Physician Assisted Suicide

PhysicianAssisted Suicide


PICOTQuestion: How accessible are resources (O) for terminally illpatients (P) who choose Physician-Assisted Suicide (I) to be able toestablish how/when they die (T) in Europe compared to the UnitedStates (C)?

Overthe years, arguments over the right to die with the help of a doctorat the time and manner people choose have intensified across theworld. Some of the arguments include diversified perspectivesregarding states such as Colombia in the United States and others inEurope allowing some form of physician-assisted death. However, draftbills, ballot initiatives and court cases continue to progress inmore countries across the world. For instance, the Canadian SupremeCourt recently eradicated a ban on assisting patients in dying. Theircourse of action motivated other nations in Europe such as Germanyand Britain to incorporate physician-assisted death. Nevertheless,these works fill critics with dismay as some argue thatphysician-assisted death is moral and absolute. The critics againstsuch actions believe that the deliberate ending of an individual’slife violates the right to life because it is sacred and theendurance of suffering confers its dignity. On the other hand,supporters of physician-assisted death argue that it entails theinitial step in instances where vulnerable patients feel threatenedor where premature death becomes a cheap alternative to palliativecare.

Theessence of the present study involves determining the availability ofresources for terminally ill patients who choose Physician-assistedsuicide to establish how and when they die. It also aims atidentifying the factors that lead to the use of physician-assistedsuicide as well as its significance to nursing and patient care.These will be followed closely by the history behind the interventionstrategy and how it took place. Besides, the paper will alsodetermine how physician-assisted suicide affects legal and ethicalissues in nursing. Most of these factors will incorporate acomprehensive comparison between the actions carried out in Europeand the United States.


Thephrase physician-assisted suicide describes the act in which medicalpractitioners provide competent, terminally ill patients withprescriptions including a lethal dose of medication based on therequests of the patient. However, these medicines occur through thepatient’s intention to use in terminating their lives orcontrolling the timing of their death. Most importantly, the practiceof physician-assisted suicide emanated from ancient Greece where thegovernment gave hemlock to those who needed it. For instance, WilliamShakespeare illustrated a memory of the Roman practice in his work“Julius Caesar” through depicting Brutus running into the swordheld by Strato. These incidents are followed closely by opposition tothe physician-assisted suicide practice where more than half of thethirty-seven states in the United States prohibited the act in 1868.They also indicate the essence of assisted suicide as a way ofpreserving one’s honor in the ancient days.

Contrastingly,over the past few decades assisted suicide has been viewed as aresponse to the progress of modern medicine as new and expensivemedical technologies have been developed with the aim of prolonginglife. However, these technologies also extend the dying processleading people to question whether modern medicine coerces patientsto live in avoidable pain when there exists no possibility of cure(Rymowicz and Joshi, 2016). Nevertheless, passive euthanasia orrather the disconnection of a respirator or removing a feeding tubehas become an acceptable solution to such a dilemma. On the otherhand, active euthanasia which describes an overdose of pills or alethal injection of morphine remain controversial. Physician-assistedsuicide employs the broad definition as a type of active euthanasiain which doctors provide the means of death by prescribing a lethaldose of drugs based on the responsibility of the patient forperforming the final act (Rymowicz and Joshi, 2016).

Inthe United States, the phrase physician-assisted suicide describesthe practice authorized under the Washington, Oregon and VermontDeath with Dignity Acts which reflects the requirement the eligiblepeople must be competent to make decisions and possess a limited lifeexpectancy of about six months or less. It also elaborates the factthat physicians provide assistance to patients who may otherwise dieor those who seek help to control the timing and circumstances oftheir death in the face of end-of-life suffering deemed intolerable(Rymowicz and Joshi, 2016). Although the phrase evades the mentalhealth connotations associated with the word suicide, critics of thepractice suggest that it could include other practices that areclearly outside the legal bounds of the three states’ death withdignity Acts (Rymowicz and Joshi, 2016). For instance, patients whoreceive assistance in ingesting the medication would constituteeuthanasia. Most of these practices employ the phrase physician aidin dying with the aim of reflecting a legal action under theWashington Death with Dignity Act. Besides, the phrasephysician-assisted suicide was rejected by the Oregon Department ofPublic Health as well as other entities responsible for maintainingproviding health care services in the United States. The rejection ofthe phrase contributed towards the adoption of the term physicianaid-in-dying applied in Oregon, Washington as well as Vermont Deathwith Dignity laws (Rymowicz and Joshi, 2016).

