Euthanasia and Its Philosophical Considerations: Authority of State or Individual Liberty?
- Hindu College Gazette Web Team
- 2 days ago
- 8 min read
Philosophers have historically engaged with the profound themes of life and death, and the contemporary discussion surrounding euthanasia exemplifies such engagement. Despite over 3,000 years of philosophical discourse, the ethical and moral dilemmas associated with euthanasia continue to evoke substantial division within society. This issue remains a focal point in interdisciplinary discussions, encompassing medical, legal, philosophical, and theological perspectives.
The term "euthanasia," derived from Greek and meaning "good death," has its origins in the Hellenistic period. Scholars in antiquity discussed concepts akin to "willing self-sacrifice," "intended death," and "death resulting from one’s own actions" (Cooper, 1989). In contemporary scholarship, the Stanford Encyclopedia of Philosophy defines euthanasia as an act where an individual intentionally causes the death of another, under the belief that the latter’s current existence is so unbearable that death would be preferable. This definition also applies to cases where, absent intervention, the individual’s life is anticipated to deteriorate significantly (Young, 1996). Moreover, euthanasia has been defined in The Black’s Law Dictionary (8th edition) “as an act or practice of killing or bringing about the death of a person who suffers from an incurable disease or condition, especially a painful one, for reasons of mercy.”
Euthanasia is commonly categorised into two types: active and passive euthanasia. Active euthanasia involves a situation where a person directly and deliberately causes a patient's death. For example, this occurs when a doctor administers a lethal dose of medication to end a patient's life or when someone is given an overdose of painkillers that results in death. In contrast, passive euthanasia refers to situations where a patient's life is not actively taken. Instead, the medical team allows the patient to die by not intervening in a life-threatening condition. In this case, the doctors are not actively killing the patient; they are simply refraining from saving them. It was in the Aruna Ramchandra Shanbaug vs Union of India Case (2011) that the Supreme Court of India made a distinction between “active” and “passive” euthanasia and allowed the latter in “certain situations”.
Euthanasia has remained a prominent topic since its inception. It is a controversial issue that has sparked debate worldwide, as it involves the intentional termination of human life. Ezekiel Emanuel, a noted opponent of euthanasia, outlines four principal arguments put forth by its advocates: a) Individuals possess a fundamental right to self-determination, which grants them the authority to make choices regarding their own fate. b) Assisting an individual in dying may be a more humane alternative to prolonging their suffering. c) The distinction between passive euthanasia, which is frequently permitted, and active euthanasia, which is generally prohibited, lacks substantive justification. d) The legalization of euthanasia does not necessarily result in adverse consequences. Proponents of euthanasia frequently reference countries such as the Netherlands and Belgium, as well as U.S. states like Oregon, where euthanasia has been legalized, to support their argument that its implementation is predominantly unproblematic.
On the other hand, Emanuel presents a comprehensive analysis of the arguments put forth by opponents of euthanasia, outlining four primary points: a) not all deaths are characterized by pain; b) there are viable alternatives, such as the cessation of active treatment in conjunction with effective pain management; c) the moral distinction between active and passive euthanasia holds significant importance; and d) the legalization of euthanasia may lead society down a slippery slope, resulting in undesirable consequences. Notably, in Oregon, data from 2013 indicated that pain was not among the top five reasons individuals pursued euthanasia. Instead, the predominant motivations were concerns regarding loss of dignity and the fear of imposing a burden on others. (Pew Research Survey)
This essay aims to investigate two primary arguments. Firstly, it posits that the discourse surrounding euthanasia is not a recent construct but is deeply entrenched in the historical philosophical thought of Ethics. Secondly, it will examine a pressing contemporary debate: the question of authority in making decisions regarding euthanasia—specifically the tension between state intervention and individual autonomy. By addressing these themes, the essay seeks to provide a comprehensive analysis that draws on historical and philosophical frameworks to understand the complexities of euthanasia in modern society, as debated in medical, legal, philosophical and theological literature.
:se misery, represents an ethical concept of the right to human life and freedom of choice. It is believed that this end-of-life experience should be understood as a fundamental right of the patient, necessitating respect for their dignity. Consequently, the practice of euthanasia is guided by a commitment to alleviating suffering and honouring individual choice. This perspective aligns with two key principles in bioethics: autonomy and dignity.
Autonomy refers to a person's right to make decisions about their life, health and well-being. It emphasizes the ability to think independently and to choose from various options without external pressure. An autonomous person possesses the freedom to determine what is best for themselves. (Westphal et al., 2019)
The right to euthanasia is also connected to the principle of dignity. Respect for a person's autonomy supports the idea that each human being has inherent dignity, which means individuals should be treated as ends in themselves and not merely as means to fulfil the needs of others. Recognising individual autonomy requires acknowledging the ethical and social diversity in today’s society.
According to Kant, autonomy is essential to understanding human dignity. Denying the option of euthanasia undermines a person's dignity. If dignity relies on the ability to make choices, then denying the right to choose contradicts the principle of dignity. (Kant, 1785)
Nietzsche provides an alternative viewpoint on this issue. He argues that sick individuals may be perceived as burdens to society. In certain situations, living longer might even be considered inappropriate, especially if a person becomes entirely dependent on medical care after losing a sense of purpose. Nietzsche claims that it is better to "die proudly when it is no longer possible to live proudly." (Nietzsche, 2008) In this context, euthanasia can be viewed as a means of liberating individuals from complete medical dependence, suggesting that such a state can strip away both the meaning of life and the right to life itself.)
