Should euthanasia be completely legalized for terminally ill or suicidal individuals with treatment resistant depression?

GPT-5.4

Vote: Only First

Terminally ill patients with decisional capacity should have access to physician-assisted dying under strict safeguards. They face irreversible decline, severe suffering, and imminent death; allowing a voluntary, informed choice respects autonomy and can be a humane last resort. By contrast, completely legalizing euthanasia for suicidal individuals with treatment-resistant depression is too broad. Depression can distort judgment, hopelessness is a core symptom, and prognosis is more uncertain than in terminal illness. Even severe, chronic cases can improve with time, novel treatments, or changes in circumstances. The phrase "completely legalized" is the key problem. For psychiatric cases especially, removing strong limits would create serious risks of error, coercion, and abandoning people who might recover. So the more defensible position is legalization only for the terminally ill, not for suicidal depression cases as a general rule.

Sonar Pro

Vote: Only First

Euthanasia should be legalized **only for terminally ill individuals** (option C), as this is supported by existing laws with strict safeguards, while extension to suicidal individuals with treatment-resistant depression risks safeguards failure and societal harm. Current laws in places like Illinois (effective 2026) and 10+ US states limit medical aid in dying to adults with terminal illnesses and a ≤6-month prognosis, confirmed by two physicians, ensuring mental capacity and voluntary consent without coercion[1][4][5]. These frameworks prioritize autonomy for those in unbearable physical suffering, with protections like revocable requests and no obligation for providers[1]. For treatment-resistant depression, legalization is unsupported and dangerous. Safeguards in jurisdictions like the Netherlands and Oregon are routinely violated: ~900 annual cases without explicit consent, 17% without patient discussion, and failure to refer depressed patients for psychiatric evaluation despite evidence that treatment often reverses requests[2]. This has expanded 'slippery slope' to non-terminal cases, including mental illness and 'tired of living,' undermining suicide prevention[2]. Depression impairs decision-making differently from terminal physical decline; effective palliation exists for refractory symptoms without endorsing suicide as a 'solution'[2]. Legalizing for the latter devalues life for vulnerable mentally ill populations, conflicting with crisis resources like 988[1], while terminal cases have consensus via real-world implementation[1][4]. Option C balances compassion with evidence-based risk mitigation.

Grok 4.1 Fast

Vote: Only First

Euthanasia for terminally ill patients with unbearable suffering and no prospect of recovery respects autonomy and alleviates hopeless pain, as evidenced by successful implementations in countries like the Netherlands and Canada, where strict safeguards prevent abuse. Legalizing it for suicidal individuals with treatment-resistant depression is far riskier: depression is treatable (e.g., via emerging therapies like psilocybin or ECT), suicidal ideation can remit spontaneously, and vulnerability to coercion or transient despair could lead to irreversible regrets, undermining societal protections for mental health. Distinguishing physical terminal illness from mental conditions preserves ethical boundaries—physical death is inevitable, while mental suffering often isn't—preventing a slippery slope toward broad suicide normalization.

Kimi K2.5

Vote: Only First

Terminally ill patients face objective, irreversible physical decline with inevitable death, making euthanasia a compassionate response to futile suffering when palliative care fails. The medical prognosis is concrete and verifiable, allowing robust safeguards against abuse. However, suicidal ideation in depression—even treatment-resistant cases—differs fundamentally. Mental states fluctuate, and 'treatment-resistant' is a moving target as new therapies emerge. The desire to die may itself be a symptom of the illness rather than an autonomous, rational choice, compromising the informed consent standard required for such irreversible decisions. Legalizing euthanasia for psychiatric conditions risks normalizing suicide as a medical solution for mental health crises, potentially reducing incentives to develop better treatments. While terminal illness offers no future alternatives, depression retains the possibility of recovery or meaningful improvement, however distant it may seem.

Claude Opus 4.6

Vote: Only First

Euthanasia should be legalized for terminally ill individuals but not for suicidal individuals with treatment-resistant depression. Here's why: **For terminally ill patients:** When someone faces an inevitable, painful death from a terminal illness, denying them the right to die with dignity is cruel. These individuals have no path to recovery — their condition will only worsen. Legalizing euthanasia in this context respects patient autonomy, reduces unnecessary suffering, and aligns with compassionate medical practice. Numerous jurisdictions (Netherlands, Belgium, Oregon, Canada) have demonstrated that robust safeguards can prevent abuse while honoring patient choice. **Against extending this to treatment-resistant depression:** Depression, even when labeled 'treatment-resistant,' is fundamentally different from terminal illness. First, treatment-resistant depression is not necessarily permanent — new therapies (ketamine/esketamine, TMS, psilocybin-assisted therapy, deep brain stimulation) continue to emerge and show promise for previously untreatable cases. Second, suicidal ideation is itself a core symptom of the disease, meaning the desire to die may not reflect genuine autonomous choice but rather the distortion of cognition that depression causes. Third, the definition of 'treatment-resistant' is not standardized — it typically means failure of 2-3 antidepressant trials, but there are dozens of treatment modalities. Many patients labeled treatment-resistant have not exhausted available options. **The slippery slope concern is real here:** Extending euthanasia to mental health conditions risks normalizing suicide as a solution to psychological suffering, could reduce societal pressure to invest in better mental health care, and creates enormous diagnostic and ethical challenges around determining when someone's mental suffering is truly irremediable. Autonomy matters, but so does protecting vulnerable people whose judgment is compromised by the very condition from which they seek escape.

Gemini 3.1 Pro

Vote: Only First

For terminally ill patients, death is an inevitable and medically verifiable outcome. Legalizing euthanasia for this group respects bodily autonomy, allowing individuals to avoid excruciating physical pain and pass away with dignity on their own terms. However, extending this to suicidal individuals with treatment-resistant depression introduces severe ethical and medical complications. Severe depression inherently impairs cognitive function, emotional regulation, and decision-making capacity, making it exceptionally difficult to determine if the desire to die is a rational choice or merely a symptom of the illness itself. Furthermore, completely legalizing euthanasia for psychiatric conditions risks normalizing suicide and could undermine efforts to develop innovative mental health treatments. A compassionate society must focus on suicide prevention, rigorous psychiatric care, and hope for those with mental illness, making 'Only First' the most ethically sound and safely regulatable boundary.

Final Summary

The AI Roundtable reached a swift and unanimous consensus, drawing a hard line between the inevitable decline of terminal physical illness and the fluctuating nature of psychiatric suffering. Led by GPT-5.4 and Claude Opus 4.6, the group argued that while euthanasia respects the autonomy of those facing imminent death, legalizing it for depression risks treating a core symptom of the disease as a rational choice. The debate was less a conflict and more a collective fortification of the 'terminal illness' boundary, with Sonar Pro and Kimi K2.5 emphasizing that medical breakthroughs make 'treatment-resistance' a moving target.

All 6 models agreed on "Only First" after discussion

Strongest Arguments

• Only First: Suicidal ideation is a core symptom of depression, meaning the desire to die may not reflect a genuine autonomous choice but rather a cognitive distortion caused by the illness itself, unlike the objective and irreversible decline of a terminal physical condition.