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Euthanasia | PETA

Approximately 6 to 8 million animals are handled by animal shelters in the U.S. each year. Even though some are reclaimed or adopted, nearly 4 million unwanted dogs and cats are left with nowhere to go. Animal shelters cannot humanely house and support all these animals until their natural deaths. They would be forced to live in cramped cages or kennels for years, lonely and stressed, and other animals would have to be turned away because there would be no room for them.

Trying to build enough animal shelters to keep up with the endless stream of homeless animals is like putting a bandage on a gunshot wound. Turning unwanted animals loose to roam the streets is not a humane option, either. If they dont starve, freeze, get hit by a car, or die of disease, they may be tormented and possibly killed by cruel juveniles or picked up by dealers who sell animals to laboratories.

Euthanasia literally means good death, and true euthanasiadelivered by an intravenous injection of sodium pentobarbitalis painless, quick, and dignified. Because of the high number of unwanted companion animals and the lack of good homes, sometimes the most humane thing that a shelter worker can do is give an animal a peaceful release from a world in which dogs and cats are often considered surplus. The American Veterinary Medical Association and the Humane Society of the United States agree that an intravenous injection of sodium pentobarbital administered by a trained professional is the kindest, most compassionate method of euthanizing animals.

Unfortunately, some animals will be killed by municipal officials using unacceptable and cruel methods, such as gunshot. Bullets are often not placed precisely in the struggling animals head or are deflected, and some animals survive the first shot only to be shot again and again.

Many animal shelters still use outdated gas chambers to kill animals who arent adopted or reclaimed. Even the best gas boxes can expose conscious animals to the horror of watching other animals in the box suffer from convulsions and muscular spasms as they slowly die. Old, young, and sick animals are particularly susceptible to gas-related trauma and will die slow and highly stressful deaths.

And as hard as it is to believe, there are still facilities in the U.S. that kill animals using painful electrocution or cruel decompression chambers, which make the gases in animals sinuses, middle ears, and intestines expand quickly, causing considerable discomfort or severe pain. Some animals survive the first go-around in decompression chambers and are recompressed because of malfunctioning equipment or an operators mistake or because they get trapped in air pockets. They are then put through the painful procedure all over again. For more information, click here.

Until dog and cat overpopulation is brought under control through spaying and neutering, we must prevent the suffering of unwanted animals in the most responsible and humane way possible. Euthanasia, performed properly, is often the most compassionate option.

The only way to stop the suffering of the innocent victims of companion animal overpopulation is to prevent their births through sterilization efforts. Every last one of the millions of animal deaths at animal shelters and in the streets, alleyways, fields, basements, and back yards that occur every year could be prevented through spaying and neutering. You can help. Its as easy as ABCanimal birth control.

Please do not allow your companion animal to be needlessly euthanized during times of crises. Take the appropriate steps now to ensure that he or she is well taken care of even after your divorce or death.

For more info see how PETA saves animals.

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Euthanasia | PETA

Euthanasia | American Medical Association

Code of Medical Ethics Opinion 5.8

Euthanasia is the administration of a lethal agent by another person to a patient for the purpose of relieving the patients intolerable and incurable suffering.

It is understandable, though tragic, that some patients in extreme duresssuch as those suffering from a terminal, painful, debilitating illnessmay come to decide that death is preferable to life.

However, permitting physicians to engage in euthanasia would ultimately cause more harm than good.

Euthanasia is fundamentally incompatible with the physicians role as healer, would be difficult or impossible to control, and would pose serious societal risks. Euthanasia could readily be extended to incompetent patients and other vulnerable populations.

The involvement of physicians in euthanasia heightens the significance of its ethical prohibition. The physician who performs euthanasia assumes unique responsibility for the act of ending the patients life.

Instead of engaging in euthanasia, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

(a) Should not abandon a patient once it is determined that a cure is impossible.

(b) Must respect patient autonomy.

(c) Must provide good communication and emotional support.

(d) Must provide appropriate comfort care and adequate pain control.

Code of Medical Ethics:Caring for Patients at the End of Life

Visit theEthics main pageto access additional Opinions, the Principles of Medical Ethics and more information about the Code of Medical Ethics.

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Euthanasia | American Medical Association

Animal euthanasia – Wikipedia

This article is about killing of non-human animals. For euthanasia of humans, see Euthanasia.

Animal euthanasia (euthanasia from Greek: ; “good death”) is the act of putting an animal to death or allowing it to die by withholding extreme medical measures. Reasons for euthanasia include incurable (and especially painful) conditions or diseases,[1] lack of resources to continue supporting the animal, or laboratory test procedures. Euthanasia methods are designed to cause minimal pain and distress. Euthanasia is distinct from animal slaughter and pest control although in some cases the procedure is the same.

In domesticated animals, this process is commonly referred to by euphemisms such as “put down” or “put to sleep”.

The methods of euthanasia can be divided into pharmacological and physical methods. Acceptable pharmacological methods include injected drugs and gases that first depress the central nervous system and then cardiovascular activity. Acceptable physical methods must first cause rapid loss of consciousness by disrupting the central nervous system. The most common methods are discussed here, but there are other acceptable methods used in different situations.[2]

Unconsciousness, respiratory then cardiac arrest follow rapidly, usually within 30seconds.[3] Observers generally describe the method as leading to a quick and peaceful death.

Some veterinarians perform a two-stage process: an initial injection that simply renders the pet unconscious and a second shot that causes death.[citation needed] This allows the owner the chance to say goodbye to a live pet without their emotions stressing the pet. It also greatly mitigates any tendency toward spasm and other involuntary movement which tends to increase the emotional upset that the pet’s owner experiences.

For large animals, the volumes of barbiturates required are considered by some to be impractical, although this is standard practice in the United States.[4] For horses and cattle, other drugs may be available. Some specially formulated combination products are available, such as Somulose (secobarbital/cinchocaine) and Tributame (embutramide/chloroquine/lidocaine), which cause deep unconsciousness and cardiac arrest independently with a lower volume of injection, thus making the process faster, safer, and more effective.

Occasionally, a horse injected with these mixtures may display apparent seizure activity before death. This may be due to premature cardiac arrest. However, if normal precautions (e.g., sedation with detomidine) are taken, this is rarely a problem.[5] Anecdotal reports that long-term use of phenylbutazone increases the risk of this reaction are unverified.

After the animal has died, it is not uncommon for the body to have posthumous body jerks, or for the animal to have a sudden bladder outburst.

Gas anesthetics such as isoflurane and sevoflurane can be controlled-atmosphere stunning used for euthanasia of very small animals. The animals are placed in sealed chambers where high levels of anesthetic gas are introduced. Death may also be caused using carbon dioxide once unconsciousness has been achieved by inhaled anaesthetic.[6] Carbon dioxide is often used on its own for euthanasia of wild animals.[7] There are mixed opinions on whether it causes distress when used on its own, with human experiments lending support to the evidence that it can cause distress and equivocal results in non-humans.[8] In 2013, the American Veterinary Medical Association (AVMA) issued new guidelines for carbon dioxide induction, stating that a flow rate of 10% to 30% volume/min is optimal for the humane euthanization of small rodents.[9]

Carbon monoxide is often used, but some states in the US have banned its use in animal shelters: although carbon monoxide poisoning is not particularly painful, the conditions in the gas chamber are often not humane.[10] Nitrogen has been shown to be effective, although some young animals are rather resistant[11] and it currently is not widely used.

Cervical dislocation, or displacement (breaking or fracturing) of the neck, is an older yet less common method of killing small animals such as mice. Performed properly it is intended to cause as painless death as possible and has no cost or equipment involved. The handler must know the proper method of executing the movement which will cause the cervical displacement and without proper training and method education there is a risk of not causing death and can cause severe pain and suffering. It is unknown how long an animal remains conscious, or the level of suffering it goes through after a correct snapping of the neck, which is why it has become less common and often substituted with inhalants.

When intravenous injection is not possible, euthanasia drugs such as pentobarbital can be injected directly into a heart chamber or body cavity.

While intraperitoneal injection is fully acceptable (although it may take up to 15 minutes to take effect in dogs and cats[6]), an intracardiac (IC) injection may only be performed on an unconscious or deeply sedated animal. Performing IC injections on a fully conscious animal in places with humane laws for animal handling is often a criminal offense.[12]

This can be a means of euthanasia for large animalssuch as horses, cattle, and deerif performed properly. This may be performed by means of:

The reasons for euthanasia of pets and other animals include:

Small animal euthanasia is typically performed in a veterinary clinic or hospital or in an animal shelter and is usually carried out by a veterinarian or a veterinary technician working under the veterinarian’s supervision. Often animal shelter workers are trained to perform euthanasia as well. Some veterinarians will perform euthanasia at the pet owner’s homethis is virtually mandatory in the case of large animal euthanasia. In the case of large animals which have sustained injuries, this will also occur at the site of the accident, for example, on a racecourse.

Some animal rights organizations support animal euthanasia in certain circumstances and practice euthanasia at shelters that they operate.[15]

In the U.S., for companion animals euthanized in animal shelters, 14 states prescribe intravenous injection as the required method[citation needed]. These laws date to 1990, when Georgia’s “Humane Euthanasia Act” became the first state law to mandate this method. Before that, gas chambers and other means were commonly employed. The Georgia law was resisted by the Georgia Commissioner of Agriculture, Tommy Irvin, who was charged with enforcing the act. In March 2007, he was sued by former State Representative Chesley V. Morton, who wrote the law, and subsequently ordered by the Court to enforce all provisions of the Act.[16]

Many pet owners choose to have their pets cremated or buried after the pet is euthanized,[17] and there are pet funeral homes that specialize in animal burial or cremation.[18] Otherwise, the animal facility will often freeze the body and subsequently send it to the local landfill.[19]

In some instances, animals euthanized at shelters or animal control agencies have been sent to meat rendering facilities[20][21][22] to be processed for use in cosmetics, fertilizer, gelatin, poultry feed, pharmaceuticals and pet food.[23] It was proposed that the presence of pentobarbital in dog food may have caused dogs to become less responsive to the drug when being euthanized.[24] However, a 2002 FDA study found no dog or cat DNA in the foods they tested, so it was theorized that the drug found in dog food came from euthanized cattle and horses. Furthermore, the level of the drug found in pet food was safe.[25]

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Animal euthanasia – Wikipedia

Euthanasia | Article about euthanasia by The Free Dictionary

(yoo’thn`zh), either painlessly putting to death or failing to prevent death from natural causes in cases of terminal illness or irreversible coma. The term comes from the Greek expression for “good death.” Technological advances in medicine have made it possible to prolong life in patients with no hope of recovery, and the term negative euthanasia has arisen to classify the practice of withholding or withdrawing extraordinary means (e.g., intravenous feeding, respirators, and artificial kidney machines) to preserve life. Accordingly, the term positive euthanasia has come to refer to actions that actively cause death. The term passive euthanasia is used when certain common methods of treatment, such as antibiotics, drugs, or surgery, are withheld or a large quantity of needed but ultimately lethal pain medication is supplied. By the end of the 20th cent. passive euthanasia was said to be a common practice among U.S. hospitals and physicians. With regard to euthanasia in animals, there are strict rules and guidelines that ensure ethical euthanasia and disposal.

Much debate has occurred in the United States and other nations among physicians, religious leaders, lawyers, and the general public over the question of what constitutes actively causing death and what constitutes merely allowing death to occur naturally. The physician is faced with deciding whether measures used to keep patients alive are extraordinary in individual situations, e.g., whether a respirator or artificial kidney machine should be withdrawn from a terminally ill patient. The Supreme Court’s decision in Cruzan v. Director, Missouri Dept. of Health set a precedent for the removal of life-support equipment from terminal cases.

Popular movements have supported the legalization of the living willliving will,legal document in which a person expresses in advance his or her wishes concerning the use of artificial life support, to be referred to should the person be unable to communicate such wishes at the end of life…… Click the link for more information. , a statement written by a mentally alert patient that can be used to express a wish to forgo artificial means to sustain life during terminal illness. In 1977, California became the first to pass a state law to this effect, known as the death-with-dignity statute. The absence of a written living will complicated the case of Terri Schiavo, a Florida woman who was in a persistent vegetative state from 1990 until 2005, when she died after having her feeding tube removed. In 2000 her husband, who was her legal guardian, won the right to remove it based upon what he stated were her orally expressed wishes, but legal challenges from her parents and Florida governor Jeb Bush and attempted government interventions through Florida and federal legislation delayed the tube’s removal for five years. (See Schiavo caseSchiavo case,the legal battles over the guardianship and rights of Theresa Maria Schindler Schiavo (19632005). Terri Schiavo was incapacitated and hospitalized in 1990, after she collapsed when her heart stopped beating due to a potassium imbalance, and her brain….. Click the link for more information. .)

Societies advancing the cause of positive euthanasia were founded in 1935 in England and 1938 in the United States. End-of-Life Choices (formerly the Hemlock Society) is one controversial group that has pressed for right-to-die legislation on a national level. Positive euthanasia is for the most part illegal in the United States, but physicians may lawfully refuse to prolong life when there is extreme suffering.

In the early 1990s, Dr. Jack Kevorkian, a Michigan physician, gained notoriety by assisting a number of people to commit suicide and became the object of a state law (1992) forbidding such activity. Kevorkian, who had been tried and acquitted repeatedly in the assisted deaths of seriously ill people, was convicted of murder in Michigan in 1999 for an assisted suicide that was shown on national television. Meanwhile, in 1997, the Supreme Court upheld state laws banning assisted suicide (in most U.S. states assisting in a suicide is a crime).

In Oregon in 1994, voters approved physician-assisted suicide for some patients who are terminally ill (the patients must administer the drugs); the law went into effect in 1997, following a protracted court challenge. In 2001 the Bush administration sought to undermine the law with a directive issued under the federal Controlled Substances Act, but Oregon sued to prohibit the enforcement of it, and the Supreme Court ruled (2006) that the federal government had exceeded its authority. Similar measures have since been approved, by voters, legislators, or the courts, in Washington state (2008), Montana (2009), Vermont (2013), California (2015), and Colorado (2016).

Since 1937 assisted suicide has not been illegal in Switzerland as long as the person who assists has no personal motive or gain. In 1993, the Netherlands decriminalized, under a set of restricted conditions, voluntary positive euthanasia (essentially, physician-assisted suicide) for the terminally ill, and in 2002 the country legalized physician-assisted suicide if voluntarily requested by seriously ill patients who face ongoing suffering. Belgium (2002), Luxembourg (2008), and some other nations and juridictions also have legalized physician-assisted suicide for certain patients who request it, and Canada’s supreme court has overturned (2015) laws against physician-assisted suicide.

See also bioethicsbioethics,in philosophy, a branch of ethics concerned with issues surrounding health care and the biological sciences. These issues include the morality of abortion, euthanasia, in vitro fertilization, and organ transplants (see transplantation, medical)…… Click the link for more information. .

See P. Singer, Rethinking Life and Death (1994); H. Hendin, Suicide in America (rev. ed. 1995). See also studies by J. Rachels (1986) and R. Wennberg (1989).

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Euthanasia | Article about euthanasia by The Free Dictionary

euthanasia – Dictionary Definition : Vocabulary.com

Euthanasia is the act of causing a person’s or animal’s death, without inflicting pain, to end suffering, like when a veterinarian performs euthanasia on a dog that is in great pain and has no chance of recovery.

