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Both euthanasia and assisted suicide are illegal in the United Kingdom and could be prosecuted as murder or manslaughter. [1]
Although it is an offence to actively end a patient's life, many doctors still assist their patients with their wishes by withholding treatment and reducing pain, "according to a 2006 article in the Guardian". [2] This, however, is only done when the doctors feel that "’death is a few days away and after consulting patients, relatives or other doctors". [2]
In England and Wales, people may make an advance decision [3] or appoint a proxy under the Mental Capacity Act 2005. By effect of this law, the Advance Decision to Refuse Treatment (ADRT) acquired statutory force among doctors, patient and their families. [4] This is for an advanced refusal of life-saving treatment for when the person lacks mental capacity and must be considered to be valid and applicable by the medical staff concerned. [5]
In July 2018 the Supreme Court of the United Kingdom ruled in An NHS Trust and others (Respondents) v Y (by his litigation friend, the Official Solicitor) and another (Appellants) that legal permission was not required to withdraw treatment from patients in a permanent vegetative state. [6] [7]
Subsequently, in December 2018, the British Medical Association and the Royal College of Physicians jointly published guidance on when doctors are permitted to allow patients to die. The chair of the ethics committee at the BMA, John Chisholm, said "The aim of medical treatment is not simply to prolong life at all costs." [8]
While euthanasia remains illegal in the United Kingdom, it is not uncommon for a patient’s death to be hastened and for there to be no legal ramifications attached to the physician that caused the death. Indeed, Lord Goff ruled in Airedale NHS Trust v Bland that doctors who intentionally do everything necessary and appropriate to relieve a patient’s pain and suffering, even with the foresight of possible terminal consequences, are considered legally protected when a death is hastened. [9]
Assisted suicide is related to, but distinct from, voluntary euthanasia. Voluntary euthanasia is the act of ending the life of another for the purpose of relieving their suffering. Assisted suicide is the ending of one's own life with the assistance of another. [10] The phrase "assisted dying" is often used instead of assisted suicide by proponents of legalisation and the media when used in the context of a medically assisted suicide for the purpose of relieving suffering. "Assisted dying" is also the phrase used by politicians when bills are proposed in parliament. [11]
The Nuffield Council on Bioethics launched an enquiry into critical care in foetal and neonatal medicine, looking at the ethical, social and legal issues which may arise when making decisions surrounding treating extremely premature babies.
Euthanasia is the practice of intentionally ending life to eliminate pain and suffering.
Assisted suicide describes the process by which a person, with the help of others, takes medications to end their life. It has been referred to as physician-assisted suicide (PAS), assisted suicide, assisted dying or medical aid in dying.
Life support comprises the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic and advanced life support procedures; however, basic life support is sometimes provided at the scene of an emergency by family members or bystanders before emergency services arrive. In the case of cardiac injuries, cardiopulmonary resuscitation is initiated by bystanders or family members 25% of the time. Basic life support techniques, such as performing CPR on a victim of cardiac arrest, can double or even triple that patient's chance of survival. Other types of basic life support include relief from choking, staunching of bleeding by direct compression and elevation above the heart, first aid, and the use of an automated external defibrillator.
The right to die is a concept based on the opinion that human beings are entitled to end their lives or undergo voluntary euthanasia. Possession of this right is often bestowed with the understanding that a person with a terminal illness, or in incurable pain has access to assisted suicide. The question of who, if anyone, may be empowered to make this decision is often the subject of debate.
In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia, advanced heart disease, and for HIV/AIDS, or long COVID in bad cases, rather than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. An illness which is lifelong but not fatal is called a chronic condition.
Futile medical care is the continued provision of medical care or treatment to a patient when there is no reasonable hope of a cure or benefit.
Anthony David Bland was a supporter of Liverpool injured in the Hillsborough disaster. He suffered severe brain damage that left him in a persistent vegetative state as a consequence of which the hospital, with the support of his parents, applied for a court order allowing him to "die with dignity". As a result, he became the first patient in English legal history to be allowed to die by the courts through the withdrawal of life-prolonging treatment including food and water for the injuries.
Voluntary euthanasia is the purposeful ending of another person's life at their request, in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in the 21st century, surrounding the idea of a right to die. Some forms of voluntary euthanasia are legal in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand, and Spain.
Euthanasia in the Netherlands is regulated by the "Termination of Life on Request and Assisted Suicide Act" which was passed in 2001 and took effect in 2002. It states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering, the information provided to the patient, the absence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee.
Involuntary euthanasia is illegal in all 50 states of the United States. Assisted suicide is legal in 10 jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and Washington. The status of assisted suicide is disputed in Montana, though currently authorized per the Montana Supreme Court's ruling in Baxter v. Montana that "nothing in Montana Supreme Court precedent or Montana statutes [indicates] that physician aid in dying is against public policy."
Vacco v. Quill, 521 U.S. 793 (1997), was a landmark decision of the Supreme Court of the United States regarding the right to die. It ruled 9–0 that a New York ban on physician-assisted suicide was constitutional, and preventing doctors from assisting their patients, even those terminally ill and/or in great pain, was a legitimate state interest that was well within the authority of the state to regulate. In brief, this decision established that, as a matter of law, there was no constitutional guarantee of a "right to die."
Dignity in Dying is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to have 25,000 actively subscribing supporters. The organisation declares it is independent of any political, religious or other affiliations, and has the stated primary aim of campaigning for individuals to have greater choice and more control over end-of-life decisions, so as to alleviate any suffering they may be undergoing as they near the end of their life.
The legality of euthanasia varies between countries and territories. Efforts to change government policies on euthanasia of humans in the 20th and 21st centuries have met with limited success in Western countries. Human euthanasia policies have also been developed by a variety of NGOs, most advocacy organisations although medical associations express a range of perspectives, and supporters of palliative care broadly oppose euthanasia.
Child euthanasia is a form of euthanasia that is applied to children who are gravely ill or have significant birth defects. In 2005, the Netherlands became the first country since the end of Nazi Germany to decriminalize euthanasia for infants with hopeless prognosis and intractable pain. Nine years later, Belgium amended its 2002 Euthanasia Act to extend the rights of euthanasia to minors. Like adult euthanasia, there is world-wide public controversy and ethical debate over the moral, philosophical and religious issues of child euthanasia.
Buddhist views, although varying on a series of canons within the three branches of Buddhism, observe the concept of euthanasia, or "mercy killing", in a denunciatory manner. Such methods of euthanasia include voluntary, involuntary, and non-voluntary.
There are many religious views on euthanasia, although many moral theologians are critical of the procedure.
Euthanasia in Canada in its legal voluntary form is called Medical Assistance in Dying and it first became legal along with assisted suicide in June 2016 for those whose death was reasonably foreseeable. Before this time, it was illegal as a form of culpable homicide. In March 2021, the law was further amended by Bill C-7 which to include those suffering from a grievous and irremediable condition whose death was not reasonably foreseeable. The planned inclusion of people with mental illnesses is controversial and has been repeatedly delayed. The legality of this postponement to 2027 is being challenged in court.
Terminal dehydration is dehydration to the point of death. Some scholars make a distinction between "terminal dehydration" and "termination by dehydration". Courts in the United States generally do not recognize prisoners as having a right to die by voluntary dehydration, since they view it as suicide.
Medical law is the branch of law which concerns the prerogatives and responsibilities of medical professionals and the rights of the patient. It should not be confused with medical jurisprudence, which is a branch of medicine, rather than a branch of law.
