Assisted dying

Eligibility criteria in voluntary assisted dying legislation determine access to assistance to die. This article undertakes the practical exercise of analysing whether each of the following nine medical conditions can provide an individual with access to voluntary assisted dying: cancer, motor neurone disease, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer’s disease, anorexia, frailty, spinal cord injury and Huntington’s disease. This analysis occurs across five legal frameworks: Victoria, Western Australia, a model Bill in Australia, Oregon and Canada. The article argues that it is critical to evaluate voluntary assisted dying legislation in relation to key medical conditions to determine the law’s boundaries and operation. A key finding is that some frameworks tended to grant the same access to voluntary assisted dying, despite having different eligibility criteria. The article concludes with broader regulatory insights for designing voluntary assisted dying frameworks both for jurisdictions considering reform and those reviewing existing legislation.

CARDAN E&V, Death and Medicine, 2016

This book consists of 21 chapters dealing with the entire series of important peri-mortem issues; it is neither a handbook nor a simple lecture, but a compendium of general medical knowledge on death.
Beyond a couple of short introductory chapters examining the various ways of dying and their semiotics, a good part of the text considers a range of pathologies in terms of their causal relationship to death. The first of these takes a detailed look at medical conditions of interest to intensive care units, including cardiac arrest and resuscitation, chemical pneumonia, malignant hyperthermia, drowning, and electrocution. Smoking, alcoholism, and irradiation disease come next, whereas the remaining pathologic entities are ‘allocated’ a place according to how and when they fatally interfere with the course of life.
As medicine today is no longer rigidly opposed to death, the book addresses the role modern medicine can play, on one hand, in generating organs for transplantation, and on the other hand, in engaging in society’s approach to euthanasia and – when useful – developing strategies to ease the process of dying. It is here that Dr J. Kevorkian’s contribution and Dignitas Clinic from Zürich are considered.
In addition to medical issues proper, the text also approaches several historical aspects of death, such as mummification, pandemics, the Crusades, the use of cadaveric blood, and the death penalty in its many notorious versions, including crucifixion and the guillotine.
A few short chapters are devoted to a number of postmortem matters, including autopsy, forensics, classic preservation and cryonics, cremation, and spontaneous decomposition, as well as the use of cadavers for teaching purposes, with Prof. von Hagens’ achievements. Since embalming is not currently addressed in medical materials, it is also discussed, along with – in the interest of thoroughness – contemporary taxidermy.
Finally, ethical concerns and a possible correlation between near-death experiences and paranormal phenomena are also given their due attention.
The 397-page text, supported by a list of 317 references and a thematic index, is firmly grounded in scientific and academic rigour. Its essayistic narration, some personal reflections in response to a selection of aphorisms, as well as several art reproductions, combine to strike a tone that is both accessible and memorable.
Efforts have been made by the publisher to offer a book that is easily readable. With a friendly graphic, and a robust physical structure, the volume remains open throughout, both figuratively and in the proper sense of the word.

The Voluntary Assisted Dying Act (Vic) will commence operation on 19 June 2019. Doctors were highly visible in the debate which informed the recent law reform process, and Victorian legislators relied considerably on the diverse views of the medical profession. It is important to pay attention to the role played by doctors in the legalisation of assisted dying in Victoria, not only because the current political environment suggests that further reforms may be likely in other Australian jurisdictions, but also because doctors’ knowledge and expertise visibly contributed to the outcome of that process in Victoria. This article aims to map the participation of doctors in the recent law reform process to analyse how their professional attributes positioned them in the Victorian assisted dying space. It is suggested that doctors were afforded a place in law reform because of the routine acceptance of doctors as knowledge keepers in matters of life and death and an acknowledgment of the integral role of medical expertise in the legislation. A textual analysis of the Hansard record of the Victorian debate reflects that individual practitioner advocacy for legalisation prevailed over opposition by the national branch of the Australian Medical Association in the deliberations of parliamentarians.

