Physician-assisted suicide and physician-assisted euthanasia: evidence from abroad and implications for UK neurologists

2021 ◽  
pp. practneurol-2020-002811
Author(s):  
Uma Nath ◽  
Claud Regnard ◽  
Mark Lee ◽  
Kiran Alexander Lloyd ◽  
Louise Wiblin
Keyword(s):  
Significant Variation ◽  
Assisted Suicide ◽  
Motor Neurone ◽  
Physician Assisted Suicide ◽  
Eligibility Criteria ◽  
Regulatory Oversight ◽  
Assisted Death ◽  
Common Cause ◽  
Loss Of Autonomy

In this article, we consider the arguments for and against physician-assisted suicide (AS) and physician-assisted euthanasia (Eu). We assess the evidence around law and practice in three jurisdictions where one or both are legal, with emphasis on data from Oregon. We compare the eligibility criteria in these different regions and review the range of approved disorders. Cancer is the most common cause for which requests are granted, with neurodegenerative diseases, mostly motor neurone disease, ranking second. We review the issues that may drive requests for a physician-assisted death, such as concerns around loss of autonomy and the possible role of depression. We also review the effectiveness and tolerability of some of the life-ending medications used. We highlight significant variation in regulatory oversight across the different models. A large amount of data are missing or unavailable. We explore physician-AS and physician-assisted Eu within the wider context of end-of-life practice.

When slippery slope arguments miss the mark: a lesson from one against physician-assisted death

2018 ◽  
Vol 44 (10) ◽  
pp. 657-660 ◽  
Author(s):  
Eric Blackstone ◽  
Stuart J Youngner
Keyword(s):  
Continuous Improvement ◽  
Assisted Suicide ◽  
Slippery Slope ◽  
Regulatory Agencies ◽  
Physician Assisted Suicide ◽  
Assisted Death ◽  
Slippery Slope Arguments ◽  
Life Sustaining Treatment ◽  
American Society ◽  
Susan Wolf

In 1989, Susan Wolf convincingly warned of a troublesome consequence that should discourage any movement in American society towards physician-assisted death—a legal backlash against the gains made for limiting life-sustaining treatment. The authors demonstrate that this dire consequence did not come to pass. As physician-assisted suicide gains a foothold in USA and elsewhere, many other slippery slope arguments are being put forward. Although many of these speculations should be taken seriously, they do not justify halting the new practice. Instead, our courts, regulatory agencies, journalists, professional organisations and researchers should carefully monitor and study it as it unfolds, allowing continuous improvement just as our society has done in implementing the practice of limiting life-sustaining treatment.

Szasz, suicide, and medical ethics

Thomas Szasz ◽  
2019 ◽  
pp. 55-64
Author(s):  
George J. Annas
Keyword(s):  
Mental Illness ◽  
Informed Consent ◽  
Suicide Prevention ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
The Subject ◽  
The Right ◽  
Suicidal Patients ◽  
Commit Suicide

Szasz objected to the medicalization of suicide, the legalization of suicide prevention, and especially the coercive role of psychiatry in this realm. He declared that, by medicalizing suicide, we banish the subject from discussion. What is meant by acceptable and unacceptable “suicide”? Who has a right to commit suicide? How does suicide implicate freedom? Does it reflect abortion jurisprudence? How do psychiatrists become suicide’s gatekeepers? Current phenomena (e.g., new physician-assisted suicide legislation) illuminate these and other issues (e.g., euthanasia, informed consent, informed refusal, the “right to die,”), all suggesting how Szasz would react to each. Suicide is legal, but is almost always considered a result of mental illness. Courts approve psychiatrists who want to commit “suicidal” patients involuntarily. Granting physicians prospective legal immunity for prescribing lethal drugs is, at best, a strange and tangential reaction to our inability to discuss suicide (and dying) rationally. Szasz got it right.

Physician-Assisted Suicide: Where to Draw the Line?

2000 ◽  
Vol 9 (3) ◽  
pp. 407-410 ◽  
Author(s):  
ERNLÉ W.D. YOUNG
Keyword(s):  
Public Policy ◽  
Assisted Suicide ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Assisted Death ◽  
Policy Issues ◽  
Moral Distinction ◽  
Physician Assisted Dying ◽  
Hippocratic Tradition

In brief compass, I will touch on three of the central ethical and public policy issues that divide those who are opposed to physician-assisted dying from those who are supportive of this practice. These are: (1) the moral distinction (if any) between actively hastening death and passively allowing to die; (2) how to interpret the Hippocratic tradition in medicine with respect to physician-assisted death; and (3) whether physician-assisted suicide can be effectively regulated. I shall summarize the arguments pro and con with respect to each issue, and also indicate my own position.

