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11 - Euthanasia and assisted suicide

Published online by Cambridge University Press:  30 October 2009

By
Bernard M. Dickens ,
Joseph M. Boyle  and
Linda Ganzini
Edited by
Peter A. Singer  and
A. M. Viens
Bernard M. Dickens
Affiliation:
Professor University of Toronto, Canada
Joseph M. Boyle
Affiliation:
Professor University of Toronto, Canada
Linda Ganzini
Affiliation:
Professor Oregon Health and Science University
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
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Summary

Ms. I is 32 years old and has advanced gastric cancer that has resulted in constant severe pain and poorly controlled vomiting. Despite steady increases in her opioid dose, her pain has worsened greatly over the last two days. Death is imminent, but the patient pleads incessantly with the hospital staff to “put her out of her misery.”

Mr. J is a 39-year-old injection drug user with a history of alcoholism and depression. He presents at an emergency department, insisting that he no longer wishes to live. He repeatedly requests euthanasia on the grounds that he is no longer able to bear his suffering (although he is not in any physical pain). A psychiatrist rules out clinical depression.

What are euthanasia and assisted suicide?

Euthanasia has been defined as a deliberate act undertaken by one person with the intention of ending the life of another person to relieve that person's suffering. Euthanasia may be “voluntary,” “involuntary,” or “non-voluntary,” depending on (i) the competence of the recipient, (ii) whether or not the act is consistent with the recipient's wishes (if these are known), and (iii) whether or not the recipient is aware that euthanasia is to be performed. Assisted suicide has been defined as “the act of intentionally killing oneself with the assistance of another who deliberately provides the knowledge, means, or both” (Special Senate Committee on Euthanasia and Assisted Suicide, 1995).

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Chapter
Information
The Cambridge Textbook of Bioethics , pp. 72 - 77
Publisher: Cambridge University Press
Print publication year: 2008

