Claire Dawson
Assisted suicide, also known as medical aid in dying, assisted dying, or voluntary assisted dying, is a highly debated topic that revolves around the idea of a physician facilitating a patient's death by providing the necessary means or information to end their life. While some advocates strongly oppose the term assisted suicide, preferring terms that emphasise the patient's autonomy and the medical context, others argue that it contradicts the dignity of human life and goes against religious beliefs. The practice is governed by varying state legislation and eligibility criteria, with some requiring a terminal illness or incurable disability, and individuals typically self-administering the medication at a place of their choosing. Physician-assisted suicide raises ethical concerns, with organisations like the American Medical Association (AMA) opposing it, while also acknowledging the commitment to values of care, compassion, and respect for patients' autonomy and dignity.
| Characteristics | Values |
|---|---|
| Definition | Physician-assisted suicide occurs when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act. |
| Other Names | Medical aid in dying, assisted dying, voluntary assisted dying, Death with Dignity, physician-assisted dying, aid-in-dying, and euthanasia. |
| Requirements | Requirements vary by location. In Switzerland, a medical diagnosis is not required, but a person of sound mind can seek assistance. In Canada and many European countries, eligibility includes 'unbearable suffering'. In Oregon, 92% of people choose to take the medication at home. |
| Religious Views | The Catholic Church and Hinduism view assisted suicide as a sin. |
| Physician Views | The World Medical Association, the American Medical Association (AMA), and the World Medical Assembly oppose assisted suicide. |
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What You'll Learn
Physician-assisted suicide
While some people advocate for physician-assisted suicide as a way to end life in a peaceful, humane, and dignified manner, others strongly oppose it due to ethical, religious, and moral concerns. The Catholic Church, for example, teaches that euthanasia is unacceptable as it is perceived as a sin, going against the commandment "Thou shalt not kill". Similarly, the Statement of Marbella, adopted by the World Medical Assembly in 1992, states that "physician-assisted suicide, like voluntary euthanasia, is unethical and must be condemned by the medical profession". As of 2022, the American Medical Association (AMA) also opposed medical aid in dying.
However, supporters of physician-assisted suicide argue that it allows patients to end their lives free from unnecessary suffering, respecting their autonomy and dignity. In some countries, such as Switzerland, a person of sound mind can seek assistance to commit suicide even without a medical diagnosis. In such cases, the person must have a terminal illness, an unendurable incapacitating disability, or unbearable and uncontrollable pain.
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Death with Dignity laws
Assisted suicide, also known as "medical aid in dying", "assisted dying", or "voluntary assisted dying", is a highly controversial topic. The World Federation of Right to Die Societies adopted the phrase "voluntary assisted dying" as the preferred terminology for this medical practice. The Catholic Church, on the other hand, teaches its followers that euthanasia is unacceptable as it is perceived as a sin, going against one of the Ten Commandments: "Thou shalt not kill". Hinduism also views suicide as a serious act as it conflicts with core principles like dharma (duty), karma (actions and consequences), and ahimsa (non-violence).
To qualify for Death with Dignity laws, individuals must meet specific criteria, including being a resident of a state where such laws are in effect, being capable of making and communicating their healthcare decisions, and being diagnosed with a terminal illness that will lead to death within a certain timeframe, as confirmed by qualified healthcare providers. Additionally, individuals must be capable of self-administering and ingesting the medications without assistance.
The process of finding a healthcare provider to participate in Death with Dignity laws can vary. Individuals can discuss their end-of-life goals with their current healthcare provider to determine if they are willing to participate. If the provider agrees, they can provide a referral to a second provider for further confirmation of eligibility. The Academy of Aid in Dying Medicine (AADM) also offers support for patients in states where medical aid in dying is legal.
It is important to note that Death with Dignity laws do not specify who must pay for the services, and individual insurers determine whether the procedure is covered under their policies. Federal funding, including Medicaid and Medicare, cannot be used for services or medications received under these laws. Additionally, medications prescribed under these laws are carefully tracked and regulated by federal statutes to ensure they are only taken by the person they are prescribed to.
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Religious views on assisted suicide
Assisted suicide and euthanasia are important contemporary issues, and religious faiths offer valuable insights into the discussion. Most religious groups have historically opposed the legalisation of assisted suicide, but there is a growing movement of people arguing for its introduction based on faith.
Christianity
Christian denominations vary in their approach to assisted suicide and euthanasia. The Catholic Church, for example, is one of the most active organisations in opposing euthanasia and assisted suicide. It opposes these practices on the grounds that life is a gift from God and should not be prematurely shortened. This view can be traced back to ancient Jewish and early Christian attitudes towards suicide. The Episcopal Church passed a resolution against assisted suicide and other forms of active euthanasia in 1991, stating that it is "morally wrong and unacceptable to take a human life to relieve suffering caused by incurable illness". The Anglican Church also remains opposed to the practice. However, some Episcopalians and Anglicans approve of assisted dying in rare cases. The Lutheran Church affirms that deliberately destroying life created in the image of God is contrary to their Christian conscience. The Methodist Church generally accepts the individual's freedom of conscience to determine the means and timing of death, and some regional conferences have endorsed the legalization of physician-assisted dying. The United Church of Christ affirms individual freedom and responsibility and has made pro-choice statements, but has not asserted that hastened dying is the Christian position. The United Reformed Church voted to oppose legalization when it last debated the issue in 2007.
Judaism
According to Jewish teachings, doctors and caregivers should not do anything to hasten death and must work to keep people alive as long as possible. Euthanasia and physician-assisted suicide are almost unanimously condemned in Jewish thought, as they are viewed as taking something (a human life) that belongs to God. Human life is sacred and created in the image of God, and so it must be treated as an end in itself. However, there is a distinction made between active and passive euthanasia, and most Jewish thinkers would agree that Judaism allows for the cessation of life-prolonging treatment in certain cases, such as a dying person in a coma or vegetative state.
