Euthanasia: End of Life Issues

• Euthanasia is the deliberate ending of the life of a patient, either by act or omission, usually out of compassion.
  
• Voluntary euthanasia is when the patient makes the decision to ask his doctor to end his life for him.
  
• Non-voluntary euthanasia is the deliberate ending of the life of a patient whether or not he is able to ask for or to reject euthanasia.
  
• In-voluntary euthanasia is the deliberate ending of the life of a patient even though it is against his wishes.
  
• When treatment is no longer of any benefit to a patient or is overly burdensome doctors will rightly withdraw it and will make all patients as comfortable and pain-free as possible until the time of natural death.
  
• Britain has a very high standard of hospice care for terminally ill patients.
  
• Hospice doctors can relieve 95% of pain and can help 100% of terminally ill patients.
  
• The World Health Organisation recognize that “Palliative care has promoted wider application of the principles of pain and symptom control. However, more work is needed to train all professionals in assessing, monitoring and treating pain and distressing symptoms in all settings.” (WHO Palliative Care – The Solid Facts, Elizabeth Davies and Irene J. Higginson Eds., 2004). Part of the answer to helping those seeking euthanasia is better training of health professionals in providing quality end-of-life care.
  
• Opposing euthanasia does not mean trying to keep people alive as long as possible.
  
• Supporters of euthanasia argue that only those patients who ask for euthanasia will be killed.
  
• In the Netherlands only voluntary euthanasia is legal, but there have been more cases of euthanasia without or against the request of the patient.
  
• Legalised euthanasia would not allow everyone who requests it the right to be killed. Doctors, lawyers and politicians would decide which medical condition a person must have before they have a right to euthanasia.
  
• International human rights charters recognise that we have an “inalienable” right to life. This means that no one has the right to give away his/her right to life.
  
• The law does not allow anyone the ‘right’ to die. Death is not a right. It is something that happens to everyone.
  
• Legalised euthanasia is the right to be killed. Pressure would then fall on doctors to carry out the wishes of their patients.
  
• Legalised euthanasia harms trust between doctors and patients, as patients would fear being killed by their doctors.
  
• In the Netherlands only about 5% of people who ask to be killed do so because of physical pain.
  
• It was reported in The Lancet medical journal in 2001 that “Although the traditional idea is that such deaths are wished for as a means to avoid pain and suffering, studies suggest that this explanation is insufficient. In fact, depression, hopelessness, psychological distress, and need for social support are all factors.” (Origins of the desire for euthanasia and assisted suicide in people with HIV-1 or AIDS: a qualitative study The Lancet 2001; 358:362-367). The authors reported that although this study was confined to HIV/AIDS patients, it nonetheless reflected the research on patients with other types of illness.
  
• In Britain the courts have allowed doctors to remove food and fluids from patients in a PVS (persistent vegetative state) resulting in death through starvation and dehydration. A person in a PVS cannot consent to being killed and so this is non-voluntary euthanasia.
  
• People in a PVS cannot feed themselves and they may not be able to respond to those around them. However, all of their vital organs still work and they can breathe for themselves. People in a PVS are not usually dying.
  
• Some people who ask for euthanasia suffer from depression. In these cases, his/her depression can and should be treated regardless of his/her physical condition.
  
• We all have ‘disabilities’.
  
• We were all helpless babies. We may become disabled tomorrow through disease or an accident. We are temporarily disabled through illness. We will become more and more dependent as we grow old.

SPUC Scotland
March 2003

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