Euthanasia and Assisted Suicide

Euthanasia is translated from Greek as "good death" or "easy death." As originally used, the term referred to painless and peaceful natural deaths in old age that occurred in comfortable and familiar surroundings. That usage is now archaic. As the word is currently understood, euthanasia occurs when one person ends the life of another person for the purpose of ending the killed person's pain or suffering.

Euthanasia is sometimes divided into different categories. "Voluntary euthanasia" is when a person is killed upon that person's request for reasons of ending suffering. "Involuntary or nonvoluntary euthanasia" is the mercy killing of a medically or legally incompetent person, such as a child or a demented elderly patient, at the request of, or by, a caregiver or family member.

Some people also use the term "passive euthanasia" to describe a death that occurs after undesired, life-sustaining medical treatment is withheld or withdrawn. This is a misnomer. Euthanasia, at least as the term is presently utilized, involves intentional killing. That being so, "passive euthanasia" is not euthanasia, since death, when it comes—not everyone who has life-sustaining treatment dies as a result of withheld treatment—is naturally caused by the underlying illness or injury.

Assisted suicide is closely related to euthanasia. An assisted suicide occurs when one person gives another person the instructions, means, or capability to bring about their own demise. In the context of the modern moral and public policy debates, the motive in assisted suicide, as in euthanasia, is to bring about an end to suffering. Suicide per se is not considered to be the same as "assisted suicide" because the former is an individual act while the latter involves a joint enterprise between the suicidal person and a helper to bring about death.

The Hippocratic oath explicitly prohibited doctors from giving their patients poisons to end life and thus, traditionally, euthanasia and assisted suicide have not been considered legitimate medical acts. Legalizing either practice would transform hastening patient deaths from an ethically proscribed and (usually) criminal act into a legitimate medical practice. Thus, widespread legalization would be a profound and dramatic shift in the traditional ethics of medical practice.

Euthanasia is currently illegal and punishable as murder throughout the United States. Assisted suicide is a felony akin to manslaughter in most states, proscribed either by statute or court interpretation of the common law. The federal government has outlawed the use of federal funds in assisted suicide.

Assisted suicide is, however, legal in Oregon, where state law authorizes physicians to write lethal prescriptions at the request of patients who have been diagnosed with a terminal illness reasonably likely to cause death within six months. In order for the assisted suicide to be legal, the prescribing physician must follow regulatory guidelines. These guidelines include: requiring a second opinion to verify the diagnosis; referral of the patient to a mental health professional if the doctor suspects the patient has a psychiatric or psychological condition that causes "impaired judgment"; a fifteen-day waiting period between request and prescription; and, reporting the assisted suicide to the Oregon Department of Health. Most current legalization proposals in the United States follow the format of the Oregon law.

Internationally, both euthanasia and assisted suicide are almost universally outlawed. There are a few exceptions to this general rule. In Colombia euthanasia is legal due to a ruling by that country's supreme court (Republic of Colombia Constitutional Court: Sentence: no. C-239/97: REF. EXPEDIENT no. D-1490. May 20, 1997). As of this writing the Colombia law has not gone into effect pending the creation of legal guidelines to govern the practice. Euthanasia and assisted suicide, while technically illegal, are practiced widely by doctors in the Netherlands. The Netherlands experience will be discussed in detail below. Assisted suicide is not illegal in Switzerland, where assisted suicides committed by physicians and laypersons alike are reportedly not prosecuted if based on alleviating suffering caused by serious illness.