The debate over voluntary euthanasia extends far beyond terminal illness to encompass unbearable chronic or psychiatric suffering. Proponents argue that respecting autonomous bodily sovereignty demands permitting it when safeguards (multiple medical opinions, waiting periods, psychiatric evaluation, capacity assessment) minimize abuse. Denying it forces individuals into prolonged torment against their informed will, violating principles of liberty central to liberal ethics. Secular frameworks prioritizing experiential well-being over biological sanctity find no compelling override once abuse risks are contained—Oregon-style regimes demonstrate stability for decades, while Dutch/Belgian expansions reflect cultural choice rather than inevitable slide. Empirical data show palliative care often improves post-legalization (the “Dutch paradox”), suggesting prohibition diverts resources from suffering relief. Critics counter with intrinsic prohibitions: intentional killing of innocents treats persons as means to end suffering, breaching deontological absolutes or natural-law views of inalienable life. Even secular versions invoke dignity that precludes self-instrumentalization. The slippery slope remains potent—Belgium/Netherlands/Canada now include psychiatric-only cases, minors, and advance directives for dementia, with euthanasia deaths rising sharply (Netherlands: ~2,300 in 2002 to over 8,700 in 2023). Normalization lowers thresholds; vulnerable patients report feeling burdensome. Medical ethos fractures: physicians become agents of death, eroding trust—many in permissive jurisdictions experience distress or opt out. Socially, availability disincentivizes investment in long-term care, psychiatry, or pain management, subtly coercing the elderly/disabled. Consequentialists weigh present concrete suffering against probabilistic future harms; most find the asymmetry favors permission if safeguards demonstrably work. Yet evidence suggests they do not universally prevent expansion or indirect pressure. Prohibition thus rests on either absolute rules (hard to defend secularly) or prioritizing speculative societal integrity over individual autonomy in extremis. The balance tips toward permission for terminal cases but remains contested for non-terminal suffering, where psychiatric vulnerability amplifies coercion risks. Ultimately, no argument fully eliminates the tension between mercy and protection of the fragile.