Assisted suicide occurs when one person helps another to end their life. It's legal in various countries and states, typically for mentally competent adults with terminal illnesses expected to live for six months or less. This practice is often viewed as a means to relieve suffering, but remains highly contentious.

What’s the Difference Between Assisted Suicide and Euthanasia?

The terms assisted suicide and euthanasia are frequently mixed up but have distinct differences. 

Assisted Suicide versus Euthanasia

• Assisted suicide occurs when a person, typically a physician, provides drugs upon the patient's request, which the patient then self-administers to end their life.
• Euthanasia involves someone intentionally ending another person's life, often performed by a physician. 

The crucial disparity lies in the act: assisted suicide empowers the patient to end their life, while euthanasia involves another party actively ending the patient's life.

Types of Euthanasia

• Active euthanasia: This involves a deliberate action, like administering a lethal drug, and can be either voluntary or involuntary, depending on the patient's consent.
• Voluntary active euthanasia: A patient explicitly requests euthanasia, and a physician or another individual carries it out.
• Involuntary active euthanasia: Here, a patient's life is ended by a physician or another party without their consent.
• Passive euthanasia: This occurs when life-saving treatment, such as a feeding tube or ventilator, is withheld from a patient.
  

There Is Much Disagreement Among Use of the Term 'Assisted Suicide'

Several organizations, such as the American Academy of Hospice and Palliative Medicine and the American Public Health Association, oppose labeling assisted suicide as "suicide" because the intention to end one's life when faced with a terminal illness differs from traditional suicidal behavior. Additionally, they argue that the term can carry stigmatizing connotations. Meanwhile, some critics challenge the term "physician-assisted suicide" for its emphasis on the physician, which they argue undermines the patient's agency by implying that the physician holds the decision-making power, thus potentially detracting from the patient's autonomy and involvement in the decision-making process.

Alternative Terms: Hastened Death, Assisted Dying, and Medical Aid in Dying

In light of these debates, some propose adopting terms like "hastened death" or "assisted dying" to encompass both euthanasia and assisted suicide.

Conversely, many favor the term "medical aid in dying" as a substitute for assisted suicide:

• It denotes a practice where a mentally competent adult with a terminal illness receives a prescription medication from their doctor.
• This medication allows them the option to peacefully end their life by self-administration.

Where Is Assisted Suicide Legal?

Public opinion increasingly favors assisted suicide and euthanasia. According to a 2018 Gallup poll, 72% of Americans support legalizing euthanasia, while 65% support legalizing assisted suicide.

However, only a handful of states—California, Colorado, Hawaii, New Jersey, Oregon, Washington, Washington D.C., and Vermont—permit doctor-assisted suicide, with none allowing euthanasia.

Internationally, Switzerland and certain parts of Australia legalize assisted suicide, while the Netherlands, Belgium, Luxembourg, Canada, and Colombia allow both assisted suicide and euthanasia.

The criteria for permitting euthanasia or assisted suicide vary by jurisdiction. In the Netherlands, for instance, individuals over 12 (with parental consent required for those under 16) can request euthanasia or assisted suicide if they're enduring unbearable, unimprovable suffering. In contrast, Oregon and Vermont only allow assisted suicide for patients with terminal illnesses.

A Brief History of Assisted Suicide

In the 5th century BC, Hippocrates, the Greek physician who authored the Hippocratic Oath, explicitly prohibited new physicians from participating in assisted suicide. However, historical records suggest that some physicians aided terminally ill patients in ending their lives, despite no explicit prohibition.

By the 13th century, widespread adoption of Judeo-Christian beliefs, which oppose suicide under any circumstances, largely discouraged the practice of physician-assisted suicide.

Nevertheless, throughout history, some medical professionals have been willing to assist terminally ill individuals in hastening their deaths.

How Prevalent Is Assisted Suicide?

As of 2021, Canada leads in the number of deaths attributed to assisted suicide or euthanasia, with a rapid increase in recent years following the legalization of the practice in 2015. In 2021, Canada extended approval for individuals with irremediable medical conditions and unbearable suffering, even if not terminally ill.

Consequently, assisted suicide and euthanasia accounted for 3.3% of all deaths in the country in 2021. Following Canada, the Netherlands, Belgium, and the United States report significant numbers of deaths from assisted dying.

A study suggests that in regions where assisted suicide or euthanasia is legal, such occurrences remain relatively rare, with estimates ranging between 0.3% and 4.6% of deaths each year.

What Motivates Assisted Suicide?

Research indicates that in the United States, the main reasons for seeking assisted suicide are the loss of dignity and autonomy, as well as the inability to engage in activities that bring joy to life. Pain is cited as a factor by a minority of patients. Globally, the majority of requests for euthanasia and assisted suicide come from individuals diagnosed with cancer, accounting for over 70% of cases.

What to Know About the Arguments For and Against Assisted Suicide

Arguments For Assisted Suicide

• Advocates argue that individuals should have autonomy over their lives, including the timing of their death.
• Those with terminal illnesses or irreversible conditions should have the right to a dignified death on their own terms.
• Physicians and caregivers have a duty to alleviate suffering, and granting requests for assisted suicide can be an act of compassion.
  

Arguments Against Assisted Suicide

• Requiring healthcare professionals to participate in assisted suicide conflicts with their moral beliefs or the Hippocratic Oath.
• Assisted suicide contradicts the moral principles of several religions.
• Concerns arise about the potential expansion of assisted suicide to include individuals with disabilities, mental health issues, or dementia, leading to pressure to end their lives.
• Financial constraints may influence decisions towards assisted suicide over costly end-of-life care.
• Mental health complexities complicate the decision-making process, especially for individuals suffering from depression or other mental illnesses.
• Normalizing assisted suicide may lead to its routine use for various conditions rather than as an exceptional measure for limited circumstances.
• Emphasis should be placed on improving end-of-life care and symptom management rather than promoting assisted suicide.
• Evaluating mental competence for assisted suicide requests can be challenging.

How Assisted Suicide Impacts Loved Ones

Research indicates that most individuals whose family members died from assisted suicide experienced similar mental health outcomes as those whose family members died from other causes. Additionally, those whose loved ones opted for hastened measures showed fewer traumatic grief symptoms compared to those whose loved ones died of natural causes. However, certain studies suggest a higher prevalence of post-traumatic stress disorder (PTSD) and depression among those whose loved ones underwent medical assistance in dying, particularly when lacking sufficient social support and perceiving less social acceptance of such practices.

Conversely, some cases suggest that openly discussing death with a loved one facilitated the acceptance of their impending death for friends and family members. Moreover, family members of individuals who died by assisted suicide reported feeling more prepared and accepting of the death.