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Map of the legality of euthanasia.

Efforts to change government policies on euthanasia in the 20th century have met limited success in Western countries. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organizations.

Contents

Euthanasia law by country

Albania

Euthanasia was legalized in Albania in 1999, it was stated that any form of voluntary euthanasia was legal under the rights of the terminally ill act of 1995. Passive euthanasia is considered legal should three or more family members consent to the decision. Albania's euthanasia policy has been controversial among life groups and the Catholic Church, but due to other more prominent countries also legalizing forms of euthanasia, it has met a more relaxed world attitude to the matter .

Resources: Bardhyl Çipi, Department of Forensic Medicine, Faculty of Medicine, Tirana University. Some philosophical, juridical and bioethical problems of end of life: death criterion and euthanasia. A paper analyzing the situation in Albania. From The third international symposium on bioethics, Ukraine, Kyiv, April 2004.

Australia

Euthanasia was legalized in Australia's Northern Territory, by the Rights of the Terminally Ill Act 1995. Soon after, the law was voided by an amendment by the Commonwealth to the Northern Territory (Self-Government) Act 1978.[1] The powers of the Northern Territory legislature, unlike those of the State legislatures, are not guaranteed by the Australian constitution. However, before the Commonwealth government made this amendment, three people had already practiced legal voluntary euthanasia (PAS), aided by Dr Philip Nitschke. The first person was a carpenter, Bob Dent, who died on 22 September 1996. In August 2009, the Supreme Court of Western Australia ruled that it was up to Christian Rossiter, a 49 year old quadraplegic, to decide if he was to continue to receive medical care (tube feeding) and that his carers had to abide by his wishes. Chief Justice Wayne Martin also stipulated that his carers, Brightwater Care, would not be held criminally responsible for following his instructions. Rossiter died on 21 September, 2009 following a chest infection.[2][3]

Belgium

The Belgian parliament legalized euthanasia in late September 2002. Proponents of euthanasia state that prior to the law, several thousand illegal acts of euthanasia were carried out in Belgium each year. According to proponents, the legislation incorporated a complicated process, which has been criticized as an attempt to establish a "bureaucracy of death".

Canada

Canadian laws on living wills and passive euthanasia are a legal dilemma. Documents which set out guidelines for dealing with life-sustaining medical procedures are under the Provinces control, in Ontario under the Health Care Consent Act, 1996.[4]

India

In a first step towards legalising euthanasia, The Law Commission of India, Ministry of Law and Justice has decided to recommend to the Indian Government to allow terminally ill to end their lives.[5]

Japan

The Japanese government has no official laws on the status of euthanasia and the Supreme Court of Japan has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University in 1995. The first case involved "passive euthanasia" (消極的安楽死 shōkyokuteki anrakushi?) (i.e., allowing a patient to die by turning off life support) and the latter case involved "active euthanasia" (積極的安楽死 sekkyokuteki anrakushi?) (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.[6]

In the case of passive euthanasia, three conditions must be met:

  1. the patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she/ is unlikely to make a recovery;
  2. the patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a pre-written document such as a living will or the testimony of the family;
  3. the patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc.

For active euthanasia, four conditions must be met:

  1. the patient must be suffering from unbearable physical pain;
  2. death must be inevitable and drawing near;
  3. the patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.)
  4. the physician must have (ineffectively) exhausted all other measures of pain relief.

Luxembourg

The country's parliament passed a bill legalizing euthanasia on 20 February 2008 in the first reading with 30 of 59 votes in favour. On 19 March 2009, the bill passed the second reading, making Luxembourg the third European Union country, after the Netherlands and Belgium, to decriminalise euthanasia. Terminally ill people will be able to have their lives ended after receiving the approval of two doctors and a panel of experts (Err/Huss law in french [7])

Mexico

In Mexico, active euthanasia is illegal but since 7 January 2008 the law allows the terminally ill —or closest relatives, if unconscious— to refuse medication or further medical treatment to extend life (also known as passive euthanasia) in Mexico City,[8] in the central state of Aguascalientes (since 6 April 2009)[9] and, since 1 September 2009, in the Western state of Michoacán.[10] A similar law extending the same provisions at the national level has been approved by the senate[11] and an initiative decriminalizing active euthanasia has entered the same legislative chamber on 13 April 2007.[12]

The Netherlands

In 2002, The Netherlands legalized euthanasia including physician assisted suicide. The law codified a twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care."[13]

The United Nations has reviewed and commented on the Netherlands euthanasia law.[14]

New Zealand

Euthanasia is illegal in New Zealand and two attempts at passing Bills thought Parliament have been made to give it legal standing.

