Articles’ Claims
The two presented articles deal with the issue of euthanasia in opposite ways. Ewan C. Goligher and his colleagues state in the beginning on behalf of the World Medical Association (WMA) that they have always opposed these invasions and considered them unethical (Goligher et al., 2019). Their response to the controversial question of the patient’s right to death is straightforward and negative. The main reason for the rejection of euthanasia is that it contradicts the essence of health care and the physician’s role in treatment and cure. The WMA representatives believe that euthanasia “fundamentally devalues the patient, … puts patients at risk, … totally lacks evidence as ‘medical treatment” (Goligher et al., 2019, p.35). Moreover, they argue that euthanasia acceptance will confuse boundaries between palliative care and end-of-life care practices that intend death.
Calabro and colleagues, on the opposite, consider the appropriateness of end-of-life decisions from a positive perspective on the patient’s right to die. They emphasize the notion of the dignity of human life, that is, “everyone has the right to a worthy death” (Calabro et al., 2016, p.12). They place this notion in the paradigm of patient-centered medicine, arguing that, indeed, the decision to interrupt life-sustaining therapies is the most suitable way to support individual patients’ needs.
Background
Discussion of permitting or prohibiting euthanasia has been continuing for a long time in many countries. Both views have strong advocates, and a compromise between them seems unlikely. Euthanasia in the legal sense can be defined as the deliberate deprivation of a hopelessly sick person’s life to save them from suffering. According to the methods of application, there are two main types of euthanasia: “active” (positive), which consists in performing certain actions to accelerate the death of a hopelessly ill person, and “passive” (negative), the meaning of which is the rejection of measures that prolong the life of such a patient (Dintcho, 2020). In the article by Goligher et al. (2015), this division is presented as euthanasia and physician-assisted suicide. In the theory of human rights, there is no explanation as to whether the right to life provides for the use of such a right as an unauthorized departure from life.
According to the adherents of this position, the main criterion for refusing to use euthanasia is the hope that it will be possible to defeat the disease. Euthanasia is often opposed by official organizations that reflect society’s point of view and the state on this issue, while supporters of euthanasia, as a rule, represent civil society. They include non-governmental organizations that defend the rights and interests of individuals and social groups.
The Controversy from a Theoretical Perspective
If one applies the social constructivist paradigm, one can find that each side (supporters and opponents of euthanasia) acts within the framework of various rhetorical idioms, and sets its own system of meanings. An approach of rhetorical deconstruction focuses on the analysis of the text and allows a researcher to reconstruct the meanings with which a social problem is endowed and to describe the moral order in which it is inscribed (Miller & Holstein, 2017). The same social problem may have different semantic connotations.
Proponents of euthanasia act within the rhetoric of empowerment in making their claims. There is an appeal to such human rights as “the right to life” and “the right to death,” which are assigned the same meaning for the individual. The discourse is full of such categories as “the right to die with dignity,” “the right to natural death.” It is emphasized that modern society has privatized the “natural” human right to control his own life (Lefebvre, 2018). It is necessary to “return” this right to a person, especially in situations of an incurable disease (for example, cancer), when he is experiencing unbearable suffering, or in situations of artificial life support (loss of brain function) (Calabro et al., 2016). The discussion of euthanasia problematizes the human right to life and death, sharpening the contradiction between the individual and society in this matter. The empowerment rhetoric is more characteristic of euthanasia supporters, whereas its opponents set the rhetoric of loss (Dintcho, 2020). The problem of euthanasia is associated with the devaluation of human life, violation of medical duties, and the loss of universal human values. Opponents of euthanasia often use the concepts of “murder,” “suicide,” “mercy killing” as a synonym for euthanasia, which gives and strengthens its morally negative connotation. Within the rhetoric of loss, euthanasia acts as a symbol of modern society’s devaluation of life.
Articles’ Arguments, Evidence, and Logical Fallacies
The main criterion to evaluate the article’s arguments is the combination of logical fallacies and a patient-centered paradigm in healthcare. Goligher et al. (2015) present their argument from the medical professionals’ community, thus making ad populum appeal. It does not correlate with the patient-centered approach wherein the patient’s desires and needs are the core of the treatment. Calabro et al. (2016) avoid this mistake and focus on dignity; however, their argument involves the “straw man”: they oversimplify and overgeneralize euthanasia opponents’ viewpoint making them all adversaries of human dignity. However, their argument is stronger since they stay at the core of the medical evidence, whereas Goligher et al. (2015) switch and substitute the notions. They state that euthanasia “totally lacks evidence as medical treatment” (Goliger et al., 2019, p.35). However, euthanasia cannot be logically put into the category of a treatment since it does not presuppose patients’ physical improvement.
Significance for a Broader Context
A social problem is not only rhetoric, discourse, but also politics – actions, interests that stand behind this rhetoric. The ways of its solution depend on what definition of a social problem will be accepted as the authoritative, dominant “version of reality”. It is essential to see who benefits from this or that view, who stands behind it, why the social problem is represented in this way.
The power groups (economic, political, religious, medical) have the right to define and typify social problems in the arenas of public discourse. In many European countries, the issue of euthanasia divides the political elite, which uses it, gaining “points” and popularity with their voters. The medical community is divided on the issue of euthanasia. Mainstream medicine opposes euthanasia, citing the doctor’s duty to save the patient’s life and the ability of medicine to help and alleviate suffering in all diseases (Goligher et al., 2019). However, modern medicine in a number of situations is not able to stop pain syndrome. Besides, there are still incurable diseases, before which doctors are powerless. For a long time, representatives of the medical profession made decisions about what life and death were. Currently, doctors are beginning to lose control over a person’s life: the choice in a situation of terminal illness becomes the patient’s right. Thus, the issue of euthanasia undermines the traditional systems of medical, religious, and state power that control all aspects of human life, including death and dying.
References
Calabrò, R. S., Naro, A., De Luca, R., Russo, M., Caccamo, L., Manuli, A., … Bramanti, P. (2016). The right to die in chronic disorders of consciousness: Can we avoid the slippery slope argument? Innovations in Clinical Neuroscience, 13(11–12), 12–24.
Dintcho, A. D. (2020). Should Active Euthanasia Be Morally and Legally Permissible?. Sound Decisions: An Undergraduate Bioethics Journal, 5(1), 1.
Goligher, E. C., Cigolini, M., Cormier, A., Donnelly, S., Ferrier, C., Gorshkov-Cantacuzène, V. A., … Quinlan, J. (2019). Euthanasia and physician-assisted suicide are unethical acts. World Medical Journal, 65(1), 34–37.
Lefebvre, A. (2018). Human Rights and the Care of the Self. Duke University Press.
Miller, G., & Holstein, J. A. (2017). Constructionist controversies: Issues in social problems theory. Routledge.