Doctors sometimes perform euthanasia when it’s requested by people who have a terminal illness and are in a lot of pain. Local laws, someone’s physical and mental health, and their personal beliefs and wishes all play a role.
What’s chosen depends on a variety of factors, including someone’s outlook and level of consciousness. In many cases, doctors will provide people with a drug they can take to end their lives.
With euthanasia, a doctor is allowed to end the person’s life by painless means. Purposely giving someone a lethal dose of a sedative is considered active euthanasia.
Passive euthanasia is sometimes described as withholding or limiting life-sustaining treatments so that a person passes more quickly. Palliative care focuses on keeping people as comfortable as possible at the end of their life.
For example, a palliative care doctor might allow someone approaching death to stop taking a medication that causes unpleasant side effects. If someone makes a conscious decision to seek help with ending their lives, it’s considered voluntary euthanasia.
The person must give their full consent and demonstrate that they fully understand what will happen. It usually involves passive euthanasia, such as withdrawing life support from someone who’s showing no signs of brain activity.
In addition, many states currently have PAS measures on legislative ballots, so this list may grow. A 2013 poll in the New England Journal of Medicine found that 65 percent of people in 74 countries were against PAS.
By 2017, a Gallup poll found a large shift in attitudes in the United States. Interestingly, a study in the United Kingdom found that the majority of doctors weren’t in favor of voluntary euthanasia and PAS.
In countries where it’s legal, a 2016 review found euthanasia accounts for 0.3 to 4.6 percent of deaths. The review also found that in Washington and Oregon, doctors write less than 1 percent of prescriptions for assisted suicide.
In addition, many churches, religious groups, and faith organizations argue against euthanasia for similar reasons. One study found that doctors aren’t always capable of recognizing when someone is fit to make the decision.
Some argue that the Hippocratic oath supports PAS since it ends suffering and brings no more harm. “Death with dignity” is a movement that encourages legislatures to allow people to decide how they want to die.
Some people simply don’t want to go through a long dying process, often out of concern of the burden it puts on their loved ones. Making decisions about PAS for yourself or a loved one is extremely difficult, even if everyone’s in complete agreement.
The National Hospice and Palliative Care Organization offers many free resources on their website through their Cringing program. This program is designed to help people navigate complicated end-of-life issues, from state laws to finding spiritual support.
Euthanasia (from Greek : ; “good death”: , EU ; “well” or “good” + , Thanos ; “death”) is the practice of intentionally ending a life to relieve pain and suffering. The British House of Lords select committee on medical ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”.
In the Netherlands and Belgium, euthanasia is understood as “termination of life by a doctor at the request of a patient”. The Dutch law, however, does not use the term 'euthanasia' but includes the concept under the broader definition of “assisted suicide and termination of life on request”.
Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary: As of 2006 euthanasia had become the most active area of research in bioethics.
In some countries divisive public controversy occurs over the moral, ethical, and legal issues associated with euthanasia. Passive euthanasia (known as “pulling the plug”) is legal under some circumstances in many countries.
In current usage, euthanasia has been defined as the “painless inducement of a quick death”. However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia.
In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional. Another approach incorporates the notion of suffering into the definition.
The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma”, This approach is included in Marvin Kohl and Paul Kurtz's definition of it as “a mode or act of inducing or permitting death painlessly as a relief from suffering”. Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as Tom Beauchamp and Arnold Davidson have argued that doing so would constitute “murder simplicity” rather than euthanasia.
Michael Green argued that “the principal thing that distinguishes euthanasia from intentional killing simplicity is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned.” Likewise, James Field argued that euthanasia entails a sense of compassion towards the patient, in contrast to the diverse non-compassionate motives of serial killers who work in health care professions.
Green also considered a seventh requirement: “(7) The good specified in (6) is, or at least includes, the avoidance of evil”, although as Green noted in the paper, he was not convinced that the restriction was required. In discussing his definition, Green noted the difficulty of justifying euthanasia when faced with the notion of the subject's right to life “.
Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPIC) Ethics Task Force, the authors offered: “Medicalized killing of a person without the person's consent, whether nonvoluntary (where the person is unable to consent) or involuntary (against the person's will) is not euthanasia: it is murder.
Although the EPIC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other. Euthanasia may be classified into three types, according to whether a person gives informed consent : voluntary, non-voluntary and involuntary.
There is a debate within the medical and bioethics literature about whether the non-voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient's circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Green, consent on the part of the patient was not considered as one of their criteria, although it may have been required to justify euthanasia.
Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont. Voluntary, non-voluntary and involuntary types can be further divided into passive or active variants.
Passive euthanasia entails the withholding treatment necessary for the continuance of life. While some authors consider these terms to be misleading and unhelpful, they are nonetheless commonly used.
