pay

Hi! I'm Amy, your personal assistant!

Don't know where to start? Give me your paper requirements and I connect you to an academic expert.

short deadlines

100% Plagiarism-Free

Certified writers

More From Forbes

5 strategies to unlock your winning college essay.

• Share to Facebook
• Share to Twitter
• Share to Linkedin

CAMBRIDGE, MASSACHUSETTS - JUNE 29: People walk through the gate on Harvard Yard at the Harvard ... [+] University campus on June 29, 2023 in Cambridge, Massachusetts. The U.S. Supreme Court ruled that race-conscious admission policies used by Harvard and the University of North Carolina violate the Constitution, bringing an end to affirmative action in higher education. (Photo by Scott Eisen/Getty Images)

The college application season is upon us, and high school students everywhere are staring down at one of the most daunting tasks: the college essay. As someone who has guided countless applicants through the admissions process and reviewed admissions essays on an undergraduate admissions committee, I've pinpointed the essential ingredient to a differentiated candidacy—the core of your college admissions X-factor .

The essential ingredient to your college admissions X-factor is your intellectual vitality. Intellectual vitality is your passion for learning and curiosity. By demonstrating and conveying this passion, you can transform an average essay into a compelling narrative that boosts your chances of getting accepted to your top schools. Here are five dynamic strategies to achieve that goal.

Unleash Your Authentic Voice

Admissions officers sift through thousands of essays every year. What stops them in their tracks? An authentic voice that leaps off the page. Forget trying to guess what the admissions committee wants to hear. Focus on being true to yourself. Share your unique perspective, your passions, and your values. Authenticity resonates deeply with application reviewers, making your essay memorable and impactful. You need not have experienced trauma or tragedy to create a strong narrative. You can write about what you know—intellectually or personally—to convey your enthusiasm, creativity, and leadership. Intellectual vitality shines through when you write with personalized reflection about what lights you up.

Weave A Captivating Story

Everyone loves a good story, and your essay is the perfect place to tell yours. The Common Application personal statement has seven choices of prompts to ground the structure for your narrative. The most compelling stories are often about the smallest moments in life, whether it’s shopping at Costco or about why you wear socks that have holes. Think of the Common Application personal statement as a window into your soul rather than a dry list of your achievements or your overly broad event-based life story. Use vivid anecdotes to bring your experiences to life. A well-told story can showcase your growth, highlight your character, and illustrate how you've overcome challenges. Intellectual vitality often emerges in these narratives, revealing how your curiosity and proactive approach to learning have driven you to explore and innovate.

Reflect And Reveal Insights

It's not just about what you've done—it's about what you've learned along the way. When you are writing about a specific event, you can use the STAR framework—situation, task, action, and result (your learning). Focus most of your writing space on the “R” part of this framework to dive deeply into your experiences and reflect on how they've shaped your aspirations and identity.

What To Watch This Weekend New Streaming Shows And Movies On Netflix Hulu Prime Video And More

Wwe smackdown results, winners and grades as aj styles turns heel again, the top 10 richest people in the world june 2024.

The most insightful college-specific supplement essays demonstrate depth of thought, and the ability to connect past experiences with your future life in college and beyond. Reflecting on your intellectual journey signals maturity and a readiness to embrace the college experience. It shows admissions officers that you engage deeply with your studies and are eager to contribute to the academic community.

Highlight Your Contributions—But Don’t Brag

Whether it's a special talent, an unusual hobby, or a unique perspective, showcasing what you can bring to the college environment can make a significant impact. Recognize that the hard work behind the accomplishment is what colleges are interested in learning more about—not retelling about the accomplishment itself. (Honors and activities can be conveyed in another section of the application.) Walk us through the journey to your summit; don’t just take us to the peak and expect us know how you earned it.

Intellectual vitality can be demonstrated through your proactive approach to solving problems, starting new projects, or leading initiatives that reflect your passion for learning and growth. These experiences often have a place in the college-specific supplement essays. They ground the reasons why you want to study in your major and at the particular college.

Perfect Your Prose

Great writing is essential. Anyone can use AI or a thesaurus to assist with an essay, but AI cannot write your story in the way that you tell it. Admissions officers don’t give out extra credit for choosing the longest words with the most amount of syllables.

The best essays have clear, coherent language and are free of errors. The story is clearly and specifically told. After drafting, take the time to revise and polish your writing. Seek feedback from teachers, mentors, or trusted friends, but ensure the final piece is unmistakably yours. A well-crafted essay showcases your diligence and attention to detail—qualities that admissions officers highly value. Intellectual vitality is also reflected in your writing process, showing your commitment to excellence and your enthusiasm for presenting your best self.