Mostimportantly, these laws indicate the difference between the use ofeuthanasia and physician aid-in-dying which entails disparity in theadministrator of the medication that will end the patient’s life(Finlay and George, 2010). In physician aid-in-dying, the patientshould administer the medications themselves or seek assistance froma doctor based on their decision on whether and when to ingest theprescribed dose. On the other hand, euthanasia occurs when a thirdparty administers medication or acts directly to end the patient’slife. Nevertheless, euthanasia is illegal in all the states inAmerica (Finlay and George, 2010).

InEurope, the issue of physician-assisted suicide brings aboutcontroversial perspectives based on legal and ethical factors. Forinstance, the European Court of Human Rights encountered an issue ofvoluntary euthanasia where a patient suffered from motor neurondisease which affected the control of her muscle activity. Theeffects included the inability to speak, walk, breathe and swallowand in its terminal phase, the illness contributed towards thepatient becoming paralyzed and later died of suffocation (Gamondi etal. 2013). The death of the patient occurred as a result of thedifficulties in breathing, but the patient’s intellect and capacityto make decisions remained unimpaired throughout the illness. Thesefactors drove the patient towards requesting the intervention of theDirector of Public Prosecutions to pardon her husband as opposed toprosecuting him in case he assisted her in committing suicide(Gamondi et al. 2013). However, the UK authorities denied her theundertaking which drove the husband to seek approval before theEuropean Court. Some of the claims that the refusal violated includedviolation of the right to life which also includes the right toterminate an individual’s life, human dignity, the right toprivacy, just to mention but a few. The Court thus held that theincident did not violate any of these rights and hence rejected thepetition (Gamondi et al. 2013).

Legally,the event brings about an interpretation as the collision of twonon-quantifiable human rights which entail the right to life and theright to human dignity. On the ethical perspective, the incidentbrings about a different question regarding the limits of stateintervention to protect individuals from their self-harming conducts.Nevertheless, paternalism in Europe refers to the coerciveintervention to the Behaviour of a person with the aim of preventingthem from causing harm to themselves (Gamondi et al. 2013). Theincident described above portrays an elaborate instance ofpaternalism as it involved the intervention of professionals as wellas family members in taking any medical stands regarding ending thepatient’s life. However, there exist disparities in the variousforms of euthanasia used in Europe. The variations involve voluntary,involuntary and non-voluntary forms euthanasia. Involuntaryeuthanasia focuses on the subject against the patient’s will ordisregards their consent. It also qualifies as murder as it ends apatient’s life without their approval or consent irrespective ofthe criticality of their health situation (Gamondi et al. 2013). Onthe other hand, non-voluntary euthanasia involves mental incompetenceof the patient in making informed decisions. Passive euthanasiafocuses on the refusal of medical treatment by terminally illpatients while active voluntary euthanasia means a physician’sdirect contribution towards the patient’s death based on theirrequest.

