Euthanasia and the Law
Encyclopedia
Efforts to change government policies
on euthanasia
in the 20th century have met limited success in Western countries
. Euthanasia policies have also been developed by a variety of NGOs
, most notably medical associations and advocacy organizations. As of 2011, active euthanasia is only legal in the three Benelux
countries: the Netherlands
, Belgium
and Luxembourg
. Assisted suicide is legal in Switzerland
and in the US states of Washington, Oregon and Montana.
. It was once legal in the Northern Territory
, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal Government overrode the Northern Territory legislation through the introduction of the Euthanasia Laws Act 1997. Unlike the states
, legislation in the Northern Territory is not guaranteed by the Australian constitution
. Before this law was passed by the Australian Government, Dr. Philip Nitschke
helped three people by them using his Deliverance machine. Organisations such as Exit International (founded by Nitschke himself), want the government to bring back euthanasia rights to Australia. Exit made TV commercials which were banned before they made it to air in September 2010.
parliament legalized euthanasia in late September 2002.
A survey published in 2010 that those who died from euthanasia (compared with other deaths) were more often younger, male, cancer patients and more often died in their homes. In almost all cases, unbearable physical suffering were reported. Euthanasia for nonterminal patients was rare.
, it is illegal for a doctor (or anyone) to actively contribute to someone's death. It is not, however, illegal to remove life support and other treatment (the "right to die") should a person (or their next of kin) request it - in other words, passive euthanasia is legal. A September 2010 Irish Times poll showed that a majority, 57% of adults, believed that doctor-assisted suicide should be legal for terminally ill patients who request it.
ese government has no official laws on the status of euthanasia and the Supreme Court of Japan
has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University
in 1995. The first case involved (i.e., allowing a patient to die by turning off life support) and the latter case involved (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.
In the case of passive euthanasia, three conditions must be met:
For active euthanasia, four conditions must be met:
The problems that arose from this, in addition to the problem faced by many other families in the country, has led to the creation of "bioethics SWAT teams".These teams will be made available to the families of terminally ill patients in order to help them, along with the doctors, come to a decision based on the personal facts of the case. Though in its early stages and relying on “subsidies from the Ministry of Health, Labor and Welfare” there are plans to create a nonprofit organization to “allow this effort to continue.”
, active euthanasia is illegal but since 7 January 2008 the law allows the terminally ill —or closest relatives, if unconscious— to refuse medication or further medical treatment to extend life (also known as passive euthanasia) in Mexico City
, in the central state of Aguascalientes
(since 6 April 2009) and, since 1 September 2009, in the Western state of Michoacán
. A similar law extending the same provisions at the national level has been approved by the senate and an initiative decriminalizing active euthanasia has entered the same legislative chamber on 13 April 2007.
In 2002, the Netherlands
passed a law legalizing euthanasia including physician assisted suicide. This law codifies the twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care." The United Nations has reviewed and commented on the Netherlands euthanasia law.
In September 2004 the Groningen Protocol
was developed, which sets out criteria to be met for carrying out child euthanasia
without the physician being prosecuted.
.
The second largest political party, Progress Party
, have several times tried to legalize euthanasia.
. The aide who helped a person to suicide or other ways to kill oneself will be punished for assisting and encouraging suicide under the stipulation of article 84 of the Turkish Criminal Law. In condition of active euthanasia, article 81 of the same law sets forth that any person who carries out this act will be judged and punished for life imprisonnement just like a simple murder.
. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (e.g. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great). Between 2003 and 2006 Lord Joffe
made four attempts to introduce bills that would have legalized voluntary euthanasia - all were rejected by the UK Parliament. Currently, Dr Nigel Cox
is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended sentence
in 1992. In 1957 Judge Devlin
in the trial of Dr John Bodkin Adams
ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.
While active euthanasia is illegal throughout the US, assisted suicide
is legal in three states: Oregon, Washington and Montana.
On euthanasia (narrowly-defined here as directly causing death), Brody sums up the U.S. medical NGO arena:
Other NGOs that advocate for and against various euthanasia-related policies are found throughout the world. Among proponents, perhaps the leading NGO is the UK's Dignity in Dying
, the successor to the (Voluntary) Euthanasia Society. In addition to professional and religious groups, there are NGOs opposed to euthanasia found in various countries.
Policy
A policy is typically described as a principle or rule to guide decisions and achieve rational outcome. The term is not normally used to denote what is actually done, this is normally referred to as either procedure or protocol...
on euthanasia
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
in the 20th century have met limited success in Western countries
Western world
The Western world, also known as the West and the Occident , is a term referring to the countries of Western Europe , the countries of the Americas, as well all countries of Northern and Central Europe, Australia and New Zealand...
