Assisted Death and Euthanasia
Background and Project Overview
What is Assisted Suicide?
According to dictionary.com, it is “a person’s voluntary suicide
with help from another individual, mainly a physician.”
– Most often, a person who chooses to do this suffers from some
form of terminal illness and/or extreme suffering.
Assisted Suicide refers to the act of providing an individual with
the means to commit suicide, knowing what they plan to do in
– Ex: a doctor prescribes an overdose of drugs to a patient who
wants to die, and they use those drugs to kill themselves.
What is Euthanasia?
According to dictionary.com, it is “the practice of mercifully ending
a person’s life in order to release the person from an incurable
disease, intolerable suffering, or undignified death.”
– May not necessarily be the person’s decision
The word euthanasia is derived from Greek, meaning “good
death” and originally referred to intentional mercy killing.
When medical advances made prolonging the lives of dying or
comatose patients possible, the term euthanasia was also applied
to the action of not acting to prevent death.
Types of Euthanasia/Assisted Death
– A physician painlessly puts someone who is suffering from
incurable conditions/diseases to death.
– Any act that allows the patient to die, which may include failing
to provide necessary medication, as well as taking a patient off
Both Active and Passive euthanasia can be voluntary,
non-voluntary or involuntary.
– A patient or their proxy (someone legally authorized to act on behalf of the patient)
chooses to be euthanized and makes a fully-informed request to do so.
– Occurs without the consent and request of a patient or that of their proxy.
– The patient is either unconscious, unable to communicate, or is too sick and weak to
be aware of what is happening or to take any action on his/her own behalf.
Involuntary euthanasia: (rare)
– Occurs over the objection of a patient or their proxy for a variety of reasons.
– Generally considered murder!
Ex: A patient changes their mind at the last minute, and doctors must respect their decision.
Often covered up afterwards.
– A combination of medically inducing a deep sleep and stopping other treatment, with
the exception of medication for symptom control in the last hours or days of a
– It is considered to be euthanasia by some, but under current law and medical
practice it is considered a form of palliative care.
Reduces severity of symptoms, but doesn’t cure the ailment.
The ancient Greeks and Romans were the first to keep official
records of “mercy killing.”
– They believed that in some situations, it was permissible to help others
We know for a fact that infanticide was practiced in Sparta for children who
lacked “health and vigor.”
Euthanasia of the elderly was an acceptable custom in other
smaller, ancient societies as well.
In other societies such as Ancient Egypt for example, criminals
were allowed to commit suicide by drinking poison to avoid shame
in the afterlife, and servants often committed ritual suicide via the
same methods to follow their masters into the afterlife.
– Can be considered “assisted death” since someone else prepared the
poison for them to drink.
Ancient Japanese ritual suicide by disembowelment.
Key part of Bushido, which is the code of the samurai.
– Used by warriors to avoid falling into enemy hands.
– Some were ordered by their lords to commit it.
– Disgraced or captured samurai were sometimes allowed or forced to do it.
It can be considered “assisted death” despite the fact that the person would stab
themselves in the stomach.
– The person committing seppuku would need the aid of an assistant (kaishakunin)
who would perform the final death maneuver, called daki-kubi, where the person
was all but decapitated- leaving a slight band of flesh left to attach the head to
It was considered dishonorable to be completely decapitated.
This step required precision, and this assistant was usually a friend of the person
committing seppuku, whom they trusted.
About 400 B.C.: The Hippocratic Oath- “no
doctor shall give lethal medicine” is written.
Most religions, such as Christianity, Judaism,
Islam, etc. held (and still hold) human life
sacred and do not agree with killing of any
United States – 1800’s
Suicide and voluntary euthanasia were illegal
If a person advised someone to commit suicide, and
they did, the advisor would be charged with murder.
If a person had someone assist in their suicide, that
person would be charged with murder.
According to the law, the right to life was sacred and
– Due to this, people who suffered from terminal illnesses,
fatal wounds, etc. as well as criminals condemned to death
were under the protection of the law for as long as they lived.
In 1828, the earliest law to clearly outlaw assisted suicide
was written in New York.
– It was enacted on December 10 of that year.
– Many of the new states and territories followed suit.
Between 1857 and 1865, a criminal code was drafted by
Dudley Field, a law reformer, that prohibited the act of
helping with a suicide, and specifically, “furnishing another
person with any deadly weapon or poisonous drug, knowing
that such person intends to use such weapon or drug in
taking his own life."
Many states began to permit:
– “Living wills”
a document written by someone still legally capable requesting
that they should be allowed to die if they were to become
severely disabled or suffering from a terminal illness.
– Surrogate health care decision making
– Withdrawal or refusal of life sustaining medical treatment
– Drs. Alfred Hoche and Karl Binding published the book
“Permitting the Destruction of Life not Worthy of Life.”
Helped support the argument for pro-euthanasia.
However, it also would help inspire and support Hitler and the
Nazis’s involuntary euthanasia program later on.
Nazi Germany- 1939 Codename: Aktion T4
Hitler authorized the Nazi Euthanasia Program in October of 1939
– Widespread “mercy killing” of the sick and disabled.
– Purpose was to eliminate “life unworthy of life.”
– The people had no choice in the matter though.
"This person suffering from
hereditary defects costs the
community 60,000 Reichsmark
during his lifetime. Fellow German,
that is your money, too."
Before the Holocaust, the German government established
“euthanasia” programs for handicapped German children and adults to
“purify” the gene pool and to keep the cost of their health care down.
-Sanctioned by the government and society.
An estimated 200,000 people were killed at “killing centers” and
psychiatric institutions as a result of the program.