To correctly pronounce euthanasia, remember that it sounds like “youth in Asia.” Euthanasia is sometimes referred to as mercy killing, meant to spare a living thing a slow, painful death. Originally a Greek word, euthanasia means “an easy or happy death,” as eu- means “good” and thanatos means “death.” The use of the word as “legally sanctioned mercy killing” is first recorded in English in 1869.

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euthanasia – Dictionary Definition : Vocabulary.com

Euthanasia | definition of euthanasia by Medical dictionary

euthanasia[uthah-nazhah]

1. an easy or painless death.

1. A quiet, painless death.

2. The intentional putting to death of a person with an incurable or painful disease intended as an act of mercy.

[eu- + G. thanatos, death]

1. an easy or painless death.

2. mercy killing; the deliberate ending of life of a person suffering from an incurable disease.

The act or practice of ending the life of a person or animal having a terminal illness or a medical condition that causes suffering perceived as incompatible with an acceptable quality of life, as by lethal injection or the suspension of certain medical treatments.

Etymology: Gk, eu, good; thanatos, death

2 an easy, quiet, painless death.

1. The intentional putting to death of a person with an incurable or painful disease, intended as an act of mercy.

[eu- + G. thanatos, death]

The act of putting a person or animal to death painlessly or allowing them to die by withholding medical services, usually because of a painful and incurable disease. Mercy killing is another term for euthanasia.

n the act of facilitating death in a terminally ill patient, whether by deliberate activity, such as the administration of drugs that hasten death (known as active euthanasia), or passive, as in the withholding of life-extending treatment (passive euthanasia).

1. A quiet, painless death.

2. The intentional putting to death of a person with an incurable or painful disease intended as an act of mercy.

[eu- + G. thanatos, death]

(thnzh), n an act of deliberately bringing about the death of a person who is suffering from an incurable disease or condition; also called mercy killing. Active euthanasia is illegal in most jurisdictions; passive euthanasia, or the withholding of some life support systems, has legal standing in some jurisdictions.

1. an easy or painless death.

2. the deliberate ending of life of an animal suffering from an incurable disease; called also mercy killing, to put down, to put to sleep.

For the individual animal intravenous injection of a massive dose of barbiturate is best. Any narcotizing drug creates difficulties if the carcass is to be disposed of for pet meat. In those cases shooting with a bullet or captive bolt pistol is recommended because of the speed of the despatch. For large numbers of animals at a pound or shelter, injection procedures are still superior to the bulk methods which all have the fallibility of poorly managed and supervised machinery. Carbon monoxide is very fast but dangerous to the operators of the cabinet. Electrocution cannot be performed en masse and gassing with carbon monoxide or lowering of the atmospheric pressure are not really quick enough. Small laboratory animals are still despatched by a sharp blow to the head and birds by guillotine or separation of the cervical vertebrae.

uses mains electrical current passed through the subject’s body via clips applied to the skin of the ear and the tail. Not much employed because of danger to human operators, likelihood of equipment failure and need for close contact with device.

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Euthanasia | definition of euthanasia by Medical dictionary

Euthanasia – definition of euthanasia by The Free Dictionary

The act or practice of ending the life of a person or animal having a terminal illness or a medical condition that causes suffering perceived as incompatible with an acceptable quality of life, as by lethal injection or the suspension of certain medical treatments.

[Greek euthanasi, a good death : eu-, eu- + thanatos, death.]

(Medicine) the act of killing someone painlessly, esp to relieve suffering from an incurable illness. Also called: mercy killing

[C17: via New Latin from Greek: easy death, from eu- + thanatos death]

n.

[164050;

1. the act of putting to death without pain a person incurably ill or suffering great pain; mercy killing.2. an easy, painless death. euthanasic, adj.

the deliberate killing of painfully ill or terminally ill people to put them out of their misery. Also called mercy killing.

ThesaurusAntonymsRelated WordsSynonymsLegend:

Translations

eutanasimedlidenhedsdrab

eutanzia

lknardrp

eutanazijaneskausmingas numarinimas

eitanzija

eutanzia

tenazitatl lm

n. eutanasia, muerte infringida sin sufrimiento en casos de una enfermedad incurable.

euthanasia n eutanasia

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Euthanasia – definition of euthanasia by The Free Dictionary

What Is Euthanasia and Physician-Assisted Suicide?

Euthanasia is the act of a physician or other third party ending a patient’s life in response to severe, persistent and untreatable pain and suffering. It is sometimes referred to as assisted suicide, physician-assisted death, physician-assisted suicide, mercy killing, and other variations; however, assisted suicide and euthanasia have differences.

Assisted suicide is intentionally and knowingly providing the means for another to commit suicide. For example, providing a prescription medication to someone with the knowledge that they intend to use it for the purpose of suicide.

Euthanasia involves a person, such as a physician, knowingly acting to cause the death of a person suffering from severe and incurable pain. For example, a physician giving injections of drugs to induce coma and then stop the heart.

There are two primary classifications of euthanasia.

Voluntary euthanasia is not legal in most parts of the world. The Netherlands and Belgium are currently the only countries who allow the practice. Involuntary euthanasia is not legal anywhere.

Physician-assisted suicide is currently legal in the United States in several states, including Oregon and Washington, and in a handful of other countries.

Physician-assisted suicide is only done when a patient has a terminal diagnosis and is suffering, with little or no relief. In such cases, a patient may wish to control when and how they die. A key part of physician-assisted suicide involves how the suicide is enacted: The patient must be the one to take the medication. It is illegal for a friend, family member, physician or anyone else to administer the medication; to do so crosses the legal line into the definition of euthanasia.

Sometimes called terminal sedation, palliative sedation is the progressive use of sedatives to achieve a desirable level of comfortpatients who are terminally ill and experiencing unrelievedsuffering.Death usually follows shortly after a patient becomes sedated.

Palliative sedation is neither euthanasia nor is itphysician-assisted suicide as the intent is not to cause death. Though death may occur, it is often unclear whether the death occurred because of the sedation or the terminal illness itself.

Palliative sedation requires the consent of the patient. If a patient is unable to make decisions for himself or herself, the decision falls to the patient’s designated health care decision maker. The patient is unable to deliver the correct dosage of a palliative sedative, which is usually given as a suppository or an infusion. Because the sedation is fast-acting, the sedatives can be only given by a physician, nurse or another of the patient’s primary caregivers.

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What Is Euthanasia and Physician-Assisted Suicide?

Euthanasia – Simple English Wikipedia, the free encyclopedia

Euthanasia is when a person’s life is ended because of disease or pain, which has made them suffer. This is different from assisted suicide, where a person helps someone kill themselves. It is also different to murder, where the reason is not suffering, but to kill for the killer’s own ends. Euthanasia can be voluntary, where the person who dies asks for help in ending their life. Where the person is unable to make their decision known, it is usually called non-voluntary euthanasia. Where someone is killed against their will, it is usually called murder.

Euthanasia is illegal in most countries. It is permitted in a small number of countries, such as the Netherlands, Belgium and Victoria, Australia.[1] Where it is permitted there are many rules, and only in cases where the patient is terminally ill. Though euthanasia is not legal in the United States, doctors can assist people to kill themselves. This is legal in Washington, Oregon, and Montana. Physician Assisted Suicide (PAD) is different to euthanasia; it is about who gives the medication to end a patients life. The World Federation of Right to Die Societies says physician-assisted suicide means “making lethal means available to the patient to be used at a time of the patients own choosing.” In these cases the patient takes the legal dose of poison themselves, it is not given by the doctor. It is euthanasia when the doctor has the main role in ending the patients life by giving the poison.

Euthanasia can be active or passive, and voluntary, non-voluntary and involuntary. Many people see important differences and they can accept some types but not others.

Passive euthanasia means letting a person die. A terminally ill person is allowed to die, even if treatment could help them to live longer. This includes removing life support, such as a ventilator which is being used to keep the person alive, or by not giving them food or water. Active euthanasia means doing something to end a person’s life. This could be giving them an injection or pills that will cause their death.[2]

Some people see passive euthanasia as a more acceptable choice, because it is not a deliberate act to kill. However, others argue that once someone has decided to allow another person to die, they should make it as fast and as painless as possible, and then act to bring about their death. This is also known as mercy killing.[3]

Voluntary euthanasia is when someone asks to be allowed to die or to be killed. This is often seen as the best option by people who believe in euthanasia, because it is clear that the person wants to die. If the person can not say that they want to die, but people think that they would ask to die if they could, then it is non-voluntary euthanasia. Non-voluntary euthanasia is a choice for people who are in a coma or who are very young, as they can not say what they want. Involuntary euthanasia is when someone is killed even though they asked not to die, or when they could have asked to die but did not.[4] Many people think that this is murder, not euthanasia.[5]

These types of euthanasia can be mixed. If someone asks to die, and another person gives them an injection that will kill them, then it is active voluntary euthanasia. Someone in a coma who is kept alive with a ventilator, and the doctors turn it off and they die, would be passive non-voluntary euthanasia.[6]

Some people believe that euthanasia should be allowed, and some people think that it should not.

Some people believe that allowing euthanasia will result in bad things happening. If it is allowed for people asking to die, then it might be allowed for people who are very sick but are not able to ask to die. If that happens, then maybe it would be allowed for people who are very sick and will not recover, but do not want to die. This is called the “slippery slope” argument.[7]

People who believe in the slippery slope argument point to times when this happened. In Germany, Adolf Hitler allowed disabled children to be killed, and called it euthanasia. People now agree that this was wrong, but if euthanasia was allowed it could happen again. They think it is too big a risk to allow euthanasia at all.[7]

Other people say there is a big difference between killing a very sick person who asks to die, and killing a child with a disability. They do not think euthanasia will lead to bad things. They say that Hitler’s actions were not euthanasia.[7]

The American Medical Association (AMA) and other doctors believe it is a doctor’s role to help, not kill people.[source?] In one study 76% of doctors said they would not carry out euthanasia, even if it was legal.[source?] They feel patients would not trust them. In the Netherlands where euthanasia is legal, 60% of older people in one study were scared that their their doctors would kill them.[source?]

Palliative care is when people who are ill and going to die are given special care to make them more comfortable. It may include hospice care, when the patient is sent to a special hospital for people who are dying. Palliative care can involve pain relief and help for the patient and family to come to terms with death. In some cases, doctors will give patient drugs which make them stay asleep, so that they will not feel pain.[8][9]

Palliative care is not perfect, and so it is not always seen as a replacement for euthanasia. There is still some pain, and there can be other side-effects, where the patient can still feel very sick. Palliative care is not available for all people, and not all people who wish to die through euthanasia are so sick that they will die soon. Some people have healthy bodies, but they are suffering in other ways, and palliative care will not always help them.[7]

The principle of double effect was first described by Thomas Aquinas over 700 years ago. It says that it is sometimes alright to do a bad thing if something good happens, and if a bad ending was not wanted.[10] Aquinas used the example of self defense: sometimes a person will kill someone who attacks them, but killing was not what the person was trying to do. They only wanted to protect themselves. So even though killing someone is bad, wanting to protect themselves was not.[11]

Some people say that doctors may treat a person to reduce the their pain, and as a result the person will die sooner. If the doctor gives the treatment in order to help the patient die, then it is euthanasia. But if the doctor gives the treatment in order to stop the pain, and does not intend for the patient to die, then it may not be euthanasia, even if the doctor knew that the treatment would kill the patient.[11]

Suicide is when a person kills themselves. Sometimes when a person is very sick they need help to die, and this is called assisted suicide.[12] In some countries people are allowed to help as long as they do not kill the person,[13] and it can be seen as a more acceptable option because it must be the person’s own decision.[12] Because the assisting person did not kill, it is not always considered to be euthanasia. [7]

[1]

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Euthanasia – Simple English Wikipedia, the free encyclopedia

Euthanasia – All.org

When we talk about euthanasia, what exactly do we mean? Today, we usually hear about euthanasia in the health care context. For our purposes, euthanasia amounts to doing, or not doing, something to intentionally bring about a patients death. Because theres so much confusion surrounding the term, lets make sure we understand what euthanasia is not.

It is not euthanasia to administer medication needed to control painthats called good medical care. It is not euthanasia to stop treatment that is gravely burdensome to a patientthats called letting the patient exercise the moral option to refuse extraordinary medical means. It is not euthanasia to stop tube-feeding a patient whose diseased or injured body can no longer assimilate food and waterthats called simply accepting death.

In these circumstances, pain control, refusing extraordinary means, and stopping feeding may all allow death. Butand this is crucial to our understandingunlike euthanasia, their purpose and intent is not to bring about death.

Actually, euthanasia could be called a form of suicide, assisted suicide, or even murder, depending on the patients level of involvement and consent. To define euthanasia this way, though, seems to diminish its threat. After all, arent there laws or, at the very least, strong social taboos against suicide, assisted suicide, and murder?

Unfortunately, when it comes to the sick and disabled, this is no longer entirely true. And, the rationale and cultural forces behind the movement that brought this about threaten even more to tear down the legal and social barriers to killing.

Most of us know about Jack Kevorkian and his efforts to help ailing people commit suicide. Many of us may not realize, though, that Kevorkians maverick image masks a serious crusade that is building on emerging legal and cultural trends. Our society is poised to accept euthanasia on demandand worse. What we dont know about that could kill us.

In sum, it is vitally important to understand that everyones most basic rightthe right to lifeis in jeopardy when our law and collective morality no longer view all persons as equally worthy of life, solely on the basis of our common humanity. Not only is it the right thing to do, it is also in our own best interests to protect and cherish weak and vulnerable members of our human family.

In order to do that, we must educate ourselves and others about the growing threat of euthanasia, vigorously oppose its legalization, and pray for the wisdom and compassion to properly comfort, care for and dissuade those considering suicide.

The information on euthanasia is a PowerPoint Presentation (2007) prepared for American Life League by Julie Grimstad, Executive Director of Life is Worth Living, Inc.

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Euthanasia – All.org

Euthanasia – Wikipedia

Euthanasia (from Greek: ; “good death”: , eu; “well” or “good” , thanatos; “death”) is the practice of intentionally ending a life to relieve pain and suffering.[1][2]

There are different euthanasia laws in each country. The British House of Lords Select Committee on Medical Ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”.[3] In the Netherlands and Belgium, euthanasia is understood as “termination of life by a doctor at the request of a patient”.[4] The Dutch law however, does not use the term ‘euthanasia’ but includes it under the broader definition of “assisted suicide and termination of life on request”.[5]

Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary. Voluntary euthanasia is legal in some countries. Non-voluntary euthanasia (patient’s consent unavailable) is illegal in all countries. Involuntary euthanasia (without asking consent or against the patient’s will) is also illegal in all countries and is usually considered murder.[6] As of 2006, euthanasia is the most active area of research in contemporary bioethics.[7] In some countries there is a divisive public controversy over the moral, ethical, and legal issues of euthanasia. Passive euthanasia (known as “pulling the plug”) is legal under some circumstances in many countries. Active euthanasia however is legal or de facto legal in only a handful of countries (e.g. Belgium, Canada, Switzerland) and is limited to specific circumstances and the approval of councilors and doctors or other specialists. In some countries such as Nigeria, Saudi Arabia and Pakistan, support for active euthanasia is almost non-existent.

