What Is Euthanasia?

Euthanasia is when a doctor gives someone who is dying medication that will end their life.

Some use the terms assisted suicide, physician-assisted death, physician-assisted suicide, and mercy killing as synonyms for euthanasia. But legal and medical experts define these differently.

This article defines euthanasia, explains how it is distinguished from assisted suicide, and explores some of the legal limitations around this practice.

What Is Assisted Suicide?

Assisted suicide is when severely or terminally ill people end their life with someone else’s help. There are many different ways that a person might help with a suicide, but assisted suicide is generally defined as follows:

• The person who wants to end their life has asked for help.
• The person understands what they are asking for will cause death.
• The person assisting knows what they’re doing. They intentionally help.
• The person assisting provides medication to the person who is ending their life.
• The person who wants to die takes the drugs themselves.

In physician-assisted suicide, a doctor provides medication to the person who wants to end their life. The doctor may also give instructions on how to take the medication so it will cause death. But the doctor does not inject the medication or even help the sick person swallow a drug.

How Euthanasia Differs

Euthanasia is different than assisted suicide because, with euthanasia, the doctor actually administers the medication that causes death.

For example, a doctor may inject a dying person with drugs that will stop the heart.

Usually, euthanasia happens in a hospital or medical facility.

Types of Euthanasia

There are two types of euthanasia:

• Voluntary euthanasia: The sick person asks the doctor for help and the doctor agrees. Both act willingly.
• Involuntary euthanasia: Someone causes a sick person’s death without the sick person giving permission.

Legal Issues

Laws for assisted suicide and euthanasia vary by state and country.

Where Assisted Suicide Is Allowed

In the United States, physician-assisted suicide is allowed in:

• California
• Washington
• Oregon
• Montana
• Colorado
• New Mexico
• Hawaii
• Maine
• New Jersey
• Vermont
  
• Washington D.C.

Several countries have also passed laws allowing doctors to assist with a suicide.

If a doctor or anyone else actually gives the person the lethal medication, the act is considered euthanasia. That can be a crime even in areas that have assisted-suicide laws.

Where Euthanasia Is Allowed

Voluntary euthanasia is illegal in the United States and most parts of the world. Countries that do allow it include:

• Belgium
• The Netherlands
• Luxembourg
• Canada
• Colombia

Involuntary euthanasia is illegal worldwide.

Who Can Choose It?

In places where voluntary euthanasia and physician-assisted suicide are legal, they’re only allowed if you have a terminal diagnosis. “Terminal” means you cannot be cured and doctors expect you to die from your illness.

In order to legally end your life, you may also be asked to show that you’re suffering severely from pain. Under the law, you may then be allowed to decide when and how you want to die.

People in many states and countries are calling for more laws that will allow them to choose when and how to end their lives. They call this "dying with dignity." It's a topic that is hotly debated.

While a growing number of people think assisted suicide or voluntary euthanasia should be allowed, many others disagree. Those people say that it’s not morally or ethically right for doctors to help people die.

In 2019, the American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) sought to update their stance on assisted suicide. They revealed two divergent and equally valued opinions on the matter.

On the one hand, many doctors argue that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Doctors should work on making terminally ill patients comfortable, not helping them die.

On the other side, doctors argue that “a physician shall have compassion and respect for human dignity and rights.” By responding to the request of their patient to provide a lethal dose of medication that will relieve intractable pain and suffering of an incurable disease, a doctor is indeed expressing the highest level of care and compassion while supporting dignity at the end of life.

The AMA stands divided, concluding that physicians who legally participate in physician-assisted suicide are following their professional, ethical obligations as are the physicians who decline to participate. Most importantly, there should be full voluntary participation on the part of both patient and physician in these sacred decisions about how to approach end of life care.

Is Palliative Sedation Euthanasia?

No, nor is it physician-assisted suicide. Palliative sedation is when a doctor gives a terminal patient medication that will ease severe pain. This practice is sometimes more acceptable to people who disagree with assisted suicide or voluntary euthanasia.

The AMA Code of Medical Ethics says it’s acceptable for doctors to give sedatives to patients who are suffering, which are drugs that can relax the body and put you to sleep. In these instances, the patient may remain unconscious until their time of death. However, the drugs should never be used to intentionally cause a person’s death.

Palliative sedation requires:

• Permission from the person who is sick or whoever is in charge of their healthcare decisions if the patient is unable to understand the situation and give consent
• A health care professional who can administer the drugs

Palliative sedatives are usually given in an IV that goes directly into the bloodstream or as a suppository. A suppository is medication that’s inserted into your rectum where it dissolves into the body.

Because the medication is fast-acting, sedatives must be given by a physician, nurse, or other health care professional.

People do sometimes die while under heavy sedation, but that is not the goal of the treatment. In these cases, it may not be clear whether someone died because of the medication or the illness.

Summary

There are clear legal differences between euthanasia and assisted suicide. In euthanasia, a doctor performs an act that causes someone’s death. In assisted suicide, a doctor gives an ill person the lethal means they can then use to take their own life.

The arguments for or against ending a person’s life are never neat and clear.

It’s also important to understand that these are not the only ways to help a terminally ill person who is in severe pain. Palliative medicine and hospice care may offer other options for easing a loved one’s suffering.

A Word From Verywell

Whether or not to help someone die is an overwhelming question to consider. There are also legal issues to think about.

Ultimately, you must decide what is the right thing to do. If you have a loved one who is seriously ill, you should discuss all sides of the issue with them sooner rather than later. This way, you can make the best decisions when it’s time to think about their end-of-life care.