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An international look at assisted suicide and euthanasia

 

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Written By:
Laza Florina

Edited By:
Rachit Mehrotra

It’s hardly easy to talk about assisted suicide or euthanasia without giving it much thought and consideration of the pain and sufferings those condemned by faith had to endure to arrive at the unfortunate point of choosing to leave the world of the living. In a spirit of compassion and only considering each person’s past experiences, ethics and different levels of tolerance we could be able to issue valuable judgments over one’s decision, but that judgment represents only one opinion in a sea full of motives and reasons. The truth is that no one can provide a universal recipe for fairness and after all, no one can speak on behalf of another’s heart.

Is it really necessary to introduce the right to control one’s life and death as a fundamental civil right from which no one of sound mind should be excluded? Some people talk about this possible future right describing it as an incontestable ultimate personal liberty that could only be exercised by using the manner of one’s choosing. But what is assisted suicide? And, of course, what is euthanasia?

Assisted suicide is the suicide committed with the help of a physician who knowingly and intentionally provided a person with the knowledge or means or both required to commit suicide [1]. This help takes place in the form of prescribing the lethal drugs necessary, counseling about the use of those drugs or only supplying them. On the other hand, euthanasia means knowingly and intentionally performing an act that is explicitly intended to end another person’s life under some circumstances [2].

Assisted suicide and euthanasia are considered morally equivalent, although there is a clear medical and legal distinction between them. Those practices are not accepted by most medical associations and are prohibited by law in almost all the countries in the world. But there are countries that allow them to take place and the argument that supports the need for medical aid in dying is that a patient should have the right to shorten the unbearable dying process and end his life in a more reliable and peaceful way.

First of all, the taboo subject concerning the right of a doctor to take someone’s life if requested by the patient stood in the souls of men for centuries to come before the birth of Christ. Even though the Hippocratic Oath included the following statement “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan” [3], it was common knowledge among the Greek and Roman physicians, during the 5th Century B.C., that voluntarily death was preferred over prolonged torment and so they would often give their patients the poisons they requested [4].
After the spread of Christianity upon the whole world, the moral views changed and so it became a matter of Christian belief since life is a gift from God and taking it would represent a violation of God’s authority [5]. The views didn’t change for a long period of time is actually outrageous to talk about such a thing openly until the Age of Enlightenment when the most remarkable thinkers questioned Church’s teachings on all matters including the subject of assisted suicide, but this proved to be only temporarily [6].

It was only Samuel Williams the first man to raise the subject of euthanasia in the public’s eyes after centuries of silence by advocating for the use of morphine and other painkiller drugs to intentionally end a patient’s life during the late 1800s. It received much attention from the medical publications at the time, especially from the Journal of the American Medical Association [7] who responded by comparing Mr. William’s proposals to the image of a physician wearing the grim reaper robe.
The subject of euthanasia has attracted much attention and encouragement from the American public when a Chicago surgeon, Dr. Harry J. Haiselden, chose not to perform a surgery that could have saved a newborn’s life. The baby had numerous disabilities and according to his diagnosis, he did not have much time to live. Baby’s parents agreed with his decision of letting “nature completes its bungled job” [8]. As a result, 45 percent of the American population overtook the belief of permitting permanently deformed newborn to die for the good of the society. Many believed it was only a matter of time until euthanasia would have become legal, but the news about the Nazi atrocities upon mental patients and handicapped children [9] arrived at the Americans’ ears and the euthanasia movement had to take several steps back.

Later, the British and American Euthanasia Societies as principal actors in the support of euthanasia and assisted suicide submitted a petition to the UN Commission on Human Rights to include “the right of incurable sufferers to end their life to euthanasia of merciful death”, but the petition wasn’t presented to the commission.

By the end of the 20th century, the right-to-die movement gained considerable support and this time more than half of the American public was now in favor of those practices. On June 4, 1990, Jack Kevorkian became the first man to assist a person in committing suicide after he helped Janet Atkins who suffered from the Alzheimer’s disease. But eight years later he is sentenced to 10-25 years in prison for the 2nd-degree murder for his role in the euthanasia of Thomas Youk [10]. However, he is released after spending only 8 years in jail.

In 1996, Philip Nitschke became the first doctor in the world to administer a legal, lethal voluntary injection under the short-lived Rights of the Terminally Ill Act 1995 (NT). Four of Philip’s terminally ill patients used this law to end their suffering before the law was dropped out by the Australian Parliament. After this, Dr. Nitschke founded Exit International one of many organizations that support medical aid in dying [11].