Like other terms borrowed from history, “euthanasia” has had different meanings depending on usage. The first apparent usage of the term “euthanasia” belongs to the historian Suetonius, who described how the Emperor Augustus, “dying quickly and without suffering in the arms of his wife, Livia, experienced the ‘euthanasia’ he had wished for.”[8] The word “euthanasia” was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a “physician’s responsibility to alleviate the ‘physical sufferings’ of the body.” Bacon referred to an “outward euthanasia”the term “outward” he used to distinguish from a spiritual conceptthe euthanasia “which regards the preparation of the soul.”[9]

In current usage, euthanasia has been defined as the “painless inducement of a quick death”.[10] However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional.[11][12]

Another approach incorporates the notion of suffering into the definition.[11] The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma”,[13] This approach is included in Marvin Khol and Paul Kurtz’s definition of it as “a mode or act of inducing or permitting death painlessly as a relief from suffering”.[14] Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as Tom Beauchamp and Arnold Davidson have argued that doing so would constitute “murder simpliciter” rather than euthanasia.[11]

The third element incorporated into many definitions is that of intentionality the death must be intended, rather than being accidental, and the intent of the action must be a “merciful death”.[11] Michael Wreen argued that “the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent’s motive: it must be a good motive insofar as the good of the person killed is concerned.”[15] Similarly, Heather Draper speaks to the importance of motive, arguing that “the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end.”[12] Definitions such as that offered by the House of Lords Select Committee on Medical Ethics take this path, where euthanasia is defined as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering.”[3] Beauchamp and Davidson also highlight Baruch Brody’s “an act of euthanasia is one in which one person… (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed”.[16]

Draper argued that any definition of euthanasia must incorporate four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Based on this, she offered a definition incorporating those elements, stating that euthanasia “must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies.”[17] Prior to Draper, Beauchamp and Davidson had also offered a definition that includes these elements. Their definition specifically discounts fetuses to distinguish between abortions and euthanasia:[18]

“In summary, we have argued… that the death of a human being, A, is an instance of euthanasia if and only if (1) A’s death is intended by at least one other human being, B, where B is either the cause of death or a causally relevant feature of the event resulting in death (whether by action or by omission); (2) there is either sufficient current evidence for B to believe that A is acutely suffering or irreversibly comatose, or there is sufficient current evidence related to A’s present condition such that one or more known causal laws supports B’s belief that A will be in a condition of acute suffering or irreversible comatoseness; (3) (a) B’s primary reason for intending A’s death is cessation of A’s (actual or predicted future) suffering or irreversible comatoseness, where B does not intend A’s death for a different primary reason, though there may be other relevant reasons, and (b) there is sufficient current evidence for either A or B that causal means to A’s death will not produce any more suffering than would be produced for A if B were not to intervene; (4) the causal means to the event of A’s death are chosen by A or B to be as painless as possible, unless either A or B has an overriding reason for a more painful causal means, where the reason for choosing the latter causal means does not conflict with the evidence in 3b; (5) A is a nonfetal organism.”[19]

Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition:

“Person A committed an act of euthanasia if and only if (1) A killed B or let her die; (2) A intended to kill B; (3) the intention specified in (2) was at least partial cause of the action specified in (1); (4) the causal journey from the intention specified in (2) to the action specified in (1) is more or less in accordance with A’s plan of action; (5) A’s killing of B is a voluntary action; (6) the motive for the action specified in (1), the motive standing behind the intention specified in (2), is the good of the person killed.”[20]

Wreen also considered a seventh requirement: “(7) The good specified in (6) is, or at least includes, the avoidance of evil”, although as Wreen noted in the paper, he was not convinced that the restriction was required.[21]

In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject’s “right to life”. In response, Wreen argued that euthanasia has to be voluntary, and that “involuntary euthanasia is, as such, a great wrong”.[21] Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: “Medicalized killing of a person without the person’s consent, whether nonvoluntary (where the person in unable to consent) or involuntary (against the person’s will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only.”[22] Although the EPAC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.[21]

Euthanasia may be classified into three types, according to whether a person gives informed consent: voluntary, non-voluntary and involuntary.[23][24]

There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient’s circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Wreen, consent on the part of the patient was not considered as one of their criteria, although it may have been required to justify euthanasia.[11][25] However, others see consent as essential.

Voluntary euthanasia is conducted with the consent of the patient. Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. Passive voluntary euthanasia is legal throughout the US per Cruzan v. Director, Missouri Department of Health. When the patient brings about his or her own death with the assistance of a physician, the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont.

Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. Examples include child euthanasia, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol.

Involuntary euthanasia is conducted against the will of the patient.

Voluntary, non-voluntary and involuntary types can be further divided into passive or active variants.[26] Passive euthanasia entails the withholding treatment necessary for the continuance of life.[3] Active euthanasia entails the use of lethal substances or forces (such as administering a lethal injection), and is the more controversial. While some authors consider these terms to be misleading and unhelpful, they are nonetheless commonly used. In some cases, such as the administration of increasingly necessary, but toxic doses of painkillers, there is a debate whether or not to regard the practice as active or passive.[3]

Euthanasia was practiced in Ancient Greece and Rome: for example, hemlock was employed as a means of hastening death on the island of Kea, a technique also employed in Marseilles. Euthanasia, in the sense of the deliberate hastening of a person’s death, was supported by Socrates, Plato and Seneca the Elder in the ancient world, although Hippocrates appears to have spoken against the practice, writing “I will not prescribe a deadly drug to please someone, nor give advice that may cause his death” (noting there is some debate in the literature about whether or not this was intended to encompass euthanasia).[27][28][29]

The term euthanasia in the earlier sense of supporting someone as they died, was used for the first time by Francis Bacon. In his work, Euthanasia medica, he chose this ancient Greek word and, in doing so, distinguished between euthanasia interior, the preparation of the soul for death, and euthanasia exterior, which was intended to make the end of life easier and painless, in exceptional circumstances by shortening life. That the ancient meaning of an easy death came to the fore again in the early modern period can be seen from its definition in the 18th century Zedlers Universallexikon:

Euthanasia: a very gentle and quiet death, which happens without painful convulsions. The word comes from , bene, well, and , mors, death.[30]

The concept of euthanasia in the sense of alleviating the process of death goes back to the medical historian, Karl Friedrich Heinrich Marx, who drew on Bacon’s philosophical ideas. According to Marx, a doctor had a moral duty to ease the suffering of death through encouragement, support and mitigation using medication. Such an “alleviation of death” reflected the contemporary zeitgeist, but was brought into the medical canon of responsibility for the first time by Marx. Marx also stressed the distinction between the theological care of the soul of sick people from the physical care and medical treatment by doctors.[31][32]

Euthanasia in its modern sense has always been strongly opposed in the Judeo-Christian tradition. Thomas Aquinas opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival,[33] as did Francois Ranchin (15651641), a French physician and professor of medicine, and Michael Boudewijns (16011681), a physician and teacher.[28]:208[34] Other voices argued for euthanasia, such as John Donne in 1624,[35] and euthanasia continued to be practised. In 1678, the publication of Caspar Questel’s De pulvinari morientibus non-subtrahend, (“On the pillow of which the dying should not be deprived”), initiated debate on the topic. Questel described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was “against the laws of God and Nature”.[28]:209211 This view was shared by others who followed, including Philipp Jakob Spener, Veit Riedlin and Johann Georg Krnitz.[28]:211 Despite opposition, euthanasia continued to be practised, involving techniques such as bleeding, suffocation, and removing people from their beds to be placed on the cold ground.[28]:211214

Suicide and euthanasia became more accepted during the Age of Enlightenment.[34] Thomas More wrote of euthanasia in Utopia, although it is not clear if More was intending to endorse the practice.[28]:208209 Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, as it is used in cases of honor, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.[36]

In the mid-1800s, the use of morphine to treat “the pains of death” emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a schoolteacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club in England, which was subsequently published in a one-off publication entitled Essays of the Birmingham Speculative Club, the collected works of a number of members of an amateur philosophical society.[37]:794 Williams’ proposal was to use chloroform to deliberately hasten the death of terminally ill patients:

That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anaesthetic as may by-and-bye supersede chloroform so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.

The essay was favourably reviewed in The Saturday Review, but an editorial against the essay appeared in The Spectator.[38] From there it proved to be influential, and other writers came out in support of such views: Lionel Tollemache wrote in favour of euthanasia, as did Annie Besant, the essayist and reformer who later became involved with the National Secular Society, considering it a duty to society to “die voluntarily and painlessly” when one reaches the point of becoming a ‘burden’.[38][39] Popular Science analyzed the issue in May 1873, assessing both sides of the argument.[40] Kemp notes that at the time, medical doctors did not participate in the discussion; it was “essentially a philosophical enterprise… tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life”.[38]

The rise of the euthanasia movement in the United States coincided with the so-called Gilded Age, a time of social and technological change that encompassed an “individualistic conservatism that praised laissez-faire economics, scientific method, and rationalism”, along with major depressions, industrialisation and conflict between corporations and labour unions.[37]:794 It was also the period in which the modern hospital system was developed, which has been seen as a factor in the emergence of the euthanasia debate.[41]

Robert Ingersoll argued for euthanasia, stating in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. Felix Adler offered a similar approach, although, unlike Ingersoll, Adler did not reject religion. In fact, he argued from an Ethical Culture framework. In 1891, Adler argued that those suffering from overwhelming pain should have the right to commit suicide, and, furthermore, that it should be permissible for a doctor to assist thus making Adler the first “prominent American” to argue for suicide in cases where people were suffering from chronic illness.[42] Both Ingersoll and Adler argued for voluntary euthanasia of adults suffering from terminal ailments.[42] Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler enabled others to stretch the definition of euthanasia.[43]

The first attempt to legalise euthanasia took place in the United States, when Henry Hunt introduced legislation into the General Assembly of Ohio in 1906.[44]:614 Hunt did so at the behest of Anna S. Hall, a wealthy heiress who was a major figure in the euthanasia movement during the early 20th century in the United States. Hall had watched her mother die after an extended battle with liver cancer, and had dedicated herself to ensuring that others would not have to endure the same suffering. Towards this end she engaged in an extensive letter writing campaign, recruited Lurana Sheldon and Maud Ballington Booth, and organised a debate on euthanasia at the annual meeting of the American Humane Association in 1905 described by Jacob Appel as the first significant public debate on the topic in the 20th century.[44]:614616

Hunt’s bill called for the administration of an anesthetic to bring about a patient’s death, so long as the person is of lawful age and sound mind, and was suffering from a fatal injury, an irrevocable illness, or great physical pain. It also required that the case be heard by a physician, required informed consent in front of three witnesses, and required the attendance of three physicians who had to agree that the patient’s recovery was impossible. A motion to reject the bill outright was voted down, but the bill failed to pass, 79 to 23.[37]:796[44]:618619

Along with the Ohio euthanasia proposal, in 1906 Assemblyman Ross Gregory introduced a proposal to permit euthanasia to the Iowa legislature. However, the Iowa legislation was broader in scope than that offered in Ohio. It allowed for the death of any person of at least ten years of age who suffered from an ailment that would prove fatal and cause extreme pain, should they be of sound mind and express a desire to artificially hasten their death. In addition, it allowed for infants to be euthanised if they were sufficiently deformed, and permitted guardians to request euthanasia on behalf of their wards. The proposed legislation also imposed penalties on physicians who refused to perform euthanasia when requested: a 612 month prison term and a fine of between $200 and $1,000. The proposal proved to be controversial.[44]:619621 It engendered considerable debate and failed to pass, having been withdrawn from consideration after being passed to the Committee on Public Health.[44]:623

After 1906 the euthanasia debate reduced in intensity, resurfacing periodically, but not returning to the same level of debate until the 1930s in the United Kingdom.[37]:796

Euthanasia opponent Ian Dowbiggin argues that the early membership of the Euthanasia Society of America (ESA) reflected how many perceived euthanasia at the time, often seeing it as a eugenics matter rather than an issue concerning individual rights.[42] Dowbiggin argues that not every eugenist joined the ESA “solely for eugenic reasons”, but he postulates that there were clear ideological connections between the eugenics and euthanasia movements.[42]

The Voluntary Euthanasia Legalisation Society was founded in 1935 by Charles Killick Millard (now called Dignity in Dying). The movement campaigned for the legalisation of euthanasia in Great Britain.

In January 1936, King George V was given a fatal dose of morphine and cocaine to hasten his death. At the time he was suffering from cardio-respiratory failure, and the decision to end his life was made by his physician, Lord Dawson.[45] Although this event was kept a secret for over 50 years, the death of George V coincided with proposed legislation in the House of Lords to legalise euthanasia.[46]

A 24 July 1939 killing of a severely disabled infant in Nazi Germany was described in a BBC “Genocide Under the Nazis Timeline” as the first “state-sponsored euthanasia”.[47] Parties that consented to the killing included Hitler’s office, the parents, and the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses.[47] The Telegraph noted that the killing of the disabled infantwhose name was Gerhard Kretschmar, born blind, with missing limbs, subject to convulsions, and reportedly “an idiot” provided “the rationale for a secret Nazi decree that led to ‘mercy killings’ of almost 300,000 mentally and physically handicapped people”.[48] While Kretchmar’s killing received parental consent, most of the 5,000 to 8,000 children killed afterwards were forcibly taken from their parents.[47][48]

The “euthanasia campaign” of mass murder gathered momentum on 14 January 1940 when the “handicapped” were killed with gas vans and killing centres, eventually leading to the deaths of 70,000 adult Germans.[49] Professor Robert Jay Lifton, author of The Nazi Doctors and a leading authority on the T4 program, contrasts this program with what he considers to be a genuine euthanasia. He explains that the Nazi version of “euthanasia” was based on the work of Adolf Jost, who published The Right to Death (Das Recht auf den Tod) in 1895. Lifton writes:

Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the individual’s ‘right to die’ or ‘right to death’ or ‘right to his or her own death,’ as the ultimate human claim. In contrast, Jost was pointing to the state’s right to kill…. Ultimately the argument was biological: ‘The rights to death [are] the key to the fitness of life.’ The state must own deathmust killin order to keep the social organism alive and healthy.[50]

In modern terms, the use of “euthanasia” in the context of Action T4 is seen to be a euphemism to disguise a program of genocide, in which people were killed on the grounds of “disabilities, religious beliefs, and discordant individual values”.[51] Compared to the discussions of euthanasia that emerged post-war, the Nazi program may have been worded in terms that appear similar to the modern use of “euthanasia”, but there was no “mercy” and the patients were not necessarily terminally ill.[51] Despite these differences, historian and euthanasia opponent Ian Dowbiggin writes that “the origins of Nazi euthanasia, like those of the American euthanasia movement, predate the Third Reich and were intertwined with the history of eugenics and Social Darwinism, and with efforts to discredit traditional morality and ethics.”[42]:65

On 6 January 1949, the Euthanasia Society of America presented to the New York State Legislature a petition to legalize euthanasia, signed by 379 leading Protestant and Jewish ministers, the largest group of religious leaders ever to have taken this stance. A similar petition had been sent to the New York Legislature in 1947, signed by approximately 1,000 New York physicians. Roman Catholic religious leaders criticized the petition, saying that such a bill would “legalize a suicide-murder pact” and a “rationalization of the fifth commandment of God, ‘Thou Shalt Not Kill.'”[52] The Right Reverend Robert E. McCormick stated that

“The ultimate object of the Euthanasia Society is based on the Totalitarian principle that the state is supreme and that the individual does not have the right to live if his continuance in life is a burden or hindrance to the state. The Nazis followed this principle and compulsory Euthanasia was practiced as a part of their program during the recent war. We American citizens of New York State must ask ourselves this question: ‘Are we going to finish Hitler’s job?'”[52]

The petition brought tensions between the American Euthanasia Society and the Catholic Church to a head that contributed to a climate of anti-Catholic sentiment generally, regarding issues such as birth control, eugenics, and population control. However, the petition did not result in any legal changes.[42]

Historically, the euthanasia debate has tended to focus on a number of key concerns. According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have presented four main arguments: a) that people have a right to self-determination, and thus should be allowed to choose their own fate; b) assisting a subject to die might be a better choice than requiring that they continue to suffer; c) the distinction between passive euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that the underlying principlethe doctrine of double effectis unreasonable or unsound); and d) permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia activists often point to countries like the Netherlands and Belgium, and states like Oregon, where euthanasia has been legalized, to argue that it is mostly unproblematic.

