We defined “Passive Sterbehilfe” (“passive euthanasia”) as measures by which a patient commits suicide-using drugs which he or she received, upon request, by pre- scription from a physician (consistent with PAS).
Requests for euthanasia occur frequently in the daily practice of German GPs. Whereas the majority of GP’s are not willing to perform AVE or PAS under the cur- rent legislation, our data suggest that euthanasia takes place and is accepted by a number of physicians in Germany.
A recent investigation (2005) including several European countries estimated the overall rate of all documented deaths due to AVE between 0 and 2.6% and due to PAS between 1% and 3.4%.
However, the majority of GPs in Germany favoured the palliative care of dying patients —> a) palliative care IS NOT a solution! Fine for those who want die with palliative care, but other is 1) just a waste of money! (where we already have huge public debts and the health care finance get expensive day by day 2) just an additional pain 3) it's not the decision of the patient, but again from our governments or doctors! 4) die without eating, just to wait the death, is not a life. Many elderly want to die immediately, not after 1-4 weeks or more! b) this increase the self made suicide! since you reject a wish made by a patient
Requests for euthanasia occur frequently in the daily practice of German GPs. Whereas the majority of GP’s are not willing to perform AVE or PAS under the cur- rent legislation, our data suggest that euthanasia takes place and is accepted by a number of physicians in Germany.
A recent investigation (2005) including several European countries estimated the overall rate of all documented deaths due to AVE between 0 and 2.6% and due to PAS between 1% and 3.4%.
However, the majority of GPs in Germany favoured the palliative care of dying patients —> a) palliative care IS NOT a solution! Fine for those who want die with palliative care, but other is 1) just a waste of money! (where we already have huge public debts and the health care finance get expensive day by day 2) just an additional pain 3) it's not the decision of the patient, but again from our governments or doctors! 4) die without eating, just to wait the death, is not a life. Many elderly want to die immediately, not after 1-4 weeks or more! b) this increase the self made suicide! since you reject a wish made by a patient
Euthanasia refers to the act of intentionally ending the life of a patient by a health care practitioner through medical means at that patient’s explicit request while PAS involves the provision or prescribing of drugs by a health care practitioner for a patient to end their own life.
Euthanasia is currently legal in seven jurisdictions: the Netherlands (since 2002), Belgium (since 2002), Luxemburg (since 2009), Colombia (since 2015), Canada (since 2016) and Victoria (since 2017) and Western Australia (since 2019) in Australia (Table 1).
As of February 2020, the Spanish legislature is debating a bill that would legalize euthanasia and assisted suicide and similar legislation is being crafted in Portugal following the approval of related proposals by parliament (15,16). New Zealand’s parliament voted in favor of legalizing euthanasia in late 2019 and a national referendum on the issue will take place in September 2020.
The Northern Territory in Australia was the first jurisdiction to legalize euthanasia in 1995, however, the law was overturned after just nine months by the federal Parliament of Australia.
PAS without the option for euthanasia, is legally practiced in Switzerland and ten US jurisdictions.
In Canada, Luxembourg and the United States, a person must be at least 18 years old to request physician-assisted suicide. In the Netherlands, a patient can request assisted dying from the age of 12 years old. Belgium has allowed a patient of any age to request euthanasia or physician-assisted suicide since 2014, provided they are of mature judgement. Switzerland does not specify an age at which a person can request assisted suicide though most right-to-die organizations require the person to be an adult with sound judgement.
Euthanasia is currently legal in seven jurisdictions: the Netherlands (since 2002), Belgium (since 2002), Luxemburg (since 2009), Colombia (since 2015), Canada (since 2016) and Victoria (since 2017) and Western Australia (since 2019) in Australia (Table 1).
As of February 2020, the Spanish legislature is debating a bill that would legalize euthanasia and assisted suicide and similar legislation is being crafted in Portugal following the approval of related proposals by parliament (15,16). New Zealand’s parliament voted in favor of legalizing euthanasia in late 2019 and a national referendum on the issue will take place in September 2020.
