The practice of euthanasia is controversial, with significant cultural and religious debates in many nations, and is considered a criminal offense in most countries. It can be voluntary or involuntary, but most commonly it is the voluntary act of a patient with full decision-making capacity requesting their death. Euthanasia can be legal under specific conditions, and administered by medical personnel under strict guidelines. In cases where a physician executes the procedure, it would be considered physician-assisted suicide. Active euthanasia is also termed aggressive euthanasia by some accounts, while passive euthanasia is also termed assisted suicide or palliative technology for pain management. Euthanasia can take place through several methods, such as lethargy deprivation, intentional death by starvation, interruption of medical treatment, or direct application of lethal drugs.
According to the U.S. Department of Health and Human Services, euthanasia by lethargy deprivation involves the intentional sedation of a patient until they lose consciousness and then decreased oxygen consumption until they die. This method involves an excessive amount of anesthetic drugs, which can be given to the patient intravenously, or with a gas mask to induce death (Castelli Dransart 2021). It is administered in low doses, to begin with, and then increased in moderate increments that are not needed to maintain consciousness, until the patient is comatose (Andriessen 2019). Nonetheless, the dosages are not lethal, and death is due to the body’s inability to survive without oxygen. This method is used when patients are in a state of irreversible coma, where they are unable to respond or comprehend their surroundings or be aware of the procedure (Castelli Dransart 2021).
Also, intentional death by starvation, commonly referred to as involuntary euthanasia, is the deliberate withholding of food and fluids to induce unconsciousness. This method works as a last resort to avoid inflicting suffering on patients when other methods are unavailable or not sufficient (Calati 2021). It is administered in low doses and can be done over a long period, while still allowing the patient to survive. This can be accomplished through direct or indirect means, such as through the use of a feeding tube or otherwise restricting access to food and fluids (Andriessen 2019). When used directly, it is referred to as “active voluntary euthanasia” and when used indirectly, it is termed “passive voluntary euthanasia”. The practice of involuntary euthanasia is controversial and is often considered a violation of human rights (Calati 2021).
Moreover, interruption of medical treatment is also a form of euthanasia and can include dialysis, incubators, or medical ventilators. It can be carried out directly or through withholding procedures. This can be performed by both family members and healthcare professionals (Castelli Dransart 2021). Indirect interruption or withholding of medical treatment is referred to as passive voluntary euthanasia, while direct interruption is described as passive involuntary euthanasia (Dierickx 2020). An example of direct interruption is turning off or disconnecting medical machinery in an effort to end life support. When there are no longer any curative treatments available, and the treatment can only be palliative, it can be considered legal to administer passive voluntary euthanasia (Andriessen 2019). An example of an indirect interruption is the removal of morphine from a medication, which can cause patients to be in severe pain before death.
On the other hand, the direct application of lethal drugs, commonly referred to as assisted suicide, is the act of deliberately giving a patient a dose of drugs or substances sufficient to cause their death. This process is commonly used with patients who have terminal diseases and those who are suffering from unbearable pain that cannot be alleviated through any other methods (Dierickx 2020). It is commonly referred to as suicide, though in some cases it may be used instead of homicide or suicide. This can be given by physicians, pharmacists, or other healthcare professionals, who are either independent contractors or employees of a medical facility (Calati 2021). It can also be given by family members that are so concerned about the patient’s quality of life and well-being that they will give them a lethal dose if the patient requests it. This practice is not always accepted by medical personnel and has been described as unethical and immoral, but is allowed in limited cases with patients who are terminally ill or suffering from an incurable disease (Dierickx 2020).
Euthanasia can be carried out in several ways, including depriving an individual of lethargy, starving them to death on purpose, stopping their medical care, or administering deadly medications directly. Death by euthanasia is a controversial subject and it has often been shown to conflict with many ethical codes and laws. Many cultural, legal, and ethical debates surround this subject, such as the moral, religious, and medical implications of using lethal substances on another person. In some cases, euthanasia can be lawful depending on the context of the situation or country that is being discussed. Nonetheless, death by euthanasia is still a common practice in the modern world, though not always accepted or condoned by most societies.
References
Andriessen, K., Krysinska, K., Dransart, D. A. C., Dargis, L., & Mishara, B. L. (2019). Grief after euthanasia and physician-assisted suicide. Crisis.
Calati, R., Olie, E., Dassa, D., Gramaglia, C., Guillaume, S., Madeddu, F., & Courtet, P. (2021). Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature. Journal of Psychiatric Research, 135, 153-173.
Castelli Dransart, D. A., Lapierre, S., Erlangsen, A., Canetto, S. S., Heisel, M., Draper, B., … & Wyart, M. (2021). A systematic review of older adults’ request for or attitude toward euthanasia or assisted-suicide. Aging & Mental Health, 25(3), 420-430.
Dierickx, S., Onwuteaka-Philipsen, B., Penders, Y., Cohen, J., van der Heide, A., Puhan, M. A., … & Chambaere, K. (2020). Commonalities and differences in legal euthanasia and physician-assisted suicide in three countries: a population-level comparison. International Journal of Public Health, 65(1), 65-73.