Euthanasia Suicide and Physician-Assisted Suicide - Background

The Merriam-Webster dictionary definition of euthanasia, which derives from the Greek for "easy death," is "the act or practice of killing or permitting the death of hopelessly sick or injured individuals … in a relatively painless way for reasons of mercy." This present-day definition differs from that of the classical Greeks, who considered euthanasia simply "one mode of dying." To the Greeks, euthanasia was a rational act by people who deemed their lives no longer useful. That these individuals sought the help of others to end their lives was considered morally acceptable.

The movement to legalize euthanasia in England began in 1935 with the founding of the Voluntary Euthanasia Society by such well-known figures as George Bernard Shaw, Bertrand Russell, and H. G. Wells. In 1936 the House of Lords (one of the houses in the British Parliament) defeated a bill that would have permitted euthanasia in cases of terminal illness. Nonetheless, it was common knowledge that physicians practiced euthanasia. The same year, it was rumored that King George V, who had been seriously ill for several years, was "relieved of his sufferings" by his physician, with the approval of his wife, Queen Mary.

The Euthanasia Society of America was established in 1938. In 1967 this group prepared the first living will. Renamed the Society for the Right to Die in 1974, it merged in 1991 with another organization called Concern for Dying, and the two became Choice in Dying (CID). While CID took no position on physician-assisted suicide (PAS), it "advocated for the rights of dying patients." It also educated the public about the importance of advance directives and end-of-life issues. In early 2000 CID dissolved, although many of its staff remained to found Partnership for Caring, Inc., which continues its programs. That organization's goal was to "ensure that everyone in this country soon has access to quality end-of-life care." Then, in early 2004, Partnership for Caring merged with Last Acts, a coalition of professional and consumer organizations that work to improve end-of-life care. The merged organization was named Last Acts Partnership, and its mission was to provide education, service, and counseling to people who needed accurate and reliable information about end-of-life care. Last Acts Partnership was also an advocate for policy reform in end-of-life issues. In 2005 Last Acts Partnership ceased its activities and all rights and copyrights to material produced by Partnership for Caring, Last Acts, and Last Acts Partnership were legally obtained by the National Hospice and Palliative Care Organization (NHPCO).

Euthanasia and the Nazis

The Nazis' version of euthanasia was a bizarre interpretation of an idea espoused by two German professors, Alfred Hoche and Karl Binding, in their 1920 book The Permission to Destroy Life Unworthy of Life. While initially advocating that it was ethical for physicians to assist in the death of those who requested an end to their suffering, the authors later argued that it was also permissible to end the lives of the mentally retarded and the mentally ill.

Some contemporary opponents of euthanasia fear that a society that allows physician-assisted suicide may eventually follow the path of Nazi dictator Adolf Hitler's euthanasia program, which began with the killing of physically and mentally impaired individuals and culminated in the annihilation of entire religious and ethnic groups considered by the Nazis to be unworthy of life. But those supporting euthanasia argue that unlike the murderous Nazi euthanasia program designed by Hitler and his followers, modern-day proposals are based upon voluntary requests by individuals in situations of physical suffering and would be sanctioned by laws passed by democratic governments.

Distinguishing between Euthanasia and Physician-Assisted Suicide

In the United States the debate over euthanasia distinguishes between active and passive euthanasia. Active euthanasia, also called voluntary active euthanasia by those who distinguish it from the kind of euthanasia practiced by the Nazis, involves the hastening of death through the administration of lethal drugs, as requested by the patient or another competent individual who represents the patient's wishes.

Passive euthanasia, on the other hand, involves foregoing medical treatment, knowing that such a decision will result in death. This action is not considered illegal because the underlying illness, permitted to run its natural course, will ultimately cause death. It is generally accepted in the United States that terminally ill individuals have a right to refuse medical treatment, as do those who are sick but not terminally so. But some people think that allowing patients to forego medical treatment is a practice tantamount to enabling suicide and is therefore morally reprehensible.

The debate about euthanasia in the United States has been expanded to include the question of whether a competent, terminally ill patient has the right to physician-assisted suicide, in which a physician provides the means (such as lethal drugs) for the patient to self-administer and commit suicide. The distinction between the two actions, euthanasia and physician-assisted suicide, is at times difficult to define: a patient in the latter stages of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), for example, is physically unable to kill him- or herself; therefore, a physician who aids in such a person's suicide would technically be committing euthanasia.