Assisted death is an umbrella term loosely defined as the practice of ending a patient’s life to relieve their suffering, typically when terminally ill. This often involves a doctor providing a patient with the means of ending their life, for example, with a drug. Here, we will be discussing mainly euthanasia, which is defined as the painless killing of a patient to end their pain. This topic is highly debated and very controversial; many countries have different policies on it. There are many countries which allow for euthanasia under different conditions, for example in, Belgium, Netherlands, Canada, etc., while there are others that have completely banned it, such as the United Kingdom, Germany, and Turkey. 

In healthcare, autonomy refers to the patient’s right to make informed decisions about their own treatments and health. Especially in end-of-life care, this application of autonomy is vital; patients often feel the most helpless at this stage, usually being bedridden or overwhelmed with pain. It is based on this principle that people argue for euthanasia; not only is the patient given autonomy in their own care, but they also get relief from their pain. An important point to add here is that many of the people who argue for euthanasia argue that death is a private issue and individual to the patients, and therefore, state law should have no say in such matters.

But what about the family? This is where this idea of society or outside forces comes into play. What happens if a patient’s family wants them to live as long as possible? In this case, should healthcare professionals act prioritize the patient’s wishes or the family’s desire?  And for those who may argue that it’s a patient’s right to decide and that their family should support them, is that really the case? I have observed that a patient’s family is a pivotal factor when considering a patient’s care. As a volunteer at a hospice, I interact mainly with the family members of the patients. I can recall one experience speaking with a woman whose father had been admitted to the hospice; understandably, she was extremely worried. She lived far away from Massachusetts and was leaving that evening. She was very concerned with how her father would be fed and repeatedly mentioned how she was worried that her father would die of starvation. As volunteers, our job is to comfort the family members as best we can. However, this example demonstrates how important a family member’s thoughts and concerns are in the hospice setting. Whenever she came to the nurse with a problem, the nurse immediately went to help. Even when I was getting trained, I was repeatedly told that a family member’s concerns were not to be taken lightly; hearing out their concerns and actively listening to them as a volunteer was crucial. And if the concerns of a family have to be taken that seriously among volunteers, shouldn’t medical professionals take the family’s concerns even more?

Keep in mind that this is not the only thing to consider in arguments against euthanasia. There are other arguments; if we allowed for euthanasia, what if it progresses into involuntary euthanasia? Practically speaking, there is no way to regulate euthanasia, and frequenting the practice of it would undermine the commitment that doctors have to saving/preserving a patient’s life. It could also possibly discourage research for new treatments for the terminally ill. Another argument is that if the care is doing its job, the patient shouldn’t feel any pain in the first place, eliminating the need for euthanasia.  This is where another debate gets introduced: in many cases, opioids are what are used to eliminate a patient’s pain. So, how ethical is it to use these opioids to ease a patient’s pain? To answer the question of euthanasia, perhaps this is the first question that needs to be answered.

Another factor of euthanasia to consider is politics. In the United States, the topic of euthanasia and its legality is very nuanced. All 50 states completely ban involuntary euthanasia. This type of euthanasia is generally considered murder and occurs when a medical professional kills or allows a patient to die, even though they want to live. However, assisted suicide is legal in 10 states: Washington DC, California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii and Washington. Assisted suicide is where a healthcare provider gives a patient a lethal drug for a patient to take themselves. It is particularly noteworthy how there are no federal laws on euthanasia or assisted suicide. 

It is here that we can draw a comparison to how the beginning of life is handled in the US. Just up until a few years ago, there was a federal court decision about abortion, and that was Roe V. Wade, which said that states couldn’t unduly restrict abortion access. To compare more directly, why was there a decisive federal decision about abortion but not about anything related to the end of life? Currently, there are heated debates over abortion, whether to ban it or allow it. Should there be extremely tight regulation or no regulation? I offer this point simply to contrast how the end of life is thought about and precisely how both topics are treated. Today, we talk and openly debate about abortion, or more broadly, the beginning of life, but why don’t we do the same with the end of life? Shouldn’t we theoretically be discussing this topic of euthanasia and assisted death the same way? Should it be tightly regulated or have no regulation? Would end-of-life care practices improve if we talked more openly about these issues?