Euthanasia, Assisted Suicide, and Palliation

Euthanasia, an action taken by a health care practitioner intended to result in a patient's death, is illegal in the USA. Some patients whose life expectancy is reduced and who are suffering severely request euthanasia. Traditionally, euthanasia has been forbidden in medical practice, and purposeful intervention to end life disturbs most physicians and patients. However, in certain clinical situations involving hopelessness and suffering, death is the end of pain, not of meaningful life.

Assisted suicide, an action taken by a patient intended to cause his own death with drugs supplied by a physician, is illegal in all states except Oregon. Physicians can provide treatment intended to minimize physical and emotional suffering, even if a secondary result is the shortening of life, but they cannot specifically intend to hasten death.

The issue of palliation, or pain relief, is inextricable from that of assisted suicide for two reasons: (1) many dying patients have unrelieved pain or other intolerable symptoms, and (2) most patients requesting assisted suicide do not want to die; they just want the suffering to stop. The U.S. Supreme Court has emphasized the relevance and importance of the doctrine of double effect, which states that an intervention intended to relieve pain but that incidentally hastens death is still appropriate. If the physician's goal is to relieve suffering, then the action is protected.