Historical Look at Euthanasia

Professor em. James Westendorf

Definition: Euthanasia is a term derived from a Greek word meaning “happy or fortunate in death.” It is most commonly used today to denote the “merciful” infliction of death [either actively or passively] to avoid torment in fatal and incurable disease, usually by consent of the patient or his family. (Other reasons for this infliction of death can be economical or dealing with quality of life. For our purpose euthanasia includes hastening or causing the death of any person supposedly because it is an advantage to the person or society.)

Tribal Customs: There are accounts of tribes, ancient and more modern, who abandoned their aged and infirm, choked, starved, or even stomped or clubbed them to death. Sometimes these things were done at the person’s wish; in other cases they were done because the person had arrived at a certain age or stage of deterioration of health. Similar things were done to unwanted infants.

… In some Eskimo cultures, an old or sick Eskimo tells his family he is ready to die and the family, if it is a good one, will immediately comply by abandoning the aged person to the ravages of nature or by killing him. (Many Eskimos believe that anyone who has courageously faced a violent death spends eternity in the highest heaven.) Derek Humphry & Ann Wictett, The Right to Die. 1985 (DH)

Aelian [Roman historian] tells us that among the Sardinian men of advanced age used to be killed with clubs by their own sons “because they considered it disgraceful that a man should continue to live when exceedingly old.” Encyclopedia of Religion and Ethics

“Tribal” Greece: The city-state of Sparta in Greece practiced a form of euthanasia that might better be named: eugenics [ridding society of those that are deemed “unworthy of life.”]

The father had no authority to rear his child, when born, but brought it to a place called the Lesche; here the elders of his tribe sat and examined the infant. .. .but if it were feeble and ill-shaped, they sent it to the so-called Place of Casting-Out — a chasm near Mt. Taygetos — considering that for a child ill-suited from birth for health and vigor to live was disadvantageous for itself and for the state. Plutarch [Roman historian], Vita Lycurgi

Philosophical Greece: Both Plato and Aristotle were in favor of some sort of infanticide. Plato in describing his model state sounds a lot like the Spartans when he says:

The children of inferior parents, and any deformed offspring of others, they [the Guardians] will secretly put out of the way as is fitting. Plato, The Republic

Euthanasia, the practice of putting somebody else of out his misery, was not a common or approved practice, but suicide as a form euthanasia was advocated by some. Plato in his Republic had Socrates criticizing Heroditus, the teacher of Hippocrates, for “inventing lingering death.” He goes on to say:

[The god of healing] did not want to lengthen out good-for-nothing lives… Those who are diseased in their bodies, [physicians] mil leave to die, and the corrupt and incurable souls they will put an end to themselves . Plato, The Republic

The city-state of Athens seems to have had a form of state-assisted suicide. The Roman writer Libanius reports:

Whoever no longer wished to live shall state his reasons to the Senate, and after having received permission shall abandon life. If your existence is hateful to you, die; if you are overwhelmed by fate, drink the hemlock, lf you are bowed with grief, abandon life. Let the unhappy man recount his misfortune, let the magistrate supply him with the remedy, and his wretchedness will come to an end.

The Stoics also favored suicide when pain, illness, or abnormalities were too much to bear. It is reported that Zeno, the founder of Stoicism, committed suicide at the age of 98 when he fell and wrenched a finger.

Others like the Pythagoreans, Aristotelians and Epicureans opposed suicide as the coward’s way out. Physician-assisted suicide probably was practiced secretly or without much reaction from the state if Hippocrates, a Pythagorean, felt it necessary to speak out against it. His oath which, if he did not write it, at least contains his ideals, says:

.. I will give no deadly medicine to anyone if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion…

The chief point of this discussion is that among the wise men of Greece ending one’s life for a variety of reasons, pain, and illness included, was considered a rational and humane thing to do. It should also be remembered, however, that this was far from a unanimous opinion. Euthanasia, if present, is not publicly acknowledged.

Rome: Rome adopted Greek ideas here as they did in so many aspects of civilization. Suicide was punishable only if it was irrational. But there were plenty of rational reasons for suicide. Impatience with illness and pain, weariness of life, lunacy, or fear of dishonor were among them.

It makes a great deal of difference whether a man is lengthening his life or his death. But if the body is useless for service, why should one not free the struggling soul? Perhaps one ought to do this a little before the debt is due, lest, when it falls due, he may be unable to perform the act. Seneca [Roman Stoic writer], Epistulae Morales

Judaism: The Old Testament never condones any form of taking life except when done by civil authorities in the interest of justice. The suicide of King Saul, 1 Kings 31, is viewed in the context as his final alienation from the LORD. The Talmud containing the teachings of Judaism forbids suicide and doesn’t even discuss mercy-killing.

