Once a country legalises assisted suicide or euthanasia, it is inevitable that more people will argue for the right to have the same choice on less extreme grounds.
where is euthanasia and assisted suicide allowed?
Euthanasia is permitted in Belgium, Luxembourg, the Netherlands and Columbia. Assisted suicide is permitted in these countries along with Switzerland and six states in the USA.
what have we observed in these countries?
The State of Oregon in the USA has seen an almost four fold increase in the annual rate of assisted suicides since it was legalised in 1998, with no reduction in the underlying rate of suicides across the state more generally. The 2014 official report also reveals that:
- Among the people opting for assisted suicide, only one in four mentioned concerns about pain control - but 40% expressed concern about being a burden on family and friends/caregivers.
- A health care provider was only present on 20% of the occasions when the lethal medication was ingested in 2014. This means that, for 80% of the reported assisted suicides, there was no medical or regulatory supervision of the lethal drugs been administered.
In the Netherlands euthanasia and assisted suicide are still illegal, but a 2002 law change granted doctors immunity from prosecution as long as specified criteria were followed. After a slight decline following this law change, the death rate from euthanasia and assisted suicide has steadily increased by 10-15% per annum. In 2014 there were 5306 reported deaths from euthanasia and assisted suicide.
In Belgium, large-scale repeat surveys of physicians in Flanders have monitored the evolution of medical end-of- life practices since before the law was changed in 2002. The rate of euthanasia increased markedly between 2007 and 2013, from 1.9% to 4.6% of deaths. This represents an increase in both the number of requests (from 3.5% to 6.0% of deaths) and the proportion of requests granted (from 56.3% to 76.8% of requests made).
what can we learn from other countries?
Once euthanasia and/or assisted suicide are permitted in a country, two trends become apparent.
- The number of reported euthanasia and/or assisted suicide deaths steadily increases over time.
- The criteria used to allow euthanasia and/or assisted suicide are broadened over time. This trend is particularly evident in Belgium and the Netherlands.
A likely explanation for these observed trends is that the arguments advanced before euthanasia and/or assisted suicide are allowed in any given country are typically based on the grounds of compassion and relief of suffering in extreme cases. Once euthanasia and/or assisted suicide are legally permitted however, the argument shifts towards one based on rights. Once a country condones access to state assisted suicide and euthanasia by even a few of its citizens, it is inevitable that more and more citizens will argue for the same access on the grounds of discrimination. In Belgium for example, children of any age can now access euthanasia.