Ethical Challenges of Euthanasia at the Intersection of Patient Autonomy and Care Contexts

Abstract

This narrative review critically examined the ethical challenges associated with euthanasia, focusing on the tension between patient autonomy and specific care contexts. Six studies published between 2015 and 2025 were analyzed, selected from the PubMed database, addressing euthanasia in vulnerable populations (minors, patients with dementia, prisoners) and from various professional perspectives (nursing, intensive care). The analysis revealed that although autonomy is a fundamental bioethical principle, its practical application faces significant limitations in vulnerable scenarios, requiring strict criteria to ensure ethical decisions. Additionally, the role of healthcare professionals emerged as critical mediators in the decision-making process, facing dilemmas between preserving life and respecting the patient’s will. The review also demonstrated that the traditional four bioethical principles are insufficient to fully address the complexity involved, indicating the need for complementary ethical approaches such as the ethics of care and solidarity. The findings highlight the importance of specific guidelines, ongoing ethical training for professionals, and further empirical research to deepen the understanding of euthanasia’s impact in different clinical contexts.