Voluntary euthanasia

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Voluntary euthanasia is the ending of a 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 recent years. Some forms of voluntary euthanasia are legal in Australia, [1] [2] Belgium, [3] Canada, [4] Colombia, [5] Luxembourg, [6] the Netherlands, [3] New Zealand, [7] and Spain. [8]

Contents

Voluntary refusal of food and fluids (VRFF), also called voluntarily stopping eating and drinking or VSED, or Patient Refusal of Nutrition and Hydration (PRNH), is bordering on euthanasia. Some authors classify it as a form of passive euthanasia, [9] while others treat it separately because it is treated differently from legal point of view and often perceived as a more ethical option. [10] VRFF is sometimes suggested as a legal alternative to euthanasia in jurisdictions disallowing euthanasia.[ citation needed ]

Assisted suicide

Assisted suicide is a practice in which a person receives assistance in bringing about their death, typically people suffering from a severe physical illness, [11] in which the final step in the process is actively performed by the person concerned. In physician-assisted suicide (also called physician aid-in-dying or PAD) a physician knowingly provides a competent but suffering patient, upon the patient's request, with the means by which the patient intends to end his or her own life. [12] Assisted suicide is contrasted with "active euthanasia" when the difference between providing the means and actively administering lethal medicine is considered important. [13] For example, Swiss law allows assisted suicide while all forms of active euthanasia (like lethal injection) remain prohibited. [14]

History

The term euthanasia comes from the Greek words "eu"-meaning good and "thanatos"-meaning death, which combined means "well-death" or "dying well". Hippocrates mentions euthanasia in the Hippocratic Oath, which was written between 400 and 300 BC. The original Oath states: "To please no one will I prescribe a deadly drug nor give advice which may cause his death." [15] Despite this, the ancient Greeks and Romans generally did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide in cases where no relief could be offered to the dying or, in the case of the Stoics and Epicureans, where a person no longer cared for his life. [16] [17]

English Common Law from the 14th century until the middle of the last century made suicide a criminal act in England and Wales. Assisting others to kill themselves remains illegal in that jurisdiction. However, in the 16th century, Thomas More, considered a saint by Roman Catholics, described a utopian community and envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of "torturing and lingering pain", see Utopia (More book) § Interpretation. [16] [18]

Modern

Since the 19th century, euthanasia has sparked intermittent debates and activism in Europe and the Americas. According to medical historian Ezekiel Emanuel, it was the availability of anesthesia that ushered in the modern era of euthanasia. In 1828, the first known anti-euthanasia law in the United States was passed in the state of New York, with many other localities and states following suit over a period of several years. [19] After the Civil War, voluntary euthanasia was promoted by advocates, including some doctors. [20] Support peaked around the start of the 20th century in the US and then grew again in the 1930s.

In an article in the Bulletin of the History of Medicine , Brown University historian Jacob M. Appel documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906. [21] Appel indicates social activist Anna Sophina Hall, a wealthy heiress who had watched her mother die after an extended battle with liver cancer, was the driving force behind this movement. [21] According to historian Ian Dowbiggin, leading public figures, including Clarence Darrow and Jack London, advocated for the legalization of euthanasia. [22]

In 1937, doctor-assisted euthanasia was declared legal in Switzerland as long as the doctor ending the life had nothing to gain. [15] [23] During this same era, US courts tackled cases involving critically ill people who requested physician assistance in dying as well as "mercy killings", such as by parents of their severely disabled children.[ citation needed ]

Post War

During the post-war period, prominent proponents of euthanasia included Glanville Williams (The Sanctity of Life and the Criminal Law) and clergyman Joseph Fletcher ("Morals and medicine"). By the 1960s, advocacy for a right-to-die approach to voluntary euthanasia increased.

India

Since March 2018, passive euthanasia is legal in India under strict guidelines. Patients must consent through a living will, and must be either terminally ill or in a vegetative state.

