Definitions of Euthanasia and Physician-Assisted Suicide a. The terms “physician-assisted suicide” and “euthanasia” are often used interchangeably. However, the distinctions are significant.
b. “Physician-assisted suicide” involves a medical doctor who intentionally provides a patient with the means to kill him or herself, usually by an overdose of prescription medication.c. “Assisted suicide” involves a layperson providing the patient with the deadly means for suicide.
d. “Euthanasia” involves the intentional and direct killing of a patient by a physician, most commonly by lethal injection, or by another party. Euthanasia can be voluntary (at the patient’s request), non-voluntary (without the knowledge or consent of the patient), or involuntary (against the patients wishes).e.
It is important to note that a person can reject medical treatment at the end of life without committing euthanasia or physician-assisted suicide.2. Physician-assisted suicide and euthanasia are legal and widely practiced in the Netherlands where: a. About 9% of all deaths were a result of physician-assisted suicide or euthanasia in 1990. (1, 2)b. Dutch doctors practice active euthanasia by lethal injections (96.6% of all deaths actively caused by physicians in 1990).
Physician-assisted suicide is very infrequent (no more than 3.4% of all cases in Holland of active termination of life in 1990). (3) c. For patients who die of a lethal overdose of painkillers, the decision to administer the lethal dose of drugs was not discussed with 61% of those receiving it, even though 27% were fully competent. (4)d. The Board of the Royal Dutch Medical Association endorsed euthanasia on newborns and infants with extreme disabilities.
(5)e. Well over 10,000 citizens now carry “Do Not Euthanize Me” cards in case they are admitted to a hospital unexpectedly. (6)f.
Cases exist where doctors administer assisted suicide for people determined to be “chronically” depressed. (7,8) 3. Oregon is the only state that has legalized physician-assisted suicide where: a. A recent Health Division report of assisted suicides reveals that not one patient had documented uncontrollable pain.
All of the patients who requested assisted suicide cited psychological and social concerns as their primary reasons. (9)b. “Although numerous studies in the Netherlands and elsewhere report an assisted-suicide failure rate up to 25%, Oregon has yet to report even one complication in over four years. This failure to report complications has led even euthanasia advocates themselves to call the credibility of Oregon reporting on assisted suicide into question.” (10)4. The U.S.
Supreme Court ruled in 1997 in Washington v. Glucksberg that there is no federal constitutional substantive right to assisted suicide. (11) In a 1997 companion case, the U.S.
Supreme Court ruled in Vacco v. Quill that there is no federal constitutional equal protection right to assisted suicide. (12)5. Virtually every established medical and nursing organization in the United States declares physician-assisted suicide is unethical.
6. There are no laws, medical associations, church denominations, or right-to-life groups who insist that unnecessary, heroic, or truly futile treatments be provided to prolong life and all recognize the right of competent patients to refuse medical treatment. (13)7. 95% of cancer pain is controllable and the remaining 5% can be reduced to a tolerable level.
(14)8. The states of California, Washington, Michigan and Maine rejected ballot referenda questions to legalize physician-assisted suicide in their respective states. The Supreme Court of Alaska in Alaska v. Sampson declared there is no state constitutional right to physician-assisted suicide, (15) as did the Florida State Supreme Court in McIver v. Kirscher.
(16) The Hawaii State Senate voted down a bill to legalize physician-assisted suicide.References1. J.
Remmelink et al., “Medical Decisions About the End of Life”: Report of the Committee to Study the Medical Practice Concerning Euthanasia, SDU Publishing House, The Hague, 1991.2. Van der Maas, P.J.
, van Delden, J.J.M.
, Pijnenborg, L., “Euthanasia and other medical decisions concerning the end of life.” Elsevier, Amsterdam-London-New York-Tokyo 1992, 73 tabl. 7.2, 75 tabl. 7.7, 138 tabl.
13.8, 178-9, 182-3.3. Remmelink Report, vol. II, p. 61, Table 7.7.4.
Ibid.5. Royal Dutch Society of Medicine: “Answers to questions asked by State Committee on Euthanasia,” Medisch Contact 1984, 39, 999.6. The Levenswensverklaringen (Declarations of the Will to Live) have been printed and distributed by two associations in Holland since 1985.7.
“The Supreme Court abolishes the discrimination between psychological and bodily suffering: The ruling expands assistance in suicide,” Brabants Dagblad, June 22, 1994.8. “The Brongersma case: Ruling of the Court of Justice in Amsterdam,” Pro Vita Humana 2001, 8, 165-70.9. Katrina Hedberg, “Oregon’s Death with Dignity Act: Annual Report 2001.
” (Available at http://www.ohd/hr.state.or.us/chs/pas/ar-index.
htm)10. Sherwin B. Nuland, “Physician-Assisted Suicide and Euthanasia in Practice,” New England Journal of Medicine, Vol. 342, February 24, 2000.11. 521 U.
S. 702 (1997).12. 521 U.S. 793 (1997).13.
Hospital/Nursing Home Patient Bill of Rights.14. Cancer Pain Relief, World Health Organization, 1986.15. 31 P.
3d 88 (Alaska 2001).16. 697 So.2d 97 (Fla. 1997).