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Ayush Mathur
ENGH 101-021
Ben Liff
04/19/15
Euthanasia and physician assisted suicide; a controversial and sensitive topic which
has been debated for many years now. Should it be legalized or should it be illegal? Many
people question if physician assisted suicide (PAS) and euthanasia are ethically and morally
acceptable. Knowing what PAS and euthanasia are and how they differentiate is very
important before jumping to any conclusions. I believe that after a full through check-up of
the patient by multiple doctors and counsellors; if it has been concluded by most of them that
the patient is in fact terminally ill and will die within six months should be given the option
of assisted suicide and Euthanasia. Thus euthanasia and PAS should be legalized in all states
instead of a few and a patient should be allowed this freedom after he/she has gone through
rigid check-ups by multiple doctors and qualifies as a terminally ill patient with less than 6
months to live.
Physician-assisted suicide refers to the physician providing the means for death while
the patient ultimately administers the lethal medication. Euthanasia on the other hand,
generally means that the physician would act directly, for instance by giving a lethal
injection, to end the patient's life. Euthanasia is mostly done in the hospital, whereas PAS
could be performed by the patient at home. There are two main classification of euthanasia;
Voluntary and involuntary euthanasia. In voluntary euthanasia, the life of the patient is ended
on his/her request, whereas in involuntary euthanasia a physician ends the life of a patient
who is incapable of giving consent on behalf of the consent of the guardian of the patient.
There are two procedural classifications of euthanasia; Active and passive euthanasia. In

active euthanasia, the physician actively does the killing after the patients consent whereas in
passive euthanasia, the physician lets the patient die. Active euthanasia is much more of the
controversial matter rather than passive euthanasia, because people are affected by religious,
moral and ethical issues. Assisted suicide has many different interpretations; the most widely
used and accepted is the intentional hastening of death by a terminally ill patient with
assistance from a doctor. Euthanasia is currently illegal in all states of the United States;
Whereas PAS is legal in the states of, Washington, Oregon, Vermont and New Mexico.
Derek Humphry, a journalist and author who is a pro-euthanasia activist has spent the
past thirty years campaigning for making euthanasia an option for the terminally ill. He
started his campaigning after the death of his wife, Jean, from bone cancer which had become
so unbearable and distressing for her, that she decided to take her own life. She experienced
cracking of her bones and the loss of control over her bowel movements. One day his wife
said to him Will you help me die? as she was very close to death and no longer had the
physical or moral strength to fight any longer. He was faced with the toughest decision of his
life. Could he make his beloved wife continue to suffer? Would he feel guilty or would he be
a saviour? He couldnt see his wife suffer and hence he decided to help her by letting her die
peacefully. This was not an act of killing. In fact it was just the opposite; it was an act of love
and compassion he had for his wife. That is when he first encountered euthanasia; with his
wife in the hospital. There are two forms of suicides; one being emotional suicide and the
other a justifiable suicide. Self destruction due to depression or and other mental reasons is no
reason to suicide and should be opposed and prevented. Whereas a justifiable suicide is
mostly done to relieve a person from a painful disease which cannot be cured. What Derek
did for his wife was justifiable.
Margaret Battin, whose husband had become completely paralyzed by a bicycle
accident, was a psychology professor who had previously written academic articles