Australia

In 1996, the world's first euthanasia legislation, the Rights of the Terminally Ill Act 1996, was passed in the Northern Territory of Australia. [24] Four patients died through assisted suicide under the Act, using a device designed by Dr Philip Nitschke. The legislation was overturned by Australia's Federal Parliament in 1997. [15] [16] [23] In response to the overturning of the Act, Nitschke founded Exit International. In 2009, an Australian quadriplegic was granted the right to refuse sustenance and be allowed to die. [25] The Supreme Court of Western Australia ruled that it was up to Christian Rossiter, aged 49, to decide if he was to continue to receive medical care (tube feeding) and that his carers had to abide by his wishes. Chief Justice Wayne Martin also stipulated that his carers, Brightwater Care, would not be held criminally responsible for following his instructions. Rossiter died on 21 September 2009 following a chest infection. [26] [27]

Voluntary assisted dying schemes have been in effect in the following states; Victoria since 19 June 2019, [28] Western Australia since 1 July 2021, [29] Tasmania since 23 October 2022, [30] Queensland since 1 January 2023, [31] and South Australia since 31 January 2023. [32] New South Wales was the final state to pass legislation for assisted dying in May 2022, which went into effect on 28 November 2023. [33]

New Zealand

In New Zealand's 2020 general election the country included a binding referendum asking voters if the End of Life Choice Act 2019 should pass. The Act would legalise voluntary euthanasia for patients with a terminal illness and less than six months left to live if approved by two doctors. New Zealand is the first country to put euthanasia legalisation to a referendum. On 17 October 2020, 65.91% of voters supported the passing of the act; a majority. On 21 November 2021, the act was put into place. [34]

Colombia

On 20 May 1997, the Constitutional Court of Colombia decriminalised piety homicide, for terminally ill patients, stating that "the medical author cannot be held responsible for the assisted suicide of a terminally ill patient" and urged Congress to regulate euthanasia "in the shortest time possible". [35]

On 15 December 2014, the Constitutional Court had given the Ministry of Health and Social Protection 30 days to publish guidelines for the healthcare sector to use in order to guarantee terminated ill patients, with the wish to undergo euthanasia, their right to a dignified death. [36]

On 7 January 2022, Victor Escobar became the first person to undergo voluntary euthanasia without a terminal illness in the country; he had been suffering from chronic obstructive pulmonary disease. [37] Voluntary euthanasia had been legalised in Colombia for people who did not have a terminal illness in July 2021. [38]

Europe

In 1957 in Britain, Mr Justice Devlin ruled in the trial of Dr John Bodkin Adams that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome. [39] In 1993, the Netherlands decriminalized doctor-assisted suicide, and in 2002, restrictions were loosened. During that year, physician-assisted suicide was approved in Belgium. Belgium's at the time most famous author Hugo Claus, suffering from Alzheimer's disease, was among those that asked for euthanasia. He died in March 2008, assisted by an Antwerp doctor.

United States

A key turning point in the debate over voluntary euthanasia (and physician assisted dying), at least in the United States, was the public furor over the Karen Ann Quinlan case. The Quinlan case paved the way for legal protection of voluntary passive euthanasia. [40] In 1977, California legalized living wills and other states soon followed suit.

In 1980 the Hemlock Society USA was founded in Santa Monica by Derek Humphry. It was the first group in the United States to provide information to the terminally ill in case they wanted a hastened death. Hemlock also campaigned and partially financed drives to reform the law. In 2003 Hemlock was merged with End of Life Choices, which changed its name to Compassion and Choices.

