Euthanasia is often divided into two categories: active and passive. Active means taking action that leads to death and includes points 1 and 2 above. Passive means not interfering with suicide and is included in point 3 above. In a hospital this might mean allowing a patient the choice to decline vital medication or treatment. In practice most public debate has been around active euthanasia.
Proponents of euthanasia state that people should be allowed to decide that they do not want to live any more, and that terminally ill patients are respected more by having their suffering end than by being kept alive against their will. Philosopher Peter Singer has been one of the most outspoken proponents of euthanasia, arguing from a utilitarian arguments.
Arguments from opponents of euthanasia can be divided in two main categories: religious and prudential.
The religious people, primarily Christians, object that it is not loving to kill someone, and that pain medications are good enough that suffering is preventable if doctors have the will. Many religions also regard one's life as from God and that either it is His (not yours), or throwing it away insults Him.
The second type of argument against euthanasia is that it is not prudent to advocate it. Eventually we will all be on a table, and if we think ahead, we may think it better if the doctors on whom we depend are not tempted to perform euthanasia. If euthanasia would be allowed, it is feared by some, doctors might press people into euthanasia to reduce medical costs, or because their family wants them to die.
It should be noted that doctors routinely and legally provide medical treatment to the terminally ill involving the use of large quantities of pain-killing drugs, primarily to relieve the patient's pain, but in doses that may suppress bodily functions and thus shorten the life of the patient.
However, as the goal of the treatment is the relief of suffering rather than the shortening of life (even if that is a known consequence) doctors who oppose euthanasia argue vigorously that such treatment is not euthanasia.
It should be noted that in about a quarter even of the medically supervised euthanasias there are 'complications', like respiratory paralysis that make the death anything but pleasant.
In The Netherlands the Upper House passed a bill for the 'review of cases of termination of life on request and assistance with suicide' earlier approved by the Lower House of Parliament on 28 November 2000. The bill was passed by 46 votes to 28 and has taken effect from April 1, 2002. This legislation has wide support among the libertarian Dutch.
According to the new legislation, euthanasia and assistance with suicide will continue to be criminal offences. However, physicians who comply with all conditions and criteria of due care will not be prosecuted.
They must practice due care as set forth in a separate law, the Termination of life on request and assisted suicide (Review) Act. The law states that euthanasia is only allowed when the patient has asked repeatedly, when the patient's suffering is unbearable and desperate, and when the doctor has prior to the act consulted a colleague. The doctor must also report the cause of death to the municipal coroner in accordance with the relevant provisions of the Burial and Cremation Act. Regional review committees will continue to assess whether a case of termination of life on request for assisted suicide complies with the due care criteria. Depending on their findings, a case will either be closed or brought to the attention of the Public Prosecutor. Finally, the legislation offers an explicit recognition of the validity of a written declaration of will of the patient regarding euthanasia. Such declarations can be used when a patient is in coma or otherwise unable to state whether they want euthanasia or not.
From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law as created basically made official what had already become unofficial law by judgments in the courts.
The Netherlands has an excellent health care system and one of the world's highest expected life lengths. The right to euthanasia is supported by a majority of the traditionally libertarian Dutch people.
Christian organizations and Dutch anti-euthanasia organizations claim that many old people are afraid to go to a hospital in the Netherlands. Also, the same groups say that per capita, there are less than one quarter as many disabled people in the Netherlands as in the U.S. The same groups say that many doctors in the Netherlands habitually perform euthanasia for unconscious patients with severe maimings (such as double amputations above the knees), and persons with severe disease who are estimated to be near the ends of their lives without consultation, or any significant practical oversight.
Euthanasia was legalised in Australia's Northern Territory, by the Rights of the Terminally Ill Act 1995. This law was soon however made ineffective by the an amendment by the Commonwealth government to the Northern Territory (Self-Government) Act 1978. (The powers of the Northern Territory legislature, unlike those of the State legislatures, are not guaranteed by the Australian Constitution.) Three people had already been legally euthanasied, however, before the Commonwealth government made this amendment.
After an extensive discussion the Belgian parliament legalised euthanasia in late September 2002. The new legislation, however, institutes a complicated process, which has been criticized as an attempt to establish a bureaucracy of death. Nevertheless, euthanasia is now legal and its proponents in the country hope that it will stop many illegal practises (it is said that several thousand illegal acts of euthanasia have been carried out in Belgium each year).
In the United States, the most common form of euthanasia is withholding tube-feeding to elderly and incapacitated patients. This is generally considered an abuse when the patient might recover. These patients die protracted deaths by dehydration. However, it is so common in some areas that the family must actively prevent it, or it will occur.
Contrary to the rest of the United States, Oregon State residents have twice voted for the legalization of assisted suicide by lethal prescription dosage within the state. It is estimated that, as of the year 2002, nearly 100 terminally ill patients have had doctor assisted suicides administered since the inception of the law in 1997. It is difficult to determine accurate figures, since doctors are not required by law to report when they have granted the patient's request. Oregon's policy has been consistently under attack by various religious organizations, and federal government parties that support those organizations, ever since it was first inacted.
In Nazi Germany the term euthanasia was a code word for systematic killing of deformed children and mentally ill adults under Hitler's T-4 Euthanasia Program. This has stained the word in German speaking countries, as many other terms (ab)used by the Nazis. Euthanasia is thus mostly paraphrased as "Sterbehilfe" (help to die) in German speaking countries.
See also: Jack Kevorkian