Assisted Death in Europe and America: Four Regimes and Their Lessons

by Guenter Lewy

Overview

Advances in medical treatment now enable physicians to prolong life to a previously unknown extent, however in many instances these new techniques mean not the saving of life but prolonging the act of dying. In the eyes of many, medical technology has run out of control and contributes to unnecessary suffering. Hence the demand has arisen that patients should be entitled to choose death when pain and physical and mental deterioration have destroyed the possibility of a dignified and meaningful life and that their doctors should help them to realize this endeavor. At the present time there are seven jurisdictions in the world that, with various restrictions, have legalized the practice of assisted death -- physician-assisted suicide and/or voluntary euthanasia - to wit, the Netherlands, Belgium, Luxembourg, Switzerland in Europe and the states of Oregon, Washington and Montana in the United States. Four of these regimes - in the Netherlands, Belgium, Switzerland and the state of Oregon -- have been functioning for many years, and we have for them a substantial body of data as well as much observational research. This book is based upon this material. The literature dealing with the moral, legal and social aspects of assisted death is voluminous, but there is a paucity of writing that provides a detailed account of the way these four regimes are actually working. Many partisans, on both sides of the issue, cite existing data selectively or, at times, willfully distort the empirical evidence in order to strengthen their case. Based on the documentary record and interviews with officials and scholars, this book seeks to give the specialist as well as the general interested reader a reliable picture of the way assisted death functions and to draw relevant lessons. While accurate factual information cannot settle a moral debate, it nevertheless is a precondition of any well-founded argument. 'The author speaks authoritatively about the issues he addresses. I think this book does make an important contribution to the field. It will be of interest to students and scholars of PAS as a source of information and reference. I definitely recommend publication.' Stuart Youngner, Department of Bioethics, Case Western Reserve University School of Medicine 'The information collected here makes an important contribution to the literature on PAS because it collects a broad array of relevant information into a single volume. It is interesting and enlightening. This will make the book a valuable resource for anyone interested in the subject and an especially useful resource for academics who study or teach about the issues.' Rosamond Rhodes, Director, Bioethics Education, Mt Sinai School of Medicine

Product Details

ISBN-13:	9780190454012
Publisher:	Oxford University Press
Publication date:	09/24/2010
Sold by:	Barnes & Noble
Format:	eBook
File size:	2 MB

About the Author

Emeritus Professor of Political Science, University of Massachusetts, Amherst

Table of Contents

Preface 1. Introduction Why Assisted Death has Become an Important Public Policy Issue The Euthanasia and Assisted Suicide Underground The Aims of this Study 2. Euthanasia and Physician-Assisted Suicide in the Netherlands The Path to Legalization The Law of 2002 Decriminalizing Euthanasia and Physician-Assisted Suicide Empirical Data on the Practice of Euthanasia and Physician-Assisted Suicide: Who, When, Why, Where and How Problems in the Practice of Euthanasia and Physician Assisted Suicide: 1. Failure to Report Cases of Euthanasia and Physician-Assisted suicide 2. Ending Life without Explicit Request of the Patient 3. Termination of Life in Pediatric Cases 4. Assisted Death for Patients with Mental Suffering 5. Can Palliative Care Eliminate the Need for Assisted Death? The Dutch Regime of Euthanasia and Physician-Assisted Suicide Assessed 3. Voluntary Euthanasia in Belgium How Belgium Legalized Euthanasia The Law on Euthanasia of May 28, 2002 The Practice of Euthanasia since 2002 4. Assisted Suicide in Switzerland Exit German Switzerland - Association for a Humane Death Exit/Association pour le Droit de mourir dans la Dignité/Suisse Romande Dignitas Other Right-to-Die Organizations The Public Debate on Assisted Suicide 5. Physician-Assisted Suicide in Oregon A Legal Obstacle Course The Death with Dignity Act (DWDA) Ten Years of Physician-Assisted Death Criticism and Problem Areas 6. Assisted Death as a Last Resort Lessons from Four Regimes of Assisted Death A Model Statute for Physician-Assisted Suicide Dilemmas and Promise of Legalized Assisted Death Appendices 1. Dutch Termination of Life on Request and Assisted Suicide (Review Procedures) Act. 2. Belgian Act on Euthanasia. 3. Swiss Criminal Code, Arts. 114 - 115. 4. Oregon's Death with Dignity Act and Compliance Forms. Notes Works Cited Index

Editorial Reviews

Reviewer: Ryan F Holmes, MA (Saint Louis University)
Description: This book investigates empirical data on physician assisted suicide (PAS) and euthanasia in four countries where the practice is legal, analyzing evidence from state-supported and independent research.
Purpose: In analyzing the data, the author attempts to describe how the practice is carried out in the Netherlands, Belgium, Switzerland, and in Oregon in the United States, in an effort to address empirical issues within the debate rather than addressing the arguments for or against the practice. Though it does not actively engage in the ethical elements of the debate, the compilation of studies contributes to the literature in this area, mapping the current landscape and the history behind the current practice.
Audience: The book is written for academics and practitioners alike. Those unfamiliar with the major arguments perhaps will find the book lacking in depth, but it serves to address some of the raw data and, as such, provides valuable background information.
Features: The author's use of sources demonstrates a command of the subject and an understanding of the landscape in which it takes place. The book focuses upon the four geographical locations due, in part, to their relatively lengthy histories with the practice. In reviewing the available studies, the book briefly addresses the legal and social background of the legalization of PAS and euthanasia before addressing statistics in each location, including frequency and the number of assisted deaths. The book takes a particularly detailed look at the Netherlands, which has arguably the longest history with the practice, and addresses how the practice has affected the level of palliative care provided in each country. It also includes in appendixes the legal statutes in each of the areas.
Assessment: Perhaps the greatest shortcoming of the book is the last chapter, which implies a pragmatic need for legalization of the practice without a strong moral basis for such a claim. While the ethical debate is stated to be beyond the scope of the book, the implicit acceptance of the need for measured practice extends to this realm and perhaps oversteps, even if ever so slightly, the intended goals. On the whole, this book is an excellent resource for discussing the issue of PAS and euthanasia and will be useful to those engaged in the discussion.

Doody's Review Service

"This wonderful book makes a highly valuable and original contribution to our understanding of the complex phenomenon of assisted death. The description of the four existing regimes of assisted death is so well done that — regardless of the reader's view on this issue — it constitutes an excellent precondition and starting point for any ethical discussion on the issue." —Chris Gastmans, Catholic University of Leuven

"This book deals with moral, legal and social aspects of assisted death, mainly based on four regimes that have been functioning for many years and for which there is substantial information from the Netherlands, Belgium and Switzerland in Europe, and Oregon in the USA." — Anticancer Research

"This is not an ethical analysis but a thoroughly documented treatment of the facts - positive and negative - working from the assumption that, while the facts cammpt settle the ethics, any ethical debate must consider the facts. As such, the book has the potential to make a valuable contribution to readers' understanding of a very important public policy issue" — C.D. Kay, CHOICE

"This is a stimulating and thought-provoking book that provides accurate, up-to-date and objective information on what is arguably the most sensitive subject in palliative care" — John Costello, International Journal of Palliative Nursing

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