In 1990, Dr. Jack Kevorkian, a Michigan physician, became famous for educating and assisting people in committing physician-assisted suicide, which resulted in a Michigan law against the practice in 1992. Kevorkian was tried and convicted in 1999 for a murder displayed on television. [15] [23] Also in 1990, the Supreme Court approved the use of non-active euthanasia. [41]

In 1994, Oregon voters approved the Death with Dignity Act, permitting doctors to assist terminal patients with six months or less to live to end their lives. The U.S. Supreme Court allowed such laws in 1997. [16] The Bush administration failed in its attempt to use drug law to stop Oregon in 2001, in the case Gonzales v. Oregon . [23]

In 2005, amid U.S. government roadblocks and controversy, Terri Schiavo, a Floridian who had been in a vegetative state since 1990, had her feeding tube removed. Her husband had won the right to take her off life support, which he claimed she would want but was difficult to confirm as she had no living will and the rest of her family claimed otherwise. [23]

In November 2008, Washington Initiative 1000 made Washington the second U.S. state to legalize physician-assisted suicide.

China and Hong Kong

Euthanasia is a criminal offense in China. For example, in Shanghai a 67-year-old man was sentenced to five years in prison when he euthanized his 92-year-old mother when she emerged from a hospital procedure only able to move one finger and one toe. The sentence was considered lenient because he had displayed filial piety toward his mother. [42]

While active euthanasia remains illegal in China, it is gaining increasing acceptance among doctors and the general populace. [43]

Medical practitioners in China support euthanasia laws. A 2006 research emphasised that studies in the 1990s revealed a substantial surge in support for euthanasia, particularly among medical personnel. This is corroborated by a poll conducted by the Chinese Academy of Medical Science, which found that 95% of medical staffs approved of the act of euthanasia. [44]

Chinese culture, with its emphasis on filial piety and a taboo surrounding discussions of death, poses significant obstacles to the development of euthanasia. The concept of euthanasia is often seen as pessimistic in this cultural context. However, Buddhism, the predominant religion in China, views euthanasia as a means to achieve a peaceful and suffering-free death, making it more acceptable to some. [45]

In Hong Kong, support for euthanasia among the general public is higher among those who put less importance on religious belief, those who are non-Christian, those who have higher family incomes, those who have more experience in taking care of terminally ill family members, and those who are older. [46]

Canada

Legislation in Canada is actively evolving and debated. In 2016, Canadian parliament passed legislation allowing eligible adults to request medical assistance in dying (MAiD). [47] Legal access to MAiD was initially limited to persons whose death was "reasonable foreseeable", however the law was amended in 2021 to include persons who had a grievous, irremediable and irreversible medical condition, even if it is not fatal or terminal. [48] An exclusion currently exists for persons whose sole underlying condition is a mental illness. [49]

Arguments for and against

Since World War II, the debate over euthanasia in Western countries has centered on voluntary euthanasia within regulated health care systems. In some cases, judicial decisions, legislation, and regulations have made voluntary euthanasia an explicit option for patients and their guardians. [50]

Proponents of voluntary euthanasia emphasize that choice is a fundamental principle for liberal democracies and free market systems. [16] The pain and suffering a person feels during a disease, even with pain relievers, can be incomprehensible to a person who has not gone through it. Even without considering the physical pain, it is often difficult for patients to overcome the emotional pain of losing their independence. [16] Those who witness others die are "particularly convinced" that the law should be changed to allow assisted death. [51] Today in many countries there is a shortage of hospital space. Medical personnel and hospital beds could be used for people whose lives could be saved instead of continuing the lives of those who want to die, thus increasing the general quality of care and shortening hospital waiting lists. It is a burden to keep people alive past the point they can contribute to society, especially if the resources used could be spent on a curable ailment. [52]

Critics argue that voluntary euthanasia could unduly compromise the professional roles of health care employees, especially doctors.[ citation needed ] They point out that European physicians of previous centuries traditionally swore some variation of the Hippocratic Oath,[ citation needed ] which in its ancient form excluded euthanasia: "To please no one will I prescribe a deadly drug nor give advice which may cause his death." However, since the 1970s, this oath has largely fallen out of use.

Some people, including many Christians, consider euthanasia of some or all types to be morally unacceptable. [16] This view usually treats euthanasia to be a type of murder and voluntary euthanasia as a type of suicide, the morality of which is the subject of active debate.

