Life SA

Euthanasia – what is it?

Euthanasia and the law

Palliative care

Public perceptions

Quotes from the Senate Select Committee

Euthanasia is presently understood to mean ‘good’ ‘happy’ ‘easy’ ‘painless’ and ‘compassionate’ death. The word ‘euthanasia’ is derived from two Greek words, ‘eu’ which means ‘good’ or ‘well’ and ‘thanatos’ which means ‘death’. Euthanasia is now misleadingly being used to promote ‘mercy killing’ which denotes the painless killing of human beings. Euthanasia does NOT mean to take life even in a ‘good manner’ or in a ‘proper way’.

A request to be killed is usually a call for help – a call for more loving and caring treatment. Experience has shown that people asking to be killed are saying they are fearful of pain and neglect. We must oppose the active killing of any patient even when the patient has consented or has asked to be killed. If the State were to allow this type of action, the door would be open to widespread abuses which would threaten our society.

The right to life of an individual is threatened when that individual is considered to be a burden, or that person’s life is considered meaningless or worthless.

People should be entitled to die with dignity and with adequate relief of pain and suffering. Such adequate relief of pain should be provided even where this may unintentionally cause a shortening of the patient’s life. This is not ‘killing’ in any sense of the word.

Death is a process that takes place over a period of time. It involves several stages. The death process has reached an irreversible state when there is lack of brainwave activity over a specific period of time. Prior to this state, breathing, or the heart, or both, may stop but the death process may not be irreversible at this time. With the use of a respirator or heart stimulator some patients recover. Only the doctors at the bedside are competent to judge whether the patient would recover if revived. If recovery is possibly, then active resuscitation is called for.

If the death process has already reached an irreversible stage, then active resuscitation is not needed and should be withheld. Nevertheless, no person should be permitted to kill or hasten the death process in such a patient. Ordinary care such as warmth and nourishment and general nursing care should be provided until the patient is pronounced ‘dead’.

Question: Is there at present anywhere in the world legislation which allows voluntary euthanasia?

The horrors of the mass-destruction in the Third Reich of Jews, of people who were senile or psychotic and of children who were severely handicapped, arose directly from a policy of restrictive voluntary euthanasia in the first instance. These atrocities led international medical organisations to ‘Condemn the practice of euthanasia under any circumstance’ (Resolution adopted by the General Assembly of the World Medical Association in 1950).

The Dutch experiment

An article reproduced in an edition of the Journal of Medical Ethics states:

The authors reviewed the findings of a large 1995 survey into end-of-life decisions by Dutch doctors. This survey involved interviews with 405 doctors and questionnaires mailed to physicians who had attended more than 6000 deaths.

In the Netherlands, physician-assisted death is subject to criminal law, but is widely practised according to safeguards established by the courts and the Royal Dutch Medical Association.

However, the authors said the 1995 study indicated these safeguards were not being adhered to. For example, almost 60% of cases went unreported and unchecked.

In 17% of the 3600 cases of euthanasia and assisted suicide, there had been treatment alternatives available, attending physicians reported. This breached the guideline that doctors should not hasten death when the alternative of palliative treatment was available, the paper said.

The intentional shortening of patients’ lives without their explicit request was also not uncommon. One in five cases in which the doctor said they intentionally ended a life involved no explicit request from the patient.

The main reason for not discussing the issue was reported to be patient incompetence, for example due to dementia. But in some cases, the doctor could have addressed the issue but did not because they felt euthanasia was in the patient’s best interests

“Dutch claims of effective regulation ring hollow”, the authors said.

Journal of Medical Ethics 1999:25:16-21.