Norway

The second largest political party, the Progress Party, have several times tried to legalize euthanasia.

Switzerland

In Switzerland, deadly drugs may be prescribed to a Swiss person or to a foreigner, where the recipient takes an active role in the drug administration.[15] More generally, article 115 of the Swiss penal code, which came into effect in 1942 (having been written in 1918), considers assisting suicide a crime if and only if the motive is selfish.

The United Kingdom

Euthanasia is illegal in the United Kingdom. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (i.e. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great).[16][17] Although two-thirds of Britons think it should be legal,[citation needed] in 2004 the 'Assisted Dying for the Terminally-Ill Bill' was rejected in the lower political chamber, the House of Commons, by a 4-1 margin. Currently, Dr Nigel Cox is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended sentence in 1992.[18] The principle of double effect is however firmly established. In 1957 Judge Devlin in the trial of Dr John Bodkin Adams ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.[19]

United States

Active euthanasia is illegal in most of the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patients' choices hasten their deaths. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances.

Council of Europe

In 2005 the Parliamentary Assembly of the Council of Europe rejected a draft Resolution which would have called upon Member States to legalise euthanasia.

Non-governmental organizations

There are a number of historical studies about the thorough euthanasia-related policies of professional associations. In the Academy of Neurology (AAN).[20] In their analysis, Brody et al. found it necessary to distinguish such topics as euthanasia, physician-assisted suicide, informed consent and refusal, advance directives, pregnant patients, surrogate decision-making (including neonates), DNR orders, irreversible loss of consciousness, quality of life (as a criterion for limiting end-of-life care), withholding and withdrawing intervention, and futility. Similar distinctions presumably are found outside the U.S., as with the highly contested statements of the British Medical Association.[21][22]

On euthanasia (narrowly-defined here as directly causing death), Brody sums up the U.S. medical NGO arena:

The debate in the ethics literature on euthanasia is just as divided as the debate on physician-assisted suicide, perhaps more so. Slippery-slope arguments are often made, supported by claims about abuse of voluntary euthanasia in the Netherlands.... Arguments against it are based on the integrity of medicine as a profession. In response, autonomy and quality-of-life-base arguments are made in support of euthanasia, underscored by claims that when the only way to relieve a dying patient's pain or suffering is terminal sedation with loss of consciousness, death is a preferable alternative -- an argument also made in support of physician-assisted suicide.[23]

Other NGOs that advocate for and against various euthanasia-related policies are found throughout the world. Among proponents, perhaps the leading NGO is the UK's Dignity in Dying, the successor to the (Voluntary) Euthanasia Society.[24] In addition to professional and religious groups, there are NGOs opposed to euthanasia[25] found in various countries.

