What is Euthanasia?

 

There is a high level of confusion over what euthanasia is and isn’t. Euthanasia isn’t the administration of medications needed to ease pain and suffering at the end of life, nor is it the avoidance of burdensome treatments which may prolong the process of dying or the switching off of life support machines even if this will lead to the death of the patient.

Euthanasia is the deliberate administration of a drug which is intended to cause the death of a patient.

The proposed NSW Voluntary Assisted Dying Bill 2017 will move for the legalisation of voluntary 'assisted-dying'. This proposal allows for a doctor to supply a lethal drug (for example, in the form of a liquid) which is then administered by the patient themselves (assisted suicide), but also allows for a doctor to administer a lethal drug if that patient is physically unable to do so themselves (euthanasia).

The following definitions may be useful to your understanding of euthanasia and some surrounding concepts:

EUTHANASIA: An act where a doctor intentionally ends the life of a person by the administration of drugs, at that person’s voluntary and competent request, for reasons of compassion.  The terms active/passive, and voluntary/involuntary should be avoided when referring to euthanasia as they are ambiguous and confusing. There is no such thing as involuntary euthanasia.  If someone is killed without their consent, even in a medical setting, it is not euthanasia, it is murder.

PHYSICIAN ASSISTED SUICIDE: The situation where a doctor intentionally helps a person to commit suicide by providing drugs for self-administration, at that person’s voluntary and competent request.  Although the doctor is distanced from the act it is morally no different from euthanasia as the intention and outcome is the same.

These practices need to be distinguished from..

1. WITHDRAWAL OF FUTILE OR BURDENSOME TREATMENT  When a patient is in the terminal stages of their illness, a time may come when treatments aimed at cure either no longer work (they are futile) or the burden of side-effects such as nausea and vomiting may be so overwhelming that they cancel out any benefit of treatment.  At this stage the treatment may be not prolonging life so much as prolonging the process of dying.  At this time a decision may be made to stop, or decide not to start, such a treatment.  It is not euthanasia because the intention is not to kill the patient, but to allow the underlying disease to take its course. Full supportive care will remain in place so the patient is kept comfortable.

2. SYMPTOM CONTROL  Sometimes in the terminal stages of disease the distressing nature of a patient’s symptoms may require the careful sedation of the patient.  Once again this will be done carefully in consultation with the patient, and the sedation will be lightened periodically to allow the patient to communicate.  It is not euthanasia because the intention is not to kill the patient, but to alleviate their distressing symptoms.

Similarly treatment with morphine is often equated with euthanasia.  There is no evidence that morphine used in therapeutic doses shortens life.

These two strategies are appropriate medical practice at the end of life and should be encouraged.

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