Crafting a standout college essay is about presenting your true self in an engaging, reflective, and polished manner while showcasing your intellectual vitality. Happy writing.

• Editorial Standards
• Reprints & Permissions

• Election 2024
• Entertainment
• Newsletters
• Photography
• Personal Finance
• AP Investigations
• AP Buyline Personal Finance
• AP Buyline Shopping
• Press Releases
• Israel-Hamas War
• Russia-Ukraine War
• Global elections
• Asia Pacific
• Latin America
• Middle East
• Election Results
• Delegate Tracker
• AP & Elections
• Auto Racing
• 2024 Paris Olympic Games
• Movie reviews
• Book reviews
• Personal finance
• Financial Markets
• Business Highlights
• Financial wellness
• Artificial Intelligence
• Social Media

Yuka Saso makes headlines in Japan as special edition papers mark her US Open win

A staff distributes an extra edition of the Yomiuri Shimbun newspaper reporting on Japanese golfer Yuka Saso winning the U.S. Women’s Open golf tournament Monday, June 3, 2024, in Tokyo. The Japanese title reads as “Saso won second major.” (AP Photo/Eugene Hoshiko)

Yuka Saso, of Japan, holds the tournament trophy after winning the U.S. Women’s Open golf tournament at Lancaster Country Club, Sunday, June 2, 2024, in Lancaster, Pa. (AP Photo/Matt Slocum)

• Copy Link copied

TOKYO (AP) — Commuters at Tokyo’s Shimbashi Station were greeted with a special edition of the Yomiuri newspaper on Monday.

The big news was the victory of Yuka Saso at the U.S. Open on Sunday, the second time she has won title. Japanese papers still print special editions to mark such moments.

She won in 2021 playing under the flag of the Philippines, the land of her birth. This time she won flying the flag of Japan, the birthplace of her father.

“Winning in 2021, I represented the Philippines. I feel like I was able to give back to my mom,” Saso said. “This year I was able to represent Japan, and I think I was able to give back to my dad. I’m very happy that I was able to do it.

“It’s just a wonderful feeling that I was able to give back to my parents in the same way.”

The 22-year-old Saso shot a 2-under 68 on Sunday — early Monday Japanese time — to win by three shots at the Lancaster Country Club in Lancaster, Pennsylvania.

AP golf: https://apnews.com/hub/golf

Home — Essay Samples — Social Issues — Euthanasia — The Ethics of Euthanasia

The Ethics of Euthanasia

• Categories: Euthanasia

About this sample

Words: 804 |

Published: Jan 30, 2024

Words: 804 | Pages: 2 | 5 min read

Table of contents

Introduction, advantages of euthanasia, disadvantages of euthanasia, counterarguments and rebuttals, relieving pain and suffering, autonomy and personal choice, reducing medical costs, moral and ethical implications, the risk of abuse, impact on medical professionals, ethical considerations and alternatives, safeguards against abuse and potential solutions.

• New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMp0804651
• Journal of Medical Ethics. https://jme.bmj.com/content/early/2013/05/15/medethics-2012-101093

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Verified writer

• Expert in: Social Issues

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

3 pages / 1552 words

1 pages / 670 words

5 pages / 2356 words

2 pages / 1011 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Euthanasia

Euthanasia, also known as mercy killing, is the act of intentionally ending a person's life to relieve their suffering. This controversial topic has been the subject of much debate and ethical consideration in the medical and [...]

Euthanasia, also known as assisted suicide or mercy killing, has been a controversial topic for decades. The ethical, moral, and societal implications of euthanasia have sparked heated debates worldwide. While some argue that it [...]

End-of-life decisions have long been a topic of controversy and debate, with euthanasia being one of the most contentious subjects. Euthanasia or "merciful death" is defined as the act of intentionally ending a life to relieve [...]

Euthanasia, also known as mercy killing, is a highly controversial topic that has sparked heated debates across the globe. The concept of euthanasia involves deliberately ending the life of a patient who is suffering from an [...]

Imagine facing a terminal illness with no hope for recovery, only prolonged suffering and pain. In such situations, the concept of euthanasia, or assisted suicide, becomes a controversial but increasingly relevant topic. [...]

Battin, M. P., Rhodes, R., & Silvers, A. (2015). The Patient as Victim and Vector: Can Ethics Abandon the Ideal of the Autonomous Patient? The American Journal of Bioethics, 15(3), 3-14.Pereira, J. M. (2011). Legalizing [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

• Share full article

Advertisement

Supported by

Guest Essay

Sports Gambling Is a Ticking Time Bomb

By Leigh Steinberg

Mr. Steinberg is a sports agent who has represented athletes such as Troy Aikman, Manny Ramirez and Patrick Mahomes.

