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Assisted suicide is the process by which an individual, who may otherwise be incapable, is provided with the means (drugs or equipment) to commit suicide. In some cases, the terms aid in dying or death with dignity are preferred.1 These terms are often used to draw a distinction from suicide; in some legal jurisdictions, "suicide" (whether assisted or not) remains illegal, while "aid in dying" is permitted.
The term euthanasia refers to acts which are performed by people other than the patient, which do not involve the choice of the patient, or which involve passive withdrawal of life support.
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Legality
Aid in dying is legal in several jurisdictions, including Belgium, the Netherlands, Switzerland, and American states of Oregon (via the Oregon Death with Dignity Act) and Washington (by Washington Initiative 1000). It may or may not be required that the aid is provided by a physician.
Under the Oregon Death with Dignity Act policy in Oregon, patients of sound mind can request a prescription for a lethal dose of medication. Two doctors must confirm a diagnosis of terminal illness with no more than six months to live. Two witnesses, one non-doctor unrelated to the patient, must confirm the patient's request, and the patient must make a second request after 15 days.(Maddie Parris ) The 2008 Washington law is closely modeled on the Oregon law, which was passed in 1994.
Published research
A study approved by the Dutch Ministry of Health, the Dutch Ministry of Justice, and the Royal Dutch Medical Association reviewed the efficacy in 111 cases of physician-aided dying.2 This showed that 32% of cases had complications. These included 12% time to death longer than expected (45min – 14 days), 9% with problems administering the required drugs, 9% with a physical symptom (eg. nausea, vomiting, myoclonus) and 2% waking from coma. In 18% of cases the doctors had to go on and provide euthanasia because of problems or failures with PAD.
The Portland (Oregon) Veterens Affairs Medical Center and the Department of Psychiatry at the Oregon Health and Science University set out to assess the prevelance of depression in 58 patients who had chosen PAD.3 Of 15 patients who went to receive PAD, three (20%) had a clinical depression. The authors conclude that the, ...current practice of the (Oregon) Death with Dignity Act may fail to protect some patients whose choices are influenced by depression from receiving a prescription for a lethal drug.
In a Dutch study of patients with severe and persistent symptoms requiring sedation, the researchers found that only 9% of patients received a palliative care consultation prior to being sedated.4
See also
- Euthanasia - for a detailed discussion of ethical and legal issues
- Euthanasia and the law
- Dignitas (euthanasia group)
- Consensual homicide
References
- ^ For example, Oregon law draws a distinction between "suicide" and "aid in dying" for criminal purposes. ORS 127.880 §3.14
- ^ Groenewoud JH et al. Clinical problems with the performance of euthanasia and physician assisted suicide in the Netherlands. NEJM, 2000; 342: 551-7.
- ^ Linda Ganzini, Elizabeth R Goy, Steven K Dobscha. Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey. BMJ, 2008; 337: 1662.
- ^ Judith Rietjens, Johannes van Delden, Bregje Onwuteaka-Philipsen, Hilde Buiting, Paul van der Maas, and Agnes van der Heide. Continuous deep sedation for patients nearing death in the Netherlands: descriptive study. BMJ Apr 2008; 336: 810 - 813
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- This page was last modified on 3 December 2008, at 20:31.
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