Euthanasia

Practices of euthanasia have been found throughout the cultures of the ancient Greeks, GrecoRomans, Judeo-Christians, and early modern times to the present-day developed world. A common form of euthanasia is traced to the Greek roots eu (good) and thanatos (death), which have been variously rendered over the centuries as “heroic death,” “noble death,” and “good death.” The idea of a “good death” as painless, peaceful, dignified, and within the control of the dying individual has played a central role in both the reception and understanding of the practices of euthanasia in the contemporary United States and other developed nations. The main antecedents of the medicalmoral-legal context for contemporary understandings of euthanasia are discussed in this entry, followed by a review of modern controversies.

Ancient Greek and Greco-Roman Worlds

Ancient Greek attitudes toward death evolved with conceptions of euthanasia as a good death. Homeric heroes are depicted accepting death as an unavoidable evil. Acceptance of battlefield death was a fact of heroic life, and the resignation toward death the highest expression of respect for heroic values. Concerned with his own glory, the hero abjured shame and met his fate in a good death, which was essential to his fame. Heroic death gave no place to doctors to assist the dying in their last moments, and no confirmation of death was necessary, for the hero died his own good death. The essential component of euthanasia in the hero's attitude toward the evil of death was his modeling of a good death crowning a good life.

Death in the age of the Greek city-state acquired a social significance for the commonwealth, which glorified individual solidarity in defense of the [Page 435]state, and associated such nobility in dying for a greater good with heroic recognition and honor. Cooperative virtues supplanted competitive virtues of the older Homeric society. For a life of happiness lived in a flourishing city-state, the ultimate individual contribution to the well-being of the polis was to have sacrificed life in its name. Euthanasia, thereby, elevated the merits of citizenship and overshadowed the demerits of the individual in the golden age of community values exemplified by the city-state.

Medicine held a prominent place among cultural achievements in the era of city-states, with the influence of the Hippocratic school often memorialized in modern times. Characteristic of the Hippocratic attitude toward sickness and death was the orientation toward enumerating various etiologies of diseases via observation of symptoms of patients. Employing rational explanation to discern the causes of sickness distinguished these doctors as forebears of practitioners of scientific methods and principled investigation in the acquisition of knowledge of humanity. The Hippocratic practitioner, however, seems to have played little if no part in attempting to relieve the suffering of those who were fatally ill. Concern for the indicators of death was primarily pragmatic in that the doctor could prognosticate death and factor this into a decision of whether to accept a patient who was beyond the help of the medical art's limited resources.

Palliative care, in the modern sense of ensuring a gentle death, was not emphasized in ancient medicine. Nevertheless, contemporary medicine's appeal to a Hippocratic injunction to doctors to not give lethal potions to patients even if requested by patients is commonly referenced in discussions of euthanasia. This idea may be an inaccurate gloss of one school's code of conduct, whose actual context and concern was to ward off a criminal role for the doctor in the surreptitious killing of a patient at another's request (e.g., a family member's request). Even so, the Hippocratic school was only one of among many much more naturalistically oriented schools whose practitioners were less reluctant to assist those individuals who had already chosen a good death in suicide.

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