Active euthanasia is defined as the act of killing oneself. Passive euthanasia is the act of killing another. The term "euthanasia" is defined as the act of killing painlessly in order to end suffering from an incurable or hopelessly debilitating condition. In that sense, the act gains acceptance, as it is considered to be a justifiable premature death, when allowing a natural death would involve horrific suffering for an extended period, or would involve a prolonged life with inability to gain an acceptable quality of life.
The problem today, is first that euthanasia is considered a crime. Second, some individuals want euthanasia upon receiving a diagnosis of a terminal condition which could be treated and possibly even put into remission. Third, some societies and individuals consider killing children or the elderly who have disorders that are neither completely debilitating, nor the cause of prolonged suffering because they present economic or care burdens. Fourth, individuals with untreated emotional conditions, such as severe depression, want to die rather than to tolerate the treatment that would alleviate their symptoms.
Active euthanasia can come in the form of advance directives, which include orders to not engage in extraordinary procedures or to resuscitate when life supporting bodily functions have stopped.This applies to those who do not want extreme measures taken in order to prolong their lives in the event of major incurable and untreatable illness, horrific accident or massive injury.
The problem today is that doctors are compelled to use extraordinary technology to prolong life, then to adhere to strict ethical requirements to not withhold life sustaining care, when they know that the patient has a viable life to sustain. There are strict ethical and legal requirements to "do no harm", where removal of life support would definitely cause death. The individuals who have the legal authority to make such decisions for another are often at odds, have varying levels of emotional stability or judgment, and can engage in lengthy legal and interpersonal battles over whether to withhold or to maintain life supporting procedures.
This is how new technologies make it more difficult to determine whether an act will serve only to end exceptional life support, or to end life, itself. In the back of everyone's mind lies the well known case where life support was pulled and the person demonstrated an ability to live on his or her own, and even recovered from their coma or illness. There are also the horrific cases where it was never known for sure whether an individual wanted to live indefinitely with an effectively dead brain, or to have the extraordinary support that keeps a "brain death" patient in an indefinite state of suspension between life and death.
Throughout history, euthanasia served to end the needless suffering of mortally injured or diseased individuals, seriously debilitated infants and children, and those who suffered from causes for which there was not enough knowledge for healing or helping them. Euthanasia was used when group survival under extreme circumstances and conditions was jeopardized by having to carry and to care for the sick and injured.
Before our extreme capacities to prolong life, most severe illness, accident, and injury led to relatively quick deaths from lack of care, but various lethal or serious poisons and painkillers were also available to alleviate the pain. When those were unavailable, some other method to quickly end suffering without pain, such as quickly severing vital arteries, were used.
The hospice method of alleviating pain, while allowing a natural death from terminal and long lasting illness, is the best alternative to euthanasia that medicine has to offer today. Otherwise, without advance directives, it can be an ongoing financial, legal, or medical ethics battle in deciding how to choose between ending the suffering or the prolonged state between death and life in the most humane and ethical ways possible. In cases where a decision to end suffering before it even starts, as in the case of wanting euthanasia as soon as a diagnosis is received, there should be no support for what is essentially suicide or murder. Morally and ethically, an individual should try to fight the disorder until either the hospice method or passive euthanasia is supported.