Mostimportantly, physician-assisted suicide in Europe differs from activeeuthanasia in that the patient provides the final link in the causalchain while the doctor helps in carrying out the process. Theprohibition of voluntary euthanasia, as well as physician, assistedsuicide qualify as paternalism since in other instances they do notinterfere with the patient’s autonomy. The incident mentioned abovemay be eligible as a request for assisted suicide or even voluntaryeuthanasia (Georges et al. 2007). However, the qualification dependson who performed the suicide or murder act. Therefore, theprohibition of the UK authorities qualifies paternalism based ondistinctions such as it is an indirect, harm-preventive, coercive andpassive form. Besides, Europe provides different models forjustifying socialism where the first entails deontological ethics.This approach gives socialism an absolute priority to autonomy overother considerations. It also focuses on the kind of paternalisticinterferences that violate sovereignty as some range from weak tostrong (Georges et al. 2007). Hard paternalism propagates forcoercion to protect competent adults against their deliberateself-harming decisions. For instance, the criminal prohibition ofdrug use or active voluntary euthanasia as well as the obligation tofasten seat belts while driving. Contrastingly, soft paternalismfacilitates protection from self-regarding corrupt conduct especiallyin cases where the conduct entails substantial non-voluntary aspects(Georges et al. 2007).

Effectsto Legal and Ethical Issues in Nursing

Theuse of physician-assisted suicide brings about questions regardingethical and unethical practices of killing people with/withoutconsent or good cause. These issues may be coupled with whether itgives life its value and meaning. However, one of the most importanttopics it seeks to answer includes physician-assisted suicide, or theuse of euthanasia are acceptable practices within the ethics ofChristian people (Nelson, 2015). Some arguments focus on biblicalcodes that state that when the murder occurred, blood retributionentailed the legal right and moral duty of the victim’s next ofkin. Nevertheless, technology did not exist then and interventionssuch as antibiotics, blood transfusions, organ transplants, were notinvented yet. Evolution throughout the years and advancement intechnology contributed towards stimulation of body organs but thedetermination of the time of death may not be possible (Nelson,2015). The biblical values collide with technological and medicalexpertise available today thus rendering the conclusions of the pastinoperative for the future.

Additionally,critics argue that medical interventions such as physician-assistedsuicide or even the use of euthanasia contradict the natural causesprovided by biblical perspectives. Legally, they claim that suchpractices violate the right to life-based on the ethical element ofvaluing the lives of each. On the other hand, supporters of thepractice indicate that it provides an alternative strategy that endsthe lives of people suffering from terminal illnesses. The issuesregarding the value of life entail societal beliefs among people whouse the Bible as a reference in critiquing modern elements.Therefore, physician-assisted suicide, paternalism, as well assimilar medical interventions motivated by genuine benevolence,indicate the virtue of care (Nelson, 2015). These factors occurthrough the virtue of caring that makes people autonomous, and sincemedical practitioners carry out their services based on the provisionof attention, they follow ethical and legal requirements in makingdecisions regarding the welfare of their patients.

Importanceof the topic to Nursing and Patient Care

Physician-AssistedSuicide or paternalism, as described in other parts of the world,provides an elaborate point of discussion in the nursing professionas it evaluates their involvement in decisions made by patients andtheir relatives. Nevertheless, these phrases bring about an essentialelement in healing where they are expected to guide patients indecision making especially in instances where terminal illnessesrender their lifespan minimal. Similarly, physician-assisted suicideallows medical practitioners to portray empathy in theresponsibilities as they place themselves in the shoes of the subject(Nelson, 2015). This ensures that the subject of such practicesreceives specific attention as well as engrossment into their health.These elements facilitate in relieving the burden and pain from thepatient as well as the relatives who have endured emotion, financialand psychological torture. Therefore, suicide moderated by thephysicians with the consent of patients and their family membersserves as a means to an end that reduces the suffering throughintentional death. Contrastingly, such activities may to some extentviolate social norms related to health care especially in the socialexpectation put on the patient to devote themselves entirely torecovery. It also violates social expectations on doctors of curingand avoiding harm to the patients (Nelson, 2015).

Theselection of this topic entailed the evaluation of the ethical andlegal issues surrounding the physician-assisted suicide practice indifferent parts of the world. It also aimed at creating anunderstanding of the factors involved in conducting such practicesbased on the legal and ethical considerations held in the UnitedStates and Europe (Nelson, 2015). These factors brought about therevelation of other key elements required when participating inphysician-assisted suicide. For instance, in Europe, determination ofthese factors contributed towards understanding other practices thatmay be regarded as illegal and immoral. Nevertheless, the topicfacilitates in the depiction of the importance of nurses and othermedical practitioners in making decision regarding the life of aterminally ill patient.


