We have made great strides in improving end-of-life care through palliative care and hospice programs, but sometimes it's just not enough. The care we offer our elderly and chronically ill in America is still less than ideal. An estimated 40-70% of patients die in pain, another 50-60% die feeling short-of-breath; 90% of nursing homes, where patients go to receive 24 hour nursing care, are gravely understaffed.
Patients who remain at home with family providing care often feel like they are a burden on their caregivers, and they may well be. Medicare and state and federal Medicaid systems don’t cover the cost of hiring in-home care-giving support. The physical, psychological, emotional, financial, and social strain on caregivers is very real.
Chronic and life-limiting illness can also make a person feel like they have lost all control of their lives. The body isn’t doing what it should and there’s no way to stop it. Physician-assisted suicide (PAS) may feel like a way to regain some of that control. If they can’t control the illness, they can at least control how they die.
Quality of life is the driving force behind patients seeking PAS. Loss of autonomy, or not being able to care for oneself and make ones own decisions, is reported in 100% of cases of PAS in Oregon. Closely following are the loss of one's dignity and the loss of being able to participate in enjoyable activities, both reported in 86% of PAS cases in Oregon. It goes without saying that physical suffering greatly diminishes quality of life as well.
For those who are suffering in their final days of life, death can be a welcome event. They may feel that it will permanently relieve their suffering and alleviate the burden on their loved ones. Physician-assisted suicide may seem like the best option for them and their families.
Some Physician-Assisted Suicide Statistics
In the U.S.:
- Between 1994 and 2006, there were 75 legislative bills to legalize PAS in 21 states and all of them failed.
- Currently, PAS is legal in three states: Oregon, Washington, and Montana.
- The reasons patients gave when requesting PAS in Oregon:
- 86% reported a decreasing ability to participate in activities that made life enjoyable
- 100% reported loss of autonomy, and
- 86% reported loss of dignity
- Of those patients in Oregon that request PAS, roughly 62% of them actually complete it.
- 90% of those patients died at home.
- 88% of them were on hospice.
- Physician assisted suicide accounts for 15.6 per 10,000 deaths in Oregon.
In Canada: Physician-assisted suicide is still illegal.
In the Netherlands:
- Physician assisted suicide is legal under strict circumstances.
- The right to choose physician assisted suicide remains highly favored.
In the U.K.: Physician-assisted suicide is illegal. The current movement there is to focus on palliative care, not euthanasia.
Elsewhere in the World: Physician assisted suicide is legal in the following countries under strictly defined regulations:
Oregon State Summary of the Death With Dignity Act for 2007
Ira Byock, M.D., Both sides are wrong in suicide debate; Burlington Free Press, February 7, 2005