Euthanasia in Utopian Literature

The word euthanasia, meaning a peaceful, gentle, or easy death, has been traced back to Roman times. But the "good" in a good death is obviously open to interpretation. Good for whom? The individual? The family of the individual? The society? And, who decides? The individual? The doctor? The family of the individual? The legal system? These questions are constantly raised throughout the literature with diametrically opposed answers given from the earliest times to the present. And, unfortunately, one word is used for all the positions, with two subcategories, voluntary and involuntary, both of which are perceived as good for someone.

Death is universal but whether or not a person should have a choice about when to die or voluntary euthanasia is deeply controversial.¹ Inducing such a death, primarily in cases of a painful terminal disease, appears to be largely a nineteenth-century invention while, of course, existing as a concept well before that.² Also, discussions of voluntary euthanasia raise related issues, suicide, involuntary euthanasia, and how eugenics has determined the criteria for involuntary euthanasia. Also, the fear of someone being putting to death for the convenience or advantage of the living has been the most prominent issue, and one must wonder if involuntary euthanasia, at least when consent was possible but not given, ever constitutes a "good" death. As simply a peaceful and painless death, the earliest use of the word was by Suetonius in the early first century, where in his life of Augustus he reports Augustus's position on death as that "on hearing that anyone had died swiftly and painlessly, he prayed that he and his might have a like euthanasia, for that was the term he was wont to use."³ In his De Augmentis Scientiarum [Advancement of Learning], Francis Bacon refers to this statement, commenting, "For it is no small fidelity which Augustus Caesar was wont so earnestly to pray for, that same Euthanasia … was not so much like death as like falling into a deep and pleasant sleep." And Bacon continued: "In our times the physicians make a kind of scruple and religion to stay with the patient after he is given up, whereas in my judgment, if they would be wanting in their office, and indeed to humanity, they ought to acquire the skill and to bestow the attention whereby the dying may pass more easily out of life. This part I call the inquiry concerning outward Euthanasia, or the easy dying of the body (to distinguish from that Euthanasia which regards the preparation of the soul)."⁴

The most explicit statement, generally ignored for sixty years, was that made in an 1870 speech to the Birmingham Speculative Club by Samuel D. Williams Jr., about whom little is known. Williams proposed:

That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anæsthetic as may by-and-bye supersede chloroform—as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.⁵

This was not, though, the usual practice and many doctors saw no need to act. In an 1887 book one doctor contended that "as long as there was proper medical care, there was no need to speed up death to relieve suffering."⁶ Still, Williams's position is in almost all respects the position taken by advocates of voluntary euthanasia since then, although it did not get much of an airing again until C. Killick Millard, the Medical Officer of Health of Leicester, gave the Presidential address to the Society of Medical Officers of Health in late 1931. There he said, referring to Bacon, that

the proposition merely is that individuals, who have attained to years of discretion, and who are suffering from an incurable and fatal disease which usually...