Euthanasia and assisted suicide

1. Voluntary Euthanasia

(The patient is competent and explicitly requests it)

✅ Why it might be considered good

  • Respects patient autonomy

    • A core medical ethics principle: competent patients should have a say in decisions about their own bodies and lives.

  • Relief from unbearable suffering

    • Some conditions cause severe physical or psychological suffering that cannot be adequately relieved, even with optimal palliative care.

  • Preservation of dignity

    • Some patients fear loss of independence or control more than death itself.

  • Honest end-of-life discussions

    • Can encourage earlier conversations about goals of care, advance directives, and palliative options.

❌ Why it might not be good

  • Conflict with ‘do no harm’ (non-maleficence)

    • Actively ending life may feel incompatible with the traditional role of a doctor as a healer.

  • Risk of subtle pressure or coercion

    • Patients may feel like a burden on family or healthcare systems, influencing their choice.

  • Capacity concerns

    • Depression, fear, or pain can impair decision-making, making it hard to ensure consent is fully informed and stable.

  • Impact on doctors

    • Moral distress and emotional burden for clinicians asked to participate.

Interview tip:

“Even when voluntary, it requires extremely robust safeguards to ensure decisions are informed, free, and enduring.”

2. Non-Voluntary Euthanasia

(The patient cannot give informed consent, e.g. coma, severe cognitive impairment)

✅ Why it might be considered good

  • Relief of suffering when recovery is impossible

    • If ongoing treatment only prolongs suffering with no realistic chance of improvement.

  • Acts in the patient’s perceived best interests

    • Based on prior wishes, values, or advance directives.

  • Avoids prolonged invasive treatment

    • Can prevent extended use of life-support that may not align with quality-of-life goals.

❌ Why it might not be good

  • No explicit consent

    • This is the most serious ethical concern — autonomy cannot be directly respected.

  • High risk of abuse or error

    • Decisions depend on others’ interpretations, which may be biased or incorrect.

  • Slippery slope concerns

    • Fear that expanding non-voluntary euthanasia could normalise ending lives of vulnerable groups.

  • Who decides?

    • Raises difficult questions about whether families, doctors, or the state should have that authority.

Interview tip:

“The absence of consent makes non-voluntary euthanasia ethically far more problematic and controversial.”

2-Minute Polished Interview Answer

Voluntary euthanasia, where a competent patient requests it, may be seen as ethically positive because it respects patient autonomy and can relieve unbearable suffering when other treatments have failed. Some patients also feel it preserves dignity at the end of life.
However, it is ethically challenging because it conflicts with the principle of non-maleficence — the duty to do no harm. There are also concerns about whether consent is truly free, as patients may feel like a burden or be influenced by depression or fear.

Non-voluntary euthanasia, where the patient cannot give consent, may be argued for when treatment only prolongs suffering and decisions are made based on prior wishes or best interests. It can prevent prolonged invasive treatment with no realistic benefit.
That said, it is far more ethically problematic because autonomy cannot be respected directly. There is a higher risk of error, bias, or abuse, and it raises serious concerns about who has the authority to decide to end a life.

Overall, euthanasia requires balancing autonomy, beneficence, non-maleficence, and justice. As a future doctor, I believe any discussion must prioritise safeguarding vulnerable patients, robust capacity assessments, and access to high-quality palliative care.”

MMI Answer

“Voluntary euthanasia may be seen as ethical because it respects autonomy and relieves suffering, but it risks undermining non-maleficence and may involve subtle coercion.
Non-voluntary euthanasia might aim to act in a patient’s best interests, but it is far more ethically concerning because consent is absent, increasing the risk of error or abuse.
In medicine, these decisions require careful balancing of ethical principles and strong safeguards.”

How would you respond to a patient wanting to take their life

“First, I would respond with empathy and take the concern seriously, making sure the patient feels heard and supported. I would calmly assess their immediate risk, including whether they have active suicidal thoughts or intent.

My priority would be the patient’s safety, so I would not leave them alone if I believed there was an immediate risk. I would involve the appropriate members of the healthcare team, such as a senior physician or mental health professional, and follow established protocols to ensure the patient receives urgent evaluation and care.

Throughout, I would communicate respectfully, reassure the patient that help is available, and make sure they are connected to the appropriate supports.”

Use phrase like “I would follow the clinical protocols” and “ I would involve senior clinicians” and “ i would respond with total empathy with no judgement”

Say things like “I understand the law about this topic in the UK so therefore would not try to talk them out of this”