Assisted Suicide: Prevalence, Controversy, and Its Impact on Families
Assisted suicide is when a physician or someone else provides drugs that enable an individual to end their life.
Physician-assisted suicide is legal in several countries as well as several states in America and is generally only available to mentally competent adults with terminal diagnoses who are expected to live for six months or less. As a result, assisted suicide is often seen as a way to end a patient’s suffering. However, there is still a great deal of controversy over whether assisted suicide should be allowed or not.
Read ahead to learn more about the controversy surrounding assisted suicide, and how the practice impacts families.
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What’s the Difference Between Assisted Suicide and Euthanasia?
The terms assisted suicide and euthanasia are often confused and have been defined in various ways, but they differ in one key way.
Assisted suicide involves a physician or someone else providing drugs at the patient’s request that the patient then self-administers with the goal of ending their life
Euthanasia involves a physician or someone else intentionally ending a person’s life
Types of Euthanasia
Because it involves a physician or another third party taking action to end a person's life, there are several different kinds of euthanasia:
Voluntary active euthanasia occurs when the patient requests euthanasia.
Involuntary active euthanasia occurs when a physician or someone else ends the life of a patient who could have requested euthanasia but did not.
Nonvoluntary active euthanasia occurs when a physician or someone else ends the life of a patient who is not mentally competent due to conditions like Alzheimer’s and therefore is unable to request euthanasia.
Passive euthanasia: When a life-saving treatment is withheld from a patient. This is done with the patient's best interest in mind.
There Is Much Disagreement Among Use of the Term 'Assisted Suicide'
Various organizations, including the American Academy of Hospice and Palliative Medicine and the American Public Health Association, argue against the use of the term “suicide” in assisted suicide because the desire to end one’s life when one is dying is distinct from traditional suicidal behavior where someone who is not dying decides to end their life.
Others object to the term “physician-assisted suicide,” due to its focus on the physician. They suggest the term makes it appear as though the physician is the decision-maker, and this draws focus away from the patient.
Alternative Terms: Hastened Death, Assisted Dying, and Medical Aid in Dying
As a result of these various arguments, some have suggested that the terms “hastened death” or “assisted dying” should be used to discuss both euthanasia and assisted suicide, or in the case of “assisted dying” as an alternative term to assisted suicide.
Meanwhile, many prefer the term “medical aid in dying” as an alternative to assisted suicide:
Medical aid in dying is defined as a practice in which a mentally competent adult with a prognosis of six months or less to live requests a prescription medication from their doctor that they can decide to self-administer to peacefully end their life.
This plethora of definitions can complicate people’s understanding of assisted suicide.
Where Is Assisted Suicide Legal?
Today, public opinion has increasingly come to favor assisted suicide and euthanasia. A Gallup poll from 2018 found that 72% of Americans believe that euthanasia should be legal and 65% believe assisted suicide should be legal.
However, only a few states—California, Colorado, Hawaii, New Jersey, Oregon, Washington, Washington D.C., and Vermont—allow doctor-assisted suicide, and none allow euthanasia.
Internationally, assisted suicide is legal in Switzerland and in parts of Australia, while both assisted suicide and euthanasia are legal in the Netherlands, Belgium, Luxembourg, Canada, and Colombia.
The circumstances under which euthanasia or assisted suicide are permitted vary from country to country and state to state. For example, in the Netherlands, anyone over 12 can request euthanasia or assisted suicide if they’re enduring unbearable suffering that won’t improve. On the other hand, in Oregon and Vermont, assisted suicide is only permitted if the patient has a terminal illness.
Hippocrates, the Greek physician credited with originally composing the Hippocratic Oath that doctors continue to take today, explicitly forbid new physicians from engaging in assisted suicide in the 5th century BC. However, scholars have found that some physicians helped terminally ill patients take their lives, a practice that wasn’t explicitly outlawed.
By the 13th century, the widespread adoption of Judeo-Christian beliefs, which frown on ending life via suicide for any reason, had turned most people against the idea of physician-assisted suicide.
Nonetheless, throughout history at least some medical professionals have been willing to help terminally ill and suffering people hasten their deaths.
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How Prevalent Is Assisted Suicide?
As of 2021, Canada is the country where the most people die by assisted suicide or euthanasia, and the numbers have risen there quickly in the past several years, mostly because Canada only recently legalized the practice in 2015 and in 2021 approved it for people who have disabilities but are not terminally ill.
As a result, 3.3% of all deaths in the country in 2021 were the result of assisted suicide and euthanasia. The Netherlands, Belgium, and the United States are the next three countries where deaths from assisted dying are most prevalent.
As of 2021, Canada is the country where the most people die by assisted suicide or euthanasia.
One study estimates that in places where assisted suicide or euthanasia is legal, they remain fairly rare with between 0.3% and 4.6% of deaths resulting from these practices each year.
What Motivates Assisted Suicide?
Research has shown that the primary motivations for requesting assisted suicide in the United States are loss of dignity and autonomy and an inability to participate in activities that make life enjoyable.
A minority of patients request assisted suicide due to pain. Euthanasia and assisted suicide are primarily requested by people with cancer, with over 70% of cases around the world being the result of a cancer diagnosis.
What to Know About the Arguments For and Against Assisted Suicide
While assisted suicide remains relatively rare and evidence suggests the practice isn’t often abused,there is still a great deal of debate about whether or not it should be legal.
Arguments For Assisted Suicide
People should be able to control their own lives, including when they die.
People with a terminal illness or other irreversible conditions deserve a dignified death on their own terms.
Physicians and others have an obligation to relieve suffering. As a result, if a person is suffering with no hope of improvement and asks for their suffering to be ended, compassion dictates that their request should be granted.
Arguments Against Assisted Suicide
It’s unfair to require healthcare professionals to grant requests for assisted suicide if they believe it is immoral or goes against the Hippocratic Oath.
Hastening death in any way, including via assisted suicide, is considered morally unacceptable to believers of a number of religions.
The more widespread assisted suicide becomes, the more likely it’ll be expanded to include those with other issues like disabilities, mental health struggles, or dementia, and that could lead to people with these conditions to feel pressure to end their lives.
For those who lack adequate insurance or financial support, assisted suicide could be chosen simply because it costs less than services and support to lengthen one’s life.
People who are depressed or who are suffering from other mental illnesses are more likely to request assisted suicide, making the decision more complicated, because in these cases, assisted suicide would be more like traditional suicide.
The more acceptable assisted suicide becomes, the more likely it’ll come to be seen as a routine option for various conditions instead of an exceptional practice reserved for limited circumstances.
Given the relatively rare use of assisted suicide, it would be more valuable to focus on improving end-of-life care and symptom management than espousing assisted suicide as the best solution.
Requests for assisted suicide are supposed to be granted only to those who are mentally competent, but it can be challenging to assess mental competence.
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How Assisted Suicide Impacts Loved Ones
Research suggests that most people with family members who died from assisted suicide experienced the same mental health outcomes as those whose family members died from other causes.
In addition, those whose loved ones died by hastened measures had less traumatic grief symptoms or symptoms associated with sudden death. However, one study found that post-traumatic stress disorder (PTSD) and depression was more prevalent in those whose loved ones chose assisted dying, especially for those who lacked adequate social support and perceived less social acceptance of medical aid in dying.
On the other hand, in some cases, it seems the opportunity to discuss death openly with a loved one made it easier for friends and family members to come to terms with their loved one’s pending death. Moreover, the family members of people who died by assisted suicide felt more prepared and accepting after the death occurred.