| Part of a series on |
| Euthanasia |
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| Types |
| Animal · Child · Voluntary Non-voluntary · Involuntary |
| Views |
| Religious (Buddhist · Catholic) |
| Groups |
| Dignitas · Dignity in Dying Exit International |
| People |
| Jack Kevorkian · Philip Nitschke |
| Books |
| Final Exit The Peaceful Pill Handbook |
| Jurisdictions |
| Australia · Canada India · Mexico Netherlands · New Zealand Switzerland · United Kingdom United States |
| Laws |
|
Oregon Death with Dignity Act Washington Death with Dignity Act |
| Court cases |
| Washington v. Glucksberg (1997) Gonzales v. Oregon (2006) Baxter v. Montana (2009) |
| Alternatives |
| Assisted suicide Palliative care Principle of double effect Terminal sedation |
| Other issues |
| Suicide tourism Groningen Protocol Euthanasia device Euthanasia and the slippery slope |
Efforts to change government policies on euthanasia in the 20th century have met limited success in Western countries. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organizations. As of 2011, active euthanasia is only legal in the three Benelux countries: the Netherlands, Belgium and Luxembourg. Assisted suicide is legal in Switzerland and in the US states of Washington, Oregon and Montana.
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Euthanasia is now illegal in Australia. It was once legal in the Northern Territory, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal Government overrode the Northern Territory legislation through the introduction of the Euthanasia Laws Act 1997.[1] Unlike the states, legislation in the Northern Territory is not guaranteed by the Australian constitution. Before this law was passed by the Australian Government, Dr. Philip Nitschke helped three people by them using his Deliverance machine. Organisations such as Exit International (founded by Nitschke himself), want the government to bring back euthanasia rights to Australia. Exit made TV commercials which were banned before they made it to air in September 2010.[2]
The Belgian parliament legalized euthanasia in late September 2002.[3]
A survey published in 2010 that those who died from euthanasia (compared with other deaths) were more often younger, male, cancer patients and more often died in their homes. In almost all cases, unbearable physical suffering were reported. Euthanasia for nonterminal patients was rare.[4]
Canadian laws on living wills and passive euthanasia are a legal dilemma. Documents which set out guidelines for dealing with life-sustaining medical procedures are under the Provinces control, in Ontario under the Health Care Consent Act, 1996.[5]
In Ireland, it is illegal for a doctor (or anyone) to actively contribute to someone's death. It is not, however, illegal to remove life support and other treatment (the "right to die") should a person (or their next of kin) request it - in other words, passive euthanasia is legal. A September 2010 Irish Times poll showed that a majority, 57% of adults, believed that doctor-assisted suicide should be legal for terminally ill patients who request it.[6]
The Japanese government has no official laws on the status of euthanasia and the Supreme Court of Japan has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University in 1995. The first case involved "passive euthanasia" (消極的安楽死 shōkyokuteki anrakushi) (i.e., allowing a patient to die by turning off life support) and the latter case involved "active euthanasia" (積極的安楽死 sekkyokuteki anrakushi) (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.[7]
In the case of passive euthanasia, three conditions must be met:
For active euthanasia, four conditions must be met:
The problems that arose from this, in addition to the problem faced by many other families in the country, has led to the creation of "bioethics SWAT teams".[8]These teams will be made available to the families of terminally ill patients in order to help them, along with the doctors, come to a decision based on the personal facts of the case. Though in its early stages and relying on “subsidies from the Ministry of Health, Labor and Welfare” there are plans to create a nonprofit organization to “allow this effort to continue.” [9]
The country's parliament passed a bill legalizing euthanasia on 20 February 2008 in the first reading with 30 of 59 votes in favour. On 19 March 2009, the bill passed the second reading, making Luxembourg the third European Union country, after the Netherlands and Belgium, to decriminalise euthanasia. Terminally ill people will be able to have their lives ended after receiving the approval of two doctors and a panel of experts[10].
In Mexico, active euthanasia is illegal but since 7 January 2008 the law allows the terminally ill —or closest relatives, if unconscious— to refuse medication or further medical treatment to extend life (also known as passive euthanasia) in Mexico City,[11] in the central state of Aguascalientes (since 6 April 2009)[12] and, since 1 September 2009, in the Western state of Michoacán.[13] A similar law extending the same provisions at the national level has been approved by the senate[14] and an initiative decriminalizing active euthanasia has entered the same legislative chamber on 13 April 2007.[15]
In a 6-3 decision, Colombia's Constitutional Court ruled May 20, 2010 that "no person can be held criminally responsible for taking the life of a terminally ill patient who has given clear authorization to do so," according to the Washington Post. The court defined "terminally ill" person as those with diseases such as "cancer, AIDS, and kidney or liver failure if they are terminal and the cause of extreme suffering," the Post reported. The ruling specifically refused to authorize euthanasia for people with degenerative diseases such as Alzheimer's, Parkinson's, or Lou Gehrig's disease.