Similarly, Emanuel argues that there are four major arguments presented by opponents of euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment, combined with the use of effective pain relief, are available; c) the distinction between active and passive euthanasia is morally significant; and d) legalising euthanasia will place society on a slippery slope,[53] which will lead to unacceptable consequences.[37]:797-8 In fact, in Oregon, in 2013, pain wasn’t one of the top five reasons people sought euthanasia. Top reasons were a loss of dignity, and a fear of burdening others.[54]

In the United States in 2013, 47% nationwide supported doctor-assisted suicide. This included 32% of Latinos, 29% of African-Americans, and almost nobody with disabilities.[54]

A 2015 Populus poll in the United Kingdom found broad public support for assisted dying. 82% of people supported the introduction of assisted dying laws, including 86% of people with disabilities.[55]

West’s Encyclopedia of American Law states that “a ‘mercy killing’ or euthanasia is generally considered to be a criminal homicide”[56] and is normally used as a synonym of homicide committed at a request made by the patient.[57]

The judicial sense of the term “homicide” includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering.[57][58][59] Not all homicide is unlawful.[60] Two designations of homicide that carry no criminal punishment are justifiable and excusable homicide.[60] In most countries this is not the status of euthanasia. The term “euthanasia” is usually confined to the active variety; the University of Washington website states that “euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient’s life”.[61] Physician-assisted suicide is thus not classified as euthanasia by the US State of Oregon, where it is legal under the Oregon Death with Dignity Act, and despite its name, it is not legally classified as suicide either.[62] Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal.[63] The use of pain medication to relieve suffering, even if it hastens death, has been held as legal in several court decisions.[61]

Some governments around the world have legalized voluntary euthanasia but most commonly it is still considered to be criminal homicide. In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal conditions.[64][65][66][67]

In a historic judgment, the Supreme court of India legalized passive euthanasia. The apex court remarked in the judgment that the Constitution of India values liberty, dignity, autonomy, and privacy. A bench headed by Chief Justice Dipak Misra delivered a unanimous judgment.[68]

A 2010 survey in the United States of more than 10,000 physicians found that 16.3% of physicians would consider halting life-sustaining therapy because the family demanded it, even if they believed that it was premature. Approximately 54.5% would not, and the remaining 29.2% responded “it depends”.[69] The study also found that 45.8% of physicians agreed that physician-assisted suicide should be allowed in some cases; 40.7% did not, and the remaining 13.5% felt it depended.[69]

In the United Kingdom, the assisted dying campaign group Dignity in Dying cites research in which 54% of General Practitioners support or are neutral towards a law change on assisted dying.[70] Similarly, a 2017 Doctors.net.uk poll reported in the British Medical Journal stated that 55% of doctors believe assisted dying, in defined circumstances, should be legalised in the UK.[71]

The Roman Catholic Church strongly opposes and condemns euthanasia and assisted suicide as morally wrong. It states that, “intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator”. Because of this, the practice is unacceptable within the Church.[72] The Orthodox Church in America, along with other Eastern Orthodox Churches, also opposes euthanasia stating that it must be condemned as murder stating that, “Euthanasia is the deliberate cessation to end human life.”[73]

Many non-Catholic churches in the United States take a stance against euthanasia. Among Protestant denominations, the Episcopal Church passed a resolution in 1991 opposing euthanasia and assisted suicide stating that it is “morally wrong and unacceptable to take a human life to relieve the suffering caused by incurable illnesses.” [73] Other Protestant churches which oppose euthanasia include:

The Church of England accepts passive euthanasia under some circumstances, but is strongly against active euthanasia, and has led opposition against recent attempt to legalise it.[83] The United Church of Canada accepts passive euthanasia under some circumstances, but is in general against active euthanasia, with growing acceptance now that active euthanasia has been partly legalised in Canada.[84].

Euthanasia is a complex issue in Islamic theology; however, in general it is considered contrary to Islamic law and holy texts. Among interpretations of the Koran and Hadith, the early termination of life is a crime, be it by suicide or helping one commit suicide. The various positions on the cessation of medical treatment are mixed and considered a different class of action than direct termination of life, especially if the patient is suffering. Suicide and euthanasia are both crimes in almost all Muslim majority countries.[85]

There is much debate on the topic of euthanasia in Judaic theology, ethics, and general opinion (especially in Israel and the United States). Passive euthanasia was declared legal by Israel’s highest court under certain conditions and has reached some level of acceptance. Active euthanasia remains illegal, however the topic is actively under debate with no clear consensus through legal, ethical, theological and spiritual perspectives.[86]

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Euthanasia – Wikipedia

Euthanasia – ProCon.org

Proponents of euthanasia and physician-assisted suicide (PAS) contend that terminally ill people should have the right to end their suffering with a quick, dignified, and compassionate death. They argue that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, and the refusal or termination of life-saving medical treatment.

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a “slippery slope” from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

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CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a “slippery slope” from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

PROS & CONS BY CATEGORY

CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

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Euthanasia – ProCon.org

Euthanasia | law | Britannica.com

Euthanasia, also called mercy killing, act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures. Because there is no specific provision for it in most legal systems, it is usually regarded as either suicide (if performed by the patient himself) or murder (if performed by another). A physician may, however, lawfully decide not to prolong life in cases of extreme suffering, and he may administer drugs to relieve pain even if this shortens the patients life. In the late 20th century, several European countries had special provisions in their criminal codes for lenient sentencing and the consideration of extenuating circumstances in prosecutions for euthanasia.

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ethics: Abortion, euthanasia, and the value of human life

A number of ethical questions are concerned with the endpoints of the human life span. The question of whether abortion or the use of human embryos as sources of stem cells can be morally justified was exhaustively discussed

The opinion that euthanasia is morally permissible is traceable to Socrates, Plato, and the Stoics. It is rejected in traditional Christian belief, chiefly because it is thought to contravene the prohibition of murder in the Ten Commandments. The organized movement for legalization of euthanasia commenced in England in 1935, when C. Killick Millard founded the Voluntary Euthanasia Legalisation Society (later called the Euthanasia Society). The societys bill was defeated in the House of Lords in 1936, as was a motion on the same subject in the House of Lords in 1950. In the United States the Euthanasia Society of America was founded in 1938.

The first countries to legalize euthanasia were the Netherlands in 2001 and Belgium in 2002. In 1997 Oregon became the first state in the United States to decriminalize physician-assisted suicide; opponents of the controversial law, however, attempted to have it overturned. In 2009 the Supreme Court of South Korea recognized a right to die with dignity in its decision to approve a request by the family of a brain-dead woman that she be removed from life-support systems.

The potential of modern medical practice to prolong life through technological means has provoked the question of what courses of action should be available to the physician and the family in cases of extreme physical or emotional suffering, especially if the patient is incapable of choice. Passively doing nothing to prolong life or withdrawing life-support measures has resulted in criminal charges being brought against physicians; on the other hand, the families of comatose and apparently terminal patients have instituted legal action against the medical establishment to make them stop the use of extraordinary life support.

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Euthanasia | law | Britannica.com

Eugenics – Wikipedia

Eugenics (; from Greek eugenes ‘well-born’ from eu, ‘good, well’ and genos, ‘race, stock, kin’)[2][3] is a set of beliefs and practices that aims at improving the genetic quality of a human population.[4][5] The exact definition of eugenics has been a matter of debate since the term was coined by Francis Galton in 1883. The concept predates this coinage, with Plato suggesting applying the principles of selective breeding to humans around 400BCE.

Frederick Osborn’s 1937 journal article “Development of a Eugenic Philosophy”[6] framed it as a social philosophythat is, a philosophy with implications for social order. That definition is not universally accepted. Osborn advocated for higher rates of sexual reproduction among people with desired traits (positive eugenics), or reduced rates of sexual reproduction and sterilization of people with less-desired or undesired traits (negative eugenics).

Alternatively, gene selection rather than “people selection” has recently been made possible through advances in genome editing,[7] leading to what is sometimes called new eugenics, also known as neo-eugenics, consumer eugenics, or liberal eugenics.

While eugenic principles have been practiced as far back in world history as ancient Greece, the modern history of eugenics began in the early 20th century when a popular eugenics movement emerged in the United Kingdom[8] and spread to many countries including the United States, Canada[9] and most European countries. In this period, eugenic ideas were espoused across the political spectrum. Consequently, many countries adopted eugenic policies with the intent to improve the quality of their populations’ genetic stock. Such programs included both “positive” measures, such as encouraging individuals deemed particularly “fit” to reproduce, and “negative” measures such as marriage prohibitions and forced sterilization of people deemed unfit for reproduction. People deemed unfit to reproduce often included people with mental or physical disabilities, people who scored in the low ranges of different IQ tests, criminals and deviants, and members of disfavored minority groups. The eugenics movement became negatively associated with Nazi Germany and the Holocaust when many of the defendants at the Nuremberg trials attempted to justify their human rights abuses by claiming there was little difference between the Nazi eugenics programs and the U.S. eugenics programs.[10] In the decades following World War II, with the institution of human rights, many countries gradually began to abandon eugenics policies, although some Western countries, among them the United States and Sweden, continued to carry out forced sterilizations.

Since the 1980s and 1990s, when new assisted reproductive technology procedures became available such as gestational surrogacy (available since 1985), preimplantation genetic diagnosis (available since 1989), and cytoplasmic transfer (first performed in 1996), fear has emerged about a possible revival of eugenics.

A major criticism of eugenics policies is that, regardless of whether “negative” or “positive” policies are used, they are susceptible to abuse because the criteria of selection are determined by whichever group is in political power at the time. Furthermore, negative eugenics in particular is considered by many to be a violation of basic human rights, which include the right to reproduction. Another criticism is that eugenic policies eventually lead to a loss of genetic diversity, resulting in inbreeding depression due to lower genetic variation.

Seneca the Younger

The concept of positive eugenics to produce better human beings has existed at least since Plato suggested selective mating to produce a guardian class.[12] In Sparta, every Spartan child was inspected by the council of elders, the Gerousia, which determined if the child was fit to live or not. In the early years of ancient Rome, a Roman father was obliged by law to immediately kill his child if they were physically disabled.[13] Among the ancient Germanic tribes, people who were cowardly, unwarlike or “stained with abominable vices” were put to death, usually by being drowned in swamps.[14][15]

The first formal negative eugenics, that is a legal provision against the birth of allegedly inferior human beings, was promulgated in Western European culture by the Christian Council of Agde in 506, which forbade marriage between cousins.[16]

This idea was also promoted by William Goodell (18291894) who advocated the castration and spaying of the insane.[17][18]

The idea of a modern project of improving the human population through a statistical understanding of heredity used to encourage good breeding was originally developed by Francis Galton and, initially, was closely linked to Darwinism and his theory of natural selection.[20] Galton had read his half-cousin Charles Darwin’s theory of evolution, which sought to explain the development of plant and animal species, and desired to apply it to humans. Based on his biographical studies, Galton believed that desirable human qualities were hereditary traits, although Darwin strongly disagreed with this elaboration of his theory.[21] In 1883, one year after Darwin’s death, Galton gave his research a name: eugenics.[22] With the introduction of genetics, eugenics became associated with genetic determinism, the belief that human character is entirely or in the majority caused by genes, unaffected by education or living conditions. Many of the early geneticists were not Darwinians, and evolution theory was not needed for eugenics policies based on genetic determinism.[20] Throughout its recent history, eugenics has remained controversial.

Eugenics became an academic discipline at many colleges and universities and received funding from many sources.[24] Organizations were formed to win public support and sway opinion towards responsible eugenic values in parenthood, including the British Eugenics Education Society of 1907 and the American Eugenics Society of 1921. Both sought support from leading clergymen and modified their message to meet religious ideals.[25] In 1909 the Anglican clergymen William Inge and James Peile both wrote for the British Eugenics Education Society. Inge was an invited speaker at the 1921 International Eugenics Conference, which was also endorsed by the Roman Catholic Archbishop of New York Patrick Joseph Hayes.[25]

Three International Eugenics Conferences presented a global venue for eugenists with meetings in 1912 in London, and in 1921 and 1932 in New York City. Eugenic policies were first implemented in the early 1900s in the United States.[26] It also took root in France, Germany, and Great Britain.[27] Later, in the 1920s and 1930s, the eugenic policy of sterilizing certain mental patients was implemented in other countries including Belgium,[28] Brazil,[29] Canada,[30] Japan and Sweden.

In addition to being practiced in a number of countries, eugenics was internationally organized through the International Federation of Eugenics Organizations. Its scientific aspects were carried on through research bodies such as the Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics, the Cold Spring Harbour Carnegie Institution for Experimental Evolution, and the Eugenics Record Office. Politically, the movement advocated measures such as sterilization laws. In its moral dimension, eugenics rejected the doctrine that all human beings are born equal and redefined moral worth purely in terms of genetic fitness. Its racist elements included pursuit of a pure “Nordic race” or “Aryan” genetic pool and the eventual elimination of “unfit” races.

Early critics of the philosophy of eugenics included the American sociologist Lester Frank Ward,[39] the English writer G. K. Chesterton, the German-American anthropologist Franz Boas, who argued that advocates of eugenics greatly over-estimate the influence of biology,[40] and Scottish tuberculosis pioneer and author Halliday Sutherland. Ward’s 1913 article “Eugenics, Euthenics, and Eudemics”, Chesterton’s 1917 book Eugenics and Other Evils, and Boas’ 1916 article “Eugenics” (published in The Scientific Monthly) were all harshly critical of the rapidly growing movement. Sutherland identified eugenists as a major obstacle to the eradication and cure of tuberculosis in his 1917 address “Consumption: Its Cause and Cure”,[41] and criticism of eugenists and Neo-Malthusians in his 1921 book Birth Control led to a writ for libel from the eugenist Marie Stopes. Several biologists were also antagonistic to the eugenics movement, including Lancelot Hogben.[42] Other biologists such as J. B. S. Haldane and R. A. Fisher expressed skepticism in the belief that sterilization of “defectives” would lead to the disappearance of undesirable genetic traits.[43]

Among institutions, the Catholic Church was an opponent of state-enforced sterilizations.[44] Attempts by the Eugenics Education Society to persuade the British government to legalize voluntary sterilization were opposed by Catholics and by the Labour Party.[45] The American Eugenics Society initially gained some Catholic supporters, but Catholic support declined following the 1930 papal encyclical Casti connubii.[25] In this, Pope Pius XI explicitly condemned sterilization laws: “Public magistrates have no direct power over the bodies of their subjects; therefore, where no crime has taken place and there is no cause present for grave punishment, they can never directly harm, or tamper with the integrity of the body, either for the reasons of eugenics or for any other reason.”[46]

As a social movement, eugenics reached its greatest popularity in the early decades of the 20th century, when it was practiced around the world and promoted by governments, institutions, and influential individuals. Many countries enacted[47] various eugenics policies, including: genetic screenings, birth control, promoting differential birth rates, marriage restrictions, segregation (both racial segregation and sequestering the mentally ill), compulsory sterilization, forced abortions or forced pregnancies, ultimately culminating in genocide.

