A Cure for

the
Incurable?
Euthanasia and Physician-
Assisted Suicide
Monday February 27th, 7:00-8:30,
Community Room, 201 Municipal
Building, 243 S. Allen Street
 Introduction

Euthanasia is defined by Merriam Webster as the act or practice of killing or

permitting the death of hopelessly sick or injured individuals (as persons or domestic
animals) in a relatively painless way for reasons of mercy. This term is often (incorrectly)
used interchangeably with physician-assisted suicide, that is, suicide by a patient
facilitated by means (as a drug prescription) or by information (as an indication of a
lethal dosage) provided by a physician aware of the patient's intent. Both topics are
sources of great debate in todays world, with legitimate arguments for and against.
As of June 2016, human euthanasia is legal in the Netherlands, Luxembourg,
Colombia, and Belgium. Physician-assisted suicide is legal in Switzerland, Germany,
Japan, and Canada, as well as the states of Washington, Oregon, Colorado, Vermont,
Montana, Washington, D.C., and California of the U.S. As time goes on, more and more
countries are either adopting pro-euthanasia/physician-assisted suicide laws or
expanding those already in place. These decisions have been both lauded and
denounced by various factions; many religious organizations, citing their faith, assert
that these practices are immoral and should be prohibited. Many disability groups, that
is, organizations focused on the needs and concerns of disabled individuals, are also
generally against these practices. On the other hand, many self-proclaimed human rights
groups cite every persons right to die as reason to establish and expand these laws.
We have compiled three methods of approach to the topic of euthanasia and
physician assisted suicide, which will be discussed in detail in the subsequent issue
guide. The first supports the claim that an individual possesses a right to die and should
be able to request to end his or her life either by euthanasia or the assistance of a
physician when in an irrecoverable or painful state. The second approach is more
moderate, limiting the amount of freedom the individual has due to moral and ethical
reasons and taking religious views into account. However, some terminally ill patients
who cannot afford treatment or even patients with very severe depression could possibly
have the right to die. The final approach involves implementing very strict regulations on
euthanasia as well as banning the practice of physician assisted suicide, due to moral
reasons and its potential to be easily abused.

Approach One: Patients Right to Die

 The first approach to the issue of physician assisted suicide is in support of the
patients right to die, and this right should not be interfered with. The right to die of the
patient must be taken into account in the proper care of the
patient. This approach will focus on the moral standards and
logical reasoning behind legalizing euthanasia. As stated in
the Hippocratic Oath, an ethical standard signed by
physicians, all practitioners of medicine must do no harm. If a
patient is suffering from intense pain and the medical
practitioner cannot solve the issue, the medical practitioner
could end the life without pain through assisted suicide.
Thus, do no harm has been achieved by ending the patients continual suffering. This is
one of the moral stances for legalizing euthanasia.
There are many cases in which a person suffering from an illness desired to end
their life to prevent their current or future suffering in death. However, due to current
laws in many countries such as the United States and the United Kingdom, they are
unable to take their own life without fear of those who assist them being prosecuted.
Diane Pretty, a British woman diagnosed with motor neuron disease, was unable to get a
doctor to help her end her life painlessly. After appealing the court, her plea was rejected
and just days later she developed intense chest and lung pain which resulted in her
death about two weeks later. Had Pretty been allowed to take her own life when she
wanted, she could have died painlessly and comfortably. There are similar known cases
in which patients die an unpleasant death rather than being able to take their life sooner.
One logical reason in support of euthanasia include the caregivers financial
burden. Caregivers to terminally ill patients suffer the high hospital costs for keeping
their loved ones alive. In many cases, the federal government must step in to pay for
Medicare beneficiaries for terminally ill patients. According to a study by CBS news, in
2008, Medicare paid $50 billion just for doctor and hospital bills during the last two
months of patients lives. Also, CBS estimates that 20 to 30
percent of these medical expenditures may have no
meaningful impact. Clearly, keeping the terminally ill alive
costs a lot and euthanasia is a solution to that financial
burden. Not only does the right to die approach alleviate
financial burdens, it also encourages organ transplantation.
According to the US Department of Health and Human
Services, on average, 22 people die each day while waiting
for a transplant and every ten minutes, someone is added to
the national transplant waiting list. Euthanasia would allow for patients to die without
failure of important organs. This in turn will help patients with organ failure seeking
organ transplants and eventually gives the right to life for organ needy patients.
The Netherlands are an excellent case in which physician assisted suicide has been
allowed. In a study done by the New England Journal of Medicine, the number of patient
deaths without the patients permission dropped from .8 percent in 1991 to only .4
percent in 2005. In between this time period, physician assisted suicide was legalized.
Since implementation, the Netherlands have made physician assisted suicide legal to
patients who suffer from chronic mental illnesses, and are also now considering granting
the right to patients who feel they have lived a complete life.
 Approach Two: Following Deaths Protocols:
Regulations to Physician Assisted Suicide and
Euthanasia
Physician assisted suicide laws and regulations differ greatly between countries,
states and regions; this being said, such strict and highly variable government protocols
have a contentious set of pros and cons.