References

  1. ^ Legislative Assembly
  2. ^ [1]
  3. ^ [2]
  4. ^ http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_96h02_e.htm
  5. ^ Indian Law Commission to recommend euthanasia to Government
  6. ^ "安楽死". 現代用語の基礎知識. 自由国民社. 2007. pp. 951,953. 
  7. ^ Proposition de Loi sur le droit de mourir en dignité
  8. ^ "Publica GDF Ley de Voluntad Anticipada" (in Spanish). ElUniversal. Notimex (Mexico City). 2008-01-07. http://www.eluniversal.com.mx/notas/472474.html. Retrieved 2009-09-25. 
  9. ^ Rodríguez, Susana; Salazar, Aníbal (2009-04-08). "Sólo falta reglamentar la voluntad anticipada para aplicarla: Ruvalcaba" (in Spanish). La Jornada Aguascalientes. http://lajornadaaguascalientes.com.mx/index.php?option=com_content&task=view&id=1837&Itemid=13:testset. Retrieved 2009-09-26. 
  10. ^ "Michoacán aprueba Ley de Voluntad Anticipada" (in Spanish). El Economista. Notimex (Morelia, Mexico). 2009-09-01. http://eleconomista.com.mx/notas-online/politica/2009/09/01/michoacan-aprueba-ley-voluntad-anticipada. Retrieved 2009-09-25. 
  11. ^ "Senado México aprueba a enfermos terminales rehusar tratamientos" (in Spanish). EcoDiario. Reuters (Mexico). 2008-11-26. http://ecodiario.eleconomista.es/noticias/noticias/885713/11/08/Senado-Mexico-aprueba-a-enfermos-terminales-rehusar-tratamientos.html. Retrieved 2009-09-25. 
  12. ^ "Mexico moves to legalise euthanasia". Reuters. Mexico City. 2007-04-13. http://uk.reuters.com/article/idUKN1238979720070413. Retrieved 2009-09-25. 
  13. ^ discussion of euthanasia on the site of the Dutch ministry of Health, Welfare and Sport
  14. ^ Observations of the UN human rights committee
  15. ^ Lundin, Leigh (2009-08-02). "YOUthanasia". Criminal Brief. http://criminalbrief.com/?p=7887. Retrieved 2009-08-27. 
  16. ^ Suicide Act 1961 s.2
  17. ^ Smartt, Ursula (2009). "Euthanasia and the Law". Criminal Law & Justice Weekly 173 (7): 100. 
  18. ^ Nigel Cox conviction
  19. ^ Margaret Otlowski, Voluntary Euthanasia and the Common Law, Oxford University Press, 1997, pp. 175-177
  20. ^ Brody, Baruch, McCullough, Rothstein and Bobinski. Medical Ethics: Analysis of the issues raised by the Codes, Opinions and Statements
  21. ^ On the BMA controversy.
  22. ^ For professional policies in the English-speaking world, see this selection by an advocacy NGO.
  23. ^ Brody et al., p.283
  24. ^ Dignity in Dying. In an unsympathetic account, the International Task Force on Euthanasia and Assisted Suicide has detailed the ebb and flow of euthanasia proponents. http://www.internationaltaskforce.org/rpt2005_I.htm#204
  25. ^ Euthanasia suicide mercy-killing right-to-die physician assisted suicide living wills research


Efforts to change government policies on euthanasia in the 20th century have met limited success in Western countries. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organizations.

Contents

Euthanasia law by country

Albania

Euthanasia was legalized in Albania in 1999, it was stated that any form of voluntary euthanasia was legal under the rights of the terminally ill act of 1995. Passive euthanasia is considered legal should three or more family members consent to the decision. Albania's euthanasia policy has been controversial among life groups and the Catholic Church, but due to other more prominent countries also legalizing forms of euthanasia, it has met a more relaxed world attitude to the matter.

Resources: Bardhyl Çipi, Department of Forensic Medicine, Faculty of Medicine, Tirana University. Some philosophical, juridical and bioethical problems of end of life: death criterion and euthanasia. A paper analyzing the situation in Albania. From The third international symposium on bioethics, Ukraine, Kyiv, April 2004.

Australia

Euthanasia was legalized in Australia's Northern Territory, by the Rights of the Terminally Ill Act 1995. Soon after, the law was voided by an amendment by the Commonwealth to the Northern Territory (Self-Government) Act 1978.[1] The powers of the Northern Territory legislature, unlike those of the State legislatures, are not guaranteed by the Australian constitution. However, before the Commonwealth government made this amendment, three people had already practiced legal voluntary euthanasia (PAS), aided by Dr Philip Nitschke. The first person was a carpenter, Bob Dent, who died on 22 September, 1996.

Belgium

The Belgian parliament legalized euthanasia in late September 2002. Proponents of euthanasia state that prior to the law, several thousand illegal acts of euthanasia were carried out in Belgium each year. According to proponents, the legislation incorporated a complicated process, which has been criticized as an attempt to establish a "bureaucracy of death".

Canada

Living wills, Passive Euthanasia, are a legal dilemma. Documents which set out guidelines for dealing with life-sustaining medical procedures are under the Provinces control, in Ontario under the Health Care Consent Act, 1996.[2] Living wills would, for example inform medical staff not to provide extraordinary life-preserving procedures on their bodies if they are incapable of expressing themselves and suffering from an incurable and terminal condition, or treatable and expressing themselves. Passive Euthanasia can include starvation or de-hydration, or any life-preserving procedures. Patients do not have to be informed if they are deemed "Incapable", even if they speak and respond, by the medical staff. Their legal representative (Wife-Relation) does not have to be advised or evaluated as capable when invoked in medical emergencies.

Health Care Consent Act, 1996 http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_96h02_e.htm

India

In a first step towards legalising euthanasia, The Law Commission of India, Ministry of Law and Justice has decided to recommend to the Indian Government to allow terminally ill to end their lives.[3]

Japan

The Japanese government has no official laws on the status of euthanasia and the Supreme Court of Japan has never ruled on the matter. Rather, to date, Japan's euthanasia policy has been decided by two local court cases, one in Nagoya in 1962, and another after an incident at Tokai University in 1995. The first case involved "passive euthanasia" (消極的安楽死 shōkyokuteki anrakushi?) (i.e., allowing a patient to die by turning off life support) and the latter case involved "active euthanasia" (積極的安楽死 sekkyokuteki anrakushi?) (e.g., through injection). The judgments in these cases set forth a legal framework and a set of conditions within which both passive and active euthanasia could be legal. Nevertheless, in both of these particular cases the doctors were found guilty of violating these conditions when taking the lives of their patients. Further, because the findings of these courts have yet to be upheld at the national level, these precedents are not necessarily binding. Nevertheless, at present, there is a tentative legal framework for implementing euthanasia in Japan.[4]

In the case of passive euthanasia, three conditions must be met:

  1. the patient must be suffering from an incurable disease, and in the final stages of the disease from which he/she/ is unlikely to make a recovery;
  2. the patient must give express consent to stopping treatment, and this consent must be obtained and preserved prior to death. If the patient is not able to give clear consent, their consent may be determined from a pre-written document such as a living will or the testimony of the family;
  3. the patient may be passively euthanized by stopping medical treatment, chemotherapy, dialysis, artificial respiration, blood transfusion, IV drip, etc.

For active euthanasia, four conditions must be met:

  1. the patient must be suffering from unbearable physical pain;
  2. death must be inevitable and drawing near;
  3. the patient must give consent. (Unlike passive euthanasia, living wills and family consent will not suffice.)
  4. the physician must have (ineffectively) exhausted all other measures of pain relief.

Luxembourg

The country's parliament passed a bill legalizing euthanasia on 20 February 2008 in the first reading with 30 of 59 votes in favour. On 19 March 2009, the bill passed the second reading, making Luxembourg the third European Union country, after the Netherlands and Belgium, to decriminalise euthanasia. Terminally ill people will be able to have their lives ended after receiving the approval of two doctors and a panel of experts (Err/Huss law in french [5])

The Netherlands

In 2002, The Netherlands legalized euthanasia including physician assisted suicide. The law codified a twenty year old convention of not prosecuting doctors who have committed euthanasia in very specific cases, under very specific circumstances. The Ministry of Public Health, Wellbeing and Sports claims that this practice "allows a person to end their life in dignity after having received every available type of palliative care."[6]

The United Nations has reviewed and commented on the Netherlands euthanasia law.[7]

New Zealand

Euthanasia is illegal in New Zealand and two attempts at passing Bills thought Parliament have been made to give it legal standing.

Switzerland

In Switzerland, deadly drugs may be prescribed to a Swiss person or to a foreigner, where the recipient takes an active role in the drug administration. More generally, article 115 of the Swiss penal code, which came into effect in 1942 (having been written in 1918), considers assisting suicide a crime if and only if the motive is selfish.

Thailand

Thailand's National Health Act BE 2550 (2007) has come into force as of 20 March 2007. Such Act contains the provisions in relation to euthanasia as follows, with the pertained provisions:[8]

Section 12. A person shall have right to express in a written form the intention not to receive the public health service as provided for prolonging the death in the final stage of his or her life or for extinguishing the sufferings occurred from illness.

The performances according to the written document under Paragraph One shall be in accordance with the rule and procedure as prescribed in the Ministerial Regulations.

After the medical practitioner has followed the intention of the person under Paragraph, such performance shall not be deemed wrongful and he shall be exempted from all liabilities.

Section 3. In this Act:

"public health service" means all services concerning the enhancement of health, the protection and monitor of illness and homininoxious factors, the exploration and therapy of illness and the rehabilitation of the capability of person, family and community;

"medical practitioner" means a medical practitioner under the law on xenodochium.