The scientific reputation of eugenics started to decline in the 1930s, a time when Ernst Rdin used eugenics as a justification for the racial policies of Nazi Germany. Adolf Hitler had praised and incorporated eugenic ideas in Mein Kampf in 1925 and emulated eugenic legislation for the sterilization of “defectives” that had been pioneered in the United States once he took power. Some common early 20th century eugenics methods involved identifying and classifying individuals and their families, including the poor, mentally ill, blind, deaf, developmentally disabled, promiscuous women, homosexuals, and racial groups (such as the Roma and Jews in Nazi Germany) as “degenerate” or “unfit”, and therefore led to segregation, institutionalization, sterilization, euthanasia, and even mass murder. The Nazi practice of euthanasia was carried out on hospital patients in the Aktion T4 centers such as Hartheim Castle.

By the end of World War II, many discriminatory eugenics laws were abandoned, having become associated with Nazi Germany.[50] H. G. Wells, who had called for “the sterilization of failures” in 1904,[51] stated in his 1940 book The Rights of Man: Or What are we fighting for? that among the human rights, which he believed should be available to all people, was “a prohibition on mutilation, sterilization, torture, and any bodily punishment”.[52] After World War II, the practice of “imposing measures intended to prevent births within [a national, ethnical, racial or religious] group” fell within the definition of the new international crime of genocide, set out in the Convention on the Prevention and Punishment of the Crime of Genocide.[53] The Charter of Fundamental Rights of the European Union also proclaims “the prohibition of eugenic practices, in particular those aiming at selection of persons”.[54] In spite of the decline in discriminatory eugenics laws, some government mandated sterilizations continued into the 21st century. During the ten years President Alberto Fujimori led Peru from 1990 to 2000, 2,000 persons were allegedly involuntarily sterilized.[55] China maintained its one-child policy until 2015 as well as a suite of other eugenics based legislation to reduce population size and manage fertility rates of different populations.[56][57][58] In 2007 the United Nations reported coercive sterilizations and hysterectomies in Uzbekistan.[59] During the years 2005 to 2013, nearly one-third of the 144 California prison inmates who were sterilized did not give lawful consent to the operation.[60]

Developments in genetic, genomic, and reproductive technologies at the end of the 20th century have raised numerous questions regarding the ethical status of eugenics, effectively creating a resurgence of interest in the subject.Some, such as UC Berkeley sociologist Troy Duster, claim that modern genetics is a back door to eugenics.[61] This view is shared by White House Assistant Director for Forensic Sciences, Tania Simoncelli, who stated in a 2003 publication by the Population and Development Program at Hampshire College that advances in pre-implantation genetic diagnosis (PGD) are moving society to a “new era of eugenics”, and that, unlike the Nazi eugenics, modern eugenics is consumer driven and market based, “where children are increasingly regarded as made-to-order consumer products”.[62] In a 2006 newspaper article, Richard Dawkins said that discussion regarding eugenics was inhibited by the shadow of Nazi misuse, to the extent that some scientists would not admit that breeding humans for certain abilities is at all possible. He believes that it is not physically different from breeding domestic animals for traits such as speed or herding skill. Dawkins felt that enough time had elapsed to at least ask just what the ethical differences were between breeding for ability versus training athletes or forcing children to take music lessons, though he could think of persuasive reasons to draw the distinction.[63]

Lee Kuan Yew, the Founding Father of Singapore, started promoting eugenics as early as 1983.[64][65]

In October 2015, the United Nations’ International Bioethics Committee wrote that the ethical problems of human genetic engineering should not be confused with the ethical problems of the 20th century eugenics movements. However, it is still problematic because it challenges the idea of human equality and opens up new forms of discrimination and stigmatization for those who do not want, or cannot afford, the technology.[66]

Transhumanism is often associated with eugenics, although most transhumanists holding similar views nonetheless distance themselves from the term “eugenics” (preferring “germinal choice” or “reprogenetics”)[67] to avoid having their position confused with the discredited theories and practices of early-20th-century eugenic movements.

Prenatal screening can be considered a form of contemporary eugenics because it may lead to abortions of children with undesirable traits.[68]

The term eugenics and its modern field of study were first formulated by Francis Galton in 1883,[69] drawing on the recent work of his half-cousin Charles Darwin.[70][71] Galton published his observations and conclusions in his book Inquiries into Human Faculty and Its Development.

The origins of the concept began with certain interpretations of Mendelian inheritance and the theories of August Weismann. The word eugenics is derived from the Greek word eu (“good” or “well”) and the suffix -gens (“born”), and was coined by Galton in 1883 to replace the word “stirpiculture”, which he had used previously but which had come to be mocked due to its perceived sexual overtones.[73] Galton defined eugenics as “the study of all agencies under human control which can improve or impair the racial quality of future generations”.[74]

Historically, the term eugenics has referred to everything from prenatal care for mothers to forced sterilization and euthanasia.[75] To population geneticists, the term has included the avoidance of inbreeding without altering allele frequencies; for example, J. B. S. Haldane wrote that “the motor bus, by breaking up inbred village communities, was a powerful eugenic agent.”[76] Debate as to what exactly counts as eugenics continues today.[77]

Edwin Black, journalist and author of War Against the Weak, claims eugenics is often deemed a pseudoscience because what is defined as a genetic improvement of a desired trait is often deemed a cultural choice rather than a matter that can be determined through objective scientific inquiry.[78] The most disputed aspect of eugenics has been the definition of “improvement” of the human gene pool, such as what is a beneficial characteristic and what is a defect. Historically, this aspect of eugenics was tainted with scientific racism and pseudoscience.[79][80][81]

Early eugenists were mostly concerned with factors of perceived intelligence that often correlated strongly with social class. Some of these early eugenists include Karl Pearson and Walter Weldon, who worked on this at the University College London.[21]

Eugenics also had a place in medicine. In his lecture “Darwinism, Medical Progress and Eugenics”, Karl Pearson said that everything concerning eugenics fell into the field of medicine. He basically placed the two words as equivalents. He was supported in part by the fact that Francis Galton, the father of eugenics, also had medical training.[82]

Eugenic policies have been conceptually divided into two categories.[75] Positive eugenics is aimed at encouraging reproduction among the genetically advantaged; for example, the reproduction of the intelligent, the healthy, and the successful. Possible approaches include financial and political stimuli, targeted demographic analyses, in vitro fertilization, egg transplants, and cloning.[83] The movie Gattaca provides a fictional example of a dystopian society that uses eugenics to decided what people are capable of and their place in the world. Negative eugenics aimed to eliminate, through sterilization or segregation, those deemed physically, mentally, or morally “undesirable”. This includes abortions, sterilization, and other methods of family planning.[83] Both positive and negative eugenics can be coercive; abortion for fit women, for example, was illegal in Nazi Germany.[84]

Jon Entine claims that eugenics simply means “good genes” and using it as synonym for genocide is an “all-too-common distortion of the social history of genetics policy in the United States”. According to Entine, eugenics developed out of the Progressive Era and not “Hitler’s twisted Final Solution”.[85]

According to Richard Lynn, eugenics may be divided into two main categories based on the ways in which the methods of eugenics can be applied.[86]

The first major challenge to conventional eugenics based upon genetic inheritance was made in 1915 by Thomas Hunt Morgan. He demonstrated the event of genetic mutation occurring outside of inheritance involving the discovery of the hatching of a fruit fly (Drosophila melanogaster) with white eyes from a family with red eyes. Morgan claimed that this demonstrated that major genetic changes occurred outside of inheritance and that the concept of eugenics based upon genetic inheritance was not completely scientifically accurate. Additionally, Morgan criticized the view that subjective traits, such as intelligence and criminality, were caused by heredity because he believed that the definitions of these traits varied and that accurate work in genetics could only be done when the traits being studied were accurately defined.[123] Despite Morgan’s public rejection of eugenics, much of his genetic research was absorbed by eugenics.[124][125]

The heterozygote test is used for the early detection of recessive hereditary diseases, allowing for couples to determine if they are at risk of passing genetic defects to a future child.[126] The goal of the test is to estimate the likelihood of passing the hereditary disease to future descendants.[126]

Recessive traits can be severely reduced, but never eliminated unless the complete genetic makeup of all members of the pool was known, as aforementioned. As only very few undesirable traits, such as Huntington’s disease, are dominant, it could be argued[by whom?] from certain perspectives that the practicality of “eliminating” traits is quite low.[citation needed]

There are examples of eugenic acts that managed to lower the prevalence of recessive diseases, although not influencing the prevalence of heterozygote carriers of those diseases. The elevated prevalence of certain genetically transmitted diseases among the Ashkenazi Jewish population (TaySachs, cystic fibrosis, Canavan’s disease, and Gaucher’s disease), has been decreased in current populations by the application of genetic screening.[127]

Pleiotropy occurs when one gene influences multiple, seemingly unrelated phenotypic traits, an example being phenylketonuria, which is a human disease that affects multiple systems but is caused by one gene defect.[128] Andrzej Pkalski, from the University of Wrocaw, argues that eugenics can cause harmful loss of genetic diversity if a eugenics program selects a pleiotropic gene that could possibly be associated with a positive trait. Pekalski uses the example of a coercive government eugenics program that prohibits people with myopia from breeding but has the unintended consequence of also selecting against high intelligence since the two go together.[129]

Eugenic policies could also lead to loss of genetic diversity, in which case a culturally accepted “improvement” of the gene pool could very likelyas evidenced in numerous instances in isolated island populations result in extinction due to increased vulnerability to disease, reduced ability to adapt to environmental change, and other factors both known and unknown. A long-term, species-wide eugenics plan might lead to a scenario similar to this because the elimination of traits deemed undesirable would reduce genetic diversity by definition.[130]

Edward M. Miller claims that, in any one generation, any realistic program should make only minor changes in a fraction of the gene pool, giving plenty of time to reverse direction if unintended consequences emerge, reducing the likelihood of the elimination of desirable genes.[131] Miller also argues that any appreciable reduction in diversity is so far in the future that little concern is needed for now.[131]

While the science of genetics has increasingly provided means by which certain characteristics and conditions can be identified and understood, given the complexity of human genetics, culture, and psychology, at this point no agreed objective means of determining which traits might be ultimately desirable or undesirable. Some diseases such as sickle-cell disease and cystic fibrosis respectively confer immunity to malaria and resistance to cholera when a single copy of the recessive allele is contained within the genotype of the individual. Reducing the instance of sickle-cell disease genes in Africa where malaria is a common and deadly disease could indeed have extremely negative net consequences.

However, some genetic diseases cause people to consider some elements of eugenics.

Societal and political consequences of eugenics call for a place in the discussion on the ethics behind the eugenics movement.[132] Many of the ethical concerns regarding eugenics arise from its controversial past, prompting a discussion on what place, if any, it should have in the future. Advances in science have changed eugenics. In the past, eugenics had more to do with sterilization and enforced reproduction laws.[133] Now, in the age of a progressively mapped genome, embryos can be tested for susceptibility to disease, gender, and genetic defects, and alternative methods of reproduction such as in vitro fertilization are becoming more common.[134] Therefore, eugenics is no longer ex post facto regulation of the living but instead preemptive action on the unborn.[135]

With this change, however, there are ethical concerns which lack adequate attention, and which must be addressed before eugenic policies can be properly implemented in the future. Sterilized individuals, for example, could volunteer for the procedure, albeit under incentive or duress, or at least voice their opinion. The unborn fetus on which these new eugenic procedures are performed cannot speak out, as the fetus lacks the voice to consent or to express his or her opinion.[136] Philosophers disagree about the proper framework for reasoning about such actions, which change the very identity and existence of future persons.[137]

A common criticism of eugenics is that “it inevitably leads to measures that are unethical”.[138] Some fear future “eugenics wars” as the worst-case scenario: the return of coercive state-sponsored genetic discrimination and human rights violations such as compulsory sterilization of persons with genetic defects, the killing of the institutionalized and, specifically, segregation and genocide of races perceived as inferior.[139] Health law professor George Annas and technology law professor Lori Andrews are prominent advocates of the position that the use of these technologies could lead to such human-posthuman caste warfare.[140][141]

In his 2003 book Enough: Staying Human in an Engineered Age, environmental ethicist Bill McKibben argued at length against germinal choice technology and other advanced biotechnological strategies for human enhancement. He writes that it would be morally wrong for humans to tamper with fundamental aspects of themselves (or their children) in an attempt to overcome universal human limitations, such as vulnerability to aging, maximum life span and biological constraints on physical and cognitive ability. Attempts to “improve” themselves through such manipulation would remove limitations that provide a necessary context for the experience of meaningful human choice. He claims that human lives would no longer seem meaningful in a world where such limitations could be overcome with technology. Even the goal of using germinal choice technology for clearly therapeutic purposes should be relinquished, since it would inevitably produce temptations to tamper with such things as cognitive capacities. He argues that it is possible for societies to benefit from renouncing particular technologies, using as examples Ming China, Tokugawa Japan and the contemporary Amish.[142]

Some, for example Nathaniel C. Comfort from Johns Hopkins University, claim that the change from state-led reproductive-genetic decision-making to individual choice has moderated the worst abuses of eugenics by transferring the decision-making from the state to the patient and their family.[143] Comfort suggests that “the eugenic impulse drives us to eliminate disease, live longer and healthier, with greater intelligence, and a better adjustment to the conditions of society; and the health benefits, the intellectual thrill and the profits of genetic bio-medicine are too great for us to do otherwise.”[144] Others, such as bioethicist Stephen Wilkinson of Keele University and Honorary Research Fellow Eve Garrard at the University of Manchester, claim that some aspects of modern genetics can be classified as eugenics, but that this classification does not inherently make modern genetics immoral. In a co-authored publication by Keele University, they stated that “[e]ugenics doesn’t seem always to be immoral, and so the fact that PGD, and other forms of selective reproduction, might sometimes technically be eugenic, isn’t sufficient to show that they’re wrong.”[145]

In their book published in 2000, From Chance to Choice: Genetics and Justice, bioethicists Allen Buchanan, Dan Brock, Norman Daniels and Daniel Wikler argued that liberal societies have an obligation to encourage as wide an adoption of eugenic enhancement technologies as possible (so long as such policies do not infringe on individuals’ reproductive rights or exert undue pressures on prospective parents to use these technologies) in order to maximize public health and minimize the inequalities that may result from both natural genetic endowments and unequal access to genetic enhancements.[146]

Original position, a hypothetical situation developed by American philosopher John Rawls, has been used as an argument for negative eugenics.[147][148]

Notes

Bibliography

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Eugenics – Wikipedia

Euthanasia | American Medical Association

Euthanasia is the administration of a lethal agent by another person to a patient for the purpose of relieving the patients intolerable and incurable suffering.