. Euthanasia policies have also been developed by a variety of NGOs
Non-governmental organization
A non-governmental organization is a legally constituted organization created by natural or legal persons that operates independently from any government. The term originated from the United Nations , and is normally used to refer to organizations that do not form part of the government and are...
, most notably medical associations and advocacy organizations. As of 2011, active euthanasia is only legal in the three Benelux
Benelux
The Benelux is an economic union in Western Europe comprising three neighbouring countries, Belgium, the Netherlands, and Luxembourg. These countries are located in northwestern Europe between France and Germany...
countries: the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
, Belgium
Belgium
Belgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...
and Luxembourg
Luxembourg
Luxembourg , officially the Grand Duchy of Luxembourg , is a landlocked country in western Europe, bordered by Belgium, France, and Germany. It has two principal regions: the Oesling in the North as part of the Ardennes massif, and the Gutland in the south...
. Assisted suicide is legal in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
and in the US states of Washington, Oregon and Montana.
Australia
Euthanasia is now illegal in AustraliaAustralia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
. It was once legal in the Northern Territory
Northern Territory
The Northern Territory is a federal territory of Australia, occupying much of the centre of the mainland continent, as well as the central northern regions...
, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal Government overrode the Northern Territory legislation through the introduction of the Euthanasia Laws Act 1997. Unlike the states
States and territories of Australia
The Commonwealth of Australia is a union of six states and various territories. The Australian mainland is made up of five states and three territories, with the sixth state of Tasmania being made up of islands. In addition there are six island territories, known as external territories, and a...
, legislation in the Northern Territory is not guaranteed by the Australian constitution
Constitution of Australia
The Constitution of Australia is the supreme law under which the Australian Commonwealth Government operates. It consists of several documents. The most important is the Constitution of the Commonwealth of Australia...
. Before this law was passed by the Australian Government, Dr. Philip Nitschke
Philip Nitschke
Dr. Philip Nitschke is an Australian medical doctor, humanist, author and founder and director of the pro-euthanasia group Exit International. He campaigned successfully to have a legal euthanasia law passed in Australia's Northern Territory and assisted four people in ending their lives before...
helped three people by them using his Deliverance machine. Organisations such as Exit International (founded by Nitschke himself), want the government to bring back euthanasia rights to Australia. Exit made TV commercials which were banned before they made it to air in September 2010.
Belgium
The BelgianBelgium
Belgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...
parliament legalized euthanasia in late September 2002.
A survey published in 2010 that those who died from euthanasia (compared with other deaths) were more often younger, male, cancer patients and more often died in their homes. In almost all cases, unbearable physical suffering were reported. Euthanasia for nonterminal patients was rare.
Canada
Canadian laws on living wills and passive euthanasia are a legal dilemma. Documents which set out guidelines for dealing with life-sustaining medical procedures are under the Provinces control, in Ontario under the Health Care Consent Act, 1996.Ireland
In IrelandRepublic of Ireland
Ireland , described as the Republic of Ireland , is a sovereign state in Europe occupying approximately five-sixths of the island of the same name. Its capital is Dublin. Ireland, which had a population of 4.58 million in 2011, is a constitutional republic governed as a parliamentary democracy,...
, it is illegal for a doctor (or anyone) to actively contribute to someone's death. It is not, however, illegal to remove life support and other treatment (the "right to die") should a person (or their next of kin) request it - in other words, passive euthanasia is legal. A September 2010 Irish Times poll showed that a majority, 57% of adults, believed that doctor-assisted suicide should be legal for terminally ill patients who request it.
Japan
The JapanJapan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
ese government has no official laws on the status of euthanasia and the Supreme Court of Japan
Supreme Court of Japan
The Supreme Court of Japan , located in Chiyoda, Tokyo is the highest court in Japan. It has ultimate judicial authority to interpret the Japanese constitution and decide questions of national law...
has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University
Tokai University
is a private university in Tokyo, Japan. It was established in 1943 by Shigeyoshi Matsumae, who had formerly been the engineering president of the Ministry of Communications...
in 1995. The first case involved (i.e., allowing a patient to die by turning off life support) and the latter case involved (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.
In the case of passive euthanasia, three conditions must be met:
- the patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she is unlikely to make a recovery;
- the patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a pre-written document such as a living willLiving willAn advance health care directive, also known as living will, personal directive, advance directive, or advance decision, are instructions given by individuals specifying what actions should be taken for their health in the event that they are no longer able to make decisions due to illness or...
or the testimony of the family; - the patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc.
