Ethical Reflections on Euthanasia: Autonomy at Life's End

Recently, I was deeply moved by news of a severely ill patient who traveled to Switzerland for euthanasia. A young woman suffering from lupus erythematosus complicated by renal failure had to rely on dialysis to sustain her life, with an extremely poor quality of life. Eventually, she chose to say goodbye to this world through euthanasia in a foreign country. This incident made me deeply reflect: why didn't she have this choice in our own country?

For me, death need not only come passively; it can also be a right of personal choice under specific conditions. The significance of euthanasia lies in giving those who are suffering and have no hope of recovery an opportunity to end their lives autonomously and with dignity. Therefore, I sincerely support the legalization of euthanasia and would like to share some of my thoughts.

Death is Also a Right of Autonomy

Everyone has their own understanding of life and death. In our culture, life is viewed as a supremely precious treasure, and extending life is often considered the natural choice. But I also believe that when life reaches an irreversible point of suffering, choosing how to leave this world should be part of one's personal autonomy. Death is not just the end of life, but also an expression of personal will.

As some advocates point out, people not only have the right to live but also the right to end their lives under certain circumstances. Especially for those with terminal illnesses, whose lives are counting down and who are experiencing extreme physical and mental suffering, choosing to end life to escape pain is an exercise of self-rights and a preservation of life's dignity.

Such ideas are not new. More than a decade ago, Wang Xuan, the "father of Chinese laser typesetting," wrote a special request in his will: once his condition was beyond cure, he firmly requested euthanasia, unwilling to excessively consume social and family resources. His calmness and courage in facing the end of life remain moving to this day. This calmness is not a disregard for life, but rather seeing "dying with dignity" as an extension of "living with dignity." I believe that respecting one's choice about death is also respecting life itself.

Prohibition is Not the Solution; Regulation is the Way Forward

Of course, when euthanasia is mentioned, many people have concerns: what if it is exploited by criminals, or what if there are misuses or abuses? Some compare euthanasia to a "double-edged sword," potentially allowing suffering patients to find release but also potentially being used as a criminal tool by those with ulterior motives. These concerns are not without reason. Without regulation, euthanasia could indeed pose moral risks. However, I believe that mere prohibition cannot solve the problem; on the contrary, strict legal regulations are the way forward.

In fact, many countries that allow euthanasia have adopted extremely rigorous legislation to prevent risks. For example, the Netherlands, the first country to legalize euthanasia, has established legal thresholds such as minimum age requirements, multiple consents, medical certificates, and standard procedures. Belgium, Germany, and other countries have similarly attached almost stringent conditions when opening up euthanasia.

These experiences show that through detailed legal regulations, euthanasia can be strictly limited to operate within a specific scope, maximizing the prevention of potential abuse. As some scholars have said, only after euthanasia legislation can there be strong management of actual operations based on legal guidelines and strict regulations. In other words, through legislation, we can both satisfy the wishes of patients who truly need it and ensure that euthanasia always proceeds on a controllable, safe track, rather than evolving into an unregulated gray area.

Looking at our current approach to euthanasia, "outright prohibition" has not eliminated risks but merely covered up the problem. Ignoring the suffering of dying patients and depriving them of the right to choose can lead to more serious social consequences. Rather than prohibiting, regulating is the better approach—this is particularly prominent in the issue of euthanasia.

The Dilemma in the Legal Vacuum

Unfortunately, euthanasia in China currently exists in a legal vacuum. Active euthanasia or assisted suicide is still absolutely prohibited in our country, with any such act being criminalized, generally prosecuted as intentional homicide. In other words, if a doctor or family member helps relieve a patient's suffering in accordance with the patient's wishes, they will face legal charges of murder. While this strict legal stance is intended to protect the right to life from infringement, it also produces a consequence that cannot be ignored: those in desperate situations are often forced to choose more extreme and dangerous ways to end their lives when they have no other options.