If there is some reason to believe the cause of a patient's illness or suffering is or will soon be curable, the correct action is sometimes considered to attempt to bring about a cure or engage in palliative care. [16]

Feasibility of implementation: Euthanasia can only be considered voluntary if a patient is mentally competent to make the decision, i.e., has a rational understanding of options and consequences. Competence can be difficult to determine or even define. [16]

Consent under pressure: Given the economic grounds for voluntary euthanasia, critics of voluntary euthanasia are concerned that patients may experience psychological pressure to consent to voluntary euthanasia rather than be a financial burden on their families. [53] Even where health costs are mostly covered by public money, as in most developed countries, voluntary euthanasia critics are concerned that hospital personnel would have an economic incentive to advise or pressure people toward euthanasia consent. [54]

Non-voluntary euthanasia is sometimes cited as one of the possible outcomes of the slippery slope argument, in which it is claimed that permitting voluntary euthanasia to occur will lead to the support and legalization of non-voluntary and involuntary euthanasia. [55]

Medical ethics

Euthanasia brings about many ethical issues regarding a patient's death. Some physicians say euthanasia is a rational choice for competent patients who wish to die to escape unbearable suffering. [56] [57]

Physicians who are in favor of euthanasia state that to keep euthanasia or physician-assisted suicide (PAS) illegal is a violation of patient freedoms. They believe that any competent terminally-ill patient should have the right to choose death or refuse life-saving treatment. [56] [58] Suicide and assistance from their physician is seen as the only option those patients have. [56] With the suffering and the knowledge from the doctor, this may also suggest that PAS is a humane answer to the excruciating pain. [56]

An argument against PAS is the violation of the Hippocratic oath that some doctors take. The Hippocratic oath states: "I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan." [56]

Another reason for prohibiting PAS and euthanasia is the option of abusing PAS if it were to become legal. Poor or uninsured patients may not have the money or no access to proper care will have limited options, and they could be pressured toward assisted death. [56]

Legality

During the 20th century, efforts to change government policies on euthanasia have met limited success in Western countries. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organisations.

Australia

There are a range of eligibility requirements which must be satisfied before a patient can receive VAD treatment. Those that are deemed ineligible are required to wait months for care through the public or private health system and at times at their own financial costs. Furthermore, according to The RAGCP more than $38 billion is spent on people with chronic health conditions a year. [59]

Examples of health conditions that require further assessment before granting the VAD procedure include, respiratory diseases such as cardiovascular disease which is a common cause of death among people over the age of 65. [60] Debilitating chronic pain and disease is heavily assessed when considering patients for assisted dying and for people over the age of 65, even if several medical conditions are present, it does not mean the person is eligible for this procedure. [60] Poor mental health, geriatric syndromes, falls, delirium are underlying conditions that have the potential to exarate one’s pain and suffering in this age group, this also does not guarantee access to assisted dying. [61]

Chronic and acute conditions are common amongst elderly Australians that can range from mild to debilitating pain levels, limiting physical abilities, and taking large mental tolls on individuals. [61] Regardless of personal choice and the complexity of health and medical issues, medical professionals can object to Voluntary Assisted Dying at any point regardless of eligibility should they feel it necessary. [60]

Religion

There are many different religious views on the issue of voluntary euthanasia, although many moral theologians are critical of the procedure.