The Regulations
In the United States alone, 37 states have
instilled laws prohibiting physician assisted suicide.
In 1997, Oregon became the first state to legalize
physician assisted suicide under the Death with
Dignity Act, which permits terminally ill patients to
self-administer lethal drugs. The three most
frequently mentioned endoflife concerns reported
by Oregon residents who took advantage of the
Death with Dignity Act in 2015 were a decreased
ability to participate in activities that made life enjoyable, a reduction of autonomy and
independence, and a loss of dignity. During 2015, there were 218 people in the state who
were approved and received the lethal prescription medicines to end their own life. Of
that 218, 132 terminally ill patients ultimately made the decision to ingest the
medication, resulting in their death. According to the state of Oregon Public Health
Divisions survey, the majority of the participants, 78%, were 65 years of age or older.
Today, there are six states in which aid in dying is legal, including Oregon, Montana,
Colorado, California, Washington, and Vermont. On an international level, physician
assisted suicide is legal with regulations in, Switzerland, Canada, Luxembourg, Germany,
and the Netherlandseach of these with their own varying rules applying to assisted
suicide.
While most states and countries have not legalized physician assisted suicide, the
few that have are enforcing fairly strict protocols. In the United States, a series of three
written requests, two oral and one written, a minimum of 15 days apart are required to
receive the lethal drugs. The physician must also be licensed and refer the patient to an
additional licensed professional in mental health. Alternatively, in Canada the protocol is
fairly similar except they allow any ill patient to request physician assisted suicide, while
in the United States the patient must have no more than 6 months left to live.

Switzerlands protocol is particularly unique in that you do

not need to be terminally ill to be administered lethal drugs
by a health professional; in fact, 25% of the people who
apply for physician assisted suicide in Switzerland are not ill
or disabled, and are described as tired of life. This is often
referred to as death tourism since citizenship in
Switzerland is not required for assisted suicide.

The Pros/Cons Debate

Such complicated protocols can be viewed as beneficial since physician assisted

suicide is often a contentious dilemma. Taking extensive measures to confirm that
patients are ill, disabled, or have true medical
purpose to assisted suicide ensure that medical
practices are ethical. However, many view these
limitations as dangerous since people may seek
illegal or hazardous methods to contract lethal drugs.
The ethical battle only grows when monetary aspects
come into play; medical costs and insurance
complicate the restrictions placed on physician
assisted suicide. Similarly, religion comes into play as a
type of restriction, per se, since some religions,
such as Baptism, Presbyterianism, Lutheranism, and Buddhism, have adapted to accept
physician assisted suicide while others, such as Islam, Russian Orthodoxy, Roman
Catholicism, and Judaism view it as immoral. This raises the question as to how much
authority the government should hold over the matters of life and death of its
individuals.
On the whole, the controversy does not end with whether or not physician assisted
suicide should be legalized or not, but how it should be regulated as well. These confines
to acquiring lethal drugs continue to stir debate religiously, economically, and morally.

Approach Three: The Right to Life

The final approach to the issue of euthanasia is also the most conservative, the
complete banning of physician-assisted suicide, along with extremely strict guidelines for
other forms of euthanasia for the terminally ill. The practice of legally being allowed to
end a life is a slippery slope and has significant impact on the medical and legal system.
Morality is a huge issue in the debate of euthanasia
practice. While objectivity and data should be the
primary basis of any argument, it seems nearly
impossible to discuss the topic of euthanasia and
physician-assisted suicide without acknowledging the
moral and philosophical beliefs that are closely
attributed with the decision of whether or not one can
end another persons (or their own) life.
The first question that should be answered
regarding euthanasia is who can give consent to get euthanized. An outright ban of
euthanasia obviously means no one can give such consent; however, the current
practice in the Netherlands allows euthanasia to be legal with or without the consent of
the patient.1 This fact can have consequences not only for the family and friends of the
patient, but also for the medical system as a whole. Since the time of the early Greeks,
those in the medical field have taken a Hippocratic Oath to swear to do no harm to
their patients. This has been the primary goal of physicians ever since; however, the
implementation of physician-assisted suicide goes directly against this aim. Euthanasia
allows doctors and caretakers to make a decision which does not necessarily line up with
the Hippocratic Oath. Nearly one third of American believe that medical professionals
should do everything they can to preserve the life of a patient who is terminally ill.2 While
the remaining two thirds of the US populace believes that there are certain scenarios
where euthanasia is appropriate, this data is not constant across all demographics. When
polled, white Americans stated that if they had an incurable disease, 65% of them would
agree to euthanasia.2 Conversely, 61% of black Americans and 55% of Hispanic
Americans stated that they would want their doctors to continue to do everything to
battle whatever circumstances they are facing.
Another significant issue with euthanasia revolves around the theory of slippery
slope. With the complete implementation of euthanasia with little to no restrictions it
becomes easy for individuals in the system to begin to abuse the practice. What starts
out as a good idea and something that could be used for positive impact on society could
very easily begin to deteriorate. An example of this includes a restriction on patients who
are terminally ill, those facing certain death. However, once his policies implemented it
becomes very easy to move from a restriction on just terminally ill patients to something
more liberal such as chronic real patients. In addition, the legal system and
implementation of euthanasia is extremely complex and could easily resolve many
issues. Some include, the liability of an individual
who performs a euthanasia, whether insurance
policies are still valid, and who is responsible for
the death.
While euthanasia may be appropriate for
those who are most terminally ill and greatly
suffering, it is these previously stated reasons that
this approach determines that euthanasia is not a
seriously beneficial policy to be implemented in
todays society. Additionally, this approach holds
evident that physician-assisted suicide only gives
those suffering an ultimatum and not a truly effective treatment for recovery.

