Mahsa Dini
M.A. in International Relations, Allameh Tabataba’i University
The concept of euthanasia, due to its ethical, legal, medical, and religious dimensions, represents one of the most complex issues confronting human rights. Factors such as access to modern medical technologies designed to prolong human life; the legacy of historically challenging laws that generally prohibit euthanasia; the phenomenon of population aging and the considerable number of individuals suffering from debilitating illnesses (such as AIDS); existing legal frameworks that challenge this concept; and the influence of religious institutions that regard life as sacred—perceiving deliberate termination of life as both a violation of faith and an intrusion upon divine matters—all render the study of euthanasia as a profoundly important and controversial subject.
Historical and Philosophical Background of Euthanasia
Debates about euthanasia trace back to antiquity. The term derives from the Greek words “eu” (good) and “Thanatos” (death). The ancient Greeks considered severe and unbearable illness a legitimate ground to request authorization for suicide from the state. Thinkers such as Socrates did not regard the suffering caused by illness as sufficient justification for the continuation of life. He argued that individuals afflicted with incurable physical diseases or moral corruption should be left free to die or end their own lives. Socrates himself, after being convicted of heresy, accepted death by drinking hemlock before the execution of his sentence. Moreover, Stoic philosophers were the first to recognize suicide in cases of illness or severe deprivation as permissible. Following the conquest of Greece by Rome, Stoic philosophy on death permeated the thought and law of that era. Consequently, Roman law accepted the termination of life in cases of insanity, incurable disease, or fear of disgrace (Akhtyrska & Grodetskiy, 2021: 132).
The Role of Judicial Systems
Euthanasia is generally regarded as an illegal act. However, an increasing trend toward its legalization—particularly within Western jurisdictions—can be observed. Serious political and legal efforts by advocates of euthanasia have pushed the issue to the threshold of legal recognition. As a result, laws permitting voluntary euthanasia have been enacted in a small number of countries, while domestic courts elsewhere have repeatedly faced the question of whether benefits associated with the “right to die” should be recognized (Chekhovska, 2919: 191). In this context, judicial systems must actively engage in interpreting fundamental rights. Courts are thus required to balance the right to life (Article 6, International Covenant on Civil and Political Rights) against the right to privacy and individual autonomy (Article 8, European Convention on Human Rights).
For example, in Albania, euthanasia-induced death constitutes a criminal offense and is deemed a violation of the right to life. Nevertheless, the country’s medical ethics legislation contains provisions allowing a form of intervention (known as passive euthanasia), with the decision left to the physician’s discretion. In Pretty v. the United Kingdom (2002), the European Court of Human Rights ruled that prohibiting assistance in suicide does not violate the right to privacy (Article 8), since the state is entitled to impose such prohibitions to protect vulnerable persons from abuse. Conversely, in Carter v. Canada (2015), the Supreme Court of Canada, invoking the “right to life, liberty, and security of the person,” held that the prohibition of physician-assisted dying was incompatible with the dignity of terminally ill patients and therefore invalidated it (Shala & Gusha, 2016: 15).
By contrast, in countries such as the Netherlands and Belgium, new legal frameworks have been created, with courts pioneering the recognition of voluntary euthanasia and obligating parliaments to adopt new laws. Typically, such laws permit euthanasia under conditions such as incurable illness with unbearable pain, repeated and informed consent of the patient, and confirmation by at least two independent physicians. It is worth noting that passive euthanasia (withdrawal of life-sustaining treatment) is widely accepted and considered more reasonable than active euthanasia (administration of lethal drugs). Even in countries where euthanasia remains prohibited, physicians sometimes invoke the “doctrine of double effect” (pain relief rather than intentional killing) to justify indirect euthanasia.
Euthanasia as a Human Right?
Proponents of euthanasia argue that respecting patients’ choices about how to die contributes to preserving their dignity. This perspective contrasts with rulings such as in R v. Martin, which emphasized the sanctity of life and denied any legal right to receive assistance in dying.