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References

Airedale NHS Trust v. Bland [1993] 1 All ER 821 (House of Lords, England).
Angell, M. (1997). The Supreme Court and physician-assisted suicide: the ultimate right. N Engl J Med 336: 50–3.CrossRefGoogle ScholarPubMed
Annas, G. J. (1996). The promised end: constitutional aspects of physician-assisted suicide. N Engl J Med 335: 683–7.CrossRefGoogle ScholarPubMed
,Anon. (1996). Managing a comfortable death. Lancet 347: 1777.CrossRefGoogle Scholar
Bachman, J. G., Alcser, K. H., Doukas, D. J., et al. (1996). Attitudes of Michigan physicians and the public toward legalizing physician-assisted suicide and voluntary euthanasia. N Engl J Med 334: 303–9.CrossRefGoogle ScholarPubMed
Brock, D. W. (1992). Voluntary active euthanasia. Hastings Cent Rep 22: 10–22.CrossRefGoogle ScholarPubMed
Brody, H. (1992). Assisted death: a compassionate response to a medical failure. N Engl J Med 327: 1384–8.CrossRefGoogle ScholarPubMed
Brody, H. (1993). Causing, intending, and assisting death. J Clin Ethics 4: 112–17.Google ScholarPubMed
Callaghan, D. (1992). When self-determination runs amok. Hastings Cent Rep 22: 52–5.CrossRefGoogle Scholar
Compassion in Dying v. Washington [1996] 79 F 3d 790 (9th Cir).
Dickens, B. M. (1993). Medically assisted death: Nancy B. v. Hotel–Dieu de Quebec. McGill Law J 38: 1053–70.Google Scholar
Dobscha, S. K., Heintz, R. T., Press, N., and Ganzini, L. (2004). Oregon physicians' responses to requests for assisted suicide: a qualitative study. J Palliat Med 7: 450–61.CrossRefGoogle ScholarPubMed
Drickamer, M. A., Lee, M. A., and Ganzini, L. (1997). Practical issues in physician-assisted suicide. Ann Intern Med 126: 146–51.CrossRefGoogle ScholarPubMed
Foley, K. M. (1997). Competent care for the dying instead of physician-assisted suicide. N Engl J Med 336: 54–8.CrossRefGoogle ScholarPubMed
Ganzini, L. and Dobscha, S. K. (2003). If it isn't depression. J Palliat Med 6: 927–30.CrossRefGoogle ScholarPubMed
Ganzini, L., Nelson, H. D., Schmidt, T. A., et al. (2000). Physicians' experiences with the Oregon Death with Dignity Act. N Engl J Med 342: 557–63.CrossRefGoogle ScholarPubMed
Ganzini, L., Harvath, T. A., Jackson, A., et al. (2002). Experiences of Oregon nurses and social workers with hospice patients who requested assistance with suicide. N Engl J Med 347: 582–8.CrossRefGoogle ScholarPubMed
Genuis, S. J., Genuis, S. K., and Chang, W. C. (1994). Public attitudes toward the right to die. CMAJ 150: 701–8.Google ScholarPubMed
Gillon, R. (1988). Euthanasia, withholding life-prolonging treatment, and moral differences between killing and letting die. J Med Ethics 14: 115–7.CrossRefGoogle ScholarPubMed
Guillod, O. and Schmidt, A. (2005). Assisted suicide under Swiss law. Eur J Health Law 12: 25–38.CrossRefGoogle ScholarPubMed
Kamisar, Y. (1958). Some non-religious views against proposed “mercy killing” legislation. Minnesota Law Rev 42: 969–1042.Google Scholar
Kamisar, Y. (1995). Against assisted suicide: even a very limited form. Univ Detroit Mercy Law Rev 72: 735–69.Google Scholar
Kinsella, D. T. (1991). Will euthanasia kill medicine?Ann R Coll Physic Surg Canada 24: 489–92.Google Scholar
Kuhse, H. and Singer, P. (1988). Doctors' practices and attitudes regarding voluntary euthanasia. Med J Aust 148: 623–7.Google ScholarPubMed
Lee, M. A., Nelson, H. D., Tilden, V. P., et al. (1996). Legalizing assisted suicide: views of physicians in Oregon. N Engl J Med 334: 310–15.CrossRefGoogle ScholarPubMed
Meier, D. E., Emmons, C. A., Wallenstein, S., et al. (1998). A national survey of physician-assisted suicide and euthanasia in the United States. N Engl J Med 338: 1193–201.CrossRefGoogle ScholarPubMed
Meier, D. E., Emmons, C. A., Litke, A., Wallenstein, S., and Morrison, R. S. (2003). Characteristics of patients requesting and receiving physician-assisted suicide. Arch Intern Med 163: 1537–42.CrossRefGoogle Scholar
Quill, T. E. (1993). The ambiguity of clinical intentions. N Engl J Med 329: 1039–40.CrossRefGoogle ScholarPubMed
Quill, T. E., Cassel, C. K., and Meier, D. E. (1992). Care of the hopelessly ill. Proposed clinical criteria for physician-assisted suicide. N Engl J Med 327: 1380–4.CrossRefGoogle ScholarPubMed
Quill v. Vacco [1996] 80 F 3d 716 (2nd Cir).
R v. Adams (1957). Crim LR 365.
Rachels, J. (1975). Active and passive euthanasia. N Engl J Med 292: 78–80.CrossRefGoogle ScholarPubMed
Rodriguez v. Attorney-General of British Columbia (1993) 107 DLR (4d) 342 (Supreme Court of Canada).
Roy, D. J. (1990). Euthanasia: where to go after taking a stand?J Palliat Care 6: 3–5.Google Scholar
Shapiro, R. S., Derse, A. R., Gottlieb, M., Schiedermayer, D., and Olson, M. (1994). Willingness to perform euthanasia. A survey of physician attitudes. Arch Intern Med 154: 575–84.CrossRefGoogle ScholarPubMed
Singer, P. A., Choudhry, S., Armstrong, J., Meslin, E. M., and Lowy, F. H. (1995). Public opinion regarding end of life decisions: influence of prognosis, practice and process. Soc Sci Med 41: 1517–21.CrossRefGoogle ScholarPubMed
Special Senate Committee on Euthanasia and Assisted Suicide (1995). Of Life or Death. Ottawa: Supply and Services Canada.
Sue Rodriguez v. British Columbia (Attorney General) (1993) 3 SCR 519 [See Justice Cory's dissent].
Maas, P. J., Wal, G., Haverkate, I., et al. (1996). Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990–1995. N Engl J Med 335: 1699–705.CrossRefGoogle ScholarPubMed
Veldink, J. H., Wokke, J. H., Wal, G., Jong, Vianney J. M., and Berg, L. H. (2002). Euthanasia and physician-assisted suicide among patients with amyotrophic lateral sclerosis in the Netherlands. N Engl J Med 346: 1638–44.CrossRefGoogle ScholarPubMed
Ward, B. J. and Tate, P. A. (1994). Attitudes among NHS doctors to requests for euthanasia. BMJ 308: 1332–4.CrossRefGoogle ScholarPubMed
Williams, G. (2001). The principle of double effect and terminal sedation. Med Law Rev 9: 41–53.CrossRefGoogle ScholarPubMed
Wysong, P. (1996). Doctors divided on euthanasia acceptance: preference is to refer euthanasia to another doctor. Med Post 32: 1: 90.Google Scholar

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