rehearsing the arguments for and against the legalization of physician assisted suicide and
euthanasia. Her deep knowledge and opinions on the legalization of euthanasia and her
personal experience due to her husband facing hell after being paralyzed fully. She still
could not convince herself to make the decision for her husband and repeatedly asked herself
did he really want to die? The doctors and nursing staff gave in their best efforts to save her
husband even though he was suffering through a lot of pain and even said he wanted to die.
The doctors only consider euthanasia when it is completely necessary for the patient as well
as their family. Her husband did get off the ventilator and was sent home, but soon passed
away. Her social acceptance and legalization of euthanasia never diminished but made her
realize that every case is different and complex and should be handled differently, but making
euthanasia illegal is not a good way of handling it.
Oregon is one state that took the initiative to legalize PAS in 1997. Since its
enactment nearly 1,100 people were offered life ending drugs and only 750 chose to do so.
(Oregon Public Health Division) Not only has this act worked very well but it has also
published statistics for the public so that they can asses this act. Patients must be a resident of
Oregon and must be age 18 or older. Also the patient must be capable of making and
communicating with doctors and advisors about their health care decisions. The patients must
be checked by two physicians who should determine that the patient has less than six months
to live in order to qualify for the DWDA (Death with Dignity Act). A physician must educate
the patient about the procedure and its pros and cons. Also, a counsellor is assigned to talk to
the patient and their family regarding PAS to see if they are educated about it enough to carry
on with the procedure. After noticing Oregons successful model, Washington in 2008, British
Columbia in 2012, Vermont in 2013 and Quebec in 2014 have legalized physician assisted
suicide and euthanasia. Thanks to the DWDA, the once widely rejected assisted suicide is
finally receiving recognition as an appropriate response to the suffering of patients nearing

the end of their life. This is mostly due to Oregons safe and effective implementation of the
DWDA.
Brittany Maynard was 29 years old when she was told that she suffered from a
terminally ill brain cancer. She had been married a little more than a year when she was
diagnosed. She had been suffering from blinding headaches for months. Doctors performed
multiple surgeries which included a partial resection of her temporal lobe. These surgeries
were an effort to prevent the tumor from growing and causing further pain. After a couple of
months though, Brittany was informed that not only had her tumor come back, but this time it
was much more aggressive than earlier. Her doctors informed her that she had around six
months to live. Her tumor was so large that doctors prescribed her a full brain radiation.
There were various side-effects, her hair rapidly fell off, and she also incurred first degree
burns on her scalp. She knew that these side-effects were just a start to a long list; Her quality
of life, as she knew, would be gone.
Brittany and her family knew that there was no treatment that could have
saved her life, and even the treatments that her doctors did recommend, would have destroyed
her quality of life and the little time she had. She didnt want to be hospitalized or visit
hospitals regularly in the six months she had. She wanted to enjoy them with her husband and
family. Thus, she started researching about euthanasia and PAS as she did not want to burden
and trouble her family. Oregon is one of the only five states that allowed those two options
for her through the Death with Dignity Act which allowed her to end her own life. She and
her husband moved to Oregon from California so she could take advantage of the act. After
becoming a new resident of Oregon and going through the long procedures in order to be a
qualified patient for the Death with Dignity Act, Brittany was prescribed the lethal
medications. But, she did no consume them until it was extremely necessary and that she
could not bear the pain. She did not want to die, but she was dying and did not want anyone

else but herself to decide whether she should suffer for months in tremendous amount of
physical and emotional pain or not. Brittany felt safe after she received the medications and
looked forward to enjoying the remaining time she had left with her husband and family. She
passed away in her bedroom next to her husband, best friend and family members peacefully.
She could not even have imagined of robbing anyone else in the same situation of the same
choice she had; that is PAS and euthanasia.
Since Maynards death, four states including Washington D.C. have introduced a so
called right-to-die legislation. The fact that Brittany had to leave California for Oregon in
order to ease her sufferings is appalling and simply not acceptable. California Senator Lois
Wolk and Senator Bill Monning both co-signed a bill allowing terminally ill patients with six
months to live the freedom to obtain the life ending drugs. The bill would somewhat be
similar to Oregons Death with Dignity Act, where the patient would have to be seen and
recommended by two different doctors who would then approve if the patient does indeed
have six month or less to live and would be allowed to receive the life ending drugs. Only
two other states have passed the right-to-die legislation; Washington and Vermont. While the
judges in New Mexico and Montana has legalized it completely. PAS or euthanasia for a long
time was mostly associated with Dr. Jack Kevorkian, a Michigan physician who participated
in many physician assisted suicides. Maynard offered a far more understanding angle for the
movement. Her story was used to promote the Death with Dignity Act as well as other proeuthanasia movements. Since her death, legislators from fourteen different states have either
introduced or plan to introduce right-to-die bills. Even if the bills are not passed, they sure
have awakened the citizens about euthanasia and PAS which will in the future, lead to the
enactment of right-to-die acts in other states.
Legalization of euthanasia is an important step towards a humans freedom of choice
to either stay alive and continue to suffer or to end his/her life and relive themselves and their