In some cases, such as the administration of increasingly necessary, but toxic doses of painkillers, there is a debate whether to regard the practice as active or passive. Euthanasia was practiced in Ancient Greece and Rome : for example, hemlock was employed as a means of hastening death on the island of KEA, a technique also employed in Marseilles.
Euthanasia, in the sense of the deliberate hastening of a person's death, was supported by Socrates, Plato and Seneca the Elder in the ancient world, although Hippocrates appears to have spoken against the practice, writing “I will not prescribe a deadly drug to please someone, nor give advice that may cause his death” (noting there is some debate in the literature about whether this was intended to encompass euthanasia). The term euthanasia in the earlier sense of supporting someone as they died, was used for the first time by Francis Bacon.
Euthanasia: a very gentle and quiet death, which happens without painful convulsions. The word comes from , been, well, and , more, death.
The concept of euthanasia in the sense of alleviating the process of death goes back to the medical historian, Karl Friedrich Heinrich Marx, who drew on Bacon's philosophical ideas. According to Marx, a doctor had a moral duty to ease the suffering of death through encouragement, support and mitigation using medication.
Such an “alleviation of death” reflected the contemporary zeitgeist, but was brought into the medical canon of responsibility for the first time by Marx. Marx also stressed the distinction between the theological care of the soul of sick people from the physical care and medical treatment by doctors.
Euthanasia in its modern sense has always been strongly opposed in the Judeo-Christian tradition. Thomas Aquinas opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival, as did Francois Ranching (1565–1641), a French physician and professor of medicine, and Michael Boldewijn (1601–1681), a physician and teacher.
In 1678, the publication of Caspar Quested's DE pulmonary morientibus non-subtrahend, (“ On the pillow of which the dying should not be deprived “), initiated debate on the topic. Quested described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was “against the laws of God and Nature”.
:209–211 This view was shared by others who followed, including Philipp Jakob Spencer, Vat Raiding and Johann Georg Units. :211 Despite opposition, euthanasia continued to be practiced, involving techniques such as bleeding, suffocation, and removing people from their beds to be placed on the cold ground.
Thomas More wrote of euthanasia in Utopia, although it is not clear if More was intending to endorse the practice. :208–209 Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, as it is used in cases of honor, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.
In the mid-1800s, the use of morphine to treat “the pains of death” emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bulgar in 1866.
Popular Science analyzed the issue in May 1873, assessing both sides of the argument. Kemp notes that at the time, medical doctors did not participate in the discussion; it was “essentially a philosophical enterprise ... tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life”.
Felix Adler, circa 1913, the first prominent American to argue for permitting suicide in cases of chronic illness rise of the euthanasia movement in the United States coincided with the so-called Gilded Age, a time of social and technological change that encompassed an “individualistic conservatism that praised laissez-faire economics, scientific method, and rationalism “, along with major depressions, industrialization and conflict between corporations and labor unions. :794 It was also the period in which the modern hospital system was developed, which has been seen as a factor in the emergence of the euthanasia debate.
Robert Ingersoll argued for euthanasia, stating in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. In fact, he argued from an Ethical Culture framework.
Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler enabled others to stretch the definition of euthanasia. The first attempt to legalize euthanasia took place in the United States, when Henry Hunt introduced legislation into the General Assembly of Ohio in 1906.
:614 Hunt did so at the behest of Anna Sofina Hall, a wealthy heiress who was a major figure in the euthanasia movement during the early 20th century in the United States. Hall had watched her mother die after an extended battle with liver cancer, and had dedicated herself to ensuring that others would not have to endure the same suffering.
Along with the Ohio euthanasia proposal, in 1906 Assemblyman Ross Gregory introduced a proposal to permit euthanasia to the Iowa legislature. However, the Iowa legislation was broader in scope than that offered in Ohio.
It allowed for the death of any person of at least ten years of age who suffered from an ailment that would prove fatal and cause extreme pain, should they be of sound mind and express a desire to artificially hasten their death. In addition, it allowed for infants to be euthanized if they were sufficiently deformed, and permitted guardians to request euthanasia on behalf of their wards.
The proposed legislation also imposed penalties on physicians who refused to perform euthanasia when requested: a 6–12-month prison term and a fine of between $200 and $1,000. Euthanasia opponent Ian Dowbiggin argues that the early membership of the Euthanasia Society of America (ESA) reflected how much perceived euthanasia at the time, often seeing it as a eugenics matter rather than an issue concerning individual rights.
Dowbiggin argues that not every eugenics joined the ESA “solely for eugenic reasons”, but he postulates that there were clear ideological connections between the eugenics and euthanasia movements. In January 1936, King George V was given a fatal dose of morphine and cocaine to hasten his death.