Opponents of the Oregon Death with Dignity Act predicted legalization of assisted dying would result in serious harmful consequences, such as a decline in the quality of palliative care, disparate impact on vulnerable populations, and numerous, uncontrollable abuses. An objective analysis of the evidence establishes these harms did not materialize. Accordingly, Oregon's experience argues in favor of legalization of assistance in dying.

This issue of assisted dying is once again in the public consciousness given several recent high-profile cases on both sides of the Atlantic challenging the legal prohibition on assisted dying. Central to any debate on this topic are the emotions which motivate those involved in assisted dying. It is difficult to imagine a more emotionally charged event than the taking of life, particularly the life of a loved one who is suffering, a fact often acknowledged by the courts. Yet, the courts, review bodies and commissions, legislators and commentators have failed to place emotions at the centre of the debate. This article will concentrate on the role which emotions play in end of life decisions and the proper legal response to such decisions given the strong emotions which underpin them. It seeks to address the questions of whether and why these emotions are relevant to the imposition of criminal liability by pointing to the properly exculpatory nature of emotions of this nature in the criminal law, particularly given the modern understanding of emotions as capable of both rationality and evaluation. The existing state of the law in this area is examined, focusing on the availability of existing criminal law defences and how these could be utilised, reformed or supplemented to deal with the circumstances under consideration. Following a review of the existing defences available to one who assists another to die, a new defence is proposed which looks to the love and/or compassion experienced by the defendant.

Euthanasia for psychiatric conditions is currently legal in Belgium and the Netherlands. It is also highly controversial, as illustrated by some recent, high-profile cases. In this paper, I show how a better understanding of the associated phenomenology can inform debate in this area. I focus on how phenomenological changes that occur in psychiatric illness can erode the ability to experience and entertain certain types of possibility, making some scenarios seem inevitable and others impossible. Although strong convictions that originate in competent decisions differ from verbal and non-verbal behaviours stemming from losses of possibility, detecting the difference is by no means straightforward. I add that a sense of the possible can be sustained, enhanced, or diminished by ways of experiencing and relating to other people. Consequently, the extent to which decision-making capacity is impaired in a given case may vary with interpersonal context. I consider the implications of these points for evaluating euthanasia as a response to mental suffering.

As of February 2016, physician-assisted dying will become legal in Canada. This paper utilizes a review of news articles and scholarly, legal, and grey literature to summarize international and domestic assisted dying legislation. Literature reviews were conducted using database searches of Scopus, PubMed, LexisNexis,  and Google Scholar. A grey literature review and news article search was conducted using the Google search engine.

That Kant’s moral thought is invoked by both advocates and opponents of a right to assisted dying attests to both the allure and and the elusiveness of Kant’s moral thought. In particular, the theses that individuals have a right to a ‘death with dignity’ and that assisting someone to die contravenes her dignity appear to gesture at one of Kant’s signature moral notions, dignity. The purposes of this article are to outline Kant’s understanding of dignity and its implications for the ethics of assisted dying. According to Kant, that which has dignity must be treated as an end in itself and may not permissibly be exchanged for that which merely has price. Kant’s reasoning thus seems to preclude acts of self-killing, including voluntary assisted dying, that rest on individual self-interest, since a person’s interests merely have price. However, a recognizably Kantian view of dignity can permit assisted dying under two sets of circumstances: First, it can be permissible for agents who anticipate a degradation of their rational agency due to conditions such as dementia to direct others to end their lives once sufficiently demented. In so doing, such agents in effect exercise a right to impose obligations on others regarding how their bodies, which will at some future point no longer be the vessels of their rational agency, are to be disposed of. Second, Kant errs in supposing that our dignity can stem solely from our moral personality, i.e., from our capacity to abide by universalizable moral principles. Rather, complete dignity also requires the capacity for setting discretionary ends and the means to those ends, i.e., the dignity of humanity. Individuals with prolonged and intense depression, in severe pain, or with serious disability may lack humanity while retaining their moral personality. In such cases, I propose that their opting to end their lives, with or without the assistance of others, does not amount to exchanging their dignified selves for something which merely has price and is therefore not objectionable on Kantian grounds.

