The increased interest in physician aid in dying/assisted suicide is one of the reasons for the growth in palliative care and hospice care.
The word euthanasia is combination of the Greek eu= good, and thanatos = death. Literally and etymologically it therefore means “good death”. Historically and scholarly, euthanasia in the strict- and in the Dutch context the only proper- sense refers to the situation in which a doctor kills a person who is suffering “unbearably” and “hopelessly” at the latter’s explicit request (usually by administering a lethal injection)… and euthanasia is in the Netherlands reserved for killing on request. In concrete terms, euthanasia invovles injecting the patient with two types of eubstances: barbiturates to induce coma, followed by neuromuscular blockers which cause respiratory muscle paralysis. The consequent anoxia and cardiac arrest bring on immediate death.
In contrast to euthanasia, the doctor is not the final actor in physician-assisted suicide (PAS, also known as Physician assisted death – PAD) but instead a lethal medication is prescribed by a physician at the patient’s explicit request, and is self-administered by the patient with the aim of ending his/her life. PAD has been legalized in six states (California, Montana, Oregan, Washingon, Colorado, and Vermont). Each state stipulates carefully the circumstances in which such activity may be undertaken, and provides careful delineation of the processes involved. The key difference between the two is that with PAD the patient self-administers the medication and with euthanasia it is physician administered. Euthanasia is against the law in all states. While there has been increasing discussion about the practice and legalization of PAD in the United States, the topic remains highly controversial. There is general agreement among nursing organizations that nurses’ participation in PAD and euthanasia are contrary to the ethical noms of the nursing profession.