Protocols

Euthanasia can be accomplished either through an oral, intravenous, or intramuscular administration of drugs, or by oxygen deprivation (anoxia), as in some euthanasia machines. In individuals who are incapable of swallowing lethal doses of medication, an intravenous route is preferred. The following is a Dutch protocol for parenteral (intravenous) administration to obtain euthanasia:

Intravenous administration is the most reliable and rapid way to accomplish euthanasia. A coma is first induced by intravenous administration of 20 mg/kg sodium thiopental (Nesdonal) in a small volume (10 ml physiological saline). Then a triple intravenous dose of a non-depolarizing neuromuscular muscle relaxant is given, such as 20 mg pancuronium bromide (Pavulon) or 20 mg vecuronium bromide (Norcuron). The muscle relaxant should preferably be given intravenously, in order to ensure optimal availability. Only for pancuronium bromide (Pavulon) are there substantial indications that the agent may also be given intramuscularly in a dosage of 40 mg. [62]

In other jurisdictions (such as Australia and New Zealand), voluntary assisted dying uses 30 mL oral suspensions containing pentobarbital and an anti-emetic to induce a coma leading to respiratory arrest. However, if the person is too ill to administer the medication themselves, a typical surgical anesthesia induction is performed (midazolam + propofol) and then once a coma is achieved, pancuronium or vecuronium is used to paralyse the diaphragm and induce respiratory arrest. [63]

With regards to voluntary euthanasia, many people argue that 'equal access' should apply to access to suicide as well, so therefore disabled people who cannot kill themselves should have access to voluntary euthanasia.

Apart from The Old Law , a 17th-century tragicomedy written by Thomas Middleton, William Rowley, and Philip Massinger, one of the early books to deal with euthanasia in a fictional context is Anthony Trollope's 1882 dystopian novel, The Fixed Period . Ricarda Huch's novel The Deruga Case (1917) is about a physician who is acquitted after performing euthanasia on his dying ex-wife.

"Quality of Mercy" in The Prosecution Rests is a fable exploring the facets of aging, Alzheimer's disease, and euthanasia. [64] The story line makes no judgement but frees the reader to decide.

The plot of Christopher Buckley's 2007 novel Boomsday involves the use of 'voluntary euthanasia' of seniors as a political ploy to stave off the insolvency of social security as more and more of the aging US population reaches retirement age.

The films Children of Men and Soylent Green depict instances of government-sponsored euthanasia in order to strengthen their dystopian themes. The protagonist of the film Johnny Got His Gun is a brutally mutilated war veteran whose request for euthanasia furthers the work's anti-war message. The recent films Mar Adentro and Million Dollar Baby argue more directly in favor of euthanasia by illustrating the suffering of their protagonists. These films have provoked debate and controversy in their home countries of Spain and the United States respectively.

In March 2010, the PBS Frontline TV program in the United States showed a documentary called "The Suicide Tourist" which told the story of Professor Craig Ewert, his family, and the Swiss group Dignitas, and their decision to help him commit assisted suicide in Switzerland after he was diagnosed and suffering with ALS (Lou Gehrig's Disease). [65]

Thrash metal band Megadeth's 1994 album Youthanasia (the title is a pun on euthanasia) implies that society is euthanizing its youth.

The documentary film How to Die in Oregon follows the lives of select terminally ill individuals who weigh the options of continuing to live and euthanasia. This film employs emotional appeal to the audience on the controversial topic of voluntary euthanasia. [66]

In the House episode "Known Unknowns", Dr. Wilson plans to deliver a speech at a medical conference in which he admits to having euthanized a terminally ill patient. Ultimately, Dr. House delivers the speech using a false identity. In another episode, "The Dig", Dr. Hadley ("Thirteen") reveals that she euthanized her brother who was suffering from Huntington's disease. After learning that Thirteen herself will eventually develop Huntington's, House offers to euthanize her once she is in the advanced stages of the disease.

The 2017 TV program Mary Kills People follows a doctor illegally performing assisted suicides as a side business. [67]

See also


Related Research Articles

Euthanasia is the practice of intentionally ending life to eliminate pain and suffering.

<span class="mw-page-title-main">Assisted suicide</span> Suicide undertaken with aid from another person

Assisted suicide means a procedure in which people take medications to end their own lives with the help of others, usually medical professionals. The term usually refers to physician-assisted suicide (PAS), which is an end of life measure for a person suffering a painful, terminal illness. Once it is determined that the person's situation qualifies under the physician-assisted suicide laws for that location, the physician's assistance is usually limited to writing a prescription for a lethal dose of drugs.

