The Moral Dilemma of Euthanasia Through the Eyes of the Medical Society in Bulgaria

Abstract

Introduction: With the development of human society, the question of the value and inviolability of human life begins to occupy a central place in the various social strata and social structures. With the adoption of the Universal Declaration of Human Rights after the Second World War, the basic postulates protecting the right to inviolability of human life were laid. The question focused on euthanasia has been discussed in several European countries, such as Germany, Ireland, France, and Italy, leading to considerable interest in the medical community in Bulgaria.

Materials and methods: A prospective study was performed using approved sample cards, analyzing the general knowledge of the medical community in the Republic of Bulgaria about euthanasia and assisted suicide over a period of four months, between January 2023 and May 2023. In this process, 623 people were surveyed, and the questionnaire included several targeted questions through electronically generated samples on the Microsoft Forms platform. The target group had doctors with and without a specialty in various fields of hospital and pre-hospital care, dentists, and students from the fields of medicine and dentistry.

Results and discussion: The results show that the majority of medical professionals clearly state their positive opinion on the adoption of a law to legalize euthanasia in the Republic of Bulgaria, clearly taking into account the fact that the right to life has always been and always will be the most absolute and fundamental human right. Contrary to the above, it is implied that it is inevitably linked to a quality and fulfilling life without suffering. Identically, they also answered that a person should have the right to know exactly when to end his own life. The medical society in Bulgaria clearly shows its positive opinion regarding the idea that the different forms of euthanasia (active euthanasia and assisted suicide) should be defined as morally and legally permissible. Our research confirms the Bulgarian medical community's opinion that the subject of the problems of euthanasia and its legal regulation are already ripe for public discussion, similar to many other European countries.

Conclusion: The actual issue of euthanasia as a conclusion raises several questions related to the process of acceptance of standard algorithms for action in such cases where the same action is legalized by law. It also includes the process of acceptance of strict regulations by the countries for the so-called negative phenomenon "death tourism" and several other administrative actions related to the mandatory registration of every case of euthanasia, the implementation of mandatory consultations with a psychiatrist and psychologist for patients seeking euthanasia as the only possible option, and providing possible alternatives regarding their illness. This is the unchangeable cornerstone for standardizing the legalization process and acceptance of "good death" in Bulgaria. In its essence, euthanasia creates both a social and an ethical conflict in our modern society, appearing at the same time as a kind of "stress test" for the health system.

Keywords: active euthanasia; bulgarian medical society; euthanasia; mercy killing; moral dilemma; perspectives on euthanasia; physician-assisted suicide.

Figure 1. Answers by percentages to the first question: What effect would the legalization of euthanasia have on the doctor-patient relationship?

Figure 2. Answers by percentages to the second question: Do you think that the legalization of euthanasia would lead to a cascade of negative consequences associated with this act by significantly increasing the wish among patients to end their lives?

Figure 3. Answers by percentages to the third question: Do you think that quality palliative care for patients can be an alternative to euthanasia?

Figure 4. Answers by percentages to the fourth question: Do you think that every single patient can make a correct decision about the exact point at which they want to end their life by the method of euthanasia?

Figure 5. Answers by percentages to the fifth question: From a religious point of view, would you approve of any act of euthanasia?

Figure 6. Answers by percentages to the sixth question: In your opinion, has the development of medicine reached the level of fully diagnosing and treating terminal conditions and deriving an objective assessment of the duration and quality of life of terminally ill patients?

Figure 7. Answers by percentages to the seventh question: Do you think there is a difference between euthanasia and assisted suicide?

Figure 8. Answers by percentages to the eighth question: In your opinion, will the adoption of a law legalizing euthanasia help the vulnerable groups of society and those groups of people with various incurable disabilities and diseases?

Figure 9. Answers by percentages to the ninth question: Do you think the right to life is the highest, inviolable, and absolute human right?

Figure 10. Answers by percentages to the tenth question: Do you think that a person should have the choice of when and in what way to end his life?

Figure 11. Answers by percentages to the eleventh question: What do you think is morally and legally permissible as a possible action?