Additionally, several human rights–based arguments have been advanced in favor of recognizing euthanasia, including:
- Right to life and choice: It is argued that the right to life also includes the right to choose not to live. Accordingly, a request for euthanasia may be seen as consistent with this interpretation of the right to life.
- Personal autonomy and human dignity: The decision to end one’s life relates to dignity, autonomy, and fundamental security—all concepts protected under international human rights instruments. While the interpretation of the “right to liberty and security” has thus far been largely confined to freedom from arbitrary detention, the notion of personal autonomy could influence the future development of human rights.
- Right to privacy: Article 8 of the European Convention on Human Rights (right to respect for private life) has been suggested as a foundation for defending a patient’s request for assistance in dying. The European Court of Human Rights has also acknowledged that prohibitive laws may interfere with this right. Nevertheless, this right is not absolute and is subject to restrictions necessary to protect health, morals, or the rights of others in a democratic society (as in Article 8(2) of the Convention and Article 17 of the ICCPR).
- Right to non-discrimination: Under Article 19 of the European Convention / Article 21 of the Charter of Human Rights, it is argued that prohibiting physician-assisted suicide disproportionately affects individuals with severe physical or psychological disabilities who are unable to end their lives independently. However, the European Court has accepted that such distinctions may be justified if compelling reasons exist (such as the protection of vulnerable persons). On the other hand, arguments based on freedom of thought and conscience (Article 9 of the European Convention) or on the prohibition of cruel and degrading treatment (Article 3) have generally been less accepted in the euthanasia context.
Key Challenges and Considerations
Current euthanasia laws are primarily designed to protect human life—especially that of vulnerable groups such as the elderly, the mentally ill, and those under external pressure—and to prevent abuses by physicians, families, or institutions. At the same time, euthanasia raises deep philosophical, religious, and social conflicts about the value and meaning of life, the virtue of enduring suffering, and entrenched social taboos against suicide, which human rights law alone cannot resolve.
Euthanasia regulations must include psychological evaluations and assessments of the absence of external pressure, since economic, social, or family factors may push patients toward choosing death. Concerns also exist about possible abuses, such as reducing euthanasia to a cost-effective solution for healthcare systems, expanding eligibility to psychiatric patients or elderly individuals without genuine consent, or rising cases of euthanasia among those with depression or dementia.
Furthermore, euthanasia raises transnational challenges, such as migration from countries prohibiting euthanasia to those permitting it, which exposes inequalities in access to the “right to die.” The lack of a universal definition of euthanasia, combined with cultural and religious dimensions of acceptance, places the issue under ongoing scrutiny and contestation.
Conclusion
Despite the general prohibition of euthanasia, a growing trend toward legalization is visible, particularly in European states. National and international courts (such as the European Court of Human Rights) are frequently confronted with claims concerning the “right to die.” Although international human rights law does not explicitly recognize a right to die as an independent right, principles such as personal autonomy and privacy provide argumentative space for its possible future recognition. Accordingly, recognition of such a right in some states will require robust legal frameworks with safeguards to prevent abuse and to protect vulnerable persons. Ultimately, while human rights play an important role in shaping this debate, they cannot fully address the profound ethical, religious, and social dilemmas raised by euthanasia. Hence, disputes about the value of life and the endurance of suffering will remain fundamental questions beyond mere legal resolution.
References
- Chekhovska, I. V., Balynska, O. M., Blahuta, R. I., Sereda, V. V., & Mosondz, S. O. (2019). Euthanasia or palliative care: legal principles of the implementation in the context of the realization of human rights to life. Wiad Lek, 72(4), 677–81. From: https://www.academia.edu/download/87065460/wlek201904136.pdf#page=171
- Shala, I., & Gusha, K. (2016). The debate over Euthanasia and human rights. European Scientific Journal, 12. From: https://core.ac.uk/download/pdf/328025369.pdf
- Akhtyrska, N. M., & Grodetskiy, Y. V. (2021). The right to life from the point of view of personal autonomy in decision-making on euthanasia (review of the ECHR practice and the legislation of selected countries). Wiadomości Lekarskie, 3108. From: https://www.academia.edu/download/101421226/wlek202111206.pdf#page=252