<span class="mw-page-title-main">Rights of the Terminally Ill Act 1995</span> Law of the Northern Territory, Australia

The Rights of the Terminally Ill Act 1995(NT) was a law legalising euthanasia in the Northern Territory of Australia, which was passed by the territory's Legislative Assembly on 1995. The Act was passed by the Northern Territory Legislative Assembly on 25 May 1995 by a vote of 15 to 10, received the Administrator's assent on 16 June 1995, and entered into force on 1 July 1996. A year later, a repeal bill was brought before the Northern Territory Parliament in August 1996, but was defeated by 14 votes to 11.

The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of the right to die is often bestowed with the understanding that a person with a terminal illness, incurable pain, or without the will to continue living should be allowed to end their own life, use assisted suicide, or decline life-prolonging treatment. 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 or advanced heart disease 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. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.

<span class="mw-page-title-main">Suicide legislation</span> Laws concerning suicide around the world

Suicide is a crime in some parts of the world. However, while suicide has been decriminalized in many countries, the act is almost universally stigmatized and discouraged. In some contexts, suicide could be utilized as an extreme expression of liberty, as is exemplified by its usage as an expression of devout dissent towards perceived tyranny or injustice which occurred occasionally in cultures such as ancient Rome, medieval Japan, or today's Tibet Autonomous Region.

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."

<span class="mw-page-title-main">Dignity in Dying</span> UK pro-euthanasia organisation

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.

<span class="mw-page-title-main">Legality of euthanasia</span>

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 euthanasia, there is world-wide public controversy and ethical debate over the moral, philosophical and religious issues of child euthanasia.

Euthanasia became legal in New Zealand when the End of Life Choice Act 2019 took full effect on 7 November 2021. It is illegal to "aid and abet suicide" under Section 179 of the New Zealand Crimes Act 1961. The clauses of this act make it an offence to "incite, procure or counsel" and "aid and abet" someone else to commit suicide, regardless of whether a suicide attempt is made or not. Section 179 covers both coercion to undertake assisted suicide and true suicide, such as that caused by bullying. This will not change under the End of Life Choices Act 2019, which has provisions on coercion of terminally ill people.

<span class="mw-page-title-main">Assisted dying in Australia</span> Legal history of euthanasia in Australia

Laws regarding euthanasia or assisted suicide in Australia are matters for state and territory governments. As of June 2024 all states and the Australian Capital Territory have passed legislation creating an assisted suicide and euthanasia scheme for eligible individuals. These laws typically refer to the practices as "voluntary assisted dying".

<span class="mw-page-title-main">Assisted suicide in the United States</span> Medically-induced suicide with help from another person

In the United States, the term "assisted suicide" is typically used to describe what proponents refer to as medical aid in dying, in which a terminally ill adult is prescribed and self-administers barbiturates if they feel that they are suffering significantly. The term is often used interchangeably with physician-assisted suicide (PAS), "physician-assisted dying", "physician-assisted death", "assisted death" and "medical aid in dying" (MAiD).

Both Euthanasia and Assisted Suicide are illegal in the United Kingdom and could be prosecuted as murder or manslaughter.

<span class="mw-page-title-main">Euthanasia in Canada</span> Legal history of euthanasia in Canada

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.

My Death, My Decision (MDMD) is an organisation that campaigns for the legalisation of assisted dying in England and Wales. The group was founded in 2009, in order to campaign for a change in the law and advocate on behalf of adults of sound mind, who are either terminally ill or incurably suffering.

Assisted suicide is the ending of one's own life with the assistance of another. Physician-assisted suicide is medical assistance in helping another person end their own life for the purpose of relieving their suffering, and voluntary euthanasia is the act of ending the life of another, also for the purpose of relieving their suffering. The phrase "assisted dying" is often used instead of physician-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. Assisted suicide is illegal under English law.