In 1997, Oregon became the first and only state to legalize physician-assisted suicide through the Dignity Act [12]. As the process of this new concept spread other 4 countries in America legalized the prescription of lethal doses of medicine to terminally ill patients.
In 2002, Netherlands and Belgium decriminalized the practice paving the way for future countries to reconsider the right to die with dignity under the continuing change of mentalities over the years. In France, this practice is prohibited by law, but in 2005 was introduced the possibility to “limit or stop any treatment that is not useful, is disproportionate or has no other object than to artificially prolong life” or “to use pain-killing drugs that might as a side effect shorten life” through the Leonetti law [13].

In Germany, the term “euthanasia” is avoided, because of the similarity with the Nazi practices and it is preferred the usage of “active and passive assisted suicide”. It is legal only if the lethal drug is taken without any help and respecting a set of conditions. So is the case for the Swiss law whose actually more permissive requesting only the absence of no “self-seeking motives” [14]. Moreover, Switzerland permitted the creation of organizations such as Dignitas and Exit, which are specialized in assisted dying services in exchange for a fee.

And only four years ago, in 2014, Belgium became the first country to legalize euthanasia for minors respecting a set of conditions such as discernment, being terminally ill, close to death, suffering beyond any medical help and explicit consent from parents or legal representatives [15].
However, in India, only passive euthanasia is allowed since the Supreme Court of India’s historic decision in the Aruna Shanbaug case finally placing the possibility to choose to die in the hand of the individual, but only by means of withdrawal of life support to patients in a permanent vegetative state [16].

In conclusion, the constant debate over a person’s right to die with dignity, usually in cases of painful terminal illness, is still grabbing opinions and disagreements all over the world. If we take into consideration how different populations are given the regions they are coming from, history, traditions, it’s only natural that some countries permit at the moment the usage of euthanasia and assisted suicide and others don’t. However, I am certain that in the decades to come we will most certainly see things moving faster and the collective mentality of the people will finally reach a consensus.

[1] CMA. (2007). Euthanasia and assisted suicide. [online] Available at: https://www.cma.ca/Assets/assets-library/document/en/advocacy/EOL/cma-policy-euthanasia-assisted-death-updated-2014-e.pdf. [Accessed 4 Feb. 2018].
[2] Ibid.
[3] U.S. National Library of Medicine. (n.d.). Greek Medicine – The Hippocratic Oath. [online] Available at: https://www.nlm.nih.gov/hmd/greek/greek_oath.html [Accessed 4 Feb. 2018].
[4] Dowbiggin, I. (2007). A concise history of euthanasia. Lanham: Rowman & Littlefield, pp. 9 – 10.
[5] Ibid, pp. 15.
[6] Ibid., pp. 35.
[7] Ibid, pp. 50.
[8] Dowbiggin, I. (2003). A merciful end. Oxford [England]: Oxford University Press, pp. 23.
[9] Ibid., pp. 72.
[10] LATSON, J. (2015). Why ‘Dr. Death’ Wanted to Be Charged with Murder. Time. [online] Available at: http://time.com/3748245/kevorkian-trial-history/ [Accessed 4 Feb. 2018].
[11] Exit International. (n.d.). Philip Nitschke. [online] Available at: https://exitinternational.net/about-exit/dr-philip-nitschke/ [Accessed 4 Feb. 2018].
[12] Connecticut General Assembly. (2002). OREGON’S ASSISTED SUICIDE LAW. [online] Available at: https://www.cga.ct.gov/2002/rpt/2002-R-0077.htm [Accessed 4 Feb. 2018].
[13] The Guardian (2018). France adopts sedated dying law as a compromise on euthanasia. [online] Available at: https://www.theguardian.com/society/2016/jan/28/france-adopts-sedated-dying-law-as-compromise-on-euthanasia [Accessed 4 Feb. 2018].
[14] The Guardian (2014). Euthanasia and assisted suicide laws around the world. [online] Available at: https://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world [Accessed 4 Feb. 2018].
[15] Ibid.
[16] PANDEY, A. (2016). Everything You Need To Know About Aruna Shanbaug, Whose Case Led To India’s Euthanasia Debate. India Times. [online] Available at: https://www.indiatimes.com/news/india/everything-you-need-to-know-about-aruna-shanbaug-whose-case-led-to-india-s-euthanasia-debate-254885.html [Accessed 4 Feb. 2018].

 

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