In this paper I test the methodological potential of a set of six questions, called the “What's the Problem Represented to be?,” or WPR approach, borrowed from the field of discursive policy analysis (Bacchi, 2012a) for doing critical health communication (CHC) research. WPR is generative for critical health researchers because it shares the goal of challenging implicit and explicit causality and correlation within discourse. I apply these questions to examine the case of legalized medical assistance in dying (MAiD) in Canada, arguing that their simplicity and capaciousness facilitate critical responses to care disparities. This particular case is edifying for CHC researchers, because ideals of good living, “dignified” death, and the role of medicine are all crystallized within legal, media, and medical discourse on assisted dying. Debating what death can or should look like depends on a clearer understanding of how the logics of embodied difference (especially ability, race, and gender) are always already stacking the odds against equal political participation in, and access to health. The WPR approach flips the “proper objects” of health-centered critical research, beginning by scrutinizing proposed solutions in order to rethink the problems implicit therein. Asking such questions as “How has this representation of the “problem” come about?,” “What effects are produced by this representation of the ‘problem'?” and “How has it been (or could it be) questioned, disrupted and replaced?” productively situates the researcher between the discursive practices governing health and health care praxis itself. Ultimately, I argue that the WPR method encapsulates some of the best critical perspectives from the corpus of CHC research praxis, making it a helpful tool for advancing health communication research.

The various jurisdictions worldwide that now legally permit assisted suicide (or voluntary euthanasia) vary concerning the medical conditions needed to be legally eligible for assisted suicide. Some jurisdictions require that an individual be suffering from an unbearable and futile medical condition that cannot be alleviated. Others require that individuals must be suffering from a terminal illness that will result in death within a specified timeframe, such as six months. Popular and academic discourse about assisted suicide paradigmatically focuses on individuals with 'physical,' i.e., non-psychiatric medical conditions, such as cancer or AIDS. Here I defend analyses of the notions of unbearable suffering, futility, and terminality that imply that, regardless of which of these medical conditions is invoked, at least some individuals with severe and persistent psychiatric illnesses satisfy these conditions and ought to be classified as legally eligible for assisted suicide. The legal and moral case for a right to assisted suicide is therefore not in principle weaker for the severely psychiatrically disordered than for those with 'typical' terminal or futile medical conditions.

The contemporary juridico-political and bioethical debate over physician assisted dying has emerged as one of the most divisive of the late 20th and early 21st centuries. Commonly strained through Western conceptions of individual rights and near ubiquitous calls for the respect an abstractly defined human dignity, popular discourse on assisted dying tends to promote universal understandings of both human beings as well as ethical, legal, moral action. This thesis, however, holds these debates in abeyance preferring rather to explore the ways in which the possibility of an assisted death creates a more meaningful dying space for many Canadian advocates. And though I cannot answer for everyone, for many of the 24 individuals I spent months interviewing, “hanging out” with and generally following around to various meetings/training sessions, the assisted death is not some nihilistic response to the suffering of our materially bounded/feeling bodies, but a contemporary recurrence of a deeply spiritual, relational and artful dying.

It is an honour to have been asked to launch this outstanding, timely and "essential" book, and I pay tribute to John's equally outstanding summary of the core issues of the book in his opening remarks. Book launches are normally happy occasions. There are two reasons why this launch is less so than normal. The first is its subject matter, which charts the progress of an intrinsic evil. The second is that Australia faces two upcoming parliamentary debates which might well have the effect of ensuring legal euthanasia across the breadth of our land. So, this is a sober book launch. It is a book launch coinciding with a political campaign.

This essay considers sources of opposition to allowing access to medical assistance in dying for individuals with mental illness. It originated with an observation by members of the University of Toronto Joint Centre for Bioethics that in mainstream Canadian culture—as well as in political, academic, and professional circles—such opposition remains widespread (and often reflexive) even in light of broad support for access to assisted dying for individuals with illness manifesting in physical suffering. Most Canadians treat the prospect of assisted dying for those with mental illness with suspicion, and it is worth exploring why this opposition persists, what arguments can be leveled to support it, and whether those arguments can be sustained. To that end, I identify five sources of opposition to assisted dying for the mentally ill that seem to characterize the public debate, and argue that none succeed. They either rely on false premises or otherwise fail to secure the conclusion th...

