Euthanasia and assisted suicide

In the hundred years since Victorian times, attitudes to sex and death have completely reversed. In those days death was much discussed and celebrated as a normal part of daily life while sex was virtually unmentionable. Now the reverse is true - sex is open for wide discussion while death has become the great taboo.

Perhaps this is one of the reasons why the way in which we leave this world is a subject that brings out intense emotion and often anger. And nothing seems to raise the debate to more fevered levels than the idea that each of us may choose the time and place of our death. Not many people sit on the fence on the issue of euthanasia or assisted suicide - most have fairly strong beliefs that they're either morally right or morally wrong.

Definitions

A variety of terms are used to describe the intentional termination of life. Euthanasia itself is said to be derived from the Greek, euthanatos, which means a gentle and easy death, but this hardly sums up what euthanasia is about. Killing in the name of compassion, or mercy killing, are other terms given to euthanasia.

In the Netherlands, euthanasia is understood to mean termination of life by a doctor at the request of a patient. The Dutch government doesn't turn a blind eye to it. There, the question of whether and how criminal liability for euthanasia should be restricted has been the subject of broad political and public debate for the past 30 years.

Arguments for and against

There are plenty of arguments against sanctioning euthanasia. For instance, how can we be sure a person really wants to die and isn't being taken advantage of (for financial reasons, for example)?

On the other hand, shouldn't people enduring unbearable suffering as part of terminal disease be allowed to relieve their agony and bring forward their inevitable death?

You can hear both sides of the argument from organisations with opposing views. Those in support include the Dignity in Dying, Exit, and The World Federation of Right to Die Societies. Those who believe euthanasia to be dangerous or wrong include the Patients Rights Council, Care Not Killing and Euthanasia.com.

Voluntary euthanasia

Voluntary euthanasia simply emphasises that the choice to die has been made voluntarily by the person in question, rather than imposed on them by legal or social rules. However, opponents of euthanasia often argue that it can be very difficult to be sure that someone's request is truly voluntarily made. For example, an elderly person requiring expensive healthcare may feel that they're such a burden to relatives that they should request euthanasia. There's also a risk that people being treated with powerful painkillers or cancer drugs may not be in a sufficiently clear state of mind or competent enough to make an informed and balanced judgement.

Assisted suicide

In assisted suicide, it's the person who dies who takes the final action to end his or her life, but this action relies on the help or assistance of another (for example, to provide the means of death), compared with euthanasia where the other person actually performs the killing.

Many don't like the word 'suicide' because it brings to mind impulsive and often dramatic acts. The term self-deliverance is being increasingly used instead by those who feel suicide is an inappropriate term to describe the action taken, for example, by someone whose suffering cannot be relieved. But to others, including the law, it's the same as suicide.

A survey found that more than 50 per cent of doctors were in favour of a change in the law to allow physician-assisted suicide in some circumstances, such as extremes of suffering. Opinion polls consistently show that more than 80 per cent of the British public also support it.

The legal position

Around the world, different countries, even different states within countries, have alternate views on assisted suicide. Some countries have defined laws prohibiting the act, such as Canada, Italy, Russia, Hungary and Ireland. Others,such as Sweden and Germany have no specific law but a charge of ‘manslaughter’ may be brought against anyone assisting suicide.

Switzerland, Belgium, Netherlands and Oregon (USA) have laws allowing certain methods of assisted suicide, in well defined circumstances. These vary with the illness, condition, mental state and specific requests of the person seeking help.

In the Netherlands, euthanasia is now covered by the Termination of Life on Request and Assisted Suicide Act (January 2002) which amends the criminal code - so that while euthanasia is still a criminal offence, doctors are exempted from liability if they report their actions and show they've satisfied certain criteria. Find out more about the Act at the website of the Netherlands Ministry of Foreign Affairs.

In Switzerland,in 2001 The Swiss National Council confirmed the assisted suicide law, although voluntary euthanasia is still prohibited. There are four groups involved in assisted suicide in Switzerland, but only one (Dignitas, based near Zurich) will accept non-Swiss citizens, and the decision, by Dignitas, to accept them is closely monitored.

In the UK, the law is also clear about euthanasia: it's illegal and has never been sanctioned.

However, according to a report in the British Medical Journal, a considerable number of doctors are already acceding to requests for active voluntary euthanasia. They're breaking the law, albeit in the belief that they are acting in their patient's best interests.

With several high profile cases recently, there's increasing awareness of the issue, and an increasing openness to discuss it. There has also been an increasing awareness of the need to consider every aspect of a patients' 'end of life' needs and rights, and is a topic being raised and examined by medical teams in every aspect of health and social care.

This gradual eroding of the taboos around death, how we die and what it means to an individual, can only be a good thing