Euthanasia and physician-assisted suicide in the Dutch homecare sector: the role of the district nurse

2007 ◽  
Vol 58 (1) ◽  
pp. 44-52 ◽  
Author(s):  
G.G. van Bruchem-van de Scheur ◽  
Arie J.G. van der Arend ◽  
Cor Spreeuwenberg ◽  
Huda Huijer Abu-Saad ◽  
Ruud H.J. ter Meulen
Keyword(s):  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
District Nurse

Death with “dignity”: The wedge that divides the disability rights movement from the right to die movement

2011 ◽  
Vol 30 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susan M. Behuniak
Keyword(s):  
Human Rights ◽  
Assisted Suicide ◽  
Personal Autonomy ◽  
Right To Die ◽  
Disability Rights ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
A Value ◽  
The Right

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives—one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how “dignity” serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use “dignity” to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary—a finding that offers opportunities for dialogue and perhaps even advances in public policy.

Physician-Assisted Suicide: The Role of Mental Health Professionals

1996 ◽  
Vol 6 (4) ◽  
pp. 353-366 ◽  
Author(s):  
Nico Peruzzi ◽  
Andrew Canapary ◽  
Bruce Bongar
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Assisted Suicide ◽  
Physician Assisted Suicide

The Euthanasia Debate: Attitudes, Practices and Psychiatric Considerations

1995 ◽  
Vol 40 (10) ◽  
pp. 593-602 ◽  
Author(s):  
Harvey Max Chochinov ◽  
Keith G Wilson
Keyword(s):  
Mental Health Professionals ◽  
Assisted Suicide ◽  
Psychiatric Morbidity ◽  
Physician Attitudes ◽  
Current Status ◽  
Physician Assisted Suicide ◽  
Recent Developments ◽  
Hastened Death ◽  
Desire For Death

Objective To review the current status of the euthanasia debate by examining public and physician attitudes towards euthanasia, the practice of euthanasia in the Netherlands, recent developments in Canada and other countries, psychosocial considerations related to the desire for death in terminally inpatients, and the roles that psychiatrists may be asked to play in the event of legislative reform involving decriminalization. Methods A literature review was conducted focusing on recent surveys regarding physician and patient attitudes towards euthanasia, the role of psychiatrists and empirical data pertaining to the mental state of patients who request physician-hastened death. Results Psychiatric morbidity among patients requesting physician-hastened death is considerable. Conclusion As a special case of suicide, euthanasia and physician-assisted suicide are of particular relevance to mental health professionals.

scholarly journals Role of non-governmental organisations in physician assisted suicide

BMJ ◽  
2007 ◽  
Vol 334 (7588) ◽  
pp. 295-298 ◽  
Author(s):  
Stephen J Ziegler ◽  
Georg Bosshard
Keyword(s):  
Assisted Suicide ◽  
Physician Assisted Suicide

Death with “dignity”: The wedge that divides the disability rights movement from the right to die movement

2011 ◽  
Vol 30 (01) ◽  
pp. 17-32
Author(s):  
Susan M. Behuniak
Keyword(s):  
Human Rights ◽  
Assisted Suicide ◽  
Personal Autonomy ◽  
Right To Die ◽  
Disability Rights ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
A Value ◽  
The Right

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives—one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how “dignity” serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use “dignity” to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary—a finding that offers opportunities for dialogue and perhaps even advances in public policy.

Rights of the Terminally Ill Act of the Australian Northern Territory

1996 ◽  
Vol 5 (1) ◽  
pp. 157-166 ◽  
Author(s):  
Robert L. Schwartz
Keyword(s):  
United States ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Federal Court ◽  
The United States ◽  
Intractable Pain ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
Court Of Appeals

Over the past year the debate over physician-assisted death has been waged in several courts and legislatures, and before at least one electorate as well. Measure 16, the Oregon Death With Dignity initiative that would permit physician-assisted suicide in some circumstances, was approved by the electorate; but it remains on hold while a permanent injunction issued against it by a Federal judge is reviewed by the United States Court of Appeals. Another Federal court judge's decision that the Washington statute criminalizing physician-assisted suicide was unconstitutional when applied to the case of a competent terminally ill patient in intractable pain, was reversed by a three judge panel of that same United States Court of Appeals.

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