Background: Voluntary assisted dying was legalized in Victoria, Australia in June 2019, and was the first jurisdiction internationally to legislatively mandate training for doctors conducting eligibility assessments of patients. Mandatory training was designed as a safeguard to ensure compliance within the system, so that only eligible patients would gain access to voluntary assisted dying. Objective: This article outlines the development of training mandated for doctors prior to undertaking eligibility assessments for voluntary assisted dying. The training addressed required legal knowledge, including doctors’ roles, duties and legal protections, and also provided instruction on relevant clinical skills. Design: Training design was based on 2 main principles: to comprehensively impart the legal duties imposed by the legislation; and to be readily accessible for busy doctors. The law was first mapped into a curriculum, and circulated to medical colleges, societies and professional o...

The Voluntary Assisted Dying Act 2017 (Vic) will come into force in June 2019, becoming the first law in Australia in 20 years to permit voluntary assisted dying (VAD). This paper considers how other Australian states and territories are likely to respond to this development. It analyses three key factors that suggest that law reform is likely to occur in other parts of Australia: (1) the growing international trend to permit VAD; (2) social science evidence about how VAD regimes operate; and (3) changes to the local political environment. The paper argues that these three factors, coupled with the effect of Victoria changing its law, suggest that other VAD law reform is likely to occur in Australia. It also considers the different types of laws that may be adopted, including whether other states and territories will follow the very conservative Victorian approach or adopt more liberal models.

Objectives: The aim of this paper is to provide insight into what it means to live with the intention to end life at a self-chosen moment from an insider perspective.

Setting: Participants who lived independent or semidependent throughout the Netherlands.

Participants 25 Dutch older citizens (mean age of 82 years) participated. They were ideating on a self-chosen death because they considered their lives to be no longer worth living. Inclusion criteria were that they: (1) considered their lives to be ‘completed’; (2) suffered from the prospect of living on; (3) currently wished to die; (4) were 70 years of age or older; (5) were not terminally ill; (6) considered themselves to be mentally competent; (7) considered their death wish reasonable.

Design: In this qualitative study, in-depth interviews were carried out in the participants’ everyday home environment (median lasting 1.56 h). Verbatim transcripts were analysed based on the principles of phenomenological thematic analysis.

Results: The liminality or ‘in-betweenness’ of intending and actually performing self-directed death (or not) is characterised as a constant feeling of being torn explicated by the following pairs of themes: (1) detachment and attachment; (2) rational and non-rational considerations; (3) taking control and lingering uncertainty; (4) resisting interference and longing for support; (5) legitimacy and illegitimacy.

Conclusions: Our findings show that the in-between period emerges as a considerable, existential challenge with both rational and non-rational concerns and thoughts, rather than a calculative, coherent sum of rational considerations. Our study highlights the need to take due consideration of all ambiguities and ambivalences present after a putatively rational decision has been made in order to develop careful policy and support for this particular group of older people.

In October of 2018, Norman Hardy became the first individual to be cryopreserved after successful recourse to California's then recently passed End of Life Options Act. This was a right not afforded to Thomas Donaldson, who in 1993 was legally denied the ability to end his own life before a tumor irreversibly destroyed his brain tissue. The cases of Norman Hardy and Thomas Donaldson reflect ethical and moral issues common to the practice of assisted dying, but unique to cryonics. In this essay, I explore the intersections between ideologies of immortality and assisted dying among two social movements with seemingly opposing epistemologies: cryonicists and medical aid in dying (MAiD) advocates. How is MAiD understood among cryonicists, and how has it been deployed by cryonicists in the United States? What are the historical and cultural circumstances that have made access to euthanasia a moral necessity for proponents of cryonics and MAiD? In this comparative essay, I examine the similarities between the biotechnological and future imaginaries of cryonics and MAiD. I aim to show that proponents of both practices are in search of a good death, and how both conceptualize dying as an ethical good. Cryonics members and terminal patients constitute unique biosocial worlds, which can intersect in unconventional ways. As temporalizing practices, both cryonics and MAiD reflect a will to master the time and manner of death.