families of the unbearable pain that cannot make a person happy while they exist. This is also
not a question of whether PAS and euthanasia is socially accepted or ethically correct, but is a
question of whether or not the patient will enjoy being alive with all the pain they have to
endure and not wishing they could die.
Data linked with Oregons Death with Dignity Act shows that 90% people who do
seek lethal prescription and undergo PAS and euthanasia because they are not able to engage
in activities and are afraid of losing autonomy and 32% because they cannot bear the pain
from the illness and treatments along with worrying about being a burden. 80% of the people
who passed away suffered from malignant tumours and around 7% from ALS. Other medical
illnesses included chronic respiratory disease, heart disease and AIDS. Also, 95% of the
patients died at home with family and friends by their side while only a small 4% died in a
long term facility care. 46% of the people who chose to undergo PAS were college graduates
while only 14% were high school graduates. This goes to show that people who chose to
undergo PAS were educated and knew the advantages and disadvantages of it. ( Barone, E)
The median age of those who died by PAS was 71. Only 3% were under the age of 44
while 12% were older than 85. In 2013 62 doctors wrote and prescribed 122 prescriptions for
lethal life ending drugs. (Barone, E) This comes to around an average of ten prescriptions per
physician. The prescription is a lethal dose of barbiturates which slows the activity of the
brain and nervous system and decreases the heart rate until it comes to a complete stop. It
takes around twenty five minutes between ingestion of the dose and death of the patient.
In the debate of the legalization of physician-assisted suicide, there are many valid
arguments on both sides. The practice of aid in dying does not replace end-of-life care.
Patients will always have a choice of dying in their homes, or in hospice care. If the patient
wants, they can also return the lethal drugs even after receiving them if they are not

completely certain. There are many cases in which the process of withdrawing life support for
terminally ill patients leads to natural death if the patient is unconscious and not able to be
consulted with. The patient should be given the right to decide what they want and think is
best for them. This aid in dying provides patients with autonomy and allows them to avoid
life support which only extends their dying process and doesnt help in making quality of life
better.
It is very important to view euthanasia and PAS as a neutral policy by which a
terminally ill patient can decide what he/she wants to do with their life. It is a persons right
to decide their medical treatment, and assisted suicide and euthanasia should be a part of the
treatment. Some patients feel that apart from the unbearable pain and deteriorating quality of
their existing life that they will also be a burden on their families not only financially but also
mentally and physically. Regardless of whether this thinking is wrong or right, it is a personal
choice and can only be distinguished for the better or worse by the patient itself. A person
cannot be forced to stay alive even if it is against their will; this is especially true when it
comes to the field of health care. It is cruel and non-human. Some may object that a persons
life is the most valuable thing in the world. But what if they arent healthy and happy and are
in extreme pain? Will their life be valuable then? Will they be happy being alive? Would you
make your loved one suffer? Thus it is very important for every state to create an efficient
protocol for patients willing to undergo PAS so that there is no misuse or any mistakes and
that only the terminally ill can benefit from it. The legalization of physician assisted suicide
and euthanasia in all states with a proper protocol will only help the patients by allowing
them their right to a peaceful death.

