Last updated on: 7/29/2009 | Author: ProCon.org

Do Euthanasia and Physician-Assisted Suicide Ensure a Good Death?

General Reference (not clearly pro or con)

Caitlin Mahar, PhD, Adjunct Research Fellow at Swinburne University of Technology, in a Sep. 26, 2017 article, “When a ‘Good Death’ Was Often Painful: Euthanasia through the Ages,” available at theconversation.com, stated:

“Today, a primary goal of both movements aimed at care of the dying – palliative care and euthanasia – is to eliminate suffering. These are underpinned by the idea that a good death is a painless death. But it wasn’t always so.

The term ‘euthanasia’ is derived from the Greek for good death, but it only began to be used in a modern and familiar way in the late 19th century. For centuries in Western societies, ‘euthanasia’ referred to a pious death blessed by God.

The means of achieving a good death was set out in the enormously popular ars moriendi (art of dying) guides that offered prayers, attitudes and actions intended to guide the dying towards salvation. This wasn’t necessarily a painless process. Far and away the most reproduced image of good dying was Christ’s crucifixion…

In the 19th century, pain began to be seen as a discrete and aberrant physiological phenomenon. Both dying and suffering were increasingly medicalised. Doctors gradually took over from the clergy and family as carers of the dying.

At the same time, the word ‘euthanasia’ took on a new meaning. It began to refer to this new medical duty to assist the terminally ill – but not to hasten death.”

Sep. 26, 2017 - Caitlin Mahar, PhD

Emily A. Meier, PhD, Assistant Clinical Professor of Psychiatry at Moores Cancer Center at the University of California San Diego Health, et al., in an Apr. 24, 2016 American Journal of Geriatric Psychiatry article, “Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue,” stated:

“There is little agreement about what constitutes good death or successful dying. The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death… We identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spiritualty [sic], emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with HCP [healthcare provider], and other. The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%)… Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%)… In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%).”

Apr. 24, 2016 - Emily Meier, PhD

Tessa Love, freelance writer, in a Sep. 28, 2017 article, “Who Gets to Have a ‘Good Death’?,” available at medium.com stated:

“While death positivity takes many forms, a major tenet of this movement is the advocation for a ‘good death,’ a death that is in line with one’s own individual values. While this means something different for everyone, the basic principle of a good death is that it’s been planned; this means the dying person is aware of their approaching demise, has come to terms with it, has legally prepared for it, has chosen their plans for interment, and can die at peace without pain, easing the mourning process for those left behind.

But it’s not always this simple. It’s true that categorizing any death as ‘good’ is radical in our death-fearing society, but lurking behind this movement is a complicated disparity and dichotomy: A good death is often a privileged one, and the bad deaths?—?the violent, untimely, unexpected and patterned deaths?—?are disproportionately experienced by the country’s most marginalized people… For those without this privilege, death is a regular fixture of their identity. And these people, of course, more often than not are black, brown, gay, trans, nonbinary, female, and/or poor, and are at a higher risk of being denied a good death.”

Sep. 28, 2017 - Tessa Love

Charles Garfield, PhD, Clinical Professor of Psychology at the University of California School of Medicine at San Francisco, in an Apr. 30, 2014 Greater Good Magazine article, “Seven Keys to a Good Death,” available at berkeley.edu, stated:

“Here are seven ways to help create the conditions for a good death.

1. Experience as little pain as possible…
2. Recognize and resolve interpersonal conflicts…
3. Satisfy any remaining wishes that are consistent with their present condition…
4. Review their life to find meaning…
5. Hand over control to a trusted person, someone committed to helping them have the kind of death they desire…
6. Be protected from needless procedures that serve to only dehumanize and demean without much or any benefit…
7. Decide how social and how alert they want to be.”

Apr. 30, 2014 - Charles Garfield, PhD

PRO (yes)

Pro

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.”

Mar.-Apr. 1992 - Dan Brock, PhD

Pro

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.”

1994 - Royal Dutch Society for the Advancement of Pharmacy

CON (no)

Con

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.”

June 18, 2006 - William L. Toffler, MD

Con

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.”

Dec. 1997 - Russel Ogden, MA