At the time he was suffering from cardio-respiratory failure, and the decision to end his life was made by his physician, Lord Dawson. Although this event was kept a secret for over 50 years, the death of George V coincided with proposed legislation in the House of Lords to legalize euthanasia.
A 24 July 1939 killing of a severely disabled infant in Nazi Germany was described in a BBC “Genocide Under the Nazis Timeline” as the first “state-sponsored euthanasia”. Parties that consented to the killing included Hitler's office, the parents, and the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses.
Professor Robert Jay Clifton, author of The Nazi Doctors and a leading authority on the T4 program, contrasts this program with what he considers to be a genuine euthanasia. He explains that the Nazi version of “euthanasia” was based on the work of Adolf Most, who published The Right to Death (Was Brecht AUF den Tod) in 1895.
Most argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the individual's 'right to die' or 'right to death' or 'right to his or her own death,' as the ultimate human claim.
The Right Reverend Robert E. McCormick stated that The ultimate object of the Euthanasia Society is based on the Totalitarian principle that the state is supreme and that the individual does not have the right to live if his continuance in life is a burden or hindrance to the state.
The petition brought tensions between the American Euthanasia Society and the Catholic Church to a head that contributed to a climate of anti-Catholic sentiment generally, regarding issues such as birth control, eugenics, and population control. Historically, the euthanasia debate has tended to focus on a number of key concerns.
According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have presented four main arguments: a) that people have a right to self-determination, and thus should be allowed to choose their own fate; b) assisting a subject to die might be a better choice than requiring that they continue to suffer; c) the distinction between passive euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that the underlying principle–the doctrine of double effect –is unreasonable or unsound); and d) permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia activists often point to countries like the Netherlands and Belgium, and states like Oregon, where euthanasia has been legalized, to argue that it is mostly unproblematic.
Similarly, Emanuel argues that there are four major arguments presented by opponents of euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment, combined with the use of effective pain relief, are available; c) the distinction between active and passive euthanasia is morally significant; and d) legalizing euthanasia will place society on a slippery slope, which will lead to unacceptable consequences. :797–8 In fact, in Oregon, in 2013, pain wasn't one of the top five reasons people sought euthanasia.
Top reasons were a loss of dignity, and a fear of burdening others. In the United States in 2013, 47% nationwide supported doctor-assisted suicide.
A 2015 Populous poll in the United Kingdom found broad public support for assisted dying. In some countries, adult children of impoverished parents are legally entitled to support payments under filial responsibility laws.
Thirty out of the fifty United States as well as France, Germany, Singapore, and Taiwan have filial responsibility laws. The examples and perspective in this section may not represent a worldwide view of the subject.
(November 2011) (Learn how and when to remove this template message) West's Encyclopedia of American Law states that “a 'mercy killing' or euthanasia is generally considered to be a criminal homicide” and is normally used as a synonym of homicide committed at a request made by the patient.
The judicial sense of the term homicide includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering. The term “euthanasia” is usually confined to the active variety; the University of Washington website states that “euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life”.
Physician-assisted suicide is thus not classified as euthanasia by the US State of Oregon, where it is legal under the Oregon Death with Dignity Act, and despite its name, it is not legally classified as suicide either. Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal.
The use of pain medication to relieve suffering, even if it hastens death, has been held as legal in several court decisions. Some governments around the world have legalized voluntary euthanasia but most commonly it is still considered to be criminal homicide.
In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal conditions. In a historic judgment, the Supreme court of India legalized passive euthanasia.
The apex court remarked in the judgment that the Constitution of India values liberty, dignity, autonomy, and privacy. A bench headed by Chief Justice Disk Mira delivered a unanimous judgment.
A 2010 survey in the United States of more than 10,000 physicians found that 16.3% of physicians would consider halting life-sustaining therapy because the family demanded it, even if they believed that it was premature. The study also found that 45.8% of physicians agreed that physician-assisted suicide should be allowed in some cases; 40.7% did not, and the remaining 13.5% felt it depended.
Similarly, a 2017 Doctors.net.UK poll reported in the British Medical Journal stated that 55% of doctors believe assisted dying, in defined circumstances, should be legalized in the UK. One concern among healthcare professionals is the possibility of being asked to participate in euthanasia in a situation where they personally believe it to be wrong.
In a 1996 study of 852 nurses in adult ICUs, 19% admitted to participating in euthanasia. Broadly against The Roman Catholic Church condemns euthanasia and assisted suicide as morally wrong.
It states that, “intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator”.
Partially in favor of The Church of England accepts passive euthanasia under some circumstances, but is strongly against active euthanasia, and has led opposition against recent attempt to legalize it. The various positions on the cessation of medical treatment are mixed and considered a different class of action than direct termination of life, especially if the patient is suffering.
