A closer look at Physician-Assisted Suicide and Euthanasia

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What is the difference between Physician-assisted Suicide (PAS) and Euthanasia?

Physician assisted suicide is when you end your own life with the assistance of a physician. Euthanasia is when a physician ends your life. Physician assisted suicide by it’s very nature is always a voluntary act. Euthanasia can be voluntary or involuntary.

If we put down animals when they are suffering and dying, why don’t we treat human beings with the same level of compassion?

The key to answering this question is to realize that civilized societies have always believed we should treat human beings differently than we treat animals. We have far better options for our human loved ones than resorting to ending their lives. With 21st century advances, we have highly effective forms of pain management that allow us to alleviate a person’s suffering without having to end their life.

Is a DNR (Do Not Resuscitate Order) the same as euthanasia or assisted suicide?

No. Most ethicists believe that there is an important distinction between killing someone and letting them die of natural consequences.

It’s my life and my body, why shouldn’t I be able to die in the time and manner of my choosing?

Even in a free and democratic society, everyone’s rights are not absolute. In Canada, we have the right to life, but not the right to die. If there existed such a right, it would put many vulnerable people groups at risk. Such a right may also pave the way for absurdities like being forced to empower suicidal teenagers who want to end their lives. Furthermore, according to the criminal code of Canada, it is currently a crime to “aid or abet” a person to commit suicide “whether suicide ensues or not.”

*UPDATE* On February 6, 2015, the Supreme Court of Canada struck down Canada's existing laws prohibiting assisted suicide and gave Parliament one year to draft a new law. The government subsequently was granted an extension and on April 14th, 2016 tabled a proposed amendment to the criminal code to allow assisted suicide in some cases. The text of the proposed legislation (Bill C-14) can be accessed here: http://www.parl.gc.ca/HousePublications/Publication.aspx?Language=E&Mode=1&DocId=8183660.

What about extreme cases where there is nothing that can be done for a person’s suffering like advanced brain cancer or ALS?

The fear of dying a painful death for those with incurable diseases is a very natural fear. Thankfully, with advances in palliative care, this is rarely the case. Even for those diagnosed with ALS (which is often viewed as a "worst case" scenario), current medical technology makes it unnecessary for such individuals to fear a painful death. Consider this very eye-opening article put out by the ALS Association: http://www.alsa.org/als-care/resources/publications-videos/factsheets/reasons-for-living-with-als.html 

For extreme cases where pain cannot be managed, there is the option of continuous palliative sedation therapy (CPST). CPST is when a patient is intentionally put into a continuous state of deep sleep so they are no longer suffering. CPST should be used as a last resort for those whose suffering cannot be managed by any other means. CPST is ethical so long as the intent is to alleviate suffering and not to hasten death. The benefit of CPST over euthanasia is that CPST is reversible, whereas euthanasia is not.

To learn more about Canadian practices surrounding CPST visit:
http://www.chpca.net/media/343120/final_cpst_framework.pdf

What is Palliative Care?

The World Health Organization defines Palliative Care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psycholocial and spiritual.”