..And let not thy [evil] inclination assure thee that the grave is a place of refuge for thee. Tractate Aboth [Seen by commentators as “intended as a polemic against the idea of suicide,” which the Roman Stoics (e.g. Seneca) extolled as ‘a way out’]

Christian Rome and Other Countries: The New Testament has the same view of taking human life as the Old. The apostles’ prayer mentioning Judas’ position among the disciples by saying, “…which Judas left to go where he belongs,” indicates what they believed about suicide. Church fathers like Augustine and Roman Catholic theologians like Thomas Aquinas made it very clear that suicide and any other form of shortening life came under the category of murder. This was true through the time of the Reformation and remains wherever the influence of Biblical confessionalism is felt.

Renaissance Europe: Classical Greece and Rome are rediscovered. Their form of rationalism is revived within the church and without. The individual is emphasized. Sir Thorn More in his Utopia in 1516 (like Plato’s Republic) sanctions voluntary euthanasia.

If, besides being incurable, the disease also causes constant excruciating pain, some priests and government officials visit the person concerned and say… ‘Since your life’s a misery to you, why hesitate to die? You’re imprisoned in a torture chamber — why don’t you break out and escape to a better world… We’ll arrange for your release… ‘ If the patient finds these arguments convincing, he either starves himself to death, or is given a soporific and put painlessly out of his misery. But this is strictly voluntary.

Sir Francis Bacon at the beginning of the 17th century expressed similar ideas in The New Atlantis. He insisted that doctors should assist the dying patient “to make a fair and easy passage from life.”

18th Century: French physician, Paradys, recommended an “easy death” for incurable and suffering patients. Throughout the century French laws against suicide become more lenient. Rousseau talks about “virtuous suicide” and “to be nothing or to be well.” The essay by Scottish philosopher, David Hume, “Of Suicide,” is published in 1777, one year after his death.

When life has become a burden, both courage and prudence should engage us to rid ourselves at once of existence

19th Century to World War II: German philosopher, Arthur Schopenhauer, (1788-1860) emphasizes individualism and human autonomy by slating that man has…

“unassailable title to his own life and person… It wilt be generally found that, as soon as the terrors of life reach the point at which they outweigh the terrors of death, a man will put an end to his life.”

At the beginning of the 20th century an English doctor, C. E. Goddard, made an appeal for legalizing euthanasia as a way for terminally ill patients to avoid suffering. He included idiots, imbeciles, and “monstrosities”

Those having no will power or intelligence of their own, and being a burden themselves, and especially their friends and society, [and] of course absolutely incapable of improvement.

1906 – A euthanasia bill is introduced in Ohio legislature. It is defeated 78-22.

1931 – Dr. C. Killick Millard, health officer for the city of Leicester, England, drafted “The Voluntary Euthanasia Bill”

1. An application for a euthanasia permit may be fifed by a dying person stating that he has been informed by two medical practitioners that he is suffering from a fatal and incurable disease, and that the process of death is likely to be protracted and painful.

2. The application must be attested by a magistrate and accompanied by two medical certificates.

3. The application and certificates must be examined by the patient and relatives interviewed by a “euthanasia referee’.

4. A court will then review the application, certificates, the testimony of the referee and any other representatives of the patient. It will then issue a permit to receive euthanasia to the applicant and a permit to administer euthanasia to the medical practitioner (or euthanizer).

5. The permit would be valid for a specified period, within which the patient would determine if and when he wished to use it.

1935 – The British Euthanasia Legalization Society is formed to promote Millard’s bill, but it is defeated the next year in the House of Lords, 35-14.

1937 – A euthanasia bill is introduced in the Nebraska legislature but is not acted on.

1938 – The Euthanasia Society of America (ESA) is formed announcing:

that its members subscribed to the belief that, with adequate safeguards, it should be made legal to allow incurable sufferers to choose immediate death rather than await it in agony.

1939 – A bill legalizing euthanasia is introduced in New York but is shelved because of the war.

Germany, 1939-1945: The German Euthanasia Program began two full years before Hitler’s program of genocide of other races. Its purpose was not to kill off non-Aryans, but to purify the German race by the direct killing off of pure blooded Germans who were physically, emotionally, or mentally defective, or who were old and infirm and no longer useful to society. The program was run not by Nazis, but by prominent German psychiatrists. There is no indisputable evidence that the program was ever sanctioned by Hitler, at least in its early stages. Many homes for the institutionalized were nearly emptied. Many leaders in the program later committed suicide or were tried (and some were executed) after the war.

