Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications

Peter Hudson^a1a2a3 c1, Rosalie Hudson^a4, Jennifer Philip^a1a3, Mark Boughey^a1a3, Brian Kelly^a5 and Cees Hertogh^a6a7

^a1 Centre for Palliative Care, St. Vincent's Hospital, Melbourne Australia

^a2 Queen's University, Belfast, Northern Ireland, United Kingdom

^a3 University of Melbourne, Melbourne, Victoria, Australia

^a4 Department of Nursing, University of Melbourne

^a5 School of Medicine and Public Health, Faculty of Health, University of Newcastle, New South Wales, Australia

^a6 Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands

^a7 Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands

Abstract

Objective: Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated—particularly around ethical and legal issues—and the surrounding controversy shows no signs of abating. Responding to EAS requests is considered one of the most difficult healthcare responsibilities. In the present paper, we highlight some of the less frequently discussed practical implications for palliative care provision if EAS were to be legalized. Our aim was not to take an explicit anti-EAS stance or expand on findings from systematic reviews or philosophical and ethico-legal treatises, but rather to offer clinical perspectives and the potential pragmatic implications of legalized EAS for palliative care provision, patients and families, healthcare professionals, and the broader community.

Method: We provide insights from our multidisciplinary clinical experience, coupled with those from various jurisdictions where EAS is, or has been, legalized.

Results: We believe that these issues, many of which are encountered at the bedside, must be considered in detail so that the pragmatic implications of EAS can be comprehensively considered.

Significance of Results: Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care before further consideration is given to allocating resources for legalizing euthanasia and physician-assisted suicide.

(Received September 09 2014)

(Accepted December 21 2014)

Keywords

• Euthanasia; 
• Physician-assisted suicide; 
• Legalization

Correspondence

^c1 Address correspondence and reprint requests to: Peter Hudson, Centre for Palliative Care, St. Vincent's Hospital, P.O Box 2900, Melbourne, Australia. E-Mail: phudson@unimelb.edu.au