Finlay,&nbspI.&nbspG.,&amp George,&nbspR. (2010). Legal physician-assisted suicide inOregon and The Netherlands: evidence concerning the impact onpatients in vulnerable groups–another perspective on Oregon`sdata.&nbspJournalof Medical Ethics,&nbsp37(3),171-174. doi:10.1136/jme.2010.037044

Gamondi,&nbspC.,Pott,&nbspM., &amp Payne,&nbspS. (2013). Families` experienceswith patients who died after assisted suicide: a retrospectiveinterview study in southern Switzerland.&nbspAnnalsof Oncology,&nbsp24(6),1639-1644. doi:10.1093/annonc/mdt033

Georges,&nbspJ.,Onwuteaka-Philipsen,&nbspB.&nbspD., Muller,&nbspM.&nbspT., Vander Wal,&nbspG., Van der Heide,&nbspA., &amp Van der Maas,&nbspP.&nbspJ.(2007). Relatives` Perspective on the Terminally Ill Patients WhoDied after Euthanasia or Physician-Assisted Suicide: A RetrospectiveCross-Sectional Interview Study in the Netherlands.&nbspDeathStudies,&nbsp31(1),1-15. Doi: 10.1080/07481180600985041

Nelson,&nbspB.(2015). In right-to-die debate, a new focus on practicality: As lawslegalizing physician-assisted suicide gain ground, physiciansconsider conscientious objection, training, oversight, and access toend-of-life care.&nbspCancerCytopathology,&nbsp123(7),385-386. doi:10.1002/cncy.21579

Rymowicz,&nbspR.,&amp Joshi,&nbspP. (2016). Statistical Analysis Suggests SomeSuicidal Adults Choose in Oregon.&nbspTheAmerican Journal of Geriatric Psychiatry,&nbsp24(3),S94-S95. doi:10.1016/j.jagp.2016.01.094

Physician-Assisted Suicide




Physician-assistedsuicide denotes the act by a qualified medical practitioner to offerdeliberately a means of committing self-murder to a patient underhospice or palliative care. The practice is also called death withdignity, assisted suicide or physician-assisted dying. The variousways in which assisted suicide takes place include supplying lethaldoses of specific drugs and counseling about the use of medicationsthat induce death. A unique aspect of this practice is that thepatient in question administers a particular death-inducing drugthemselves (Radbruch et al., 2015 Sulmasy, Ely &amp Sprung, 2016).Physician-assisted suicide is one of the most controversial topics inpatient care. The controversy surrounding the issue emanates from thereason that death does not come naturally but is instead induced byartificial means. As such, this topic is relevant to the field ofnursing in its entirety. The history of physician-assisted deathprovides useful insights on the applicability of the practice. Themanner in which assisted suicide takes place in Europe and the UnitedStates vary widely. This paper seeks to examine the accessibility ofresources for executing physicians-assisted dying in Europe andAmerica. The discussion will also include a scrutiny of the ethicaland legal issues surrounding the controversial practice, a history ofdeath with dignity, and the relevance of the topic in nursing.

Relevanceof the Topic to Nursing and Patient Care

Physician-assistedsuicide as a topic is pertinent to the field of nursing.Specifically, this issue is significant to nurses involved inpalliative and hospice care. Notably, this is attributable tofrequent interactions that these practitioners have with terminallyill patients. Palliative care nurses have an important role inproviding attention to patients who might request for a dignifiedform of death. For this reason, these nurses need to have acomprehensive understanding of the various aspects ofphysician-assisted suicide. These include the legal and ethicalissues surrounding the practice, appropriate drugs for inducingdeath, and suitable mechanisms for counseling patients who mightrequest for assisted suicide to reduce their suffering. According toEmanuel,Onwuteaka-Philipsen, Urwin, and Cohen(2016), the counseling process entails advising a patient onalternative mechanisms of reducing their suffering hence, possiblyconvincing them to abandon this form of voluntary death. Aninsightful understanding of this topic also empowers nurses todevelop an open mind to examine a terminally-ill patient`sdecision-making process (Sulmasy,Ely &amp Sprung, 2016).The reason for this is that once a patient administers alife-terminating dosage as per their will the effects of such drugsare often irreversible.