Islam
Sunni and Shia Islam determine doctrine by interpreting the Quran and Hadith. Assisted suicide is almost universally considered a form of murder in Sunni praxis and is taught against by the highest-ranking Shia clerics.
Hinduism
There is less clarity around Hindu medical ethics, as the faith does not have a single historical tradition to draw on. Some Hindus argue that any unnatural ending of a life is wrong because it would interfere with the cycle of reincarnation and bring bad karma. Suicide may also be seen as breaching Hinduism's prohibition on violence. However, other streams of thought in Hinduism could lead some Hindus to support changing the law, as the act of suicide is not universally condemned and can be seen as a virtuous act in some circumstances.
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Physician's obligations
Physician-assisted suicide, also known as "medical aid in dying", "assisted dying", or "voluntary assisted dying", is a highly controversial topic that raises ethical and legal questions. While some people advocate for assisted dying, they oppose the terms "assisted suicide" and "suicide", believing that these terms do not accurately represent the medical practice.
Physicians have obligations to their patients and are expected to uphold the ethical norms of their profession, including fidelity to patients and respect for patient self-determination. The Declaration of Geneva, a revision of the Hippocratic Oath, states that physicians should "respect the autonomy and dignity of [their] patient" and "maintain the utmost respect for human life". The International Code of Medical Ethics further emphasises that "a physician shall always bear in mind the obligation to respect human life".
However, the concept of physician-assisted suicide contradicts these fundamental principles. The Statement of Marbella, adopted by the World Medical Assembly in 1992, condemns physician-assisted suicide as unethical. Additionally, the American Medical Association (AMA) has opposed medical aid in dying as of 2022.
Physicians have a duty to relieve patient suffering and provide compassionate end-of-life care. While some argue that physician-assisted suicide could alleviate suffering, others believe it is incompatible with a physician's role as a healer and would cause more harm than good. The potential for societal risks and the difficulty in controlling the practice are also significant concerns.
In most jurisdictions, criminal law prohibits physicians from intentionally assisting patients in ending their lives, whether through the direct administration of lethal drugs or by providing the means for patients to do so themselves. The US Supreme Court has ruled that legalising or criminalising physician-assisted suicide is a matter of states' rights, leaving the decision to individual states. As a result, the laws and regulations regarding physician-assisted suicide vary across different regions.
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Assisted suicide in Switzerland
Assisted suicide, also known as medical aid in dying (MAID), is a highly controversial ethical issue in the global medical community. While some advocates for assisted dying oppose the use of the term "assisted suicide", preferring terms like "medical aid in dying" or "assisted dying", the act of assisted suicide is generally understood as a medical practice in which individuals are provided with the means to end their lives in a peaceful, humane, and dignified manner. This practice is especially intended for those with terminal illnesses or incurable suffering.
In Switzerland, assisted suicide is not legally considered a medical act and is instead conducted by associations such as Dignitas, Exit, Lifecircle, Pegasos, and ExInternational. These organisations help individuals seeking assisted suicide by organising appointments, handling administrative procedures, procuring lethal doses, providing logistical support, and managing the aftermath of death. The process can be costly, ranging from 7,000€ to 11,000€, excluding transportation.
Swiss law allows any person of sound mind to seek assistance in committing suicide, even without a medical diagnosis. In the case of mental illness, the Federal Supreme Court affirmed in 2023 that intensive discussions with the individual, consulting their relatives, and obtaining a second medical opinion are sufficient for a doctor to prescribe lethal medication. Notably, a psychiatric specialist's opinion is not required.
The Swiss association Dignitas requires individuals seeking assisted suicide to have a terminal illness, an unendurable incapacitating disability, or unbearable and uncontrollable pain. Additionally, individuals must be able to self-administer the medication during the last stage of the process. While Exit, the largest right-to-die organisation in Switzerland, has similar criteria, they have also recognised symptom-oriented criteria such as "subjectively unbearable discomfort" and "intolerable disability" as sufficient for assisted dying.
Switzerland has witnessed a significant increase in the number of people choosing assisted dying over the years. While there were fewer than 40 cases per year in the mid-1990s, this number rose to nearly 1200 cases by 2018. The Swiss model of MAID emerged in the 1980s due to comparatively open legal regulations, and the country continues to be a pioneer in this field.
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Frequently asked questions
Assisted suicide, also known as "medical aid in dying", "assisted dying", or "voluntary assisted dying", is a practice in which a physician provides the means or information necessary for a patient to end their own life. This may include providing prescription medication.
The laws surrounding assisted suicide vary depending on the location. In some places, such as Canada and several European countries, eligibility for assisted suicide includes 'unbearable suffering'. In Switzerland, a medical diagnosis is not required, but the person must be of sound mind and able to administer the medication themselves. In the United States, federal funding cannot be used for services or medications received under assisted suicide laws.
There are differing opinions on the ethical implications of assisted suicide. The Statement of Marbella, adopted by the World Medical Assembly in 1992, states that "physician-assisted suicide, like voluntary euthanasia, is unethical and must be condemned by the medical profession". On the other hand, supporters of assisted suicide argue that it allows patients to end their lives free from unnecessary suffering while still upholding values such as care, compassion, respect, and dignity.
Instead of engaging in assisted suicide, physicians are expected to provide aggressive end-of-life care, good communication, emotional support, comfort care, and adequate pain control. For terminally ill patients, palliative care is recommended, which treats physical pain while also addressing psychological and spiritual suffering.
