Physician-assisted death (PAD) refers to the practice of a physician providing a potentially lethal medication to a terminally ill, suffering patient at their request that they can take (or not) at a time of their own choosing to end their life. It is also called physician-assisted suicide, physician aid-in-dying, medical aid-in-dying, and patient administered hastened death.
Deeper dive
Most states prohibit physician-assisted death, though there has been a recent flurry of legal activity. The practice was first legalized in Oregon in 1997, followed by Washington, Montana, Vermont, California, Colorado, Washington, D.C. , Hawaii, New Jersey, Maine, and New Mexico, according to The Hastings Center, a nonpartisan bioethics research institute. Last resort alternatives to PAD, include allowing patients to voluntarily stop eating and drinking and sedating patients to unconsciousness. These approaches have gained increasing acceptance to ease otherwise intractable end-of-life suffering.
- Physician-assisted death: the practice of a physician providing the means for a patient to end his own life, usually with a prescription for barbiturates that the patient takes himself; sometimes also called physician-assisted suicide.
- Euthanasia: painlessly killing or permitting the death of individuals who are ill or injured beyond hope of recovery.
- Voluntary active euthanasia: hastening one’s own death by use of drugs or other means, with a doctor’s direct assistance.
- Passive euthanasia: hastening death by withdrawing life-sustaining treatment and letting nature take its course.
- Involuntary euthanasia: causing or hastening the death of someone who has not asked for assistance with dying, such as a patient who has lost consciousness and is unlikely to regain it.
Dying patients who see their lives being destroyed by illness sometimes come to view death as the only way to escape their suffering and, therefore, as a means of self-preservation – the opposite of suicide.
The public remains deeply divided on the question of whether to permit physician-assisted death. In most surveys, approximately two-thirds of the U.S. population approve of it as an option for terminally ill patients with intractable suffering. But when the question of legalization comes to a vote, it is usually closer to 50/50. This split probably reflects the inherent tensions in the debate. On the one hand, most people know of cases of severe suffering, even with excellent palliative care, where the need for some predictable escape is very compelling.
There are real concerns that physician-assisted death could be used as a detour from effective palliative care, or as a way to eliminate the suffering of vulnerable patients by eliminating the sufferer. Proponents argue that allowing terminally ill patients to end their lives on their own terms is respectful of a person’s autonomy and allows that individual to die with dignity. Compassion & Choices is a leading advocate for this option. Opponents, including the Catholic Church and some disability rights groups, call physician-assisted suicide a form of state sanctioned murder and a violation of physicians’ Hippocratic Oath.