Euthanasia, Assisted Suicide, and Patient Rights

All persons are entitled to a dignified death, but directly killing patients (euthanasia) or assisting in their suicide is an affront to human dignity, regardless of poor quality of life, pain, or survival expectancy.

What is euthanasia? 

Euthanasia is the direct killing of a person, usually by injecting a lethal substance and is currently legal in several developed nations including:

  • Oregon, Washington, Montana, the Netherlands, Belgium and Luxembourg are the only jurisdictions in the world where laws specifically permit euthanasia or assisted suicide. Oregon and Washington passed laws and Montana’s Supreme Court determined that assisted suicide is a medical treatment.  The Netherlands, Belgium and Luxembourg permit both euthanasia and assisted suicide. Although euthanasia and assisted suicide are illegal in Switzerland, assisted suicide is penalized only if it is carried out “from selfish motives.”
  • The Netherlands:  where euthanasia is practiced, with or without the consent of the patient.  There also exist guidelines to allow for the killing of newborns with disabilities http://www.worldrtd.net/dutch-euthanasia-law-guidelines.
  • Belgium and Luxembourg (very similar law to the Netherlands).

Fortunately, Euthanasia is specifically prohibited in Louisiana and throughout the entire United States.  Louisiana Right to Life’s Center for Medical Ethics helped codify into law the Louisiana’s Natural Death Act for consenting or denying medical treatment which now specifically reads: "Nothing in this Part shall be construed to condone, authorize, or approve mercy killing or euthanasia or to permit any affirmative or deliberate act or omission to end life other than to permit the natural process of dying" (RS 40:1299.58.10).

Arguments in favor of Euthanasia include:

  • It provides a way to relieve extreme pain
  • It provides a way of relief when a person's quality of life is low
  • Frees up medical funds to help other people
  • It is another case of freedom of choice

Arguments against Euthanasia include:

  • Euthanasia devalues human life
  • Euthanasia can become a means of health care cost containment
  • Physicians and other medical care people should not be involved in directly causing death
  • There is a "slippery slope" effect that has occurred where euthanasia has been first been legalized for only 
    the terminally ill and later laws are changed to allow it for other people or to be done non-voluntarily.

Is physician-assisted suicide the same as euthanasia?  

No. Physician-assisted suicide refers to the physician providing the means for death, most often with a prescription. The patient, not the physician, will ultimately administer the lethal medication. Euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life.

Some other practices that should be distinguished from euthanasia and physician assisted suicide are:

  • Terminal sedation: This refers to the practice of sedating a terminally ill competent patient to the point of unconsciousness, then allowing the patient to die of his or her disease, starvation, or dehydration.
  • Withholding/withdrawing life-sustaining treatments:  When a competent patient makes an informed decision to refuse life-sustaining treatment, there is virtual unanimity in state law and in the medical profession that this wish should be respected.
  • Pain medication that may hasten death: Often a terminally ill, suffering patient may require dosages of pain medication that impair respiration or have other effects that may hasten death. It is generally held by most professional societies, and supported in court decisions, that this is justifiable so long as the primary intent is to relieve suffering.

What is assisted suicide? 

Assisted suicide involves one person providing the means and instructions to help another person commit suicide.  Most states have laws that prohibit assisted suicide yet attempts to legalize assisted suicide with ballot measures continue to challenge existing laws. 

Where is Assisted Suicide legal? 
Assisted suicide is legal in Oregon and Washington State as well as in the Netherlands, Belgium and Luxembourg. It is not legal but widely practiced in Switzerland and attracts people from all over the world to be assisted with suicide.  It is a widely known fact that illegal drugs from Mexico are taken to Australia and New Zealand to be used for suicide.

What do people want to legalize Assisted Suicide?  
Wherever an assisted-suicide measure is proposed, proponents’ arguments and strategies are similar.  Invariably resting on the two pillars of autonomy (independence and the right of self-determination) and the elimination of suffering:

  1. Autonomy (independence and the right of self-determination) is certainly valued in modern society and patients do, and should, have the right to accept or reject medical treatment. However, those who favor assisted suicide claim that autonomy extends to the right of a patient to decide when, where, how and why to die.
  2. The second pillar of assisted-suicide advocacy is elimination of suffering. During each and every attempt to permit euthanasia and assisted suicide, its advocates stress that ending suffering justifies legalization of the practices. However, suicide is not pain relief. Palliative care – the medical science of relieving pain – has advanced a great deal, and most pain can be controlled with proper treatment. In extreme cases, palliative sedation – putting someone in an unconscious or semi-conscious state to relieve pain – can ease suffering until the moment of death.

