Ethical decisions about euthanasia should focus only on quality of life. Discuss.

Quality matters, but quality judgements require an account of equality

Quality-of-life reasoning is morally serious because it asks what continued treatment is like for the person rather than treating biological survival as the only good. A utilitarian can consider pain, lost agency and the effects on everyone concerned; Mill's defence of competent self-direction strengthens the claim that an informed patient should interpret their own burdens. Yet the word ‘only’ turns a relevant consideration into a dangerous master value. Quality may be judged by clinicians, relatives or institutions whose assumptions about disability and dependence differ from the person's own experience. If low predicted functioning makes a life less protectable, equal dignity becomes conditional on productivity or independence. The response is not to ignore suffering but to embed it within autonomy, capacity and justice. A request has different moral force when the person understands the options, is free from coercion and has genuine access to palliative and social care. This prevents society from presenting death as the efficient answer to neglected needs. Quality of life should therefore inform compassionate decisions, especially through the patient's perspective, but it cannot alone determine permissibility; the procedure by which the judgement is formed is part of the ethics.