Suicide and euthanasia are both crimes in almost all Muslim majority countries. There is much debate on the topic of euthanasia in Judaic theology, ethics, and general opinion (especially in Israel and the United States).
Passive euthanasia was declared legal by Israel's highest court under certain conditions and has reached some level of acceptance. Active euthanasia remains illegal, however the topic is actively under debate with no clear consensus through legal, ethical, theological and spiritual perspectives.
When a person performs an act of euthanasia, she brings about the death of another person because she believes the latter's present existence is so bad that he would be better off dead, or believes that unless she intervenes and ends his life, his life will very soon become so bad that he would be better off dead. ^ Euthanasia and assisted suicide Archived 19 July 2011 at the Payback Machine BBC.
Unlocking Medical Law and Ethics (2nd ed.). ^ Voluntary and involuntary euthanasia Archived 5 September 2011 at the Payback Machine BBC Accessed 12 February 2012.
Archived from the original ^ Sorry P, Scotsman P, Derrick K (April 2006). ^ Philippe Stellar, chapter: History and Definition of a Word, in Euthanasia: Ethical and Human Aspects By Council of Europe ^ Francis Bacon: The Major Works by Francis Bacon, edited by Brian Kickers, p. 630.
A similar definition is offered by Blackburn (1994) with “the action of causing the quick and painless death of a person, or not acting to prevent it when prevention was within the agent's powers.” Caring to Death: a discursive analysis of nurses who murder patients (PhD thesis).
Materstvedt, Lars Johan; Clark, David; Ellershaw, John; Free, Radon; Beck Graveyard, Anne-Marie; Müller-Busch, Christoph; Port i Sales, Joseph; Rapid, Charles-Henri (2003). “Euthanasia and physician-assisted suicide: a view from an APC Ethics Task Force”.
^ Mystakidou, Syria; Papa, EFI; Silica, Elena; Matsuda, Emanuel; Laos, Lam bros (2005). “The Evolution of Euthanasia and Its Perceptions in Greek Culture and Civilization”.
“Active Euthanasia in Pre-ModernSociety, 1500–1800: Learned Debates and Popular Practices”. ^ Gesundheit, Benjamin; Steinberg, Abraham; Click, Simon; Or, Reuben; Moskovitz, Alan (2006).
^ Mark wart Michael (1990), “Marx, Karl, Medicine”, Nee Deutsche Biographies (NDB) (in German), 16, Berlin: Dancer & Hum blot, pp. 327–328 ; (full text online) ^ Hedge Dvorak: Biographies Lexicon her Deutsche Burschenschaft.
“The history of euthanasia debates in the United States and Britain”. A Concise History of Euthanasia: Life, Death, God, and Medicine.
A merciful end: the euthanasia movement in modern America. Quotation: “The first state-sanctioned euthanasia is carried out, after Hitler receives a petition from a child's parents, asking for the life of their severely disabled infant to be ended.
This happens after the case has been considered by Hitler's office and by the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses, whose 'experts' have laid down the basis for the removal of disabled children to special 'pediatric clinics'. At least 5,200 infants will eventually be killed through this program”.
“Named: the baby boy who was Nazis' first euthanasia victim”. ^ Genocide Under the Nazis Timeline: 14 January 1940 Archived 5 August 2011 at the Payback Machine BBC Accessed 23 July 2011.
“ Euthanasia”: A confusing term, abused under the Nazi regime and misused in present end-of-life debate”. ^ a b “The vulnerable will be the victims: Opposing view”.
“Guest Editorial: The place of elderly persons and our responsibility for care”. ^ The National Consumer Voice for Quality Long-Term Care ^ LOI Code Civil Du 1 October 2018, articles 203–211 ^ Art.
1601 Bürgerliches Gesetzbuch (BGB) (in German) ^ Chow, N. (2009), “Filial Piety in Asian Chinese Communities”, in Sung, K.T. ), Respect for the Elderly: Implications for Human Service Providers, University Press of America, pp.
Archived 13 August 2003 at the Payback Machine ^ Oluyemisi Backbone (2004). International Journal of Offender Therapy and Comparative Criminology.
^ “Euthanasia and beyond: on the Supreme Court's verdict SC Constitution Bench holds passive euthanasia, living wills permissible”. “Exclusive Ethics Survey Results: Doctors Struggle With Tougher-Than-Ever Dilemmas”.
^ “Assisted dying case 'stronger than ever' with the majority of doctors now in support”. “The role of critical care nurses in euthanasia and assisted suicide”.
^ Why the Church of England Supports the Current Law on Assisted Suicide. Dr Brendan McCarthy Archbishops' Council Church House, London 2015 ^ Submission to The Special Joint Committee on Physician-Assisted Dying.
Jordan Cantrell Moderator of The United Church of Canada. Journal of the Islamic Medical Association of North America 2007 Volume 4.