In the debate on euthanasia or assisted dying, many different
arguments have been advanced either for or against legal reform in
the academic literature, and much contemporary academic research
seeks to engage with these arguments. However, very little research
has been undertaken to track the arguments that are being advanced
by politicians when Bills proposing reform are debated in
Parliament. Politicians will ultimately decide whether legislative
reform will proceed and, if so, in what form. It is therefore essential
to know what arguments the politicians are advancing in support of
or against legal reform so that these arguments can be assessed and
scrutinised. This article seeks to fill this gap by collecting,
synthesising and mapping the pro- and anti-euthanasia and assisted
dying arguments advanced by Australian politicians, starting from
the time the first ever euthanasia Bill was introduced.

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer a compelling movement towards individuals seeking control of their dying trajectory to actualise the notion of individual choice. With this shifting landscape there is an opportunity to be grasped to change how we manage our dying trajectory away from the biomedical patterns of behaviour when dying, in order to balance life decisions. To achieve this prospect, we need to engage with a framework upon which to pin the changes. This paper offers a re-framing and representing approach, using illustrative examples that draw upon British and New Zealand literature, together with over 50 years of professional nursing, and the Ars Moriendi to reflect upon the self-centricity of the contemporary Western individual to access a 'good death' of choice.

Two matters that have a significant presence in the contemporary Dutch assisted dying debate, are the nature of the suffering required for an assisted death to be lawful, and the issue of who can lawfully assist. This article explores whether the lawful medical assisted dying model is too restrictive in failing to recognise existential suffering, considering selected case studies involving such suffering and lay assisted death. It addresses the question whether the Netherlands would take a trip down a slippery slope if the lawful model of assisted death were extended to cases where individuals are ‘tired of life’.

Euthanasia and physician-assisted suicide are a contentious issue globally. Usually, the argument focuses on assisted dying for people with a terminal physical illness. However, the Netherlands, Luxembourg, and Belgium have legalised assisted dying for a variety of circumstances including disabling psychiatric conditions and mental distress. This essay explores the ethics of such legislation from a human rights perspective.

How did I learn to understand that there can never ever be any acceptable alternative to immortality and living indefinitely forever young?

Is there any better way to learn and permanently remember the understanding that any possibly imaginable alternative to reverse all adverse effects of aging and happily live indefinitely forever young, healthy and energetic would have the same long-term negative consequences as intentionally committing suicide than I have described in this authentic experience report?

When I was only 6 years old, I went through an emotional trauma, from which I am still suffering today and that has led me to come here and be the only one working in the EIT building during Christmas break. On October 2nd, 1980, only one day before my daddy’s birthday, my aunt Frieda, who I liked a lot because she paid lots of attention to my long stories and actually took them serious, suffered from a sudden heart attack. My daddy succeeded to bring her back to life with CPR and my mom called the emergency doctor in the mean time. The doctor was a quiet man from Romania. He had short back hear and looked like being around 30 years old. His voice was very quiet and emotionally detached when he asked my grandma about the age of my aunt. My grandma replied: "She is 83 years old." And then something happened, which I never expected, i.e. the doctor went on in his empathy-lacking quiet voice to say the few German words, which I still remember as if my aunt had died yesterday. He said “Ich denke, wir hoeren auf.” In English this means, “I think, we are going to quit.” He meant going to quit any efforts and even medical interventions at our disposal to bring my aunt Frieda back to live and to make sure she’ll stay alive. When the doctor said this, it was spooky quiet, as if a ghost would kill my aunt. I felt like screaming into the face of the doctor, YOU MUST DO YOUR JOB AS EMERGENCY DOCTOR, TO DO EVERYTHING IN YOUR POWER TO MINIMIZE MY AUNT’S RISK TO DIE FROM THIS PARTIAL HEART ATTACK REGARDLESS OF HER AGE!!!! But I was only six. I was scared and confused. It was my first real encounter with death. I helplessly looked at my parents and looked at my grandma. I wanted them to demand from the doctor not to use my aunt Frieda’s advanced age against her. Although I was only six years old I strongly felt that no medical provider has the moral right and should be punished harshly when using his patient’s age as a shallow absolutely unjustified excuse for refusing to save their lives. But it was so quiet this time, which I recall must have been around 7.30 p.m. on October the 2nd, 1980, when my aunt laid diagonally across the carpet on the floor of the children’s room. Neither my mom nor my daddy nor my grandma nor my 2 younger siblings opened their mouth.