Some of the biggest scandals in sports history have revolved around players and gambling. Pete Rose is barred for life from baseball, in an agreement stemming from admissions of gambling . The Black Sox scandal , about a thrown World Series, is perhaps the most notorious sports debacle of all time.

Yet in a rush to embrace the potential profits provided by new forms of legalized sports gambling, the professional sports leagues have put players, and the people close to them, under untenable pressure. I have represented professional athletes for 50 years and I have never seen a situation that’s more perilous to them and the integrity of sports.

These aren’t just hypothetical concerns: Jontay Porter, a center for the Toronto Raptors, was recently barred for life from the N.B.A. after a league investigation found that he’d shared confidential information with a bettor, resulting in large wagers on his performance. As the new baseball season was starting, federal prosecutors said the interpreter for the star pitcher Shohei Ohtani had stolen millions from Mr. Ohtani to pay off gambling debts to an illegal sports bookie. Major League Baseball is investigating Mr. Ohtani’s former teammate David Fletcher over allegations that he placed bets with the same bookie.

Pro sports depends on authenticity and credibility. Fans must believe that the games are fair and that each athlete is making the maximum effort to win. Any suggestion that the contests might be fixed or tainted will destroy the industry.

The appearance of integrity has always been central to the success of sports. When I started as an agent a half-century ago, the major leagues all considered it so crucial to maintain distance between the worlds of gambling and athletics that they agreed that Las Vegas — then the only place where sports gambling was legal — should not have professional franchises.

Everything changed when, on May 14, 2018, in the case of Murphy v. N.C.A.A., the Supreme Court struck down a decades-old federal law that effectively banned sports betting outside Nevada. Within weeks, New Jersey had established legitimate sports betting at its casinos and racetracks. Thirty-seven states quickly followed suit.

Now casinos and betting companies are advertising in stadiums and arenas, many sports venues permit gambling outlets either inside or next door and two owners of N.F.L. teams, Robert Kraft and Jerry Jones, bought a small piece of the gambling site DraftKings. Las Vegas is now home to an N.F.L. team, the Raiders — and was the host of the Super Bowl this year.

Leagues and franchises are so embedded with gambling companies, and so enamored of the revenue these ties produce, that it’s unthinkable to reverse course. But there are crucial steps to be taken.

Leagues must install stricter guidelines and stronger oversight to protect players. They must work to closely monitor betting abnormalities (as in the case of Mr. Porter) then act quickly when such abnormalities occur. And they should negotiate with companies like FanDuel and DraftKings to discourage the lucrative but dangerous prop bets on the performance of an individual player — bets that are an obvious target for manipulation.

Let me be clear: I am not against all sports betting. Millions of people do it for enjoyment and potential profit and, let’s face it, humans started gambling long before organized sports existed.

But sports gambling has spread so quickly that pro leagues have had little time to reason through the consequences, especially for players. At a distance, the motives of someone like Mr. Porter are puzzling; this is a player who ruined his career despite having made millions of dollars legitimately while playing in the N.B.A. But pro athletics and the lure of gambling have always been intertwined.

Players have already spoken out about the verbal abuse they endure from fans angry about bets gone wrong, at times hurled at them even as a game is in progress. The Porter case points toward a much darker form of pressure: the temptation to use inside information to make wagers on a player’s performance.

I understand this kind of pressure firsthand. As an agent for professional athletes, I spent one Saturday night before a critical game sitting in a hotel room with Steve Young, then the quarterback of the San Francisco 49ers. I knew something that few people at that moment did: A defensive player had knocked Steve over during practice and he would not play in the game the next day.

Were I a betting man, I could have used that information to place potentially lucrative wagers on the game. I didn’t, because when you work with, or around, professional athletes, you are obligated to uphold the integrity of your players. But today, placing such a wager would be as easy as pulling out one’s smartphone. Or telling an acquaintance to pull out his.

There’s traditionally been an impregnable wall between professional sports and the world of gambling, but that wall is not just crumbling, it’s evaporating. Leagues must start by acknowledging that athletes are human. They have failings. They make missteps. The N.B.A., M.L.B. and other leagues have facilitated a situation that makes it all too easy for players to falter. If more of those players do, they will bring down the edifice of professional sports.

Leigh Steinberg is a sports agent who’s represented athletes such as Troy Aikman, Manny Ramirez and Patrick Mahomes.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .