Euthanasia and Physician-Assisted Suicide

Learning Outcomes

  • Describe and contrast types of euthanasia and physician-assisted suicide

Euthanasia, or helping a person fulfill their wish to die, can happen in two ways: voluntary euthanasia and physician-assisted suicide. Voluntary euthanasia refers to helping someone fulfill their wish to die by acting in such a way to help that person’s life end. This can be passive euthanasia such as no longer feeding someone or giving them food. Or it can be active euthanasia such as administering a lethal dose of medication to someone who wishes to die. In some cases, a dying individual who is in pain or constant discomfort will ask this of a friend or family member, as a way to speed up what he or she has already accepted as being inevitable. This can have lasting effects on the individual or individuals asked to help, including but not limited to prolonged guilt. [1]

Physician-Assisted Suicide: Physician-assisted suicide occurs when a physician prescribes the means by which a person can end his or her own life. [2] This differs from euthanasia, in that it is mandated by a set of laws and is backed by legal authority. Physician-assisted suicide is legal in the District of Columbia and several states, including Oregon, Hawaii, Vermont, and Washington. It is also legal in the Netherlands, Switzerland, and Belgium.

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Link to Learning

Dr. Jack Kevorkian is the individual most commonly associated with physician-assisted suicide. He was a pioneer in this practice, sparking ethical, moral, and legal debates that continue to this day. This video from the New York Times “Jack Kevorkian and the Right to Die” provides an overview of his work, and his role in the beginning of physician-assisted suicide.

The specific laws that govern the practice of physician-assisted suicide vary between states. Oregon, Vermont, and Washington, for example, require the prescription to come from either a Doctor of Medicine (M.D.) or a Doctor of Osteopathy (D.O.). [3] These state laws also include a clause about the designated medical practitioner being willing to participate in this act. In Colorado, terminally ill individuals have the option to request and self-administer life-ending medication if their medical prognosis gives them six months or less to live. In the District of Columbia and Hawaii, the individual is required to make two requests within predefined periods of time and also complete a waiting period, and in some cases undergo additional evaluations before the medication can be provided.

A growing number of the population support physician-assisted suicide. In 2000, a ruling of the U.S. Supreme Court upheld the right of states to determine their laws on physician-assisted suicide despite efforts to limit physicians’ ability to prescribe barbiturates and opiates for their patients requesting the means to end their lives. [4] The position of the Supreme Court is that the debate concerning the morals and ethics surrounding the right to die is one that should be continued. As an increasing number of the population enters late adulthood, the emphasis on giving patients an active voice in determining certain aspects of their own death is likely.

Physician-Assisted Suicide

In a recent example of physician-assisted death, David Goodall, a 104 year old professor, ended his life by choice in a Swiss clinic in May 2018. Having spent his life in Australia, Goodall traveled to Switzerland to do this, as the laws in his country do not allow for it. Swiss legislation does not openly permit physician-assisted suicide, but it does not forbid an individual with “commendable motives” from assisting another person in taking his or her own life. [5] Watch this video of a news conference with Goodall “104-year-old Australian Promotes Right to Assisted Suicide” that took place the day before he ended his life with physician-assisted suicide.

Another public advocate for physician-assisted suicide and death with dignity was 29-year old Brittany Maynard, who after being diagnosed with terminal brain cancer, decided to move to Oregon so that she could end her life with physician-assisted suicide. You can watch this video “The Brittany Maynard Story” to learn more about Brittany’s story.

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Glossary

active euthanasia:
a type of voluntary euthanasia that is active, such as administering a lethal dose of medication to someone who wishes to die
euthanasia:
helping a person fulfill their wish to die
passive euthanasia:
a type of voluntary euthanasia that is passive, such as no longer feeding someone or giving them food
physician-assisted suicide:
occurs when a physician prescribes the means by which a person can end his or her own life. This differs from euthanasia, in that it is mandated by a set of laws and is backed by legal authority. Physician-assisted suicide is legal in the District of Columbia and several states, including Oregon, Hawaii, Vermont, and Washington. It is also legal in the Netherlands, Switzerland, and Belgium
voluntary euthanasia:
helping someone fulfill their wish to die by acting in such a way to help that person’s life end

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  1. Meier, D. E., Emmons, C. A., Wallenstein, S., Quill, T., Morrison, R. S., & Cassell, C. K. (2009). A national survey of physician-assisted suicide and euthanasia in the united states. New England Journal of Medicine, 338(17), 1193-1201.
  2. Collier, R. (2017). Assisted death gaining acceptance in the US. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5250524/
  3. Theil-Reiter, S., Wetterauer, C., & Frei, I. A. (2018). Taking one's own life in hospital? Patients and health care professionals vis-a-vis the tension between assisted suicide and suicide prevention in Switzerland. International Journal of Environmental Research and Public Health, 15(6).
  4. Collier, R. (2017). Assisted death gaining acceptance in the U.S. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5250524/
  5. Bever, L. (2018). David Goodall, 104 just took his own life, after making a powerful statement about assisted death. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2018/05/09/this-104-year-old-plans-to-die-tomorrow-and-hopes-to-change-views-on-assisted-suicide/?utm_term=.236176920e3c