Do euthanasia and physician-assisted suicide ensure a good death?
General Reference (not clearly pro or con)
Ezekiel Emanuel, MD, PhD, Chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health, and Linda L. Emanuel, MD, PhD, Director of the Buehler Center on Aging, Health & Society at the Feinberg School of Medicine at Northwestern University, wrote in a May 1998 The Lancet article titled "The Promise of a Good Death":
"For more than three decades, interest in improving the care of dying patients has progressed from being the concern of a few health-care professionals to being a widespread social concern… Despite this attention, a 'good death' remains more a hope than standard medical practice for all patients…
Over the past few years there has been growing interest in the possibility that euthanasia and physician-assisted suicide might provide a 'good death.'"
The Oregon Department of Human Services (DHS) wrote in its Mar. 9, 2006 "Eighth Annual Report on Oregon's Death with Dignity Act":
"In 2005, 39 physicians wrote a total of 64 prescriptions for lethal doses of medication... Thirty-two of the 2005 prescription recipients died after ingesting the medication... In addition, six patients who received prescriptions during 2004 died in 2005 as a result of ingesting the prescribed medication, giving a total of 38 PAS [physician-assisted suicide] deaths during 2005. One 2004 prescription recipient, who ingested the prescribed medication in 2005, became unconscious 25 minutes after ingestion, then regained consciousness 65 hours later. This person did not obtain a subsequent prescription and died 14 days later of the underlying illness (17 days after ingesting the medication)...
Complications were reported for three patients during 2005; two involved regurgitation, and, as noted above, one patient regained consciousness after ingesting the prescribed medication. None involved seizures (see Complications, page 13). Fifty percent of patients became unconscious within five minutes of ingestion of the lethal medication and the same percentage died within 26 minutes of ingestion. The range of time from ingestion to death was from five minutes to 9.5 hours.."
Do euthanasia and physician-assisted suicide ensure a good death?
The New York State Task Force on Life and the Law, in a May 1994 report titled "When Death Is Sought
Assisted Suicide and Euthanasia in the Medical Context," wrote:
"Some patients decide to stop or withhold life-sustaining treatment because they perceive life as a burden and wish to die. In these cases, assisted suicide or euthanasia would end the patient's life and suffering more quickly and effectively than withdrawing or withholding treatment."
Dan Brock, PhD, Director of the University Program in Ethics and Health at the Harvard Medical School, wrote in an article titled "Voluntary Active Euthanasia" in the Mar.-Apr. 1992 issue of The Hastings Center Report:
"One last good consequence of legalizing euthanasia is that once death has been accepted, it is often more humane to end life quickly and peacefully, when that is what the patient wants. Such a death will often be seen as better than a more prolonged one. People who suffer a sudden and unexpected death, for example by dying quickly or in their sleep from a heart attack or stroke, are often considered lucky to have died this way."
The Royal Dutch Society for the Advancement of Pharmacy wrote in its 1994 report titled "Administration and Compounding of Euthanasic Agents":
"A clear general conclusion may be drawn as concerns the lethal action of the euthanasic agents recommended by the KNMP's [Royal Dutch Society for the Advancement of Pharmacy] Task Force: the administration of thiopental [a drug that causes unconsciousness] followed by a muscle relaxant--provided the latter is properly administered--causes immediate death without any problems...
Intravenous administration is the most reliable and rapid way to accomplish euthanasia and therefore can be safely recommended."
Gerrit Kimsma, MD, MPh, Associate Professor in Medical Philosophy at the Center for Ethics and Philosophy at Free University in Amsterdam, was quoted in an undated Willamette Week Online article by David Smigelski titled "Wonder Why You're Voting on Assisted Suicide Again? Sloppy Reporting in The Oregonian and Legislative Trickery" (accessed July 28, 2009):
"In the course of the on-going debate about physician-assisted suicide in the United States... a particular claim has been made by the opposition... that in cases of physician-assisted suicide in The Netherlands the established failure rate is 25 percent. This is implied to mean that in 25 percent of the cases... through orally applied means, the effect would not be death. Instead, there would be widespread reawakening of suffering patients or some form of continued coma...