There have been many heartbreaking cases in reality. In 2018, a woman in Taizhou, Zhejiang, who suffered from systemic lupus erythematosus and other serious illnesses, had long endured pain and was completely unable to care for herself. In desperation, she took poison to end her life. Her husband, daughter, and son-in-law were prosecuted for assisting suicide (intentional homicide) because they did not prevent or rescue her, and were eventually given suspended sentences. This tortured patient sought relief in such a resolute way, yet her family had to face trial—such tragedies are not isolated cases in reality and repeatedly trigger social discussions on the issue of euthanasia.

There are even more extreme cases: a patient with high paraplegia, with no hope for life, even hired someone to kill them, simply because they lacked the ability to end their own life. When I heard about this case, I felt incredibly heavy-hearted—how desperate and tragic it is for a person to need to resort to criminal means to "choose" death! These painful events reflect that in the absence of legal channels for euthanasia, severely ill patients often take more dangerous and undesirable paths to escape their suffering.

On the other hand, those who can afford it might choose to go abroad for euthanasia services. This is almost an impossible choice for families with average economic conditions and adds to the sorrow of patients having to end their lives in a foreign land. Whether it's illegal means domestically or being forced to go abroad, these dilemmas all call for the same question: should we seriously examine the necessity of legalizing euthanasia, so that those in desperate situations are no longer so helpless?

Expectations for Euthanasia Legislation

Based on all of the above, I have earnest expectations for future euthanasia legislation in China. I hope that one day, we can also, like some advanced countries, legally recognize euthanasia as a personal choice right in special circumstances, and set strict and clear implementation standards for it. In my vision, the legal conditions for implementing euthanasia should at least include:

• Hopeless Condition: Applicants for euthanasia must be diagnosed with terminal and incurable diseases, or be in extreme pain that cannot be alleviated, with a low quality of life and no possibility of improvement;
• Clear Personal Will: The request must be made by the patient themselves while of clear mind, after careful consideration, with multiple autonomous requests for euthanasia, and with prior written or video voluntary declarations, ensuring this is their persistent, consistent, and genuine wish;
• Medical Evaluation and Ethical Review: At least two independent senior doctors without conflicts of interest must evaluate and confirm the condition and prognosis, and the hospital's medical ethics committee or an independent third-party institution must review and approve, ensuring there is no deception, misjudgment, or external pressure;
• Strict Operational Procedures: Euthanasia must be performed by qualified medical personnel in designated places, following strict medical operational procedures (including necessary cooling-off periods, multiple confirmations of the patient's will, etc.), and conducted under the supervision of relevant departments, with the process being legal, transparent, recordable, and reviewable.

These conditions are less about restricting euthanasia and more about safeguarding life. Through such rigorous legislative design, we can both ensure that patients who truly need and voluntarily choose euthanasia can fulfill their wishes, and maximize the prevention of risks of euthanasia being abused. These conditions actually align with the safety measures adopted by countries like the Netherlands and Belgium where euthanasia has been legalized. It is evident that with proper system design, "dying with dignity" can be realized under the protection of the law, without evolving into something uncontrollable.

I hope that euthanasia legalization will eventually take steps forward in China. With the advancement of social concepts and medical standards, our views on life and death are also gradually changing. Since Zhao Gongmin, a committee member, called for euthanasia pilot programs at the National People's Congress in 2006, he said: "The legalization of euthanasia in the legal system is just a matter of time." I think this judgment is reasonable. As more and more people begin to face death squarely and understand others' pain, we will eventually build a consensus: to allow those lives that are hopeless and suffering to have the right to end peacefully and with dignity.

As an ordinary person, I sincerely look forward to seeing the dawn of euthanasia legalization appear on the horizon of our country in the near future. This is not only respect for personal autonomy but also the ultimate tribute to the value and dignity of life. Everyone will eventually die, and what we can do is to allow those who cannot choose to live to at least choose how to say goodbye. May the living be treated with dignity, and the deceased rest in peace as they wished.