Should doctors help patients end life?  Advocacy for legitimating physician-assisted suicide and euthanasia has been a highly debatable topic around the globe with a clear divide on opinions till date.

 

 

 

 

 

 

Recently, Australia legalised euthanasia when the medical condition of a patient was terminal or when the patient no longer desired to seek further treatment in case the disease was intractable or if the treatment was too painful or harsh.Read the full story here.

 

Here, we give a round-up of where the world stands on this thorny issue of assisted dying.

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 The Netherlands

The country was first to legalize euthanasia. It did so in 2002 to allow people to die if they no longer wished to live with their medical condition and if it became unbearable for them. It also required the patient to be in full consciousness to be able to take the decision, with no proxies allowed in most conditions. In 2010, 3,136 people were given a lethal cocktail under medical supervision.

The practice called palliative sedation is induced wherein the patients are put in a medical coma and their nutrition and water intake is stopped. The legislation, however, has provoked a debate over the granting of this new right, because suicide for non-ill patients is still counted as homicide.

One striking finding that the Dutch government has found is that around 10% to 15% of the people who look for this information actually commit suicide. The government and other organizations now provide help and assistance to patients and ensure that the decision of withdrawing from treatment is taken after appropriate consideration.

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France

Euthanasia is still unlawful. François Hollande had promised a review of the practice of dying with dignity, but the French government has been circumspect to bring forth this practice into law.

In 2005, France promulgated a law wherein the patient could refuse treatment which was harmful, had multiple side effects or which was too unbearable for the patient. In a recent case, one of France's courts authorised doctors to stop treating and feeding a young man who had been in a vegetative state on life support for six years. The patient's parents have appealed to the European court of human rights and are awaiting a decision.

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United States

Doctors are allowed to prescribe lethal doses to terminally ill patients in five U.S. states. Euthanasia, however, is illegal. Recently, assisted dying has made inroads into the community, but the issue is debated.

Oregon first legalised assisted suicide in 1997 and allowed for terminally ill, mentally competent patients with less than six months to live to request a prescription for life-ending medication. The State of Washington approved a similar law later. Recently, Vermont, Montana and New Mexico have allowed similar life-ending prescriptions. In 2013, roughly 300 terminally ill Americans were prescribed lethal medications, and around 230 people died as a result of taking them. Patients can also refuse the prescription if they change their mind.

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Germany and Switzerland

In German-speaking countries, the term "euthanasia" is generally avoided because of its association with the eugenicist policies of the Nazi era. The law, therefore, tends to distinguish between assisted suicide (beihilfe zum suizid) and "active assisted suicide" (aktive sterbehilfe).

In Germany and Switzerland, doctors cannot prescribe lethal medications except in certain circumstances. In Germany, assisted suicide is legal as long as the lethal drug is taken without any help, guidance or if someone is helping the patient hold or take the medication. Switzerland allows the patient to die only if there are no self-seeking motives of their relatives. It has also allowed the creation of organizations such as Dignitas and Exit, which provide assisted dying services for a fee.

Nearly 66% of Germans support a law that enabled active assisted suicide too. But the government has announced it wants to tighten the law around assisted suicide, however, the ministry of health has noted it would seek to tighten the law instead of allowing organizations to assist it.

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Belgium

Belgium passed a law in 2002 legalising euthanasia, becoming the second country in the world to do so. The law says doctors can help patients to end their lives when they freely express a wish to die if they are suffering unbearable pain. Patients can also receive euthanasia if they have clearly stated it before entering a coma or similar vegetative state. Assisted suicide is not mentioned in the law, which does not specify a method of euthanasia. However, unlike the U.S., the doctor can be present while the drugs are administered. Belgian euthanasia cases rose to 1,807 in 2013, compared with 1,432 in 2012, 708 in 2008 and 235 in 2003. In February 2014, Belgium became the first country to legalise euthanasia among children but only while they were close to death and beyond any cure. Parental assent is required for these cases, however, there have been no cases reported of children submitting such requests.

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India

India has allowed passive euthanasia wherein the medical establishment can withdraw life support and nutrition to patients who are in a permanent vegetative state. However, in other cases, the practice mostly remains illegal. Active euthanasia remains illegal, wherein death is actually induced through medications. The case of Aruna Shanbaug who remained in a vegetative state until 2015 was a major legal landmark in India wherein the court rejected her petition to end her life. In India, those in permanent vegetative states can be provided passive euthanasia and those who are brain dead can be allowed passive euthanasia through withdrawal of life support. The allowance of active euthanasia and euthanasia in other cases including terminal illness remains debated, although legally, there is no current case or legislation which is discussing or considering it.