It is understandable, though tragic, that some patients in extreme duresssuch as those suffering from a terminal, painful, debilitating illnessmay come to decide that death is preferable to life.

However, permitting physicians to engage in euthanasia would ultimately cause more harm than good.

Euthanasia is fundamentally incompatible with the physicians role as healer, would be difficult or impossible to control, and would pose serious societal risks. Euthanasia could readily be extended to incompetent patients and other vulnerable populations.

The involvement of physicians in euthanasia heightens the significance of its ethical prohibition. The physician who performs euthanasia assumes unique responsibility for the act of ending the patients life.

Instead of engaging in euthanasia, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

(a) Should not abandon a patient once it is determined that a cure is impossible.

(b) Must respect patient autonomy.

(c) Must provide good communication and emotional support.

(d) Must provide appropriate comfort care and adequate pain control.

AMA Principles of Medical Ethics: I, IV

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Euthanasia | American Medical Association

Euthanasia – ProCon.org

Proponents of euthanasia and physician-assisted suicide (PAS) contend that terminally ill people should have the right to end their suffering with a quick, dignified, and compassionate death. They argue that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, and the refusal or termination of life-saving medical treatment.

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a “slippery slope” from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

PROS & CONS BY CATEGORY

CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a “slippery slope” from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

PROS & CONS BY CATEGORY

CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

Original post:

Euthanasia – ProCon.org

Euthanasia – Wikipedia

Euthanasia (from Greek: ; “good death”: , eu; “well” or “good” , thanatos; “death”) is the practice of intentionally ending a life to relieve pain and suffering.[1][2]

There are different euthanasia laws in each country. The British House of Lords Select Committee on Medical Ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”.[3] In the Netherlands and Belgium, euthanasia is understood as “termination of life by a doctor at the request of a patient”.[4] The Dutch law however, does not use the term ‘euthanasia’ but includes it under the broader definition of “assisted suicide and termination of life on request”.[5]

Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary. Voluntary euthanasia is legal in some countries. Non-voluntary euthanasia (patient’s consent unavailable) is illegal in all countries. Involuntary euthanasia (without asking consent or against the patient’s will) is also illegal in all countries and is usually considered murder.[6] As of 2006, euthanasia is the most active area of research in contemporary bioethics.[7] In some countries there is a divisive public controversy over the moral, ethical, and legal issues of euthanasia. Passive euthanasia (known as “pulling the plug”) is legal under some circumstances in many countries. Active euthanasia however is legal or de facto legal in only a handful of countries (e.g. Belgium, Canada, Switzerland) and is limited to specific circumstances and the approval of councilors and doctors or other specialists. In some countries such as Nigeria, Saudi Arabia and Pakistan, support for active euthanasia is almost non-existent.

Like other terms borrowed from history, “euthanasia” has had different meanings depending on usage. The first apparent usage of the term “euthanasia” belongs to the historian Suetonius, who described how the Emperor Augustus, “dying quickly and without suffering in the arms of his wife, Livia, experienced the ‘euthanasia’ he had wished for.”[8] The word “euthanasia” was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a “physician’s responsibility to alleviate the ‘physical sufferings’ of the body.” Bacon referred to an “outward euthanasia”the term “outward” he used to distinguish from a spiritual conceptthe euthanasia “which regards the preparation of the soul.”[9]

In current usage, euthanasia has been defined as the “painless inducement of a quick death”.[10] However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional.[11][12]

Another approach incorporates the notion of suffering into the definition.[11] The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma”,[13] This approach is included in Marvin Khol and Paul Kurtz’s definition of it as “a mode or act of inducing or permitting death painlessly as a relief from suffering”.[14] Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as Tom Beauchamp and Arnold Davidson have argued that doing so would constitute “murder simpliciter” rather than euthanasia.[11]

The third element incorporated into many definitions is that of intentionality the death must be intended, rather than being accidental, and the intent of the action must be a “merciful death”.[11] Michael Wreen argued that “the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent’s motive: it must be a good motive insofar as the good of the person killed is concerned.”[15] Similarly, Heather Draper speaks to the importance of motive, arguing that “the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end.”[12] Definitions such as that offered by the House of Lords Select Committee on Medical Ethics take this path, where euthanasia is defined as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering.”[3] Beauchamp and Davidson also highlight Baruch Brody’s “an act of euthanasia is one in which one person… (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed”.[16]

Draper argued that any definition of euthanasia must incorporate four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Based on this, she offered a definition incorporating those elements, stating that euthanasia “must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies.”[17] Prior to Draper, Beauchamp and Davidson had also offered a definition that includes these elements. Their definition specifically discounts fetuses to distinguish between abortions and euthanasia:[18]

“In summary, we have argued… that the death of a human being, A, is an instance of euthanasia if and only if (1) A’s death is intended by at least one other human being, B, where B is either the cause of death or a causally relevant feature of the event resulting in death (whether by action or by omission); (2) there is either sufficient current evidence for B to believe that A is acutely suffering or irreversibly comatose, or there is sufficient current evidence related to A’s present condition such that one or more known causal laws supports B’s belief that A will be in a condition of acute suffering or irreversible comatoseness; (3) (a) B’s primary reason for intending A’s death is cessation of A’s (actual or predicted future) suffering or irreversible comatoseness, where B does not intend A’s death for a different primary reason, though there may be other relevant reasons, and (b) there is sufficient current evidence for either A or B that causal means to A’s death will not produce any more suffering than would be produced for A if B were not to intervene; (4) the causal means to the event of A’s death are chosen by A or B to be as painless as possible, unless either A or B has an overriding reason for a more painful causal means, where the reason for choosing the latter causal means does not conflict with the evidence in 3b; (5) A is a nonfetal organism.”[19]

Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition:

“Person A committed an act of euthanasia if and only if (1) A killed B or let her die; (2) A intended to kill B; (3) the intention specified in (2) was at least partial cause of the action specified in (1); (4) the causal journey from the intention specified in (2) to the action specified in (1) is more or less in accordance with A’s plan of action; (5) A’s killing of B is a voluntary action; (6) the motive for the action specified in (1), the motive standing behind the intention specified in (2), is the good of the person killed.”[20]

Wreen also considered a seventh requirement: “(7) The good specified in (6) is, or at least includes, the avoidance of evil”, although as Wreen noted in the paper, he was not convinced that the restriction was required.[21]

In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject’s “right to life”. In response, Wreen argued that euthanasia has to be voluntary, and that “involuntary euthanasia is, as such, a great wrong”.[21] Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: “Medicalized killing of a person without the person’s consent, whether nonvoluntary (where the person in unable to consent) or involuntary (against the person’s will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only.”[22] Although the EPAC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.[21]

Euthanasia may be classified into three types, according to whether a person gives informed consent: voluntary, non-voluntary and involuntary.[23][24]

There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient’s circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Wreen, consent on the part of the patient was not considered as one of their criteria, although it may have been required to justify euthanasia.[11][25] However, others see consent as essential.

Voluntary euthanasia is conducted with the consent of the patient. Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. Passive voluntary euthanasia is legal throughout the US per Cruzan v. Director, Missouri Department of Health. When the patient brings about his or her own death with the assistance of a physician, the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont.

Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. Examples include child euthanasia, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol.

Involuntary euthanasia is conducted against the will of the patient.

Voluntary, non-voluntary and involuntary types can be further divided into passive or active variants.[26] Passive euthanasia entails the withholding treatment necessary for the continuance of life.[3] Active euthanasia entails the use of lethal substances or forces (such as administering a lethal injection), and is the more controversial. While some authors consider these terms to be misleading and unhelpful, they are nonetheless commonly used. In some cases, such as the administration of increasingly necessary, but toxic doses of painkillers, there is a debate whether or not to regard the practice as active or passive.[3]

Euthanasia was practiced in Ancient Greece and Rome: for example, hemlock was employed as a means of hastening death on the island of Kea, a technique also employed in Marseilles. Euthanasia, in the sense of the deliberate hastening of a person’s death, was supported by Socrates, Plato and Seneca the Elder in the ancient world, although Hippocrates appears to have spoken against the practice, writing “I will not prescribe a deadly drug to please someone, nor give advice that may cause his death” (noting there is some debate in the literature about whether or not this was intended to encompass euthanasia).[27][28][29]

The term euthanasia in the earlier sense of supporting someone as they died, was used for the first time by Francis Bacon. In his work, Euthanasia medica, he chose this ancient Greek word and, in doing so, distinguished between euthanasia interior, the preparation of the soul for death, and euthanasia exterior, which was intended to make the end of life easier and painless, in exceptional circumstances by shortening life. That the ancient meaning of an easy death came to the fore again in the early modern period can be seen from its definition in the 18th century Zedlers Universallexikon:

Euthanasia: a very gentle and quiet death, which happens without painful convulsions. The word comes from , bene, well, and , mors, death.[30]

The concept of euthanasia in the sense of alleviating the process of death goes back to the medical historian, Karl Friedrich Heinrich Marx, who drew on Bacon’s philosophical ideas. According to Marx, a doctor had a moral duty to ease the suffering of death through encouragement, support and mitigation using medication. Such an “alleviation of death” reflected the contemporary zeitgeist, but was brought into the medical canon of responsibility for the first time by Marx. Marx also stressed the distinction between the theological care of the soul of sick people from the physical care and medical treatment by doctors.[31][32]

Euthanasia in its modern sense has always been strongly opposed in the Judeo-Christian tradition. Thomas Aquinas opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival,[33] as did Francois Ranchin (15651641), a French physician and professor of medicine, and Michael Boudewijns (16011681), a physician and teacher.[28]:208[34] Other voices argued for euthanasia, such as John Donne in 1624,[35] and euthanasia continued to be practised. In 1678, the publication of Caspar Questel’s De pulvinari morientibus non-subtrahend, (“On the pillow of which the dying should not be deprived”), initiated debate on the topic. Questel described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was “against the laws of God and Nature”.[28]:209211 This view was shared by others who followed, including Philipp Jakob Spener, Veit Riedlin and Johann Georg Krnitz.[28]:211 Despite opposition, euthanasia continued to be practised, involving techniques such as bleeding, suffocation, and removing people from their beds to be placed on the cold ground.[28]:211214

Suicide and euthanasia became more accepted during the Age of Enlightenment.[34] Thomas More wrote of euthanasia in Utopia, although it is not clear if More was intending to endorse the practice.[28]:208209 Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, as it is used in cases of honor, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.[36]

In the mid-1800s, the use of morphine to treat “the pains of death” emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a schoolteacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club in England, which was subsequently published in a one-off publication entitled Essays of the Birmingham Speculative Club, the collected works of a number of members of an amateur philosophical society.[37]:794 Williams’ proposal was to use chloroform to deliberately hasten the death of terminally ill patients:

That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anaesthetic as may by-and-bye supersede chloroform so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.

The essay was favourably reviewed in The Saturday Review, but an editorial against the essay appeared in The Spectator.[38] From there it proved to be influential, and other writers came out in support of such views: Lionel Tollemache wrote in favour of euthanasia, as did Annie Besant, the essayist and reformer who later became involved with the National Secular Society, considering it a duty to society to “die voluntarily and painlessly” when one reaches the point of becoming a ‘burden’.[38][39] Popular Science analyzed the issue in May 1873, assessing both sides of the argument.[40] Kemp notes that at the time, medical doctors did not participate in the discussion; it was “essentially a philosophical enterprise… tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life”.[38]

The rise of the euthanasia movement in the United States coincided with the so-called Gilded Age, a time of social and technological change that encompassed an “individualistic conservatism that praised laissez-faire economics, scientific method, and rationalism”, along with major depressions, industrialisation and conflict between corporations and labour unions.[37]:794 It was also the period in which the modern hospital system was developed, which has been seen as a factor in the emergence of the euthanasia debate.[41]

Robert Ingersoll argued for euthanasia, stating in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. Felix Adler offered a similar approach, although, unlike Ingersoll, Adler did not reject religion. In fact, he argued from an Ethical Culture framework. In 1891, Adler argued that those suffering from overwhelming pain should have the right to commit suicide, and, furthermore, that it should be permissible for a doctor to assist thus making Adler the first “prominent American” to argue for suicide in cases where people were suffering from chronic illness.[42] Both Ingersoll and Adler argued for voluntary euthanasia of adults suffering from terminal ailments.[42] Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler enabled others to stretch the definition of euthanasia.[43]

The first attempt to legalise euthanasia took place in the United States, when Henry Hunt introduced legislation into the General Assembly of Ohio in 1906.[44]:614 Hunt did so at the behest of Anna S. Hall, a wealthy heiress who was a major figure in the euthanasia movement during the early 20th century in the United States. Hall had watched her mother die after an extended battle with liver cancer, and had dedicated herself to ensuring that others would not have to endure the same suffering. Towards this end she engaged in an extensive letter writing campaign, recruited Lurana Sheldon and Maud Ballington Booth, and organised a debate on euthanasia at the annual meeting of the American Humane Association in 1905 described by Jacob Appel as the first significant public debate on the topic in the 20th century.[44]:614616

Hunt’s bill called for the administration of an anesthetic to bring about a patient’s death, so long as the person is of lawful age and sound mind, and was suffering from a fatal injury, an irrevocable illness, or great physical pain. It also required that the case be heard by a physician, required informed consent in front of three witnesses, and required the attendance of three physicians who had to agree that the patient’s recovery was impossible. A motion to reject the bill outright was voted down, but the bill failed to pass, 79 to 23.[37]:796[44]:618619

Along with the Ohio euthanasia proposal, in 1906 Assemblyman Ross Gregory introduced a proposal to permit euthanasia to the Iowa legislature. However, the Iowa legislation was broader in scope than that offered in Ohio. It allowed for the death of any person of at least ten years of age who suffered from an ailment that would prove fatal and cause extreme pain, should they be of sound mind and express a desire to artificially hasten their death. In addition, it allowed for infants to be euthanised if they were sufficiently deformed, and permitted guardians to request euthanasia on behalf of their wards. The proposed legislation also imposed penalties on physicians who refused to perform euthanasia when requested: a 612 month prison term and a fine of between $200 and $1,000. The proposal proved to be controversial.[44]:619621 It engendered considerable debate and failed to pass, having been withdrawn from consideration after being passed to the Committee on Public Health.[44]:623

After 1906 the euthanasia debate reduced in intensity, resurfacing periodically, but not returning to the same level of debate until the 1930s in the United Kingdom.[37]:796

Euthanasia opponent Ian Dowbiggin argues that the early membership of the Euthanasia Society of America (ESA) reflected how many perceived euthanasia at the time, often seeing it as a eugenics matter rather than an issue concerning individual rights.[42] Dowbiggin argues that not every eugenist joined the ESA “solely for eugenic reasons”, but he postulates that there were clear ideological connections between the eugenics and euthanasia movements.[42]

The Voluntary Euthanasia Legalisation Society was founded in 1935 by Charles Killick Millard (now called Dignity in Dying). The movement campaigned for the legalisation of euthanasia in Great Britain.