Although I was furious beyond anyone’s imagination, the fact that my otherwise very confident parents and even my grandma, who was best friends with my dying aunt, i.e. all three adults in the room, who’d I expect to fight for my life if I ever needed urgent medical care, and who’d otherwise readily expressed their opposition to anything they did not agree with or considered unfair, did not even attempt to pressure the doctor on a mental, emotional emphatic, moral, medical or legal level, to take his job seriously regardless how he personally felt about my aunt’s advanced age. When something totally unexpected like this happens, i.e. in case of such kind of second degree murder due to medical neglect and intentionally withholding readily available medical interventions without any apparent rational reason for not even trying to save my aunts life, when we still had a chance, I became speechless. I felt like screaming to my parents to not allow the doctor to let my aunt die, after my daddy had brought her back to life already. My daddy is very good in CPR. He’ll fight for everyone’s life as if it was his own. My daddy waited for the doctor’s instructions on how to proceed after restoring my aunts consciousness to the point where she had her eyes opened and could hear every single word, which was spoken by anyone in the children’s room. When all this happened I stood about 4 feet away from my aunt. I was afraid to move any closer because I was worried of accidentally bump into something I could not see but which would kill here. Now something happened that I can never forget. My daddy got up from the carpet and stopped CPR! I felt like screaming “NOOOOOOOOOOOOO!!!!!!!!!” “WHYYYYYYYYYY???” “DON’T!!!!!!” “KEEP BREATHING MORE AIR IN HER MOUTH!!!!! Don’t listen to this evil doctor. He has no respect for life! He does not deserve to be an emergency doctor!!! What if she were his aunt???? She is conscious and will most likely fully come back to life if you’ll just give her enough time to get over this medical crisis!!!! Actually, she was already over the hump because apparently her heart was beeping already independently and all my daddy was still doing, was breathing air in my aunt’s mouth. I wanted my mom to call another doctor. I wanted him to be a German doctor, who treats our aunt as if she was his aunt. I felt that this Rumanian doctor had no empathy for Germans because when my entire family looked up to him for help, he indirectly killed by neglect.

Even if is negative medical intuition should turn out to be true and all of our medical interventions were doomed to fail this evening, I felt he should at least try anyways or else there would have been no point in the doctor making the trip to our home. Then he could have stayed in his killer-hospital. At least that way he would not have had the opportunity to encourage my daddy from reviving my aunt with CPR. When I was six, my daddy was still very powerful. He would have kept performing CPR for hours to save my aunt’s life, if this disguised killer-doctor, would not have instructed him to stop and let her die, just because he felt no old people deserve resources intensive medical care, unless they are his own relatives. Would he let his aunt or grandmother dies like that if he had good chances to prevent or at least postpone death? This I felt would have certainly give my aunt enough time to get over the fear, which is an inherent feature of anyone surviving a heart attack, especially when the doctor is instructing my daddy to stop keeping her alive. I felt like being in a madhouse. I could not speak. My otherwise very attentive parents and grandmother did not seem to be aware that I felt so much emotional pain with such a mental intensity that I almost felt as if I was the one dying instead of my aunt. This god dam Rumanian doctor! Why did he have to be on duty when my aunt needed dedicated professional medical help to get over her heart attack? Why did the hospital not send a German doctor with a strong voice, who’d be much more assertive in his speech and actions to instruct my parents to do everything in their power to save my aunt’s life? Why did my aunt deserve such an indecisive foreign doctor, who lacks the kind of strong loud confidence inducing voice, patients and their relatives need in their struggle of succeeding in overcoming any medical crisis? Why did this stupid hospital send us this absolutely useless and even counterproductive foreign physician, who refused to even say a single word when my parents and grandma looked up to him and expected rational life-saving medical advice? What was he thinking when he condemned my aunt with the only very ambiguous sentence, I still remember verbatim from this cursed Rumanian doctor, “I think we are going to quit.”? Was he asking my parents, whether they’d approve his proposal to quit saving my aunt’s life? Did he order my daddy to quit CPR and let my aunt die? This doctor showed lack of leadership when everyone is expecting him to take charge of the medical crisis at hand and to maximize the odds for the best possible medical outcome.