Summary
Given the three approaches listed, we believe that it is possible to come to a
reasonable conclusion about the topic of euthanasia and physician assisted suicide. One
of the most important things to remember in this discussion is the distinction between
euthanasia and physician assisted suicide. While they both have the same end result,
the journey to that final decision can make a difference on someones perspective on this
issue. Another important thing to note when discussing any issue regarding literal life
and death, is to understand that it is a sensitive topic. Sensitive as it may be, we have to
be willing to talk about tough topics as a community.
As for the topic of euthanasia and physician assisted suicide, there are real-life
case studies that can be analyzed. The fact that countries like the Netherlands, Belgium,
Columbia, and Luxembourg all have comparatively lenient euthanasia laws gives
qualitative evidence for one side of the issue3. However, there are more countries than
not that have stricter rules for euthanasia; less so with physician assisted suicide
because of its inherently regulated nature. As with many political, social, and economic
issues, the answer is often found within the gray area. The question here most likely
relates to regulations and what is acceptable and in what situations; even this can be
subject to debate.
Although euthanasia and physician assisted suicide can be both sensitive and
difficult to understand, there are many resources devoted to better understand them and
discuss the issues associated with them. Please check the brochure for resources
regarding additional information about these issues.

American Academy of Medical Ethics:

http://ethicalhealthcare.org/Resources/Position-Statement/Physician-Assisted-
Suicide

Suicide Prevention Hotline:

https://suicidepreventionlifeline.org/

The Hastings Center:

http://www.thehastingscenter.org/briefingbook/physician-assisted-death/

Works Cited
1
"Fast Facts (Assisted Suicide)." Fast Facts (Assisted Suicide) Wisconsin Right to Life.
N.p., n.d. Web. 15 Feb. 2017. <http://wrtl.org/assisted-suicide/fast-facts-assisted-
suicide/>
2
Lipka, Michael. "5 Facts about Americans' Views on Life-and-death Issues." Pew
Research Center. N.p., 07 Jan. 2014. Web. 15 Feb. 2017.
<http://www.pewresearch.org/fact-tank/2014/01/07/5-facts-about- americans-views-
on-life-and-death-issues/>
3
"Physician-Assisted Suicide Fast Facts." CNN. Cable News Network, 7 June 2016. Web. 15
Feb. 2017.
<http://www.cnn.com/2014/11/26/us/physician-assisted-suicide-fast-
facts/index.html>
4
Cook, Michael. "Oregon Releases Its 2015 death with Dignity Stats." BioEdge. N.p., 20
Feb. 2016. Web. 15 Feb. 2017.
<https://www.bioedge.org/bioethics/oregon-releases-its-2015-death-with-dignity-
stats/11761>
5
"Get the Facts on Assisted Dying." Dying With Dignity Canada. N.p., n.d. Web. 15 Feb.
2017.
<http://www.dyingwithdignity.ca/get_the_facts>
6
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2017.
<http://healthresearchfunding.org/19-great-voluntary-euthanasia-statistics/>
7
Vega, Charles P., and Marcia Frellick. "The Debate of Physician-Assisted Suicide: The
Pros and Cons." Medscape, WebMD, 10 Mar. 2016,
<www.medscape.org/viewarticle/859347.>
8
CBSNews. "The Cost of Dying." CBS News. CBS Interactive, 03 Dec. 2010. Web. 23 Feb.
2017.
9
Forster, Katie. "Dutch Consider Extending Assisted Dying Laws to Those Who 'feel Their
Life Is Complete'." The Independent. Independent Digital News and Media, 13 Oct.
2016. Web. 23 Feb. 2017.
10
Justitie, Ministerie Van Veiligheid En. "Euthanasia, Assisted Suicide and Non-
resuscitation on Request - Euthanasia." Euthanasia | Government.nl. Ministerie Van
Algemene Zaken, 05 Oct. 2016. Web. 23 Feb. 2017.
11
Laville, Sandra. "Diane Pretty Dies in the Way She Always Feared." The Telegraph.
Telegraph Media Group, 13 May 2002. Web. 23 Feb. 2017.
12
"Organ Procurement and Transplantation Network." OPTN: Organ Procurement and
Transplantation Network - OPTN. N.p., n.d. Web. 23 Feb. 2017.