In January 1936, King George V was given a fatal dose of morphine and cocaine to hasten his death. At the time he was suffering from cardio-respiratory failure, and the decision to end his life was made by his physician, Lord Dawson.[45] Although this event was kept a secret for over 50 years, the death of George V coincided with proposed legislation in the House of Lords to legalise euthanasia.[46]

A 24 July 1939 killing of a severely disabled infant in Nazi Germany was described in a BBC “Genocide Under the Nazis Timeline” as the first “state-sponsored euthanasia”.[47] Parties that consented to the killing included Hitler’s office, the parents, and the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses.[47] The Telegraph noted that the killing of the disabled infantwhose name was Gerhard Kretschmar, born blind, with missing limbs, subject to convulsions, and reportedly “an idiot” provided “the rationale for a secret Nazi decree that led to ‘mercy killings’ of almost 300,000 mentally and physically handicapped people”.[48] While Kretchmar’s killing received parental consent, most of the 5,000 to 8,000 children killed afterwards were forcibly taken from their parents.[47][48]

The “euthanasia campaign” of mass murder gathered momentum on 14 January 1940 when the “handicapped” were killed with gas vans and killing centres, eventually leading to the deaths of 70,000 adult Germans.[49] Professor Robert Jay Lifton, author of The Nazi Doctors and a leading authority on the T4 program, contrasts this program with what he considers to be a genuine euthanasia. He explains that the Nazi version of “euthanasia” was based on the work of Adolf Jost, who published The Right to Death (Das Recht auf den Tod) in 1895. Lifton writes:

Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the individual’s ‘right to die’ or ‘right to death’ or ‘right to his or her own death,’ as the ultimate human claim. In contrast, Jost was pointing to the state’s right to kill…. Ultimately the argument was biological: ‘The rights to death [are] the key to the fitness of life.’ The state must own deathmust killin order to keep the social organism alive and healthy.[50]

In modern terms, the use of “euthanasia” in the context of Action T4 is seen to be a euphemism to disguise a program of genocide, in which people were killed on the grounds of “disabilities, religious beliefs, and discordant individual values”.[51] Compared to the discussions of euthanasia that emerged post-war, the Nazi program may have been worded in terms that appear similar to the modern use of “euthanasia”, but there was no “mercy” and the patients were not necessarily terminally ill.[51] Despite these differences, historian and euthanasia opponent Ian Dowbiggin writes that “the origins of Nazi euthanasia, like those of the American euthanasia movement, predate the Third Reich and were intertwined with the history of eugenics and Social Darwinism, and with efforts to discredit traditional morality and ethics.”[42]:65

On 6 January 1949, the Euthanasia Society of America presented to the New York State Legislature a petition to legalize euthanasia, signed by 379 leading Protestant and Jewish ministers, the largest group of religious leaders ever to have taken this stance. A similar petition had been sent to the New York Legislature in 1947, signed by approximately 1,000 New York physicians. Roman Catholic religious leaders criticized the petition, saying that such a bill would “legalize a suicide-murder pact” and a “rationalization of the fifth commandment of God, ‘Thou Shalt Not Kill.'”[52] The Right Reverend Robert E. McCormick stated that

“The ultimate object of the Euthanasia Society is based on the Totalitarian principle that the state is supreme and that the individual does not have the right to live if his continuance in life is a burden or hindrance to the state. The Nazis followed this principle and compulsory Euthanasia was practiced as a part of their program during the recent war. We American citizens of New York State must ask ourselves this question: ‘Are we going to finish Hitler’s job?'”[52]

The petition brought tensions between the American Euthanasia Society and the Catholic Church to a head that contributed to a climate of anti-Catholic sentiment generally, regarding issues such as birth control, eugenics, and population control. However, the petition did not result in any legal changes.[42]

Historically, the euthanasia debate has tended to focus on a number of key concerns. According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have presented four main arguments: a) that people have a right to self-determination, and thus should be allowed to choose their own fate; b) assisting a subject to die might be a better choice than requiring that they continue to suffer; c) the distinction between passive euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that the underlying principlethe doctrine of double effectis unreasonable or unsound); and d) permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia activists often point to countries like the Netherlands and Belgium, and states like Oregon, where euthanasia has been legalized, to argue that it is mostly unproblematic.

Similarly, Emanuel argues that there are four major arguments presented by opponents of euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment, combined with the use of effective pain relief, are available; c) the distinction between active and passive euthanasia is morally significant; and d) legalising euthanasia will place society on a slippery slope,[53] which will lead to unacceptable consequences.[37]:797-8 In fact, in Oregon, in 2013, pain wasn’t one of the top five reasons people sought euthanasia. Top reasons were a loss of dignity, and a fear of burdening others.[54]

In the United States in 2013, 47% nationwide supported doctor-assisted suicide. This included 32% of Latinos, 29% of African-Americans, and almost nobody with disabilities.[54]

A 2015 Populus poll in the United Kingdom found broad public support for assisted dying. 82% of people supported the introduction of assisted dying laws, including 86% of people with disabilities.[55]

West’s Encyclopedia of American Law states that “a ‘mercy killing’ or euthanasia is generally considered to be a criminal homicide”[56] and is normally used as a synonym of homicide committed at a request made by the patient.[57]

The judicial sense of the term “homicide” includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering.[57][58][59] Not all homicide is unlawful.[60] Two designations of homicide that carry no criminal punishment are justifiable and excusable homicide.[60] In most countries this is not the status of euthanasia. The term “euthanasia” is usually confined to the active variety; the University of Washington website states that “euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient’s life”.[61] Physician-assisted suicide is thus not classified as euthanasia by the US State of Oregon, where it is legal under the Oregon Death with Dignity Act, and despite its name, it is not legally classified as suicide either.[62] Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal.[63] The use of pain medication to relieve suffering, even if it hastens death, has been held as legal in several court decisions.[61]

Some governments around the world have legalized voluntary euthanasia but most commonly it is still considered to be criminal homicide. In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal conditions.[64][65][66][67]

In a historic judgment, the Supreme court of India legalized passive euthanasia. The apex court remarked in the judgment that the Constitution of India values liberty, dignity, autonomy, and privacy. A bench headed by Chief Justice Dipak Misra delivered a unanimous judgment.[68]

A 2010 survey in the United States of more than 10,000 physicians found that 16.3% of physicians would consider halting life-sustaining therapy because the family demanded it, even if they believed that it was premature. Approximately 54.5% would not, and the remaining 29.2% responded “it depends”.[69] The study also found that 45.8% of physicians agreed that physician-assisted suicide should be allowed in some cases; 40.7% did not, and the remaining 13.5% felt it depended.[69]

In the United Kingdom, the assisted dying campaign group Dignity in Dying cites research in which 54% of General Practitioners support or are neutral towards a law change on assisted dying.[70] Similarly, a 2017 Doctors.net.uk poll reported in the British Medical Journal stated that 55% of doctors believe assisted dying, in defined circumstances, should be legalised in the UK.[71]

The Roman Catholic Church strongly opposes and condemns euthanasia and assisted suicide as morally wrong. It states that, “intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator”. Because of this, the practice is unacceptable within the Church.[72] The Orthodox Church in America, along with other Eastern Orthodox Churches, also opposes euthanasia stating that it must be condemned as murder stating that, “Euthanasia is the deliberate cessation to end human life.”[73]

Many non-Catholic churches in the United States take a stance against euthanasia. Among Protestant denominations, the Episcopal Church passed a resolution in 1991 opposing euthanasia and assisted suicide stating that it is “morally wrong and unacceptable to take a human life to relieve the suffering caused by incurable illnesses.” [73] Other Protestant churches which oppose euthanasia include:

The Church of England accepts passive euthanasia under some circumstances, but is strongly against active euthanasia, and has led opposition against recent attempt to legalise it.[83] The United Church of Canada accepts passive euthanasia under some circumstances, but is in general against active euthanasia, with growing acceptance now that active euthanasia has been partly legalised in Canada.[84].

Euthanasia is a complex issue in Islamic theology; however, in general it is considered contrary to Islamic law and holy texts. Among interpretations of the Koran and Hadith, the early termination of life is a crime, be it by suicide or helping one commit suicide. The various positions on the cessation of medical treatment are mixed and considered a different class of action than direct termination of life, especially if the patient is suffering. Suicide and euthanasia are both crimes in almost all Muslim majority countries.[85]

There is much debate on the topic of euthanasia in Judaic theology, ethics, and general opinion (especially in Israel and the United States). Passive euthanasia was declared legal by Israel’s highest court under certain conditions and has reached some level of acceptance. Active euthanasia remains illegal, however the topic is actively under debate with no clear consensus through legal, ethical, theological and spiritual perspectives.[86]

Original post:

Euthanasia – Wikipedia

Euthanasia, passive legal definition of Euthanasia, passive

[Greek, good death.] The term normally implies an intentional termination of life by another at the explicit request of the person who wishes to die. Euthanasia is generally defined as the act of killing an incurably ill person out of concern and compassion for that person’s suffering. It is sometimes called mercy killing, but many advocates of euthanasia define mercy killing more precisely as the ending of another person’s life without his or her request. Euthanasia, on the other hand, is usually separated into two categories: passive euthanasia and active euthanasia. In many jurisdictions, active euthanasia can be considered murder or Manslaughter, whereas passive euthanasia is accepted by professional medical societies, and by the law under certain circumstances.

Hastening the death of a person by altering some form of support and letting nature take its course is known as passive euthanasia. Examples include such things as turning off respirators, halting medications, discontinuing food and water so as to allowing a person to dehydrate or starve to death, or failure to resuscitate.

Passive euthanasia also includes giving a patient large doses of morphine to control pain, in spite of the likelihood that the painkiller will suppress respiration and cause death earlier than it otherwise would have happened. Such doses of painkillers have a dual effect of relieving pain and hastening death. Administering such medication is regarded as ethical in most political jurisdictions and by most medical societies.

These procedures are performed on terminally ill, suffering persons so that natural death will occur sooner. They are also commonly performed on persons in a persistent vegetative state; for example, individuals with massive brain damage or in a coma from which they likely will not regain consciousness.

Far more controversial, active euthanasia involves causing the death of a person through a direct action, in response to a request from that person. A well-known example of active euthanasia was the death of a terminally ill Michigan patient on September 17, 1998. On that date, Dr. Jack Kevorkian videotaped himself administering a lethal medication to Thomas Youk, a 52-year-old Michigan man with amyotrophic lateral sclerosis. CBS broadcast the videotape on 60 Minutes less than a week later. Authorities subsequently charged Kevorkian with first-degree premeditated murder, criminal assistance of a suicide, and delivery of a controlled substance for administering lethal medication to a terminally ill man. There was no dispute that the dose was administered at the request of Mr. Youk, nor any dispute that Mr. Youk was terminally ill. A jury found Kevorkian guilty of second-degree murder in 1999. He was sent to prison.

Somewhat of a hybrid between passive and active euthanasia is physician-assisted suicide (PAS), also known as voluntary passive euthanasia. In this situation, a physician supplies information and/or the means of committing suicide (e.g., a prescription for lethal dose of sleeping pills, or a supply of carbon monoxide gas) to a person, so that that individual can successfully terminate his or her own life.

Physician-assisted suicide received greater public attention after Dr. Kevorkian, a retired pathologist from Michigan, participated in his first such procedure in 1990. Kevorkian set up a machine that allowed a 54-year-old woman suffering from Alzheimer’s disease (a degenerative neurological condition) to press a button that delivered a lethal poison into her veins. Kevorkian went on to assist in the suicides of dozens of individuals suffering from terminal, debilitating, or chronic illnesses. In 1992, Michigan passed an assisted-suicide bill (Mich. Comp. Laws 752.1021) that was specifically designed to stop Kevorkian’s activities, but technicalities and questions as to its constitutionality delayed its implementation, thus allowing Kevorkian to continue assisting suicidesoften in direct opposition to court injunctions.

Kevorkian was charged with murder several times but was not initially found guilty. When murder charges were brought against him for his first three assisted suicides, for example, they were dismissed because Michigan, at that time, had no law against assisted suicide. In 1994, Kevorkian was tried and found not guilty of assisting in the August 1993 suicide of Thomas W. Hyde Jr. In December 1994, however, Michigan’s supreme court ruled in People v. Kevorkian, 447 Mich. 436, 527 N.W. 2d 714, that there is no constitutional right to commit suicide, with or without assistance, and upheld the Michigan statute that made assisted suicide a crime. The following year, the U.S. Supreme Court refused to hear Kevorkian’s appeal from the state supreme court’s ruling.

Observers disagree about the humanity of Kevorkian’s activities. Some see him as a hero who sought to give suffering people greater choice and dignity in dying. Others point to his lack of procedural precautions and fear that the widespread practice of assisted suicide will lead to the unnecessary death of people who could have been helped by other means, including treatment for depression. Many opponents of assisted suicide find the same faults in the practice that they see in other forms of euthanasia. They envision its leading to a devaluation of human life and even to a genocidal killing of vulnerable or so-called undesirable individuals.

The U.S. Supreme Court has made two important rulings on assisted suicide. In washington v. glucksberg, 521 U.S. 702, 117 S.Ct. 2258, 138 L.Ed.2d 772, 65 (1997), three terminally ill patients, four physicians, and a non-profit organization had brought action against the state of Washington for Declaratory Judgment, that a statute banning assisted suicide violated due process clause. On June 26, 1997, the Supreme Court unanimously upheld the right of states to prohibit assisted suicide, holding that: (1) asserted right to assistance in committing suicide was not a fundamental liberty interest protected by due process clause, and (2) Washington’s ban on assisted suicide was rationally related to legitimate government interests. In Vacco v. Quill, 521 U.S. 793, 117 S.Ct. 2293, 138 L.Ed.2d 834 (1997), physicians challenged the constitutionality of New York statutes making it a crime to aid a person in committing suicide or attempting to commit suicide. The Supreme Court held that New York’s prohibition on assisting suicide did not violate the equal protection clause of the Fourteenth Amendment.

The term involuntary euthanasia is used to describe the killing of a person who has not explicitly requested aid in dying. This term is most often used with respect to patients who are in a persistent vegetative state and who probably will never recover consciousness.

Euthanasia is a divisive topic, and different interpretations of its meaning, practice, and morality abound. Those who favor active euthanasia and a patient’s right to die, do not acknowledge a distinction between active and passive euthanasia. They assert that the withdrawal of life-sustaining treatment cannot be distinguished in principle from affirmative steps to hasten a patient’s death. In both situations, they argue, a person intends to cause the patient’s death, acts out of compassionate motives, and causes the same outcome. In their view, turning off a life-sustaining respirator switch and giving a lethal injection are morally equivalent actions.

Opponents of active euthanasia argue that it undermines the value of, and respect for, all human life; erodes trust in physicians; desensitizes society to killing; and contradicts many people’s religious beliefs. Moreover, they maintain that the intentions and natures of active and passive euthanasia are not essentially the same. In active euthanasia, a person directly intends to cause death and uses available means to achieve this end. In passive euthanasia, a person decides against using a certain form of treatment and then directs that such treatment be withdrawn or withheld, accepting but not intending the patient’s death, which is caused by the underlying illness.

