CONTEMPORARY MEDICAL PRACTICES: MEDIOCO LEGAL CONTEXT OF EUTHANASIA AND PHYSICIAN ASSISTED SUICIDE
by Koketso Mwale
Euthanasia and Physician assisted suicide (EAS) are becoming one of the most common ways to die in the 21st century. Euthanasia is a death process in which a physician is allowed by law to end a patient’s life upon requested by the patient. Physician assisted suicide is when a physician assists a patient to end their life by providing them with lethal pharmaceutical drugs. EAS constitutes 0% -4,6 % of all deaths in countries where it is legalized, and it is mostly undertaken in extreme medical conditions. Although it allows people to have a say over their lives and when they want to die, some people argue that it is trying to ‘play’ God.
A recent study by Sigrid Dierickx et al (2019) evaluates EAS practice in three countries i.e., Belgium, The Netherlands, and Switzerland. In the study, they evaluated data for the three jurisdictions and observe the commonalities and differences between the countries in terms of: socio-demographic characteristics, legalisation and ethicality and physician, decision-making and clinical characteristics of death by EAS.
The Medico-legal aspects of EAS differ between the countries as euthanasia is permitted in Belgium and The Netherlands and not Switzerland, whereas physician assisted suicide is permitted in all three countries. Although the laws are different in all countries, they all share the same underlying principles, which are consent, incurability of the disease and voluntary request with no action bias. The different years of legalization between the countries indicate the increasing awareness and conceding of the government regarding the practice.
The total number of deaths studied were 3751 for Belgium,7761 for The Netherlands and 5239 for Switzerland. Deaths by EAS were 349 in Belgium,851 in The Netherlands and 65 in Switzerland. The patient’s characteristics data indicate the individuals who died by EAS were mostly males, 51% in Belgium, 53.8 % in The Netherlands and 42.5% in Switzerland. Moreover, most individuals who died by EAS were 65-79 years old and the most prominent underlying condition for all the studies was cancer.
Additionally, the study indicates the type of physician who performed EAS was a general practitioner for all three countries and an oral and written request was mostly done. The overall shortening of life was estimated to 1-7 weeks for both Belgium and The Netherlands but more than 4 weeks in Switzerland. The person who administered the lethal drugs was only the physician in Belgium (71.4%) and The Netherlands (87.3%), whereas in Switzerland (73.3%) it was the patient (with or without another person).
In conclusion, the above-mentioned data indicated the vast preference of EAS as a method of death and how most individuals suffering from life terminal diseases would like to eradicate their pain by dying in this way. As much as the physician’s role is to prolong life, the question arises as to why should it not also be to help individuals shorten their lives in excruciating circumstances? In the future, the legalization of EAS will most likely occur in more countries and people will not only have a say on how they want to live their lives, but also how they want to die.
Dierickx, S., Onwuteaka-Philipsen, B., Penders, Y. et al. Commonalities and differences in legal euthanasia and physician-assisted suicide in three countries: a population-level comparison. Int J Public Health 65, 65–73 (2020). https://doi.org/10.1007/s00038-019-01281-6.