Concerningthe actual act of giving a patient a life-terminating medication, athorough understanding of physician-assisted suicide as a topic isuseful. For example, there are certain legal considerations foradministering a lethal drug. These include age eligibility,documenting all steps of administering the medication, signing of adeath certificate, the reason for choosing this form of death, andfull knowledge of a patient`s next of kin (Chambaere,Cohen, Bernheim, Vander Stichele &amp Deliens, 2016).However, in countries and states where the law prohibits death withdignity, palliative and hospice care nurses could use theirknowledge to find alternative ways of reducing the sufferings thatterminally-ill patients go through.


Thehistory of death with dignity is as old as that of the medicalprofession itself. Throughout history, patients have often felt thatthey should only die instead of suffering from constant pains causedby illnesses and conditions. Since the advent of medicine, sufferinghas been inevitable due to the nature of some ailments. Suchsuffering has in many cases influenced patients to opt for deathinstead of palliative and hospice care. Sulmasy, Ely &amp Sprung(2016) established that since early times of modernization,physician-assisted suicide became a viable alternative to hospicecare. According to Emanuel, Onwuteaka-Philipsen, Urwin &amp Cohen(2016), Plato and Aristotle supported this form of death. Thesephilosophers did not condemn assisted suicide as religiouspersonalities did. The two greek scholars argued that there was noneed for a dignified individual to suffer helplessly if alternativesof alleviating the illness existed. However, in the ancient Greeksociety, this practice was only allowed if physicians establishedthat a patient had an incurable terminal illness. Nonetheless, theGreek mathematician, Pythagoras strongly opposed this practice sincehe argued that the power of life was beyond human control.

Effortsof making assisted suicide acceptable in the U.S. and other parts ofEurope began in the 20thcentury and went through to the 21stcentury. For instance, in 1994, the Oregon House of Representativesenacted the Death with Dignity Act (Chambaere, Cohen, Bernheim,Vander Stichele &amp Deliens, 2016). The named Act allowed healthcare practitioners to administer lethal medications to terminally illpatients who requested for assisted suicide to escape from unduesuffering. Switzerland legalized assisted suicide in the early 1940s.In the early 2000, Belgium legalized voluntary assisted suicide(Quill, Cassel &amp Meier, 2013). However, the laws that legalizedthe practice explicitly stated that patients who opted for this formof death had to make rational decisions. As such, qualifiedpsychiatrists are supposed to examine a patient’s state of mind tohave absolute certitude of their choice. Once this happens, thepatient must take the final dose in the presence of two witnesses.Today, the practice is acceptable only under various circumstances.Also, the practice is entirely illegal in countries such as Germany,the U.K., and Iceland.


Howaccessible are resources (O) for terminally ill patients (P) whochoose (I) to be able to establishhow/when they die (T) in Europe compared to the United States(C)?&nbsp

ThisPICOT question is important in establishing the extent to whichresources for performing assisted suicide are available in Europecompared to the United States.

Accessibilityof Resources for in Europe and the U.S.

Inthe United States, patients who choose physician-assisted suicide asa viable solution for eliminating the effects of an existing terminalillness can only receive such services in Montana, Washington,Vermont, California, and Oregon. According to Emanuel,Onwuteaka-Philipsen, Urwin and Cohen (2016), these are the locationswhere resources for executing physician-assisted suicide exist. Thefacilities for assisted suicide are mostly unavailable outside thesefive states since laws in other regions within the U.S. criminalizeany form of induced death. As such, terminally ill patients outsidethe five states that legalize death with dignity cannot readilyaccess the resources for this type of medical suicide.