Section 4. The Prime Minister and the Minister of Public Health shall have charge and control of the execution of this Act, and shall have power to issue Ministerial Regulations in order to comply with this Act.

Such Ministerial Regulations shall come into force upon their publication in the Government Gazette.

The United Kingdom and Ireland

Euthanasia is illegal in the United Kingdom and Ireland. Any person found to be assisting suicide is breaking the law and can be convicted of assisting suicide or attempting to do so (i.e. if a doctor gives a patient in great pain a bottle of morphine to take (to commit suicide) when the pain gets too great).[9][10] Although two-thirds of Britons think it should be legal,Template:Fact in 2004 the 'Assisted Dying for the Terminally-Ill Bill' was rejected in the lower political chamber, the House of Commons, by a 4-1 margin. Currently, Dr Nigel Cox is the only British doctor to have been convicted of attempted euthanasia. He was given a 12 month suspended sentence in 1992.[11] The principle of double effect is however firmly established. In 1957 Judge Devlin in the trial of Dr John Bodkin Adams ruled that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome.[12]

United States

Template:Main article Active euthanasia is illegal in most of the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), even if the patients' choices hasten their deaths. Additionally, futile or disproportionately burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances.

Non-governmental organizations

There are a number of historical studies about the thorough euthanasia-related policies of professional associations. In the Academy of Neurology (AAN).[13] In their analysis, Brody et al. found it necessary to distinguish such topics as euthanasia, physician-assisted suicide, informed consent and refusal, advance directives, pregnant patients, surrogate decision-making (including neonates), DNR orders, irreversible loss of consciousness, quality of life (as a criterion for limiting end-of-life care), withholding and withdrawing intervention, and futility. Similar distinctions presumably are found outside the U.S., as with the highly contested statements of the British Medical Association.[14][15]

On euthanasia (narrowly-defined here as directly causing death), Brody sums up the U.S. medical NGO arena:

The debate in the ethics literature on euthanasia is just as divided as the debate on physician-assisted suicide, perhaps more so. Slippery-slope arguments are often made, supported by claims about abuse of voluntary euthanasia in the Netherlands.... Arguments against it are based on the integrity of medicine as a profession. In response, autonomy and quality-of-life-base arguments are made in support of euthanasia, underscored by claims that when the only way to relieve a dying patient's pain or suffering is terminal sedation with loss of consciousness, death is a preferable alternative -- an argument also made in support of physician-assisted suicide.[16]

Other NGOs that advocate for and against various euthanasia-related policies are found throughout the world. Among proponents, perhaps the leading NGO is the UK's Dignity in Dying, the successor to the (Voluntary) Euthanasia Society.[17] In addition to professional and religious groups, there are NGOs opposed to euthanasia[18] found in various countries.

References

  1. Legislative Assembly
  2. http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_96h02_e.htm
  3. Indian Law Commission to recommend euthanasia to Government
  4. "安楽死". 現代用語の基礎知識. 自由国民社. 2007. pp. 951,953. 
  5. Proposition de Loi sur le droit de mourir en dignité
  6. discussion of euthanasia on the site of the Dutch ministry of Health, Welfare and Sport
  7. Observations of the UN human rights committee
  8. พระราชบัญญัติสุขภาพแห่งชาติ พ.ศ. 2550. (2550, 19 มีนาคม). ราชกิจจานุเบกษา, (เล่ม 124, ตอนที่ 16 ก).
  9. Suicide Act 1961 s.2
  10. Smartt, Ursula (2009). "Euthanasia and the Law". Criminal Law & Justice Weekly 173 (7): 100. 
  11. Nigel Cox conviction
  12. Margaret Otlowski, Voluntary Euthanasia and the Common Law, Oxford University Press, 1997, pp. 175-177
  13. Brody, Baruch, McCullough, Rothstein and Bobinski. Medical Ethics: Analysis of the issues raised by the Codes, Opinions and Statements
  14. On the BMA controversy.
  15. For professional policies in the English-speaking world, see this selection by an advocacy NGO.
  16. Brody et al., p.283
  17. Dignity in Dying. In an unsympathetic account, the International Task Force on Euthanasia and Assisted Suicide has detailed the ebb and flow of euthanasia proponents. http://www.internationaltaskforce.org/rpt2005_I.htm#204
  18. Euthanasia suicide mercy-killing right-to-die physician assisted suicide living wills research








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