This claim has no foundation whatsoever, is misleading and completely wrong... There are no scientific data nor hearsay to support it."
Pieter Admiraal, MD, PhD, a Dutch euthanasia activist and anesthesiologist, was quoted in an undated Willamette Week Online article by David Smigelski titled "Wonder Why You're Voting on Assisted Suicide Again? Sloppy Reporting in The Oregonian and Legislative Trickery" (accessed July 28, 2009):
"I realize that the article written by Mark O'Keefe in The Oregonian about an interview he had with me in the Netherlands in 1994 has been used to 'prove' that there should be a 25 percent failure rate in using oral lethal drugs... Let's face the facts... After an oral dose of 9 grams of barbiturate every patient will die.... A period of 24 hours or longer will be very exceptional."
Bill Toffler, MD, National Director of the Physicians for Compassionate Care Education Foundation (PCCEF), is quoted in a June 18, 2006 San Francisco Chronicle article by Matthew Yi titled "California Looks to Replicate Oregon's Assisted Suicide Law":
"In many of the cases, the death lingers for hours. It's not a dignified death. It's not pretty to watch somebody struggle with breathing or having irregular, shallow breathing for hours and hours on end."
Richard Fenigsen, MD, PhD, euthanasia opponenent and a former Dutch cardiologist, wrote in an article titled "A Case against Dutch Euthanasia" in Jan. 1, 1989 issue of The Hastings Center Report:
"Euthanasia is supposed to spare the sick person the agony that precedes death or the sufferings of a prolonged illness. But this is not the case. When Wibo van den Linden filmed one patient's preparations for 'voluntary' euthanasia, about a million Dutch television viewers watched the unfortunate lady's anguish and despair as the fixed day of execution approached... Euthanasia causes extreme psychological suffering--the excommunication, the exclusion of a person from the community of the living while he is still alive. "
Russel Ogden, MA, Criminology Instructor at the Kwantlen Polytechnic University, wrote in a Dec. 1997 Policy Options article "Oregon's Measure 16: A Bitter Pill":
"There is paucity of research into the dosages and types of drugs necessary to cause death and no pharmaceutical company has developed a sure-fire suicide pill... In the course of my own research I have heard horrific stories of patients taking massive quantities of drugs that have been fatal with other persons and yet they have either survived or suffered through lingering deaths. Risks include vomiting the drugs, coma, psychosis and even de-cerebration where the patient is brain dead but still breathing. Sometimes these protracted deaths elicit friends or partners to resort to smothering with pillows or asphyxiation with plastic bags. One physician reported to me that he took the recourse of holding shut the mouth and nostrils of a comatose patient."
Johanna Groenewoud, MD, PhD, Professor, and Agnes van der Heide, MD, PhD, Senior Researcher, both at the Department of Public Health at Erasmus University in Rotterdam, along with Bregje Onwuteaka-Philipsen, PhD, Associate Professor and Care and Prevention Program Leader at the Institute for Health and Care Research (EMGO) at the Free University Medical Centre in Amsterdam, and Dick Willems, MD, PhD, Senior Researcher in Ethics at the Department of General Practice in the Division of Public Health at the Academic Medical Centre in the University of Amsterdam, wrote in a Feb. 24, 2000 New England Journal of Medicine article titled "Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands":
"We analyzed data from two studies of euthanasia and physician-assisted suicide in the Netherlands... with a total of 649 cases...
Complications occurred in 7 percent of cases of assisted suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, or induction of coma followed by awakening of the patient) occurred in 16 percent of the cases; complications and problems with completion occurred in 3 percent and 6 percent of cases of euthanasia, respectively. The physician decided to administer a lethal medication in 21 of the cases of assisted suicide (18 percent), which thus became cases of euthanasia. The reasons for this decision included problems with completion (in 12 cases) and the inability of the patient to take all the medications (in 5)...
We found that there were sometimes clinical problems with the performance of physician-assisted suicide and euthanasia. The problems reported by physicians frequently concerned a longer-than-expected interval between the administration of the lethal drug (or the first drug, if more than one was administered) and the patient's death."