While people cite differing reasons for choosing to end their own lives, those suffering from a terminal illness typically state that a serious disorder or disease has adversely affected their quality of life to the point where they no longer wish to continue living. Under such circumstances, patients may have been diagnosed with a degenerative, progressive illness such as ALS, Huntington’s disease, multiple sclerosis, AIDS, or Alzheimer’s disease. Patients with such illnesses often fear, with good reason, a gradual loss of the quality of life in the future as the disease or disorder progresses, or they might already have lost a good deal of their independence and thus might require continuous care. Some feel that this loss of autonomy causes an unacceptable loss of personal dignity. Others realize that they will be dying in the near future and simply want to have total control over the process. Some point out that in addition to physical considerations, they do not want to diminish their assets by incurring large medical costs as their death approaches. They feel that they ought to have the option to die sooner and to pass on their assets to their beneficiaries.

Imagine that you are suffering from a disease that is terminal, debilitating, and very painful. Should you have the right to die when you wish rather than live in continued agony? Should your doctor be legally free to help you take your own life, perhaps by prescribing some pills and telling you their fatal dosage? Or should the law forbid anyoneincluding doctorsto assist in the suicide of another human being? These are just some of the questions that surround the issue of physician-assisted suicide, a widely debated ethical issue in modern medicine.

Physician-assisted suicide is a form of voluntary euthanasia. In other words, it involves a patient voluntarily acting to end his or her life. Physician-assisted suicide differs from conventional suicide in that it is facilitated by a physician who confirms the patient’s diagnosis, rules out conditions such as depression that may be clouding the patient’s judgment, and finally provides the means for committing suicide. Such action usually consists of taking a lethal overdose of prescription medication. However, the over 130 patients who were assisted by Dr. Jack Kevorkian between 1990 and 1998 chose to press a button which delivered a lethal poison into their veins, or to put on a mask that emitted carbon monoxide into their lungs. Assisted suicide is a felony offense in most states and is also expressly forbidden in the American Medical Association’s (AMA’s) Code of Medical Ethics. In 1999, Kevorkian was found guilty of second-degree murder in an assisted suicide case. He was sentenced to serve 10 to 25 years.

The debate surrounding physician-assisted suicide in the United States has been influenced by medical practices in other countries, particularly the Netherlands, which legalized both active euthanasia and physician-assisted suicide, in April 2001 (effective 2002). Physician-assisted suicide in the Netherlands is conducted within strict guidelines that include the following requirements: the patient’s request for assisted suicide must be voluntary, the patient must be experiencing intolerable suffering, all other alternatives for treatment must have been explored, and the physician must consult another independent physician before proceeding. A study commissioned by the Dutch government indicated that, in 2001, about 3,500 deaths, or 2.5 percent of the 140,000 death cases that were reported in the Netherlands that year, occurred by active euthanasia. The study, known as the Remmelink Report, defined euthanasia as the termination of life at the patient’s request. Figures also indicated that 300 deaths, or 0.2 percent, were caused by physician-assisted suicide.

In the United States, the debate on legalizing assisted suicide began in earnest in the 1970s. On one side of the debate have been Patients’ Rights groups who have lobbied for what they call the right to dieor the right to choose to die, as some have clarified it of terminally ill patients. The strongest opposition to the legalization of physician-assisted suicide has come from physicians’ groups such as the AMA and from religious groups that are morally opposed to the practice.

One person who has done much to make the case for physician-assisted suicide is Derek Humphry, a former journalist who founded the Hemlock Society, in 1980, after seeing the pain and suffering his first wife experienced when she died from cancer. In 2003, the organization changed its name to End-of-Life Choices, which encompasses more clearly the issues supported by its members. With a new name and a new motto, “Dignity Compassion Control,” the organization continues to advocate for the right of terminally ill people to choose voluntary euthanasia, or what Humphry has termed self-deliverance.

Humphry has written several books on the subject of voluntary euthanasia, including Jean’s Way (1978), which recounts his struggle to assist his wife’s death in 1975; Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying (1991), a controversial book that gives detailed advice on how terminally ill people may take their own life; and Lawful Exit: The Limits of Freedom for Help in Dying (1993), which contains Humphry’s own recommendations for legislation that would legalize physician-assisted suicide and active voluntary euthanasia. In Humphry’s words, the “right to choose to die” is “the ultimate civil liberty.”

Humphry presents physician-assisted suicide as a merciful, dignified option for people whose illness has eroded their quality of life beyond the limits of tolerance. He also points out that what he calls beneficent euthanasia occurs every day in medical facilities as physicians make decisions regarding the end of life. Others, including some medical ethicists, go so far as to claim that a decision to withhold antibiotics, oxygen, or nutrition from a terminally ill patient is no less “active” a form of euthanasia than is administering a fatal dose of morphine. Indeed, they see the common practice of withholding life support as more open to potential abuse than the practice of physician-assisted suicide. The former, they argue, is a less visible, less easily regulated decision. Proponents of physician-assisted suicide also claim that diseases kill people in far more cruel ways than would any means of death that a physician might provide for an irreversibly ill patient. As a result, they see the action of assisting in suicide as entirely compatible with the physician’s duty to the patient.

However, Humphry has been an open critic of Kevorkian’s work. He has described Kevorkian’s theory and practice of assisted suicide as open-ended euthanasia. Noting Kevorkian’s lack of precautionary measures such as the use of waiting periods and second opinions, Humphry sees any wider application of Kevorkian’s methods as potentially leading to abuse and tragedy. “The thinking people in our movement are appalled by it,” Humphry said. “If you have Kevorkian’s type of euthanasia, it will be a slippery slope. Kevorkian’s is a recipe for skiing down a glacier.”

Detractors of physician-assisted suicide also use the familiar “slippery slope” argument, proposing that once physician-assisted suicide is legalized, other forms of euthanasia will more likely be practiced as well. They see assisted suicide as potentially leading to situations in which elderly, chronically ill, and handicapped people, along with others, are killed through active, nonvoluntary euthanasia. Related to this idea is the view that widespread practice of physician-assisted suicide might claim the lives of those whose intolerable suffering is caused by treatable depression. They point out that terminally ill people or others in pain are often also suffering from depression, and that despite their illness, their feelings of hopelessness can often be addressed through means such as counseling and antidepressant medication.

The Catholic Church is one of many religious organizations that opposes euthanasia and assisted suicide. In Pope John Paul II’s words, medical killings such as those caused by assisted suicide are “crimes which no human law can claim to legitimize.” Basing its arguments on passages from the Bible, Catholic theology has for many centuries opposed all forms of suicide. Catholicism argues that innocent human life may not be destroyed for any reason whatsoever.

The debate over physician-assisted suicide eventually reached the Supreme Court. In 1994, an advocacy group known as Compassion in Dying filed two lawsuits (Compassion in Dying et al v. Washington and Quill et al v. Vacco) challenging the constitutionality of state laws banning assisted dying in Washington and New York. Compassion in Dying won in the District Court in Washington. Chief Judge Barbara Rothstein wrote, “There is no more profoundly personal decision, nor one which is closer to the heart of personal liberty, than the choice which a terminally ill person makes to end his or her suffering and hasten an inevitable death.” In New York, Compassion in Dying lost and filed an appeal in the Second Circuit.

In 1995, Washington’s Compassion ruling was overturned by the Ninth Circuit Court of Appeals, reinstating the anti-suicide law. In 1996, however, after reconsideration, the Ninth Circuit Court of Appeals issued a reversal decision in Compassion v. Washington. That decision held that assisted dying was protected by liberty and privacy provisions of the U.S. Constitution. The majority wrote that, “Those who believe strongly that death must come without physician assistance are free to follow that creed, be they doctors or patients. They are not free, however, to force their views, their religious convictions, or their philosophies on all the other members of a democratic society, and to compel those whose values differ with theirs to die painful, protracted, and agonizing deaths.”

In April 1996, the Second Circuit joined the Ninth in recognizing constitutional protection for assisted dying in the Quill case, holding that the New York statutes criminalizing assisted suicide violate the equal protection clause of the Fourteenth Amendment. However, on June 26, 1997, the U.S. Supreme Court reversed both the Ninth and Second Circuit Court in washington v. glucksberg, 521 U.S. 702, 117 S.Ct. 2258, 138 L.Ed.2d 772 (1997) and Vacco v. Quill, 521 U.S. 743, 117 S.Ct. 2293, 138 L.Ed.2d 834 (1997). The Court ruled that state laws against assisting a suicide are not unconstitutional, but also stated that patients have a right to aggressive treatment of pain and other symptoms, even if the treatment hastens death. The Court wrote, “Throughout the Nation, Americans are engaged in an earnest and profound debate about the morality, legality and practicality of physician assisted suicide. Our holding permits this debate to continue, as it should in a democratic society.”

Ultimately then, the voters and representatives of the states and the legal system itself will have to decide whether or not physician-assisted suicide will be legalized. Regardless of what side prevails in the debate, the exchange of ideas that it creates may lead to a greater understanding of the difficult choices surrounding death in our time.

Cohen-Almagor, Raphael. 2001. The Right to Die With Dignity: An Argument in Ethics, Medicine, and Law. New Brunswick, N.J.: Rutgers Univ. Press.

End of Life Choices. Available online at (accessed August 25, 2003).

Hendin, Herbert. 2002. “The Dutch Experience.” Issues in Law & Medicine (spring).

Death and Dying; Physicians and Surgeons.

Some patients who decide that they wish to commit suicide are unable or unwilling to accomplish the act without assistance from their physician. Physician-assisted suicide helps them to die under conditions, and at the time, that they wish. PAS is currently legal in the U.S., only in the state of Oregon, under severe restrictions. In other states, a terminally ill patient who wishes to die must continue living until their body eventually collapses, or until a family member or friend commits a criminal act by helping them to commit suicide.

Traditional Christian beliefs concerning all forms of suicide were well documented by Thomas Aquinas during the thirteenth century. He condemned all suicide (whether assisted or not) on the theory that it violated one’s natural desire to live. Among European writers, Michel de Montaigne was the first major dissenter on this issue. During the sixteenth century, he wrote a series of essays arguing that suicide should be a matter of personal choice, a human right. He concluded it to be a rational option under certain circumstances.

Attempting to commit suicide was once a criminal act. It has been decriminalized for many decades in most jurisdictions. However, assisted suicide remains a criminal act throughout the United States, with the exception of the state of Oregon. In that state, it is permitted under tightly controlled conditions.

In 1994, voters in the state of Oregon approved a ballot measure that would have legalized euthanasia under limited conditions. Under the Death With Dignity law, a person who sought physician-assisted suicide would have to meet certain criteria:

Under the proposed law, a person who met all requirements could receive a prescription of a barbiturate that would be sufficient to cause death. Physicians would be prohibited from inducing death by injection or carbon monoxide.

The National Right to Life Committee, supported by the Roman Catholic Church, obtained a court Injunction to delay implementation of the measure. The law stalled in the appeals process. In the meantime, the measure was not enacted. In 1997, there was a second public Referendum, and the law was enacted. Within 24 hours of the announcement of the results, state officials had forms for physicians to record instances of assisted suicide. These were later distributed to physicians in the state. The form is entitled “Request for Medication to End My Life in a Humane and Dignified Manner.”

Immediately after the law was affirmed, Thomas Constantine, the administrator of the federal Drug Enforcement Administration (DEA), wrote a policy statement which said that prescribing drugs to help terminally ill patients kill themselves would be a violation of the Controlled Substances Act. Nevertheless, on March 26, 1998, a woman in her mid-eighties died from a lethal dose of barbiturates, which had been prescribed by her doctor under the Oregon law. She was the first person to publicly use the law to commit suicide. She had been fighting breast cancer for 20 years and recently had been told by her doctor that she had less than two months to live. She had been experiencing increased difficulty breathing. She made a tape recording in which she stated, “I’m looking forward to it. I will be relieved of all the stress I have.” Her personal doctor would not help her end her life, so she turned to an advocacy group, Compassion in Dying. That group located a doctor to assist her. She fell into a deep sleep about five minutes after taking the lethal dose of pills, and she died peacefully about 25 minutes later. Attorney General Janet Reno officially reversed Constantine’s ruling a few weeks later, stating that doctors who use the law to prescribe lethal drugs to terminally ill patients will not be prosecuted and that drug laws were intended to block illegal trafficking in drugs, not to cover situations like the Oregon suicide law.

Despite significant controversy, by the end of 1998, one prediction of the anti-choice forces had not materialized: there was no rush of people to Oregon to seek an easy end to life. While it was predicted that many would take advantage of the law, of the 23 terminally ill individuals who applied to end their own lives in 1998, 15 committed suicide, usually within a day of receiving the prescription. Six died from their illnesses without using the medication. Two remained alive at the end of 1998. From 1998 to 2002, 129 people have opted for physician assisted suicide.

In early 2001, Oregon state senator Ron Wyden wrote Attorney General john ashcroft asking that the george w. bush administration not mount an attack on the state law permitting assistance in suicide. Ashcroft wrote a letter to Asa Hutchinson, chief of the Drug Enforcement Administration. He declared that assisting a terminally ill patient to commit suicide is not a “legitimate medical purpose” for federally controlled drugs. He said that physicians who use drugs to help patients die face suspension or revocation of their licenses to prescribe federally controlled drugs. This was contrary to the position taken by Janet Reno, his predecessor. The attorney general of Oregon, Hardy Myers, quickly initiated a lawsuit to have the Ashcroft’s directive declared unconstitutional. The federal district court in Oregon issued a temporary injunction, which prevents the federal government from enforcing Ashcroft’s interpretation of the Controlled Substances Act (CSA). The state of Oregon requested that the court block the federal department of justice from taking legal action against Oregon doctors who prescribe medication to help their patients commit suicide. A federal judge ruled in favor of the state law in 2002, and the Department of Justice appealed the decision to the U.S. Court of Appeals for the Ninth Circuit. Both sides have stated that they will appeal the decision if they lose.

According to the online website, Euthanasia.com, 35 states have legislated against assisted suicide, while nine other states have cited it as a crime under Common Law. Still more states have introduced or passed statutes criminalizing assisted suicide. These statutes forbid a person to knowingly assist or aid another in committing suicide. Some also prohibit soliciting, advising, or encouraging another to commit suicide. Some statutes penalize assisted suicide under guidelines established for murder or manslaughter, whereas others make it a unique offense with separate penalties. Few courts have interpreted the assisted-suicide statutes, because prosecutions for assisted suicide are rare. In cases of assisted suicide, a state usually prosecutes individuals for murder or manslaughter. The Ohio state supreme court, however, ruled in 1996 that assisted suicide is not a crime.

Behuniak, Susan M. 2003. Physician-Assisted Suicide: The Anatomy of a Constitutional Law Issue. Lanham, Md.: Rowman & Littlefield.

Dyck, Arthur J. 2001. When Killing Is Wrong: Physician-Assisted Suicide and the Courts. Cleveland, Ohio: Pilgrim Press.

Euthanasia.com. Available online at (accessed November 10, 2003).

Palmer, Larry I. 2000. Endings and Beginnings: Law, Medicine, and Society in Assisted Life and Death. Westport, Conn.: Praeger.

Death and Dying.

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