Resourcessuch as lethal injections and pills are less available in the U.S.compared to Europe. The availability of such resources is higher inEurope due to the number of countries that have made the practicelegal in all parts of the nations. Interestingly, Switzerland remainsthe only country in which death with dignity has remained legal sincethe nation’s parliament first made the practice lawful in the early1940s. In Switzerland, resources for administering assisted suicideare readily available on condition that a patient takes an activerole in a rational state of mind. However, this is different from theUnited States where administering any form of resource that couldresult in the death of a patient is prohibited. A unique aspect ofphysician-assisted suicide in Switzerland is that a patient who wantit does not have to be a Swiss (Sulmasy, Ely &amp Sprung, 2016).Therefore, this means that terminally ill patients from countriesthat prohibit death with dignity can seek such services inSwitzerland. According to Emanuel, Onwuteaka-Philipsen, Urwin andCohen (2016), the flexible laws on physician-assisted suicide inSwitzerland have played a pivotal role in increasing theaccessibility of resources for carrying out the practice in Europe.Today, Europe remains the leading continent where facilities forphysician-assisted suicide are highly accessible (Sulmasy, Ely &ampSprung, 2016). However, the accessibility of such resources islimited to palliative and hospice care facilities. Therefore,terminally ill patients in specific parts of Europe can readilychoose how and when to die.

Loweraccessibility of resources for executing death with dignity in attributable to the country’s Federal laws and statutes, as wellas overwhelming support from civil societies against the practice.According to Radbruch et al. (2015), human rights activists in theU.S. argue that physicians and close relatives can intentionallycoerce a terminally ill patient to take away their life. Criticsmaintain that close relatives of such patients can potentially abusethe strategy by using it as a cost-restraining strategy. In essence,this is the case, especially when relatives have spent substantialamounts of money on taking care of their ailing relatives. Therefore,resources for performing physician-assisted suicide are inaccessiblein most parts of the nation due to the need to protect patients frominhuman treatment. The United States Federal laws and policies aim atprotecting the sanctity of life at all times.

Legaland Ethical Issues

Legallyand ethically, physician-assisted suicide remains an open debate.Ethically, this practice is both acceptable and unacceptable underdifferent circumstances. For this reason, many people will continuequestioning the ethics of assisted suicide. Radbruchet al.(2015) argued that this practice is ethically permissible on thegrounds that it is a personal choice made by a terminally illpatient. The practice is further permissible if patients make theirown choices rationally. Therefore, this means that medicalpractitioners have to receive an appropriate documentation from acertified psychiatrist indicating that the patient has made arational choice without any form of undue pressure (Chambaere,Cohen, Bernheim, Vander Stichele &amp Deliens, 2016).Hence, death with dignity is ethically correct when patients need toavoid unbearable pain and suffering due to a particular medicalcondition or illness.

Assisteddeath is also ethically acceptable since health care professionalshave a skilled obligation to alleviate pain and suffering throughouttheir career. Physician-assisted death is a means of eliminatingprolonged pain that terminally-ill patients undergo. Sulmasy,Ely, and Sprung(2016) found out that assisted death with dignity is ethicallyjustifiable since the act of administering life-terminating drugstakes place voluntarily and with full knowledge of a patient.Therefore, palliative care specialists who provide lethal drugs do sofor the sole benefit of patients who do not have to sufferunnecessarily. According to Quill,Cassel and Meier(2013), physician-assisted suicide is ethically acceptable because ithappens openly and genuinely. Notably, this contrasts situations inwhich death takes place in secrecy this means that people who acceptthis form of death are honest and transparent. Besides, assisteddeath shows compassion to patients since it removes unnecessarypsychological, financial, and social burdens.