References

1. Oregons Death with Dignity Act2013, 1997 to 2013, Oregon Public Health Division.
Retrieved on 19 March, 2014.
2. Chapple, A., Ziebland, S., McPherson, A., & Herxheimer, A. (2006, December 1). What
people close to death say about euthanasia and assisted suicide: A qualitative study.
Retrieved March 19, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563356/
3. Barone, E. (2014, November 3). See Which States Allow Assisted Suicide. Retrieved
April 19, 2015, from http://time.com/3551560/brittany-maynard-right-to-die-laws/
4. Library, C. (2014, November 26). Physician-Assisted Suicide Fast Facts - CNN.com.
Retrieved April 13, 2015, from http://www.cnn.com/2014/11/26/us/physician-assistedsuicide-fast-facts/
5. Sneed, T (2014, November 3). The Future of the Right-to-Die Movement. US News.
Retrieved from http://www.usnews.com/news/articles/2014/11/03/the-future-of-theassisted-suicide-movement-after-brittany-maynard
6. Battin, M.P. (2010). The irony of supporting physician-assisted suicide: a personal
account. Medicine Health Care, And Philosophy, 13(4), 403-411. Doi:10.1007/s11019010-9274-z
7. Is physician-assisted suicide the same as euthanasia? (n.d.). Retrieved April 20, 2015,
from http://www.worldrtd.net/qanda/physician-assisted-suicide-same-euthanasia
8. About Derek Humphry - ERGO. (n.d.). Retrieved March 20, 2015, from
http://www.finalexit.org/about_derek_humphry.htm
9. Hensley, S. (2012, December 28). Americans Support Physician-Assisted Suicide For
Terminally Ill. Retrieved April 3, 2015, from
http://www.npr.org/blogs/health/2012/12/27/168150886/americans-support-physicianassisted-suicide-for-terminally-ill

10. Zenz. J,. Tryba, M., & Zenz. M. (2015). [Euthanasia and physician-assisted suicide:
Attitudes of physicians and nurses]. Schmerz (Berlin, Germany), 29(2), 211-216.
doi:10.1007/s00482-015-1513-z

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Bibliography
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5. Oregons Death with Dignity Act2013, 1997 to 2013, Oregon Public Health
Division. Retrieved on 19 March, 2014.
6. Chapple, A., Ziebland, S., McPherson, A., & Herxheimer, A. (2006, December 1).
What people close to death say about euthanasia and assisted suicide: A qualitative
study. Retrieved March 19, 2015, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563356/
7. Barone, E. (2014, November 3). See Which States Allow Assisted Suicide. Retrieved
April 19, 2015, from http://time.com/3551560/brittany-maynard-right-to-die-laws/
8. Library, C. (2014, November 26). Physician-Assisted Suicide Fast Facts - CNN.com.
Retrieved April 13, 2015, from http://www.cnn.com/2014/11/26/us/physicianassisted-suicide-fast-facts/
9. Sneed, T (2014, November 3). The Future of the Right-to-Die Movement. US News.
Retrieved from http://www.usnews.com/news/articles/2014/11/03/the-future-of-theassisted-suicide-movement-after-brittany-maynard

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10. Battin, M.P. (2010). The irony of supporting physician-assisted suicide: a personal
account. Medicine Health Care, And Philosophy, 13(4), 403-411.
Doi:10.1007/s11019-010-9274-z
11. Is physician-assisted suicide the same as euthanasia? (n.d.). Retrieved April 20, 2015,
from http://www.worldrtd.net/qanda/physician-assisted-suicide-same-euthanasia
12. About Derek Humphry - ERGO. (n.d.). Retrieved March 20, 2015, from
http://www.finalexit.org/about_derek_humphry.htm
13. Hensley, S. (2012, December 28). Americans Support Physician-Assisted Suicide For
Terminally Ill. Retrieved April 3, 2015, from
http://www.npr.org/blogs/health/2012/12/27/168150886/americans-support-physicianassisted-suicide-for-terminally-ill
14. Zenz. J,. Tryba, M., & Zenz. M. (2015). [Euthanasia and physician-assisted suicide:
Attitudes of physicians and nurses]. Schmerz (Berlin, Germany), 29(2), 211-216.
doi:10.1007/s00482-015-1513-z