Euthanasia: Question of State-Guided Decision or Individual Liberty?
After discussing the background of the concept of ‘euthanasia’ and how it is embedded in the philosophy of ethics, let us understand the ongoing debate that centres on whether the decision to allow euthanasia should be made by state authorities or if individuals should have autonomy over their own lives.
When we look at Plato's Republic, it turns out to be one of the first, foundational philosophical texts to specifically argue that a city governed by reasonableness should actively kill individuals with intellectual and physical disabilities because such individuals embody injustice as the lack of order. It implies that according to Plato, the authority lies with the city-state to eradicate individuals who lack the normative conception of human embodiment (i.e. rational and able-bodied), thereby justifying euthanasia for such individuals. (Byrne, 2000)
While Plato’s perspective on euthanasia centres on the perceived societal benefits of eliminating those deemed as ‘injustices,’ the discourse takes a darker turn with Thomas Hobbes. Hobbes critiques the notion of self-destruction and euthanasia from a fundamentally different angle, viewing such actions as contrary to human nature and a threat to societal stability.
In his work ‘Leviathan’, Hobbes talks about self-destruction (death) in the following way: (Hobbes, 2008)
“A Law of Nature (lex naturalis) is a precept or general rule, found out by reason, by which a man is forbidden to do that which is destructive of his life, or taketh away the means of preserving the same, and to omit that by which he thinketh it may be best preserved” (Leviathan 14.3).
Hobbes believes that wanting to end one's life is contrary to human nature and therefore, irrational. As a result, he is critical of suicide and rejects euthanasia. He holds a very dark view of human nature and views the government as a necessary "mortal god" to maintain stability. Consequen8tly, he supports government intervention to prohibit suicide to protect society from itself.
This instance of state intervention regarding the denial of euthanasia can be illustrated by a case in which the parents of a 30-year-old man, who had been in a vegetative state for 11 years due to severe head injuries, approached the Supreme Court in August 2024. They were appealing for permission to grant passive euthanasia to their son. However, their plea was denied. (The Economic Times)
In contrast to Hobbes's bleak view of human nature and the necessity of governmental control, John Stuart Mill, an influential British philosopher of the nineteenth century, presents a fundamentally different philosophical outlook. Mill champions individual liberty and the right to self-determination, arguing that autonomy over one's body is an essential human right that should be upheld, even when it involves challenging the perspectives that Hobbes espouses.
Mill posited that every individual possesses the inherent right to be the guardian of their own body, a fundamental aspect of human nature that allows for the rational contemplation of ending one’s own life. (Arthur, 2001) In his seminal work, On Liberty, Mill argued that neither the government nor the majority of society holds the moral authority to infringe upon an individual’s freedom, as long as that individual does not harm others. He maintained that any actions or decisions that pertain solely to oneself (self-regarding actions) should be regarded as inviolable rights, deserving of protection from external interference. (Jackson, 2003) In light of the Common Cause vs Union of India Case (2005), a five-judge bench, on March 9th 2018 comprising Dipak Misra CJI, A K Sikri, A. M. Khanvilkar, D Y Chandrachud and Ashok Bhushan JJ held that the ‘right to die with dignity’ is a fundamental right. They ruled out that an individual’s right to execute advanced medical directives is an assertion of the right to bodily integrity and self-determination. It does not depend on any recognition or legislation by a State.
Together, these philosophical perspectives illustrate the complex debate surrounding euthanasia, with Plato advocating for state intervention based on a perceived moral order, Hobbes warning against self-destructive tendencies as a threat to societal structure, and Mill advocating for personal freedom and the right to choose, offering a more individualised approach to the question of life and death.
The debate on euthanasia raises significant ethical, philosophical, and practical issues that have persisted throughout history. This essay examines two main aspects: the historical evolution of ethical thought and the tension between state authority and individual autonomy. Central to the discussion are principles of autonomy and dignity, which underscore the individual's right to self-determination in life-and-death matters. Philosophers like Kant and Nietzsche advocate for personal choice, while Hobbes and Plato stress the need for societal order, illustrating the complexities that arise from conflicting perspectives.
In modern contexts, Mill’s defence of individual liberty emphasizes the importance of preserving personal agency amid moral and legal challenges surrounding euthanasia. Ultimately, the discussion highlights the ongoing conflict between individual rights and societal responsibilities. As societies advance, the question of who should decide on matters of life and death remains critical, requiring thoughtful ethical consideration informed by both historical and contemporary insights. This requires a balance between state intervention and personal autonomy as seen in the recent historic case by the Karnataka Health Department on January 30, 2025, where it issued an order to implement the Supreme Court’s ruling allowing terminally ill patients to die with dignity.
By Riddhi Agarwal
Riddhi Agarwal is a third-year undergraduate student at the Sri Venkateswara College, University of Delhi, pursuing Political Science Honours. She has a keen interest in International Relations, Gender Studies and Climate Advocacy.
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