References

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  3. 1 2 "Euthanasia and the law". BBC News. 23 December 2002. Archived from the original on 29 September 2009.
  4. ↑ "First Quebec euthanasia case confirmed, two others reported | National Post". 15 January 2016. Archived from the original on 15 March 2016. Retrieved 17 March 2016.
  5. ↑ "Colombia just legalized euthanasia. Here's why that's a big deal". pri.org. 29 April 2015. Archived from the original on 1 December 2017.
  6. ↑ "Luxembourg: Right to Die with Dignity". Library of Congress, Washington, D.C. 20540 USA. Retrieved 3 February 2023.
  7. ↑ "End of Life Choice Act". health.govt.nz. Archived from the original on 27 June 2021. Retrieved 16 October 2022.
  8. ↑ "La ley de eutanasia entrará en vigor el 25 de junio". EL PAÍS (in Spanish). 25 March 2021. Retrieved 25 June 2021.
  9. ↑ Patient Refusal of Nutrition and Hydration: Walking the Ever-Finer Line Archived 13 October 2008 at the Wayback Machine
  10. ↑ Harvath, TA. (May 2004). "Voluntary refusal of food and fluids: attitudes of Oregon hospice nurses and social workers". Int J Palliat Nurs. 10 (5): 236–41. doi:10.12968/ijpn.2004.10.5.13072. PMID   15215708.
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  13. ↑ Bosshard, G.; Jermini, D.; Eisenhart, D.; Bär, W. (April 2003). "Assisted suicide bordering on active euthanasia". International Journal of Legal Medicine. 117 (2): 106–108. doi:10.1007/s00414-002-0346-3. PMID   12690508. S2CID   22098366.
  14. 1 2 Lundin, Leigh (2 August 2009). "YOUthanasia". Criminal Brief. Archived from the original on 26 July 2011. Retrieved 27 August 2009.
  15. 1 2 3 4 "History of Euthanasia". euthanasia.com. Archived from the original on 25 August 2009. Retrieved 2 September 2009.
  16. 1 2 3 4 5 6 7 8 9 "Voluntary Euthanasia". Stanford Encyclopedia of Philosophy. Retrieved 2 September 2009.
  17. ↑ See Senicide
  18. ↑ See Humphry and Wickett (1986:8–10) on More, Montaigne, Donne, and Bacon.
  19. ↑ "The earliest American statute explicitly to outlaw assisting suicide was enacted in New York in 1828, Act of 10 December 1828, ch. 20, §4, 1828 N. Y. Laws 19 (codified at 2 N. Y. Rev. Stat. pt. 4, ch. 1, tit. 2, art. 1, §7, p. 661 (1829)), and many of the new States and Territories followed New York's example." Thomas J. Marzen, Origins, Volume 27. p73-74.
  20. ↑ Humphry and Wickett 1986:11–12, Emanuel 2004.
  21. 1 2 Appel, Jacob M. (2004). "A Duty to Kill? A Duty to Die". Bulletin of the History of Medicine. 78: 3610–634.
  22. ↑ Ian Dowbiggin (2003). A Merciful End: The Euthanasia Movement in Modern America. OUP. ISBN   978-0-19-515443-6.
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  30. ↑ Will Murray (23 October 2022). "Tasmania's voluntary assisted dying laws come into effect today. Here's how they will work". ABC News.
  31. ↑ "Voluntary assisted dying is now legal in Queensland. Here's what you need to know". SBS News. 1 January 2023.
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  35. ↑ Constitutional Court of Colombia (20 May 1997). "REPÚBLICA DE COLOMBIA Corte Constitucional Sentencia No. C-239/97" (PDF). Retrieved 24 November 2016.[ dead link ] (in Spanish)
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  40. ↑ For the UK see the Bland case.
  41. ↑ Cruzan v. Director, Missouri Department of Health
  42. ↑ Annals of Bioethics: Regional Perspectives in Bioethics; by Mark J. Cherry and John F. Peppin; Taylor & Francis, 10 Aug 2005, page 253 Archived 12 January 2016 at the Wayback Machine .