Therespect for individuals’ autonomy also justifiesphysicians-assisted suicide. Radbruchet al. (2015)articulated that people of rational minds have the last right todecide both the manner and timing of their death upon suffering fromterminal diseases. Therefore, this implies that one has the freedomof choice, the right to privacy, the privilege to life and death, aswell as power over their body. For instance, terminally ill patientshave the right to ask for means of hastening their death instead ofreceiving any form of treatment that may not improve their condition.

Onthe downside, the ethics that oppose death with dignity point thatthe practice contravenes the Hippocratic Oath of medicine, whichstates that a certified medical practitioner should not harm oradminister any form of poison. Sulmasy,Ely, and Sprung(2016) noted that this professional pledge opposes taking away humanlife. From a professional perspective, physician-assisted suicidecould potentially damage the image of the nursing and medicalprofessions. Religious ethics also oppose to assisted suicide firmly.Major religions such Islam, Christianity, Judaism, and Hinduismbelieve in the sanctity of life. For this reason, any action thattakes way life is ethically unacceptable.

Legally,physician-assisted suicide is prohibited in most states in the U.S.and some parts of Europe. Quill,Cassel &amp Meier(2013) indicated that in the U.S., this practice is prohibited in allstates except Washington, Vermont, Oregon, California, and Montana.Therefore, this implies that any form of assisted suicide is illegal.However, for the five states, the practice is only acceptable afterphysicians take into consideration various factors. These include awitnessed written request of death, existence of a terminal illness,confirmation of the option by at least two certified physicians fromdifferent health care facilities, over 18 years, and a waiting periodof two weeks (Chambaere,Cohen, Bernheim, Vander Stichele &amp Deliens, 2016).In Europe, countries that allow assisted suicide include Switzerland,Belgium, Netherlands, Luxembourg, France, and Switzerland.


Insummation, physician-assisted suicide is a controversial topic.Despite the controversies surrounding this matter, it remainsrelevant to the field of nursing. For palliative care nurses, theissue is relevant, especially since they interact with terminally illpatients on a daily basis. The applicability of the topic is due tovarious aspects of physician-assisted suicide. The resources forexecuting this practice are easily available in Europe than in theUnited States. The reason for this is that individual countries inEurope legalize the practice. In the United States, only the statesof Vermont, Montana, Oregon, California, and Washington legalizeassisted suicide. Therefore, in the U.S., resources such lethal drugsare mainly available in the named states. Legally and ethically,physician-assisted suicide remains an open debate. Death with dignityis both acceptable and unacceptable under different circumstances.The practice is morally correct since it saves patients fromunnecessary suffering. Besides, patients need the autonomy to makedecisions about their body. The practice is also unacceptable in theview that it violates the Hippocratic Oath.


Chambaere,K., Cohen, J., Bernheim, J. L., Vander Stichele, R., &amp Deliens,L. (2016). The

EuropeanAssociation for Palliative Care White Paper on euthanasia andphysician-assisted suicide: Dodging responsibility.&nbspPalliativeMedicine,&nbsp30(9),893-894.

Emanuel,E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., &amp Cohen, J.(2016). Attitudes and

practicesof euthanasia and physician-assisted suicide in the United States,Canada, and Europe.&nbspJAMA,&nbsp316(1),79.

Quill,T. E., Cassel, C. K., &amp Meier, D. E. (2013). Proposed ClinicalCriteria for Physician-

AssistedSuicide.&nbspMedicineUnbound: The Human Body and the Limits of Medical Intervention:Emerging Issues in Biomedical Policy Volume 3,&nbsp3,188.

Radbruch,L., Leget, C., Bahr, P., Müller-Busch, C., Ellershaw, J., de Conno,F., &amp Berghe, P. V.

(2015).Euthanasia and physician-assisted suicide: A white paper from theEuropean Association for Palliative Care.&nbspPalliativemedicine,0269216315616524.

Sulmasy,D. P., Ely, E. W., &amp Sprung, C. L. (2016). Euthanasia andPhysician-Assisted