Zainal Munir, Moses Glorino Rumambo Pandin and Sri Astutik Andayani
Volume6-Issue9
Dates: Received: 2025-09-24 | Accepted: 2025-09-27 | Published: 2025-09-30
Pages: 1393-1400
Abstract
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.
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DOI: 10.37871/jbres2194
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© 2025 Munir Z, et al. Distributed under Creative Commons CC-BY 4.0 
How to cite this article
Munir Z, Pandin MGR and Andayani SA. A Study of Ethical Dilemmas: A Philosophical Perspective on Euthanasia in the Treatment of Terminal Illness. J Biomed Res Environ Sci. 2025 Sept 30; 6(9): 1380-1387. doi: 10.37871/jbres2194, Article ID: JBRES2194, Available at: https://www.jelsciences.com/articles/jbres2194.pdf
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References
- Campbell S, Moola FJ, Gibson JL, Petch J, Denburg A. The Unspeakable Nature of Death & Dying During Childhood: A Silenced Phenomenon in Pediatric Care. Omega (Westport). 2024 May;89(1):88-107. doi: 10.1177/00302228211067034. Epub 2022 Jan 14. PMID: 35029516; PMCID: PMC11017694.
- Candee D, Puka B. An analytic approach to resolving problems in medical ethics. J Med Ethics. 1984 Jun;10(2):61-70. doi: 10.1136/jme.10.2.61. PMID: 6234395; PMCID: PMC1374943.
- Hazime M, Paudel S, Restum AA, Mnkana W. Infective Endocarditis in an Intravenous Drug User: Clinical Challenges, Ethical Dilemmas, and Multidisciplinary Management. Cureus. 2025 Jun 24;17(6):e86683. doi: 10.7759/cureus.86683. PMID: 40709151; PMCID: PMC12289317.
- Lu X, Huang H, Khoshnood K, Koniak-Griffin D, Wang H, Yang M. Ethical Decision-making of Health Professionals Caring for People Living with HIV/AIDS in Hunan, China: A Qualitative Study. Inquiry. 2022 Jan-Dec;59:469580221127789. doi: 10.1177/00469580221127789. PMID: 36444995; PMCID: PMC9716589.
- El Ali M, Licqurish S, O'Neill J, Gillam L. Truth-telling to the seriously ill child - Nurses' experiences, attitudes, and beliefs. Nurs Ethics. 2024 Aug;31(5):930-950. doi: 10.1177/09697330231215952. Epub 2023 Dec 21. PMID: 38128903; PMCID: PMC11370149.
- Oh SN, Kim YA, Kim YJ, Shim HJ, Song EK, Kang JH, Kwon JH, Lee JL, Lee SN, Maeng CH, Kang EJ, Do YR, Yun HJ, Jung KH, Yun YH. The Attitudes of Physicians and the General Public toward Prognostic Disclosure of Different Serious Illnesses: a Korean Nationwide Study. J Korean Med Sci. 2020 Dec 7;35(47):e401. doi: 10.3346/jkms.2020.35.e401. PMID: 33289368; PMCID: PMC7721562.
- Laabar TD, Saunders C, Auret K, Johnson CE. Palliative care needs among patients with advanced illnesses in Bhutan. BMC Palliat Care. 2021 Jan 9;20(1):8. doi: 10.1186/s12904-020-00697-9. PMID: 33422058; PMCID: PMC7797114.
- Perry KE, Dubé K, Concha-Garcia S, Patel H, Kaytes A, Taylor J, Javadi SS, Mathur K, Lo M, Brown B, Sauceda J. A, Wohl DA, Little S, Hendrickx S, Rawlings SA, Smith DM, Gianella . My death will not [Be] in Vain: Testimonials from last gift rapid research autopsy study participants living with HIV at the end of life. AIDS Research and Human Retroviruses. 2020;36(12):1071-1082. doi: 10.1089/aid.2020.0020.
- Ndukwe SO, Patel H, Shelton B, Concha-Garcia S, Dullano C, Solso S, Hendrickx S, Riggs PK, Villa TJ, Kaytes A, Taylor J, Little SJ, Lessard D, Arora AK, Costiniuk CT, Eskaf S, Smith DM, Gianella S, Dubé K. People with HIV at the end-of-life and their next-of-kin/loved ones are willing to participate in interventional HIV cure-related research. AIDS. 2024 Feb 1;38(2):235-243. doi: 10.1097/QAD.0000000000003754. Epub 2023 Oct 17. PMID: 37861674; PMCID: PMC10842373.
- Niedzwiecki MJ, Forrow LV, Gellar J, Pohl RV, Chen A, Miescier L, Kranker K. The Medicare Care Choices Model was associated with reductions in disparities in the use of hospice care for Medicare beneficiaries with terminal illness. Health Serv Res. 2024 Aug;59(4):e14289. doi: 10.1111/1475-6773.14289. Epub 2024 Feb 29. PMID: 38419507; PMCID: PMC11249828.
- Kanazawa J, Gianella S, Concha-Garcia S, Taylor J, Kaytes A, Christensen C, Patel H, Ndukwe S, Rawlings SA, Hendrickx S, Little S, Brown B, Smith D, Dubé K. Ethical and practical considerations for HIV cure-related research at the end-of-life: a qualitative interview and focus group study in the United States. BMC Med Ethics. 2022 Jan 11;23(1):2. doi: 10.1186/s12910-022-00741-8. PMID: 35012544; PMCID: PMC8748179.
