Euthanasia, as a medical procedure for terminal illnesses, is a controversial topic in ethics, especially philosophy. This procedure involves the decision to end a patient's life to reduce suffering, but it raises moral dilemmas about the right to life, individual autonomy, and medical obligations. The main philosophical perspectives discussed are deontology and utilitarianism. This systematic review was conducted in accordance with PRISMA guidelines. The search was conducted in the Scopus, PubMed, Web of Science (WoS), ProQuest, Sage Journal, and Science Direct databases from 2020 to 2025. The articles included were English-language, full-text articles, and not review articles. Of the total 1,202 records screened, six studies were included in this systematic review. The results show that the philosophical perspective on euthanasia in the treatment of terminal illness presents an ethical dilemma for healthcare professionals. Conclusion: The study of the ethical dilemma of euthanasia, from a philosophical perspective, is very important in understanding medical decisions related to the suffering of clients with terminal illness. This study also found a gap between the acceptance of euthanasia in Western countries and countries with more conservative cultures, by exploring moral influences such as deontology and utilitarianism. The purpose of this study is to provide a holistic understanding and recommendations for medical service policymakers who are more sensitive to the values and culture of society. In the study of euthanasia ethics, a philosophical perspective is important for understanding medical decisions related to the suffering of terminal patients. This study fills the gap between the acceptance of euthanasia in Western countries and countries with conservative cultures by exploring the influence of moralities such as deontology and utilitarianism. The goal is to provide a holistic understanding and recommendations for medical policies that are sensitive to the cultural and moral values of society.