There are many ways of initiating euthanasia, and each method can have different outcomes, some very painful. Regulating methods will not deter users from using plastic bags; it will merely legitimise their use.Competent adult patients have the right to refuse medical treatment. Such refusals of treatments are morally and ethically different from euthanasia, and should remain legally different.
- Withdrawn or Withheld Treatment
- Injections and Drugs
- Carbon Monoxide, Helium, Plastic Bags
- Nitschke's 'Peaceful' Suicide Pill
Dr Tricia Briscoe said at the 2004 Medical Law Conference:
"The right to refuse treatment flows from a right to inviolability - a right not to be touched, including by continuing treatment, without one's consent - not from a right to die. Withdrawal of treatment will mean death, but it will result from the patient's underlying illness." 1When, however, an action or medication is withheld from a patient for the primary purpose of causing or hastening death, this is passive, or indirect, euthanasia. These measures may include the with-holding or withdrawal of ordinary measures such as food, water (hydration) and oxygen.
Examples of passive euthanasia are:
- when food and water is withheld from sick or disabled newborn babies who might otherwise have lived
- with-holding or withdrawing food and water from someone who is diagnosed as being in a 'persistent vegetative state,' has dementia, or who is not improving fast enough (e.g. from a stroke)
- 'do not resuscitate' orders written on patients' charts
In Oregon, a doctor can write a prescription for drugs that are intended to kill the patient. When the prescription is filled, directions centre around making certain that the patient understands about taking all the pills in a single dose, dies after taking the prescription.
The lethal drugs are covered by some Oregon health insurance plans. They are paid for by the state Medicaid program under a funding category called "comfort care."
Research into euthanasia in the Netherlands claimed people awake from comas after taking supposedly fatal drug doses and suffer side effects such as vomiting and gasping.
To reduce the chances of the euthanasia drugs being vomited up, an anti-emetic must be given.
The study showed that when patients tried to kill themselves using drugs prescribed by a doctor, the medication did not work as expected in 16% of cases. In a further 7% of cases there were technical problems or unexpected side effects.
Problems surface so often that doctors felt compelled to intervene in 18% of cases, according to a report in the New England Journal of Medicine. Even when the doctor directly performed euthanasia, complications developed in 3% of the attempts. Patients either took longer to die than expected or woke from a drug-induced coma that was supposed to be fatal in 6% of cases. 2
In the Netherlands, the practice is an injection to render the patient comatose, followed by a second injection to stop the heart.
First a coma is induced by intravenous administration of barbiturates, followed by a muscle relaxant. The patient usually dies as the result of anoxemia caused by the muscle relaxant. When death is delayed, intravenous potassium chloride is also given to hasten cardiac arrest.
Starvation and Dehydration
Right-to-die activists often advocate the withdrawal of food and water in order to hasten death. This means of death is frequently approved when application is made to the courts. Proponents of euthanasia recommend the use of what is known as Terminal Sedation in combination with the withdrawal of food and water.
Terminal sedation allows for the measured use of sedatives and analgesics for the necessary control of symptoms such as intolerable pain, agitation, and anxiety, in order to relieve the distress of the patient and of family members.
If all food and fluids (nutrition and hydration) are removed from a person -- whether that person is a healthy Olympic athlete who takes food and fluids by mouth or a frail, disabled person who receives them by a feeding tube -- death is inevitable. That death will occur because of dehydration.
Dr. Helga Kuhse, a leading campaigner for euthanasia, said in 1984: "If we can get people to accept the removal of all treatment and care - especially the removal of food and fluids - they will see what a painful way this is to die and then, in the patient's best interest, they will accept the lethal injection." 3
Gases, plastic bags and the 'peaceful pill'
This method, referred to as 'self deliverance,' is most commonly advocated by right-to-die activists such as Derek Humphry and Dr Philip Nitschke. In Humphry's book Final Exit describes the method and has been found in the possession of people who have used the method to commit suicide.
Dr Nitschke developed what he calls the 'CO Genie' - an apparatus that turns out lethal carbon monoxide that can be made at home. Nitschke has held workshops in Australia and New Zealand teaching people how to manufacture such devices for themselves.
Dr Nitschke's latest initiative is a barbiturate-based 'peaceful pill.' Nitschke's Peanut Project (named for an old street term for "Barbiturate") intends holding workshops for small groups of elderly and seriously ill Exit members from different countries to make their own Peaceful Pill.