- Tamsukhin PC, Bernardo RM, Eti S. Palliative care considerations for the older adults with HIV/AIDS: a clinical practice review. Ann Palliat Med. 2024 Jul;13(4):880-892. doi: 10.21037/apm-23-550. Epub 2024 May 9. PMID: 38735688.
- Grassi L, Folesani F, Marella M, Tiberto E, Riba MB, Bortolotti L, Toffanin T, Palagini L, Belvederi Murri M, Biancosino B, Ferrara M, Caruso R. Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders. Curr Psychiatry Rep. 2022 Jun;24(6):325-335. doi: 10.1007/s11920-022-01339-y. Epub 2022 Jun 9. PMID: 35678920; PMCID: PMC9203391.
- Lifshitz R, Bachner YG, Carmel S. Older adults' attitudes toward using Euthanasia at the end-of life: cancer vs. Parkinson's disease. Front Public Health. 2024 Jun 14;12:1393535. doi: 10.3389/fpubh.2024.1393535. PMID: 38947343; PMCID: PMC11211612.
- De Hert M, Loos S, Van Assche K. Euthanasia of a person with a psychiatric disorder does not violate the European Convention on Human Rights (Mortier v. Belgium [no. 78017/17]). Eur Psychiatry. 2022 Nov 10;65(1):e80. doi: 10.1192/j.eurpsy.2022.2342. PMID: 36352491; PMCID: PMC9724215.
- Leboul D, Bousquet A, Chassagne A, Mathieu-Nicot F, Ridley A, Cretin E, Guirimand F, Aubry R. Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests. Palliat Care Soc Pract. 2022 Jan 10;16:26323524211066925. doi: 10.1177/26323524211066925. PMID: 35036915; PMCID: PMC8755925.
- Lau AM, Wong EL. Attitude towards Euthanasia among Medical Students: A Cross-Sectional Study in Hong Kong. Int J Environ Res Public Health. 2022 Jun 23;19(13):7697. doi: 10.3390/ijerph19137697. PMID: 35805362; PMCID: PMC9265432.
- Ortega-Galán ÁM, Fernández-Martínez E, Ibáñez-Masero O, Ortiz-Amo R, Gómez-Beltrán MPA, Ruíz-Fernández MD. Attitudes of nursing students towards the legalization of euthanasia, end-of-life planning and the spiritual dimension: A quantitative study. Nurse Educ Today. 2023 May;124:105770. doi: 10.1016/j.nedt.2023.105770. Epub 2023 Feb 24. PMID: 36848698.
- Inglehart RC, Nash R, Hassan QN, Schwartzbaum J. Attitudes Toward Euthanasia: A Longitudinal Analysis of the Role of Economic, Cultural, and Health-Related Factors. J Pain Symptom Manage. 2021 Sep;62(3):559-569. doi: 10.1016/j.jpainsymman.2021.01.009. Epub 2021 Jan 22. PMID: 33493587.
- Panchuk J, Thirsk LM. Conscientious objection to medical assistance in dying in rural/remote nursing. Nurs Ethics. 2021 Aug;28(5):766-775. doi: 10.1177/0969733020976185. Epub 2021 Jan 11. PMID: 33427031; PMCID: PMC8366177.
- Moureau L, Verhofstadt M, Van Hoe C, Vandenberghe J, Van Audenhove C, Liégeois A. Discussing end-of-life care for persons experiencing severe and persistent mental illness: a qualitative study among stakeholders in Flanders. Ann Palliat Med. 2025 Mar;14(2):114-127. doi: 10.21037/apm-24-157. PMID: 40211737.
- Vadivelu N, Kaye AD, Berger JM. Essentials of palliative care. In Essentials of Palliative Care. 2013. doi: 10.1007/978-1-4614-5164-8.
- Acuñaa AMÁ, Moreno JCR, Neirab JL, Ribero OFG. Ethical principles and dilemmas in the discourse of health care practitioners involved with end-of-life care based on the Advanced Directives Document. Colombian Journal of Anesthesiology. 2023:51(1);1-11. doi: 10.5554/22562087.e1046.
- Liu G, Liu K. Ethical dilemmas and legal ambiguity in China: a chain mediation model linking suicide rumination, legitimization, and acceptance among acutely-ill adults. Front Psychol. 2024 Jan 30;14:1342798. doi: 10.3389/fpsyg.2023.1342798. PMID: 38352967; PMCID: PMC10863618.
- Picón-Jaimes YA, Lozada-Martinez ID, Orozco-Chinome JE, Montaña-Gómez LM, Bolaño-Romero MP, Moscote-Salazar LR, Janjua T, Rahman S. Euthanasia and assisted suicide: An in-depth review of relevant historical aspects. Ann Med Surg (Lond). 2022 Feb 11;75:103380. doi: 10.1016/j.amsu.2022.103380. PMID: 35242326; PMCID: PMC8857436.
- Fard Moghadam N, Hassani A, Khaninezhad, L. Exploring attitudes toward euthanasia in Iranian healthcare providers: A systematic review of influencing factors. Philosophy, Ethics, and Humanities in Medicine. 2025. doi: 10.1186/s13010-025-00186-y.
- Martins VSM, Santos CMNC, Bataglia PUR, Duarte IMRF. The Teaching of Ethics and the Moral Competence of Medical and Nursing Students. Health Care Anal. 2021 Jun;29(2):113-126. doi: 10.1007/s10728-020-00401-1. Epub 2020 Sep 17. PMID: 32944887; PMCID: PMC8106588.