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  45. ↑ Gill, Baljit Kaur (31 October 2019). "Euthanasia and Nurses Role in It". Archives of Clinical Case Studies. 2 (1). doi: 10.33552/ACCS.2019.02.000526 .
  46. ↑ Chong AM, Fok SY (December 2004). "Attitudes toward Euthanasia in Hong Kong – A Comparison Between Physicians and the General Public". Death Studies. 29 (1): 29–54. doi:10.1080/07481180590519769. PMID   15726742. S2CID   22888907.Chong AM, Fok SY (2009). "Attitudes toward euthanasia: implications for social work practice". Soc Work Health Care. 48 (2): 119–33. doi:10.1080/00981380802533298. PMID   19197770. S2CID   30564055.
  47. ↑ "Medical assistance in dying: Legislation in Canada". www.canada.ca. 30 June 2023. Retrieved 21 February 2024.
  48. ↑ Canada, Health (16 June 2016). "Medical assistance in dying: Overview". www.canada.ca. Retrieved 21 February 2024.
  49. ↑ Navarre, Brianna (5 March 2024). "Canada Backtracks on Allowing Euthanasia for the Mentally Ill".
  50. ↑ See Government policies below for specific examples
  51. ↑ Chapple, A.; Ziebland, S.; McPherson, A.; Herxheimer, A. (December 2006). "What people close to death say about euthanasia and assisted suicide: a qualitative study". J Med Ethics. 32 (12): 706–10. doi:10.1136/jme.2006.015883. PMC   2563356 . PMID   17145910.
  52. ↑ See also Utilitarianism
  53. ↑ "Terminally ill patients often fear being a burden to others and may feel they ought to request euthanasia to relieve their relatives from distress." letter to the editor of the Financial Times by Dr David Jeffrey, published 11 January 2003.
  54. ↑ Prowse, Michael (4 January 2003). "THE FRONT LINE: Don't take liberties with the right to die" Financial Times: "If euthanasia became socially acceptable, the sick would no longer be able to trust either doctors or their relatives: many of those earnestly counselling a painless, 'dignified' death would be doing so mainly on financial grounds. Euthanasia would become a euphemism for assisted murder."
  55. ↑ "Voluntary Euthanasia". Stanford Encyclopedia of Philosophy. 29 March 2010. Retrieved 13 June 2010.
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  59. ↑ "Voluntary Assisted Dying - Factsheet". End of Life Law. 15 August 2022. Retrieved 28 August 2022.
  60. 1 2 3 "Older Australians". Australian Institute of Health and Welfare. 30 November 2021. Retrieved 28 August 2022.
  61. 1 2 "Ageing and Health". World Health Organisation. 4 October 2021. Retrieved 28 August 2022.
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  63. ↑ Martin, Hannah (14 August 2020). "Euthanasia referendum: What drugs are used in assisted dying, and how do they work?". www.stuff.co.nz. Retrieved 21 July 2024.
  64. ↑ Lundin, Leigh (April 2009). Fairstein, Linda (ed.). The Prosecution Rests. MWA Anthologies. New York: Little, Brown & Company. pp.  221–233. ISBN   978-0-316-01252-2.{{cite book}}: |work= ignored (help)
  65. ↑ ""The Suicide Tourist", PBS FRONTLINE". PBS . 2 March 2010. Archived from the original on 16 September 2017.
  66. ↑ "How to Die in Oregon" Archived 7 February 2016 at the Wayback Machine . Dir. Peter Richardson. Clearcut Productions, 2011. Film.
  67. ↑ Doyle, John (24 January 2017). "Doyle: Mary Kills People is a killer of a good, provocative drama". The Globe and Mail.

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