I remember not being able to feel anything that evening. My aunt laid dead diagonally across the carpet in the children’s room when I started to understand that everyone expects me to go to sleep as usual. I hid under my blanket and wanted to die. I cried so hard. What if I had a heart attack? Would my parents and grandma follow the medical advice of the doctor, if he told them that he thinks, we should quit saving my life? Luckily, I only was 6 and no doctor would even dream about using my age as an excuse for letting me die. But, what about 80 years from now? From then onward, I wanted to become strong, innovative, energetic and knowledge to defeat death before it would inevitably kill me only about 80 years later. That is why I came to America.

Historically, an authoritarian attitude, via the law and social norms, has produced widespread suffering. This suffering far outweighs the risks of abuse of a thoroughly considered, modern liberal attitude and body of law concerning assisted dying.
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Evidence to the Commission on Assisted Dying. 23 March 2011
http://www.commissiononassisteddying.co.uk/wp-content/uploads/2011/07/Evidence-from-Alan-Cottey.pdf

This Editorial criticizes the notion that 'conscientious objection' provides an ethically justifiable reason for health care professionals not to provide professional services that they would be obliged to provide, were it not for their conscientious objection.

Purpose:
(1) To provide an in-depth analysis of Parliament’s constitutional responsibilities under the Canadian Charter and the Supreme Court decision in Carter;
(2) To present a critical analysis of the proposed policy under which “persons whose sole underlying medical condition is a mental illness” would not be eligible to medical assistance in dying, but persons whose death is not reasonably foreseeable, and who are suffering from a mental illness and an additional underlying “grievous and irremediable medical condition” under section 241.2 of the Criminal Code would be eligible;
(3) To analyze whether the proposed bill could be unconstitutional and challenged on the basis that it affects the rights to life, liberty, security, and substantive equality of the more vulnerable, in particular women victims of sexual abuse and domestic violence.

“Can I choose to die?” As the number of requests for euthanasia and physician-assisted suicide continues to rise, human rights law faces a new conflict: the right to die vs. the right to life…
The right to die or, in other words, ‘the right to choose the time and manner of one’s own death’ is a question of personal autonomy and its limits. This book provides a comprehensive understanding of the right to die and sheds light on its possible future under the European Convention on Human Rights. After setting a clear framework by defining the key terminology, the book takes a two-part approach to achieving its aim.

The first part focuses on the right to die in practice by examining selected jurisdictions. Switzerland, which is famous for its assisted suicide organizations, and the Netherlands, which was the first country to legalize euthanasia, are examined in detail. Belgium, Germany, the United Kingdom, and -as an exception to the Convention perspective - Canada are also included. While this examination offers a better understanding of what the right to die looks like in practice, it also provides insights on the slippery slope argument, which serves as a counterweight to personal autonomy, without making a definitive statement on its validity. This part also illustrates the different paths that led or did not lead to the right to die in practice.