In the 1973 "Postma case" a physician was convicted for having facilitated the death of her mother following repeated explicit requests for euthanasia.[16] While upholding the conviction, the court's judgment set out critera when a doctor would not be required to keep a patient alive contrary to their will. This set of criteria was formalized in the course of a number of court cases during the 1980s.
In 2002, the Netherlands passed a law legalizing euthanasia including physician assisted suicide.[17] This law codifies the twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care."[18] The United Nations has reviewed and commented on the Netherlands euthanasia law.[19]
In September 2004 the Groningen Protocol was developed, which sets out criteria to be met for carrying out child euthanasia without the physician being prosecuted.[20]
Two attempts have been made in the Parliament passing Bills to legalize it, but euthanasia remains illegal in New Zealand.
Euthanasia remains illegal, though a caregiver may receive a reduced punishment for taking the life of someone who consents to it, or for, out of compassion, taking the life of a person that is "hopelessly sick". [21]
The second largest political party, Progress Party, have several times tried to legalize euthanasia.
In Switzerland, deadly drugs may be prescribed to a Swiss person or to a foreigner, where the recipient takes an active role in the drug administration.[22] More generally, article 115 of the Swiss penal code, which came into effect in 1942 (having been written in 1918), considers assisting suicide a crime if and only if the motive is selfish.
Euthanasia is strictly forbidden in Turkey. The aide who helped a person to suicide or other ways to kill oneself will be punished for assisting and encouraging suicide under the stipulation of article 84 of the Turkish Criminal Law. In condition of active euthanasia, article 81 of the same law sets forth that any person who carries out this act will be judged and punished for life imprisonnement just like a simple murder.
Euthanasia is illegal in the United Kingdom. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (e.g. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great).[23][24] Between 2003 and 2006 Lord Joffe made four attempts to introduce bills that would have legalized voluntary euthanasia - all were rejected by the UK Parliament.[25] Currently, Dr Nigel Cox is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended sentence in 1992.[26] In 1957 Judge Devlin in the trial of Dr John Bodkin Adams ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.[27]
Active euthanasia is illegal in most of the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patients' choices hasten their deaths. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances and, under federal law and most state laws only with the informed consent of the patient or, in the event of the incompetence of the patient, with the informed consent of the legal surrogate. The Supreme Court of the United States has not dealt with "quality of life issues" or "futility issues" and appears to only condone active or passive "euthanasia" (not legally defined) when there is clear and convincing evidence that informed consent to the euthanasia, passive or active, has been obtained from the competent patient or the legal surrogate of the incompetent patient.
While active euthanasia is illegal throughout the US, assisted suicide is legal in three states: Oregon, Washington and Montana.[28]
There are a number of historical studies about the thorough euthanasia-related policies of professional associations. In the Academy of Neurology (AAN).[29] In their analysis, Brody et al. found it necessary to distinguish such topics as euthanasia, physician-assisted suicide, informed consent and refusal, advance directives, pregnant patients, surrogate decision-making (including neonates), DNR orders, irreversible loss of consciousness, quality of life (as a criterion for limiting end-of-life care), withholding and withdrawing intervention, and futility. Similar distinctions presumably are found outside the U.S., as with the highly contested statements of the British Medical Association.[30][31]
On euthanasia (narrowly-defined here as directly causing death), Brody sums up the U.S. medical NGO arena:
The debate in the ethics literature on euthanasia is just as divided as the debate on physician-assisted suicide, perhaps more so. Slippery-slope arguments are often made, supported by claims about abuse of voluntary euthanasia in the Netherlands.... Arguments against it are based on the integrity of medicine as a profession. In response, autonomy and quality-of-life-base arguments are made in support of euthanasia, underscored by claims that when the only way to relieve a dying patient's pain or suffering is terminal sedation with loss of consciousness, death is a preferable alternative -- an argument also made in support of physician-assisted suicide.[32]
Other NGOs that advocate for and against various euthanasia-related policies are found throughout the world. Among proponents, perhaps the leading NGO is the UK's Dignity in Dying, the successor to the (Voluntary) Euthanasia Society.[33] In addition to professional and religious groups, there are NGOs opposed to euthanasia[34] found in various countries.
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