Euthanasia

Euthanasia is the practice of assisting the death of an animal or patient, often to aleviate suffering or because the patient is in a persistent vegetative state. It is ethically controversial, and human euthanasia is outlawed in most places (Switzerland, Belgium, Albania and the Netherlands are exceptions). Opponents of euthanasia say that it is murder, although most definitions of murder note that it is unlawful killing, and if euthanasia were legal, it would not be unlawful. The term euthanasia covers a variety of different situations, which have different moral issues attached to them. Proponents believe euthanasia is the ultimate expression of free will, allowing patients to determine their fate and put an end to their suffering.

Consensuality

The term euthanasia covers both voluntary and involuntary death. In the former, a person elects or specifies conditions for medically-assisted death, often in the form of a living will. The moral issues that accompany voluntary euthanasia are whether or not assisting suicide compromises the professional ethics of doctors and other health providers. Critics will often point out that euthanasia violates the Hippocratic Oath and suggest that patients may be subjected to coercion in order to obtain consent - that people may be pressured, or at least feel pressured, into giving consent in order to save the costs of healthcare, or to free up hospital beds and resources for others.

Passivity

Euthanasia describes both passive and active euthanasia - that is, euthanasia through not providing medical care and euthanasia through an active intervention - for instance, an injection of a drug that would end a persons life. A lot of the moral discussion around the different circumstances tend to focus around the idea of double effect - that is the morality of an action that is done with a particular purpose, but which has a side-effect which, if it were performed directly would be considered immoral. In the case of euthanasia, often strong sedatives are prescribed to people close to the end of their life, with the principle effect being reduction of pain, but the side-effect being speeding up death.

Religious and theological concerns

Non-religious people are fairly consistently in support of access to doctor-assisted suicide, while many religious people and organizations oppose euthanasia, seeing it as against God's will or as an affront to the sanctity of human life.

Catholicism rejects active euthanasia, while allowing, under the 1980 Declaration on Euthanasia, some instances of passive euthanasia if done in extraordinary circumstances. Islam has similar policies. Protestant and Jewish denominations are split on euthanasia, with more liberal adherents, clergy and denominations supporting euthanasia, with conservatives in opposition.

Methods

The most common means of euthanasia, in humans and animals, is a lethal dose of barbiturates. These can be taken orally if the subject is conscious and cooperative, or administered intravenously. While some protocols follow an anesthetic dose of barbiturate with agents that paralyze the muscles and then stop the heart, these are generally not considered necessary, but an artifact of using the triple-agent sequence for cardioplegia, or elective stopping of the heart for surgery. Triple-agent sequences also are used in lethal injection.

The triple-agent method, however, is not recommended by the American Veterinary Medicine Association in its guidelines for animal euthanasia. While injected barbiturates are preferred, inhaled agents may be used with specific species and under controlled conditions. The latter include carbon dioxide and carbon monoxide.

Other methods are acceptable, with considerations of the species, skills required, and practical considerations. For example, a penetrating captive bolt physical strike to the brain is considered a humane means of slaughtering meat animals, and can be used for euthanasia in appropriate animals. In some circumstances, such as wildlife in the field, gunshot may be the only practical means.

Famous euthanasia incidents

Perhaps the most famous doctor performing assisted suicide is Jack Kevorkian - often referred to as Dr. Death, who, until his conviction and imprisonment in 1999, assisted over 130 people in their death. He created a device, called the Thanatron, to help patients administer drugs intravenously, later replacing it with the Mercitron, which administered carbon monoxide. He was convicted after sending a video of him assisting in the death of Thomas Hyde, which prompted prosecution and imprisonment - he was paroled in June 2007. Conservative critics allege that he was addicted to killing so he could further his own research, and that a number of those he killed were not ill.

Diane Pretty suffered from motor neurone disease and sued the British government under the Human Rights Act, but her appeals failed after the courts decided that the European Convention on Human Rights and Fundamental Freedoms does not provide for a right to die. She died in 2001.