The second part is an analysis of the European Court of Human Rights case law on the right to die. The Court has made important statements in only very cases, while its caution when approaching such a delicate and controversial topic among its 47 members is understandably emphasized. This analysis of the Court’s approach to the balancing of personal autonomy against other interests allows us to take a look back at the practice in more permissive jurisdictions through the lens of the Convention.

Taken together, the book’s two parts provide valuable lessons for countries that decide to practice assisted dying, which are outlined in the conclusion. In addition, given that a purely legal approach can only offer a partial picture, the book argues that an interdisciplinary approach would be much more favorable in terms of providing the necessary basis for the right to die debate.

The main aim of this article is to outline the discussion on euthanasia that affects the basic aspects of human life – the foundation of human dignity, sense of pain and suffering, the conception of the afterlife, quality and value of life, etc. All the indications are that the process of the legalisation of euthanasia will develop in the coming decades. Today we need a new paradigm of bioethics, built on the basis of a new humanism, which will allow us to adequately analyse such phenomena as death, suffering and dying. The new paradigm of bioethics can be an effective tool in the dispute over the death on request.

Opponents of medically assisted dying have long appealed to 'slippery slope' arguments. One such slippery slope concerns palliative care: that the introduction of medically assisted dying will lead to a diminution in the quality or availability or palliative care for patients near the end of their lives. Empirical evidence from jurisdictions where assisted dying has been practiced for decades, such as Oregon and the Netherlands, indicate that such worries are largely unfounded. The failure of the palliation slope argument is nevertheless instructive with respect to how slippery slope arguments can be appraised without having to await post-facto evidence regarding the effects of a proposed change in public policy. Close attention in particular to the norms operative in a given institution and how changes to policy will interact with those norms enable slippery slopes to be credibly appraised.

In the debate on euthanasia or assisted dying, many different arguments have been advanced either for or against legal reform in the academic literature, and much contemporary academic research seeks to engage with these arguments. However, very little research has been undertaken to track the arguments that are being advanced by politicians when Bills proposing reform are debated in Parliament. Politicians will ultimately decide whether legislative reform will proceed and, if so, in what form. It is therefore essential to know what arguments the politicians are advancing in support of or against legal reform so that these arguments can be assessed and scrutinised. This article seeks to fill this gap by collecting, synthesising and mapping the pro- and anti-euthanasia and assisted dying arguments advanced by Australian politicians, starting from the time the first ever euthanasia Bill was introduced.

Over two decades of Dutch experience with voluntary assisted dying can inform deliberations about the nature of a regulatory framework in Australian jurisdictions.

This article considers three issues from this perspective:

1. Whether the Government permit required in Victoria prior to providing voluntary assisted dying is defensible

2. Whether the Victorian preference for self-administration over practitioner administration is sound

3. The need for transparency about how voluntary assisted dying systems operate including research.

Although assisted dying has been most commonly presented within a medicalised framework, the notion of de-medicalisation is employed in this paper to suggest that there are emerging models of assisted dying in which some medical aspects assumed to be an integral part of the phenomenon are both challenged and diminished. The paper considers cases where relatives have facilitated a loved one's assisted suicide abroad, cases of assisted death in which the assistor in the actual suicide act is a non-medic, and the growing debate surrounding non-medical grounds for desiring death. In evaluating the potential impact of partial de-medicalisation on the assisted dying debate, the argument presented is that whilst a de-medicalised model could well contribute to a richer understanding of assisted dying and a better death for the person who is assisted, there are cogent reasons to retain some aspects of the medicalised model and that a completely de-medicalised model of assisted dying is unrealistic.

Scholars engaged in debates about the use of public reason often view religious arguments as being out of bounds. Yet the real-world impact of religious discourse remains under-explored. This study contributes to research in this area with an empirical test looking at the impact of religious arguments on a particular policy debate. A survey experiment explored the effects of religious and secular cues with varied policy directions on the issue of assisted dying. The findings showed that secular arguments were considerably more likely to elicit a positive response, and that, while religious arguments were not a conversation stopper, they produced significant distortions in political perceptions among participants, though not necessarily along the identity lines critical to the public reason debate.