For active euthanasia, four conditions must be met:
- the patient must be suffering from unbearable physical pain;
- death must be inevitable and drawing near;
- the patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.)
- the physician must have (ineffectively) exhausted all other measures of pain relief.
The problems that arose from this, in addition to the problem faced by many other families in the country, has led to the creation of "bioethics SWAT teams".These teams will be made available to the families of terminally ill patients in order to help them, along with the doctors, come to a decision based on the personal facts of the case. Though in its early stages and relying on “subsidies from the Ministry of Health, Labor and Welfare” there are plans to create a nonprofit organization to “allow this effort to continue.”
Luxembourg
The country's parliament passed a bill legalizing euthanasia on 20 February 2008 in the first reading with 30 of 59 votes in favour. On 19 March 2009, the bill passed the second reading, making Luxembourg the third European Union country, after the Netherlands and Belgium, to decriminalise euthanasia. Terminally ill people will be able to have their lives ended after receiving the approval of two doctors and a panel of experts.Mexico
In MexicoMexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...
, active euthanasia is illegal but since 7 January 2008 the law allows the terminally ill —or closest relatives, if unconscious— to refuse medication or further medical treatment to extend life (also known as passive euthanasia) in Mexico City
Mexico City
Mexico City is the Federal District , capital of Mexico and seat of the federal powers of the Mexican Union. It is a federal entity within Mexico which is not part of any one of the 31 Mexican states but belongs to the federation as a whole...
, in the central state of Aguascalientes
Aguascalientes
Aguascalientes is one of the 31 states which, with the Federal District, comprise the 32 Federal Entities of Mexico. It is divided in 11 municipalities and its capital city is Aguascalientes....
(since 6 April 2009) and, since 1 September 2009, in the Western state of Michoacán
Michoacán
Michoacán officially Estado Libre y Soberano de Michoacán de Ocampo is one of the 31 states which, with the Federal District, comprise the 32 Federal Entities of Mexico. It is divided in 113 municipalities and its capital city is Morelia...
. A similar law extending the same provisions at the national level has been approved by the senate and an initiative decriminalizing active euthanasia has entered the same legislative chamber on 13 April 2007.
Colombia
In a 6-3 decision, Colombia's Constitutional Court ruled May 20, 2010 that "no person can be held criminally responsible for taking the life of a terminally ill patient who has given clear authorization to do so," according to the Washington Post. The court defined "terminally ill" person as those with diseases such as "cancer, AIDS, and kidney or liver failure if they are terminal and the cause of extreme suffering," the Post reported. The ruling specifically refused to authorize euthanasia for people with degenerative diseases such as Alzheimer's, Parkinson's, or Lou Gehrig's disease.Netherlands
In the 1973 "Postma case" a physician was convicted for having facilitated the death of her mother following repeated explicit requests for euthanasia. While upholding the conviction, the court's judgment set out critera when a doctor would not be required to keep a patient alive contrary to their will. This set of critera was formalized in the course of a number of court cases during the 1980s.In 2002, the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
passed a law legalizing euthanasia including physician assisted suicide. This law codifies the twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care." The United Nations has reviewed and commented on the Netherlands euthanasia law.
In September 2004 the Groningen Protocol
Groningen Protocol
The Groningen Protocol is a text created in September 2004 by Eduard Verhagen, the medical director of the department of pediatrics at the University Medical Center Groningen in Groningen, The Netherlands...
was developed, which sets out criteria to be met for carrying out child euthanasia
Child euthanasia
Child euthanasia is a controversial form of non-voluntary euthanasia that is applied to children who are gravely ill or suffer from significant birth defects....
without the physician being prosecuted.
New Zealand
Two attempts have been made in the Parliament passing Bills to legalize it, but euthanasia remains illegal in New ZealandNew Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
.
Norway
Euthanasia remains illegal, though a caregiver may receive a reduced punishment for taking the life of someone who consents to it, or for, out of compassion, taking the life of a person that is "hopelessly sick".The second largest political party, Progress Party
Progress Party (Norway)
The Progress Party is a political party in Norway which identifies as conservative liberal and libertarian. The media has described it as conservative and right-wing populist...
, have several times tried to legalize euthanasia.
Switzerland
In Switzerland, deadly drugs may be prescribed to a Swiss person or to a foreigner, where the recipient takes an active role in the drug administration. More generally, article 115 of the Swiss penal code, which came into effect in 1942 (having been written in 1918), considers assisting suicide a crime if and only if the motive is selfish.Turkey
Euthanasia is strictly forbidden in TurkeyTurkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...
