Questions

What is physician-assisted suicide?
Physician-assisted suicide (PAS) occurs when a doctor writes a prescription for a drug that will end the life of a patient. The patient then must have the prescription filled at a pharmacy and self-administer the drug, which in most cases occurs at home.

What is difference between physician-assisted suicide and euthanasia?
The most important difference is in who commits the final action that results in death. With euthanasia, that action is performed by a doctor or other individual, such as giving a patient a lethal injection. In PAS, physicians or other health care professionals prescribe and instruct but cannot administer the drug and are almost never present at the patient’s suicide.

Without legalized physician-assisted suicide, are patients forced to stay alive?
No. PAS is not related to the withdrawal of feeding tubes, intravenous fluids, breathing tubes, etc. or the refusal of certain life-saving treatments. By law, no patient is required to accept or continue life-saving or life-prolonging treatments against their will.

Is “aid in dying” and “death with dignity” the same as physician-assisted suicide?
Yes. These terms are used primarily by proponents of legalized PAS in order to avoid the use of the word “suicide” and make the topic more socially tolerable.

How prevalent are physician-assisted suicide laws?
Currently, only three states, Oregon (1994), Washington (2008) and Vermont (2013), have legalized PAS. The New Hampshire legislature overwhelmingly rejected PAS in March, 2014. And an attempt through referendum to legalize PAS in Massachusetts was defeated in November, 2012. Over 100 legislative proposals in various states – and numerous referendums – have failed to legalize PAS. Two states, Montana and New Mexico, allow PAS through court decisions. However, the New Mexico decision is currently being appealed by the State Attorney General and is not in effect.

Is the fear of pain the biggest reason patients consider physician-assisted suicide?
No. Pain is a motivating factor in only the minority of cases. According to the Oregon Public Health Division concerning physician-assisted suicides in 2013, “As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (93.0%), decreasing ability to participate in activities that made life enjoyable (88.7%), and loss of dignity (73.2%).” Fear of being a burden on family and friends was a concern in 49.3% of the cases, while fear of pain was a concern in only 28.2 %.  [ “State of Oregon Death with Dignity Report 2013,” Oregon Public Health Division]

Does opposition to physician-assisted suicide come primarily from religious groups?
No. Although religious groups, such as the Catholic Church and other denominations strongly oppose this type of legislation, many other groups have spoken out loudly against PAS. Organizations representing the medical, hospice, disability and elderly communities are all strong opponents of PAS, as is the American Medical Association.

Why is physician-assisted suicide illegal in so many states?
Laws against PAS are in place to prevent abuse, exploitation and erosion of care, and to protect vulnerable people from those who might use the act for personal gain or other unscrupulous reasons.

But shouldn’t people have the right to commit suicide?
In the U.S., suicide and attempted suicide are not criminalized. However, PAS is very different in that it is not a private act. Rather, it involves a third party facilitating the death of another.

What does the medical community think of physician-assisted suicide?
In 1993, the American Medical Association took a position against physician-assisted suicide: “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Patients should not be abandoned once it is determined that cure is impossible. Multidisciplinary interventions should be sought including specialty consultation, hospice care, pastoral support, family counseling, and other modalities. Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”   [“Opinion 2.211 – Physician-Assisted Suicide”, American Medical Society, adopted 1993, updated June 1996]