Comparing Euthanasia Regimes: Empirical and Normative Analysis

This dissertation explains why some countries have legalized euthanasia while others have not, and why some have opted for more or less permissive regimes. Chapter 1 provides a conceptual and terminological foundation. It clarifies several common terms in the literature on euthanasia and establishes two ideal-types of euthanasia regime, structured around the concept of informed consent: narrow and broad. Next, this dissertation undertakes a qualitative empirical investigation of euthanasia. Chapter 2 describes the euthanasia regimes of thirteen countries, identifies nine negative cases, and demonstrates that society-based variables are insufficient to account for differences in euthanasia policy. Chapter 3 examines the matter from the perspective of institutional variables. Whereas the literature on judicial review and legislated rights expects legislatures to reason about moral matters more soundly than courts, the opposite occurred with respect to euthanasia policy. To explain this discrepancy, this dissertation argues that the party system is an institutional variable with significant effects: legislatures in two-party systems reason more soundly than those in multiparty systems, at least with respect to euthanasia. Moreover, there are institutional features explaining why courts did not behave as poorly as expected. The final two chapters perform a qualitative assessment of court cases. Chapter 4 reviews three legal systems where the courts imposed euthanasia: Canada, Colombia, and Germany. It concludes that this jurisprudence is internally inconsistent (vacillating between the competing principles of autonomy and death as an objective good) and advances an impoverished, radically libertarian understanding of the constitutional principles of dignity and autonomy. Chapter 5 turns to two legal systems where the courts refrained from imposing euthanasia: the United States and European Court of Human Rights. These courts emphasize the historical and institutional reasons favoring judicial restraint, while avoiding substantive moral reasoning on the question of euthanasia. This dissertation contends that this trend is based on a false premise of moral neutrality and is also practically self-defeating, as it allows the judicial proponents of euthanasia to dominate the moral conversation.