In the United States Oregon’s Death with Dignity plan is often used as the model for legislative advances of Physician Assisted Suicide. Additionally, records from Oregon show that few people who have sought "death with dignity" under that state's program have ranked pain as a primary reason for their request. Most people cited concern over isolation, and loss of function and autonomy as the chief reasons for wanting to die.

Even though Death with Dignity, which is code for Assisted Suicide, sounds like a good choice for some, the real world of assisted suicide is one:

  • Where insurance companies and health maintenance organizations try to limit spending on health care
  • Where many people think it's better to be dead than disabled
  • Where abuse and financial exploitation of elders and people with disabilities is at unacceptably high levels
  • Where people must fight to get adequate health care and pain relief
  • Where the wisdom, contributions and experience of elderly, ill and disabled people are thrown aside, then they are told they are a burden.

Should someone have the right to end one’s own life?

Suicide, as a solitary act, is not illegal in any state. However, assisting someone in taking one’s own life is a different conversation.  The legitimate concerns are focused on the systemic implications of adding assisted suicide to the list of “medical treatment options” available to seriously ill and disabled people.  Assisted suicide is unnecessary because current law gives every person the right to refuse lifesaving treatment, and to have adequate pain relief.

It is understandable, though tragic, that some patients in extreme agony—such as those suffering from a terminal, painful, debilitating illness—may come to decide that death is preferable to life.  However, permitting physicians or caregivers to engage in euthanasia would ultimately cause more harm than good.  Euthanasia and assisted suicide are fundamentally incompatible with the physician’s roles as healer and would be difficult or impossible to control.

Almost all of those who attempt suicide do so as a subconscious cry for help.  A suicide attempt powerfully calls attention to one's plight. This is no different for those who have terminal illnesses or whose life appears to have no value.  The ethical response is to mobilize resources to address the issues of pain and suffering. Typically, counseling and assistance with a view of the dignity of the person at this stage of life are successful. In short, suicidal people should be helped with their problems, not helped to die. Society has already determined that preventing suicide is a public health priority. Programs of awareness and intervention receive public funds, and the public is encouraged to help troubled individuals to avoid suicide. In reality, many people who attempt suicide are actually looking for help to improve their quality of life. This is born out by the fact that only 17% of suicide attempts are successful. “People seek to control their death, because public policies make it difficult to control their life. They want a loving family to gather around them as they die, because they do not have loved ones to support and help them live.”

Should people be forced to stay alive if they desire not to live?

The duty to preserve life does not involve an obligation to prolong the dying process by technological measures.  A competent patient is entitled to decline extraordinary therapeutic measures whose burdens exceed their benefits. 

In addition, an Assisted Suicide Law is a bad law:

  • Eligibility is usually based on a six-month life expectancy. But doctors agree these estimates are often wrong. Individuals outlive their prognoses by months or even years. The Oregon law leads people to give up on treatment and lose good years of their lives.
  • Patients are not required to see a psychiatrist or counselor before obtaining the lethal drug—fewer than 7% have been referred for psychiatric evaluation in Oregon. This means ill people with treatable depression can get a life-ending prescription, rather than effective psychological care.  Furthermore, over 90% of terminally ill patients who attempt suicide also suffer from treatable depression.
  • The supposed safeguards are hollow. And nothing in the Oregon law will protect patients when there are pressures, whether financial or emotional, which distort patient choice.
  • Legalizing Assisted Suicide is a recipe for elder abuse. Key provisions allow an heir or abusive caregiver to serve as a witness to help sign the patient up for the lethal drugs, and no witnesses are required when the drugs are taken.
  • We are told that in Oregon, where assisted suicide is legal, the data shows zero problems. But actually, Oregon's annual reports tell us very little. Doctors who fail to make required reports face no penalty. The State does not talk to doctors who denied a request to prescribe lethal drugs, to find out why.

Recently residents of Massachusetts dealt a significant setback to the Death with Dignity agenda by defeating a ballot measure to legalize Physician Assisted Suicide.  This accomplishment was very encouraging in a uniquely challenging campaign and political climate.  To learn more about the Massachusetts victory click here

Also, below is a list of several commercials that were aired in Massachusetts and were essential to defeating the Assisted Suicide agenda:

Additional Resources concerning Assisted Suicide and Euthanasia: