Historical Review of Euthanasia. From Ancient Times until before Modern Times

Abstract

The historical review of euthanasia shows the pivotal role played by Christianity in the perceptions and attitudes towards it. In ancient Greece and Rome, euthanasia was rejected by medicine, but philosophy and ethics supported it as an attitude to life. Euthanasia was synonymous with an honorable and good death, and as a means of avoiding the sufferings that old age might bring. These attitudes and perceptions changed with the establishment of Christianity. Euthanasia was characterized as a forbidden act and as an insult to God against the gift of life that was given to man.

Keywords:euthanasia, historical review, ancient Greece, Rome, Christianity, Middle Ages.

INTRODUCTION

The concept of euthanasia, placed at the intersection of life and death, has been a part of human existence since ancient times and continues to be a relevant and controversial issue. This interdisciplinary topic has sparked intense debate not only in the various fields of science it encompasses, but also in the diverse scientific perspectives held by practitioners of Medicine, Law, Moral Philosophy, Theology and Psychology. These discussions highlight the significant social, economic and political implications associated with euthanasia.

The topic of euthanasia has been a subject of concern to humanity since ancient times. The concept of euthanasia is a controversial one, intertwined with the mysterious nature of life and death. It has raised deep concern in various scientific disciplines. Euthanasia, a topic that falls under the umbrella of bioethics, extends beyond the boundaries of a single scientific field. It includes jurisprudence, sociology, theology and politics, and has direct relevance to the fields of medicine and psychology. However, it is in the realm of ethics where the impact of euthanasia really resonates. This contemporary dilemma challenges long-held moral assumptions and values, shaking the foundations that support any social system or practice that lacks a solid moral framework. In this context, the present historical review was developed.

Euthanasia in ancient Greece and Rome

The concept of euthanasia has been a topic of contemplation for humanity since the dawn of organized societies. The fragility of human existence has always forced individuals to contemplate both life and death. The roots of euthanasia can be traced back to ancient Greece and it is interesting that the term itself remains unchanged, retaining its original Greek origin as it is used in various modern scientific disciplines (1).

As mentioned above, the term “euthanasia” has its roots in ancient Greece and it is derived from the combination of “eu-” (å.-) as a prefix, meaning good or happy, and “thanatos” (èÜíáôïò), meaning death. This term included the idea of a peaceful, painless and glorious death, representing the desire for a life full of happiness. Ancient Greeks believed that a blessed life could only be truly achieved at its end, as evidenced by Solon’s famous words to Croesus. A notable example of this concept of euthanasia was seen in the idealized end of Diagoras’ life. Overwhelmed with joy, Diagoras passed away as his three sons, who were famous Olympic winners, carried him proudly across the field on their shoulders as the crowd cheered (1).

The concept of euthanasia, in its current form, has been a matter of debate since ancient times, presenting two opposing views: those in favor and those against euthanasia. The medical field, guided by the Hippocratic Oath, stands firmly against euthanasia, leaving no room for ambiguity. The oath expressly states: “I will not administer a poison to anybody when asked to do so, nor will I suggest such a course”. This implies a commitment to refrain from giving lethal medicine, even if requested, and to refrain from giving such advice. On the other hand, Plato, with a contrasting perspective, supports his ideas in his work “Politeia”, stressing the importance of compassion for individuals who are powerless in the ordinary stages of life. He suggested that people who lacked physical and mental well-being should be allowed to die, as their existence is not beneficial to themselves or the city (polis) (2).

In ancient Greece, euthanasia was a common practice enforced by the government, driven by both eugenics and compassion for those who suffered. Infants, children, adults and the elderly with incurable chronic illnesses were often excluded from the families of many citizens. Death, either painless or painful, often served as a solution to this tragic situation. Essentially, euthanasia was proposed primarily for social reasons, as the death of a citizen that was bringing harm to the city was justifiable for the well-being of the remaining population, which would otherwise be deprived of such well-being, as well as for the relief it would bring to said individuals. In ancient Greece, eugenic euthanasia served a dual purpose, both social and political. The first aim was to relief the unfortunate infants and assist their families, while the political significance of this practice was demonstrated by the belief that it could prevent the potential harm of raising children who would be unable to contribute to a city’s efforts, i.e. military as seen in the case of Sparta (3). However, Sophocles expressed reservations about euthanasia in his play Philoctetes, which explored the right to die and strongly opposed the idea of euthanasia (2).

Aristotle, in evaluating suicide as an act of cowardice, suggested the implementation of legislation prohibiting the rearing of disadvantaged children, thus supporting eugenic euthanasia. Plato and Aristotle were in agreement that the purpose of the medical field was to support, restore, or maintain health, with any other matter, including euthanasia, falling outside its scope. Both philosophers also held that the choice to end life, in some cases where it was deemed preferable instead of living, was primarily a matter of ethics and politics rather than medicine.

During Roman times, euthanasia was embraced by many philosophers, particularly the Stoics, who often chose to end their lives by suicide, especially in old age. In Marseilles and Kos, there was a specialized center that provided a poisonous drink, similar to hemlock, to terminally ill people willing to end their suffering peacefully, with the permission of the city senate (4). Seneca, in his Epistulae ad Lucilium, expressed his belief that just as one chooses a ship for one’s journey or a house to live in, one should also have the freedom to choose the manner in which one dies as one reaches the end of one’s life. The Stoics’ pessimistic view of life played a role in the acceptance of euthanasia, especially in cases of accidents or misfortunes (5).

Euthanasia in Christianity times

Euthanasia is sanctioned in the Old Testament under specific circumstances, such as during times of persecution and when it indicates commitment to higher principles rather than contempt for life. On the other hand, suicide as a means of escaping a miserable existence, unrelated to persecution or war, is strongly condemned and brings shame to the surviving family members of the person who committed suicide (6).

In the New Testament, there are no recorded cases of euthanasia. Christian doctrine considers death not as a terrifying ordeal but as a passage to eternal life. According to this belief, the human body is considered a sacred dwelling place for the Holy Spirit, and it is the responsibility of individuals to care for and honor this dwelling place. Consequently, any form of euthanasia is strongly condemned, as human life is considered a divine gift, possessing inherent sanctity and incalculable value. The original meaning of euthanasia, referring to a calm and peaceful death, is often expressed as “finding peace at the end”.

Euthanasia in the Middle Ages

During the medieval period, social changes and historical circumstances shifted people’s interest towards their existence and way of life, considering the end of life exclusively as a divine conception. Catholicism expressly forbade suicide, which served as a last resort for some individuals, but was seen as an act of pride or cowardice by others. In an era where life was respected as an absolute good and questioning this directly affected the belief that it was a divine gift, concepts such as euthanasia had no place. Instead, euthanasia was considered a serious offense and those who attempted suicide faced punishment. Furthermore, Christian teachings that emphasized the sanctity and inviolability of human life, as well as the belief that suffering had an educational and soul-redemptive purpose that required patience, determination, and repentance, further strengthened this perspective (7).

CONCLUSION

Euthanasia is a topic that has raised concerns since ancient times. In ancient Greece and Rome, euthanasia was not only acceptable but was also seen as a moral and honorable act, both for the individual and for the community. It was a means of recovering and safeguarding honor and dignity. With the prevalence of Christianity, however, euthanasia was considered prohibited. Life was considered a divine gift that human beings had no right to renounce by bringing about their own death. Being synonymous with insulting God, euthanasia was both socially and morally rejected.

Conflicts of Interest

None declared.

Financial Support

This work was supported by the National and Kapodistrian University of Athens Special Account for Research Grants.