Difference between euthanasia, assisted dying and assisted suicide
“The main difference between euthanasia and assisted suicide is who performs the final, fatal act,” said Richard Huxtable, professor of medical ethics and law at the University of Bristol.
Euthanasia refers to active steps taken to end someone’s life to stop their suffering and the “final deed” is undertaken by someone other than the individual, for example a doctor. If the person concerned has requested this, it falls under the term “voluntary euthanasia”.
Assisted suicide is about helping someone to take their own life at their request – in other words the final deed is undertaken by the person themselves. Assisted dying can be used to mean both euthanasia, generally voluntary, and assisted suicide; however, some campaign groups use it to refer only to assisted suicide of terminally ill people.
“One of the dilemmas we have in these ongoing debates is how people use the various phrases,” says Huxtable. Most, but not all, jurisdictions that allow some form of euthanasia or assisted suicide require the involvement of medical professionals.
Palliative sedation, in which people can request to be kept under deep sedation until they die, is allowed in many countries, including the Netherlands and France – is not euthanasia.
Which countries permit any of these variants?
The Netherlands and Switzerland are the most well known, and Belgium considered perhaps the most liberal, but several other jurisdictions allow some form of euthanasia or assisted suicide. That said, permitted circumstances differ considerably.
In the Netherlands both euthanasia and assisted suicide are legal if the patient is enduring unbearable suffering and there is no prospect of improvement. Anyone from the age of 12 can request this, but parental consent is required if a child is under 16. There are a number of checks and balances, including that doctors must consult with at least one other, independent doctor on whether patient meets the necessary criteria.
Belgium, Luxembourg, Canada and Colombia also allow both euthanasia and assisted suicide, although there are differences – for example only terminal patients can request it in Colombia, while Belgium has no age restriction for children (although they must have a terminal illness).
Assisted suicide is more widely available than euthanasia. Among the places where people can choose to end their life this way are Switzerland and a number of US states including California, Colorado, Hawaii, New Jersey, Oregon, Washington state, Vermont and the District of Columbia. Laws permitting assisted suicide came into force in the Australian state of Victoria last month.
In Australia because of the tight laws, many terminally ill prefer to buy Nembutal the euthanasia drug and administer it themselves. They complain about the lack of government sympathy.
Again, the exact circumstances in which assisted suicide is allowed vary, with some jurisdictions – Oregon and Vermont – only allowing it in the case of terminal illness. For some places it is permitted not because laws have been passed, but because laws do not prohibit it. For example in Switzerland it is an offense to assist a suicide if it is done with selfish motives. “The result of that is there is this growth of not-for-profit organizations,” says Prof Penney Lewis, an expert on the law around end-of-life care at King’s College London.