. The aide who helped a person to suicide or other ways to kill oneself will be punished for assisting and encouraging suicide under the stipulation of article 84 of the Turkish Criminal Law. In condition of active euthanasia, article 81 of the same law sets forth that any person who carries out this act will be judged and punished for life imprisonnement just like a simple murder.
United Kingdom
Euthanasia is illegal in the United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (e.g. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great). Between 2003 and 2006 Lord Joffe
Joel Joffe, Baron Joffe
Joel Goodman Joffe, Baron Joffe CBE is a Labour peer in the House of Lords.Born in South Africa, he was educated at the University of Witwatersrand , and worked as a human rights lawyer 1958-65, including at the infamous 1963-4 Rivonia Trial, representing Nelson Mandela...
made four attempts to introduce bills that would have legalized voluntary euthanasia - all were rejected by the UK Parliament. Currently, Dr Nigel Cox
Nigel Cox (doctor)
Dr Nigel Leigh Cox is a British consultant rheumatologist and the only doctor ever to have been convicted in Britain for attempted euthanasia. In 1992 he was convicted of the attempted murder of patient Lillian Boyes, and received a suspended sentence.-Lillian Boyes:In 1991 Lillian Boyes, then 70,...
is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended sentence
Suspended sentence
A suspended sentence is a legal term for a judge's delaying of a defendant's serving of a sentence after they have been found guilty, in order to allow the defendant to perform a period of probation...
in 1992. In 1957 Judge Devlin
Patrick Devlin, Baron Devlin
Patrick Arthur Devlin, Baron Devlin, PC was a British lawyer, judge and jurist. He wrote a report on Britain's involvement in Nyasaland in 1959...
in the trial of Dr John Bodkin Adams
John Bodkin Adams
John Bodkin Adams was an Irish-born British general practitioner, convicted fraudster and suspected serial killer. Between the years 1946 and 1956, more than 160 of his patients died in suspicious circumstances. Of these, 132 left him money or items in their will. He was tried and acquitted for...
ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.
United States
Active euthanasia is illegal in most of the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patients' choices hasten their deaths. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances and, under federal law and most state laws only with the informed consent of the patient or, in the event of the incompetence of the patient, with the informed consent of the legal surrogate. The Supreme Court of the United States has not dealt with "quality of life issues" or "futility issues" and appears to only condone active or passive "euthanasia" (not legally defined) when there is clear and convincing evidence that informed consent to the euthanasia, passive or active, has been obtained from the competent patient or the legal surrogate of the incompetent patient.While active euthanasia is illegal throughout the US, assisted suicide
Assisted suicide
Assisted suicide is the common term for actions by which an individual helps another person voluntarily bring about his or her own death. "Assistance" may mean providing one with the means to end one's own life, but may extend to other actions. It differs to euthanasia where another person ends...
is legal in three states: Oregon, Washington and Montana.
Non-governmental organizations
There are a number of historical studies about the thorough euthanasia-related policies of professional associations. In the Academy of Neurology (AAN). In their analysis, Brody et al. found it necessary to distinguish such topics as euthanasia, physician-assisted suicide, informed consent and refusal, advance directives, pregnant patients, surrogate decision-making (including neonates), DNR orders, irreversible loss of consciousness, quality of life (as a criterion for limiting end-of-life care), withholding and withdrawing intervention, and futility. Similar distinctions presumably are found outside the U.S., as with the highly contested statements of the British Medical Association.On euthanasia (narrowly-defined here as directly causing death), Brody sums up the U.S. medical NGO arena:
The debate in the ethics literature on euthanasia is just as divided as the debate on physician-assisted suicide, perhaps more so. Slippery-slope arguments are often made, supported by claims about abuse of voluntary euthanasia in the Netherlands.... Arguments against it are based on the integrity of medicine as a profession. In response, autonomy and quality-of-life-base arguments are made in support of euthanasia, underscored by claims that when the only way to relieve a dying patient's pain or suffering is terminal sedation with loss of consciousness, death is a preferable alternative -- an argument also made in support of physician-assisted suicide.
Other NGOs that advocate for and against various euthanasia-related policies are found throughout the world. Among proponents, perhaps the leading NGO is the UK's Dignity in Dying
Dignity in Dying
Dignity in Dying is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to have 25,000 actively subscribing supporters...
, the successor to the (Voluntary) Euthanasia Society. In addition to professional and religious groups, there are NGOs opposed to euthanasia found in various countries.
External links
- Focarelli, Carlo. Euthanasia, Max Planck Encyclopedia of Public International Law
- Pratchett, Terry http://topdocumentaryfilms.com/terry-pratchett-choosing-to-die/, Choosing to die, a documentary by terminally ill author Terry Prachett