-Nurses were active participants.
-Afterwards, most were never punished, though some were
tried along with the physicians they worked for.
-Some said they felt guilty, but most of the others didn’t see
anything wrong with what they did, and felt they were helping the
patients by stopping their suffering.
This is not really “assisted suicide” in regards to what we will be
discussing, but it does bring up the question,
WHAT IS REALLY ETHICAL?
One of the most well-known advocates of physician-assisted suicide.
In 1987, he began advertising that he would offer “death counseling”
Has helped people to die since 1990, and has ‘helped’ nearly 100
terminally ill people.
Each individual that he worked with took the final action to kill
themselves- voluntary euthanasia.
– Dr. Kevorkian supposedly helped them along only by attaching the
individual to a device that he had made, which would kill them at the
touch of a button.
The first device that Kevorkian invented was called a “Thanatron”
– Kevorkian hooked the patient up to an intravenous catheter, and they
would push a button themselves to release a solution of deadly drugs
into their systems.
The second device that he invented was called a “mercitron”
– Later patients could opt to be killed by this machine, which consisted
of a gas mask, which would administer carbon monoxide when the
patient pushed a button.
He created this because after the first two deaths with the thanatron, his
medical liscense was revoked, and he was no longer able to obtain the
60 Minutes aired a video on Nov. 24, 1998 that Kevorkian had made
of himself assisting with the death of Thomas Youk, who had ALS.
– The district attorney felt compelled to bring him up on murder charges.
On March 26, 1999, Kevorkian was convicted of second-degree
murder and the delivery of a controlled substance. He was
sentenced to 10-25 years in prison.
He is currently imprisoned in Coldwater, Michigan.
He stated in an interview with MSNBC, that if he was granted parole,
he would not actively help people to die, but rather continue to
campaign to have the law changed.
In addition, he has become terminally ill himself, with Hepatitis C,
which he apparently had contracted while doing blood transfusion
– He is expected to pass away within a year.
1995- Australia’s Northern Territory approved a euthanasia bill.
– It went into effect in 1996, but was overturned by the Australian Parliament in 1997.
1998- The U.S. state of Oregon legalizes assisted suicide, though debates about
the law still continue on to this day.
1999- Dr. Jack Kevorkian is sentenced to a 10-25 year prison term for giving a
lethal injection to Thomas Youk. His death was televised on a highly controversial
episode of 60 minutes.
– It was so controversial, that many networks did not air it.
2000- The Netherlands legalizes euthanasia.
2002- Belgium legalizes euthanasia.
2003- The Terri Schiavo case gains national attention when Schiavo’s husband
petitioned to have her feeding tube removed, and her parents opposed it.
On March 18, 2005, after many legal battles, her feeding tube was removed permanently, and she
died 13 days later.
Pros and Cons
Point/counterpoint session with:
Is assisted death constitutional?
2004 = Death with Currently assisted death
Dignity Act in Oregon is illegal in 49 states and
was attacked by the violates section 241 of
Bush administration the current U.S. Criminal
2006 = Supreme Court Code.
ruled that assisted death
was not unconstitutional
In 1990 the AMA Upon receiving a
adopted a informed medical degree each
consent that allowed a Doctor is required to
physician to withdraw take a Hippocratic oath.
terminally ill and life Assisted suicide would
support patients violate this sacred oath.
$50,000-100,000 to keep To stomp out a life
patients alive while dying because it’s not
Waste of money when the convenient or it’s
patient wants to die expensive demeans the
Health care costs => value of human life.
reduced Insurance companies
estates => saved will use assisted death
insurance premiums => as a mean of health care
lowered cost containment.
Do we really have a right to die?
Wesley J. Smith Throughout history
– “If we trust our fellow religious and non-
humans to choose their religious countries have
occupations, their established laws against
significant others, their
political persuasions, and
their stances on religion,
we should also defend
their right to dispose of
their most valuable
possessions their lives.”
Would it only be for people who are
Werth Where do you draw the
– “terminal illness, severe line?
physically or mentally
deteriorating conditions, or
quality of life no longer
acceptable to the
Will assisted suicide truly be
Currently two physicians Strong outside
and mental competence pressures, concerns,
are requirements to be and forces can lead a
granted assisted suicide person to “chose”
Is constant pain and suffering
better than just ending your life?
Margaret Pabst Battin Pain control medicines
states that assisted and medical procedures
suicide is a: are far better then they
– “Self-sacrifice for altruistic have ever been.
Miracle cures or recoveries can
Assisted suicide prompts
doctors and families to
give up on recovery
much too early.
We should never get to a
point where we spend
more time looking for a
way out of life than for a
way to sustain life.
Is assisted suicide safer?
“If you were a family In 18% of attempted
member, which would be assisted suicides, other
more traumatic saying problems occurred.
goodbye to a loved one Dr. Sherwin Nunland
at the hospital or coming – “Assisted suicide
home to see his head sometimes adds to the
and brains splattered suffering that they are
against the wall?” meant to alleviate and
might also preclude the
Hemlock Society tranquil death being
provides suicide kits sought.”
Improving the other’s lives
Vital Organs can be Each life, no matter the
obtained from the the state of the individual, is
doctor assisted suicide. valuable.
If disease is allowed to Human life is more then
run its full course then just a cluster of
some organs can fail. biological cells.
Is one life more valuable
Health Care and Nurse and Doctor
Assisted death frees up Home care for the sick
time for doctors and and elderly is frequently
nurses to treat other offered, when possible.
curable illness Registered nurses are
being replaced with less
Is assisted suicide ethical?