Euthanasia

Public policy exists to tell us how to live our lives, so it seems only natural that government should debate on how its citizens are allowed to die.  Euthanasia is not a new idea, but over the past thirty years it has become more controversial.  Before euthanasia can be investigated in the scope of public policy, it is important to first define euthanasia and understand how it can manifest in many forms.

According to T. A. Boston’s thesis An Analysis of Supreme Court Rulings and Public Opinion on Euthanasia (Southern University, 2012), euthanasia can be broadly defined as mercy killing. A more legal jargon definition could include stating that both the dying patient and those responsible for the care of that individual consent to allow the individual to die. This shared consent can occur in numerous ways:

1. Passive euthanasia allows a patient to die by natural causes through choosing to not administer life saving measures (commonly called DNR).
2. Voluntary euthanasia involves an agreement between the patient and the health professional to administer a lethal dose of medication that kills the patient.
3. Involuntary euthanasia requires the health professional to choose to end the suffering of a patient while the patient is unable to provide consent.
4. Assisted suicide requires another individual (if a physician provides the lethal prescription then it is called physician-assisted suicide) to provide a life ending tool or dose of medication and the patient administers the dose him/herself.

Passive euthanasia is legal through DNR regulations in most countries and now physician assisted suicide is legal in many European countries as well as three states in the US. There are many moral and religious views on this topic, but I will focus the main ideas found in public opinion and what role government people believe should have on death.

Of the people who actually have an opinion on the issue, there appears to be three factions in this debate:  the personal autonomy faction, the disabilities faction, and the sanctity-of-life faction.

The personal autonomy faction supports the legalization of physician assisted suicide (PAS) with restrictions. These people believe that some terminally ill patients who are experiencing such unbearable suffering should be allowed to consult a doctor to end that suffering. Patients seeking to die must be proven to be competent and must have records indicating that all other options have been consulted. People in this faction usually find this issue sever and urgent because there are a few patients who are in pain now and deserve to die with dignity.

The disabilities faction does not want PAS legalized, and they believe any assisted suicide regulation should have strict rules to protect vulnerable groups. These people usually come to this conclusion from the “slippery slope” argument. If PAS was legalized and government control was not adequate, a new form of social discrimination could occur before legislative or judicial systems could intervene. The vulnerable groups (elderly, mentally retarded, and even possibly low income individuals) could become fearful of medical professionals because of their control over medicine.

The sanctity-of-life faction opposes PAS for moral or religious reasons. They believe that any suicide is almost always irrational and most often stems from untreated depression. All human life has value and choosing to end that life early is wrong. PAS also threatens the traditional medical values of “do no harm.”

While almost everyone with opinions on euthanasia falls in one of these three factions, the amount of people who support legalizing PAS has steadily growing since the 1950s. Gallup and GSS both share this finding. People who attend church regularly and politically identify as conservative are more resistant to PAS legalization.

Places where PAS is legalized show a rise in deaths from lethal prescriptions but the number of PAS deaths is still a very small population. In Oregon, only 114 prescriptions have been written and filled by patients, and from that population, only 71 individuals died from the lethal dose. Oregon has tight regulations on releasing and controlling lethal medication. The state of Oregon does not administer the lethal drug or control who is allowed to receive the lethal dose; all the state is responsible for is record keeping. The process is entirely between the patient, their physician, their pharmacy, and their insurance provider.