The Northern Territory in Australia was the first jurisdiction to legalize euthanasia in 1995, however, the law was overturned after just nine months by the federal Parliament of Australia.
PAS without the option for euthanasia, is legally practiced in Switzerland and ten US jurisdictions.
In Canada, Luxembourg and the United States, a person must be at least 18 years old to request physician-assisted suicide. In the Netherlands, a patient can request assisted dying from the age of 12 years old. Belgium has allowed a patient of any age to request euthanasia or physician-assisted suicide since 2014, provided they are of mature judgement. Switzerland does not specify an age at which a person can request assisted suicide though most right-to-die organizations require the person to be an adult with sound judgement.
Commonalities among substantive requirements for:
a) The person must have a serious and incurable
condition caused by an illness or an accident (in the US, Colombia, and Victoria the person must also be expected to die imminently)
b) The person must have unbearable physical or psychological suffering which cannot be alleviated (not required for PAS in the US)
...
Commonalities among procedural requirements for assisted suicide and euthanasia include:
a) A second independent physician must by consulted by the treating physician before euthanasia is performed (a third consultation is required for non- terminal cases in Belgium);
b) The US and Canada require mandatory waiting periods between request and provision of assisted death;
c) Euthanasia must be reported by the physician following the procedure for review by a multidisciplinary control and evaluation committee (in Colombia this must be done prior to euthanasia being carried out)
Motivation for requests and patient demographics
Studies indicate that pain is not typically the primary motivation for requesting euthanasia or physician-assisted suicide; inadequate pain control is seen in less than 33% of patients (7). Loss of autonomy, diminished quality of life and loss of dignity are the factors most frequently associated with requests for assisted dying (22). Loss of dignity is identified as the basis for requests in 61% of cases in the Netherlands and 52% in Belgium (7). Patients who request euthanasia or assisted suicide are most often dying of cancer (60–100% cases), though a lower percentage was seen in Switzerland (38–47%) (1).
Other conditions associated with requests include amyotrophic lateral sclerosis (ALS), multiple sclerosis, cardiovascular disease and immunodeficiency syndrome (1).
In countries where both euthanasia and physician- assisted suicide are legal options, euthanasia is far more frequently requested (21,23). One study in the Netherlands indicated that in 75% of cases, euthanasia was preferred (24).
a) The person must have a serious and incurable
condition caused by an illness or an accident (in the US, Colombia, and Victoria the person must also be expected to die imminently)
b) The person must have unbearable physical or psychological suffering which cannot be alleviated (not required for PAS in the US)
...
Commonalities among procedural requirements for assisted suicide and euthanasia include:
a) A second independent physician must by consulted by the treating physician before euthanasia is performed (a third consultation is required for non- terminal cases in Belgium);
b) The US and Canada require mandatory waiting periods between request and provision of assisted death;
c) Euthanasia must be reported by the physician following the procedure for review by a multidisciplinary control and evaluation committee (in Colombia this must be done prior to euthanasia being carried out)
Motivation for requests and patient demographics
Studies indicate that pain is not typically the primary motivation for requesting euthanasia or physician-assisted suicide; inadequate pain control is seen in less than 33% of patients (7). Loss of autonomy, diminished quality of life and loss of dignity are the factors most frequently associated with requests for assisted dying (22). Loss of dignity is identified as the basis for requests in 61% of cases in the Netherlands and 52% in Belgium (7). Patients who request euthanasia or assisted suicide are most often dying of cancer (60–100% cases), though a lower percentage was seen in Switzerland (38–47%) (1).
Other conditions associated with requests include amyotrophic lateral sclerosis (ALS), multiple sclerosis, cardiovascular disease and immunodeficiency syndrome (1).
In countries where both euthanasia and physician- assisted suicide are legal options, euthanasia is far more frequently requested (21,23). One study in the Netherlands indicated that in 75% of cases, euthanasia was preferred (24).