1 By: Dianna Termin

2 What is Physician-Assisted Suicide? Occurs when a physician provides the means, medical advice, and assurance that death results. Occurs when a physician provides the means, medical advice, and assurance that death results. The person, not the physician performs the act that causes death. The person, not the physician performs the act that causes death.

3 Is it Euthanasia? No, euthanasia doesn't give the patient the choice of dying. They physician or surrogate directs the treatment. Example: bringing death by increasing painkiller beyond what is needed to kill the pain (illegal in almost most states)

4 There is more than 1 type There are four types: Voluntary active Voluntary passive Involuntary active Involuntary passive

5 Physician-Assisted Suicide Often called “aid in dying” Often called “aid in dying” Similar to voluntary, active euthanasia Similar to voluntary, active euthanasia Mental aspect of patient must be ensured Mental aspect of patient must be ensured If they are not mentally stable they will not receive physician-assisted suicide If they are not mentally stable they will not receive physician-assisted suicide

6 Janet Adkins Assisted in her suicide in 1990 by Jack Kevorkian. Assisted in her suicide in 1990 by Jack Kevorkian. Questioned if Adkins was competent because of Alzheimer's disease. Questioned if Adkins was competent because of Alzheimer's disease.

7 Jack Kevorkian Known as “Dr Death” Known as “Dr Death” Kevorkian created a device that enabled people wishing to commit suicide to administer chemicals to themselves after assistance form a physician Kevorkian created a device that enabled people wishing to commit suicide to administer chemicals to themselves after assistance form a physician a retired Michigan pathologist a retired Michigan pathologist Assisted in more than 100 suicides. Assisted in more than 100 suicides.

8 Jack Kevorkian 1999 convicted in second-degree murder in criminal trial in Michigan where assisted suicide is illegal convicted in second-degree murder in criminal trial in Michigan where assisted suicide is illegal. Criticized because he “didn’t know his patients” because he was unqualified to diagnose or understand illness because he was a pathologist. Criticized because he “didn’t know his patients” because he was unqualified to diagnose or understand illness because he was a pathologist. Also conflict of interest because of publicity of “death machine” Also conflict of interest because of publicity of “death machine”

9 In states that its illegal “comfort always” “comfort always” Sometimes administering too much morpheme never raised an unethical issue. Sometimes administering too much morpheme never raised an unethical issue. Laws didn’t consider a patients wishes and reflected the laws against homicide and laws making it illegal to assist in committing suicide. Laws didn’t consider a patients wishes and reflected the laws against homicide and laws making it illegal to assist in committing suicide.

10 Death with Dignity Act Est in Oregon 1994 (52% to 48%) Est in Oregon 1994 (52% to 48%) Permits physicians to prescribe, but not administer fatal doses of oral drugs to competent adults with less than 6 months to live. Permits physicians to prescribe, but not administer fatal doses of oral drugs to competent adults with less than 6 months to live. Must have Must have oral or written request from patient and consultations with other physician. oral or written request from patient and consultations with other physician. 15-day waiting period 15-day waiting period Notification by physician of pharmacists and state health authorities Notification by physician of pharmacists and state health authorities

11 Death with Dignity Act First suicide under Oregon law March 1998 First suicide under Oregon law March 1998 Medicaid added physician-assisted suicide to end-of life comfort care services Medicaid added physician-assisted suicide to end-of life comfort care services No movement or trend of similar laws since Oregon No movement or trend of similar laws since Oregon

12 Who Statues in 38 states criminalize assisted suicide. Statues in 38 states criminalize assisted suicide. Common law in 6 states criminalize assisted suicide. Common law in 6 states criminalize assisted suicide. In 5 states assisted Suicide is unclear. In 5 states assisted Suicide is unclear.

13 What does the U.S. Supreme Court Say? 1997 it unanimously ruled that states may ban physician-assisted suicide without violating either the due process or equal protection clauses of the 14 th Amendment to the Constitution 1997 it unanimously ruled that states may ban physician-assisted suicide without violating either the due process or equal protection clauses of the 14 th Amendment to the Constitution They did no decide whether states could pass laws such as Oregon giving people the choice. They did no decide whether states could pass laws such as Oregon giving people the choice.

14 Netherlands Supported Euthanasia by 92% of population Supported Euthanasia by 92% of population First country to legalize practice in 1999 First country to legalize practice in 1999 It must be Voluntary It must be Voluntary The patients must be competent and terminal The patients must be competent and terminal Reported Reported 2% of death caused by euthanasia 2% of death caused by euthanasia Proof of no consent from majority of patients Proof of no consent from majority of patientsU.S. 31% of physicians couldn’t do this on moral grounds. 31% of physicians couldn’t do this on moral grounds. Those who guard life now turn to dying as means of medicine. Those who guard life now turn to dying as means of medicine. Majority of physicians in Michigan and Oregon favored legalizing assisted suicide. Majority of physicians in Michigan and Oregon favored legalizing assisted suicide. 6% of physicians who regularly care for dying have prescribed injections so patients could kill themselves (when it was legal). 6% of physicians who regularly care for dying have prescribed injections so patients could kill themselves (when it was legal). By people have been assisted in their suicides in Oregon. By people have been assisted in their suicides in Oregon.

15 References Longest, Beaufort, Jonathon S. Rakich and Kurt Darr. Managing Health Services Organizations and Systems. Baltimore: Health Professions Press, Longest, Beaufort, Jonathon S. Rakich and Kurt Darr. Managing Health Services Organizations and Systems. Baltimore: Health Professions Press, Department of Human Services Record: Death With Dignity Act. Oregon.gov March November Department of Human Services Record: Death With Dignity Act. Oregon.gov March November 2007 UB Center for Clinical Ethics and Humanities in Health Care: U.S. Supreme Court Rules on Physician Assisted Suicide Cases. UB Center April November 2007 UB Center for Clinical Ethics and Humanities in Health Care: U.S. Supreme Court Rules on Physician Assisted Suicide Cases. UB Center April November 2007

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