The 1940s: Various petitions are presented by the ESA advocating euthanasia. Most fail for lack of a sponsor. In 1944 a certain San Francisco physician, Dr. Frank Hinnam, distinguished between “therapeutic” euthanasia for the incurable sufferer and “decreed” euthanasia to weed out the unfit, and he advocated them both.

The 1950s: A final attempt by the ESA to introduce legislation in New York fails. Ethicist Joseph Fletcher argues that euthanasia doesn’t fit the legal definition of murder which is “killing with malice aforethought.” Euthanasia is “with mercy aforethought.” From 1950 to 1959 more than a dozen cases of euthanasia were reported in America and abroad.

The 1960s: The ESA turns from introducing legislation to educating the public and forms the Euthanasia Education Council (EEC) in 1969. In 1969 the House of Lords in England first accepts and then rejects a voluntary euthanasia bill. Also in 1969 Louis Kutner publishes his article, “Due Process of Euthanasia: The Living Will.” He says:

The current state of the law does not recognize the right of the victim to die if he so desires. He may be in a terminal state suffering from an incurable illness and literally forced to continue a life of pain and despair. Such a denial may well infringe upon an individual’s right of privacy.

The 1970s: In the early 1970s doctors in the Netherlands have governmental permission to assist their patients to commit suicide. Euthanasia, however, does not have legal status.

Death-with-dignity bills are introduced in Wisconsin in 1971 and Washington in 1973, but are lost for insufficient backing. In 1973 a euthanasia bill is defeated in the Montana legislature, 83-15. Living will legislation is lost in 14 states, but passes in California. Voluntary Euthanasia Societies are formed in Australia and South Africa. The ESA changes its name to The Society for the Right to Die (SRD) in 1975. The EEC distributes more than 250,000 copies of the Living Will. In 1975 Karen Quinlan is removed from the respirator. [She dies 10 years later.] In 1976 17 right-to die bills are introduced in different states. All are defeated. In 1977 50 bills are introduced in 38 states. This time they are enacted in eight states.

The 1980s: In 1980 Derek Humphry with his second wife, Ann Wickett, forms the Hemlock Society advocating active euthanasia. Its stated principles were:

* Hemlock will seek to promote a climate of public opinion which is tolerant of the right of people who are terminally ill to end their lives in a planned manner.

* Hemlock does not encourage suicide for any primary emotional, traumatic, or financial reasons in the absence of terminal illness. It approves of the work of those involved in suicide prevention.

* The final decision to terminate life is ultimately one’s own. Hemlock believes this action, and most of all its timing, to be an extremely personal decision, wherever possible taken in concert with family and friends.

* Hemlock speaks only to those people who have mutual; sympathy with its goals. Views contrary to its own which are held by other religions and philosophies are respected.

In 1980 the World Federation of Right-to-Die Societies is formed with 27 groups from 18 countries joining.

In 1982 the Medical Society of New York following the earlier lead of Minnesota, North Carolina, and Alabama issued guidelines for withholding emergency resuscitation from a terminally-ill patient. Similar rulings were adopted by the Veterans’ Administration in 1983. In the same year the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research recommended that when death looms as a certainty, a mentally-competent and fully-informed patient should be allowed to halt the treatment that keeps him alive. If the patient is incompetent, the family should take the responsibility. The debate about withholding food and water from certain patients grows. By 1985, 36 states have living will legislation.

In 1988 the Royal Dutch Society of Medicine reports that 300 disabled babies die each year from starvation, dehydration, or refused surgical procedures. An additional ten are killed by lethal injection.

The 1990s: In 1990 11,800 cases of active euthanasia are reported in the Netherlands; over half are non-voluntary.

Dr. Kevorkian assists in over 40 suicides between June 4, 1990 and the present. The courts of Michigan are stymied. It is estimated that the number of assisted dying cases in the USA every year is in the thousands.

Assisted suicide bills are lost in Washington (1991) and in California (1992). A bill is passed, however, in Oregon in 1994, the first and only one of its kind in the USA.* The Northern Territories of Australia in May of 1995 becomes the second place in the world legalizing assisted suicide.

* Until that time

In 1990 the Supreme Court hears two “right-to-die” cases. In the first, justices ruled that a person has a constitutionally-protected right to refuse unwanted medical treatment. In the second case, they ruled that evidence of a comatose patient’s wishes for the withdrawal of treatment must be clear and convincing. On October 1, 1996, the Supreme Court agreed to hear a case in which they will rule whether the right to liberty also protects a dying person’s freedom to get medication that will hasten death.

Questions for Your Consideration

1. In history what are the times when debates over euthanasia and suicide have flourished?

2. What is wrong with advocating the right to commit suicide?

3. How does euthanasia go beyond suicide or even assisted suicide?

4. Do we disagree with everything Right-to-Die groups have advocated?

5. What do you see for the future?


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