Physician Assisted Dying - PowerPoint Presentation

Slide1

Physician Assisted Dying

Assisted dying (sometimes also assisted death) is where the patient himself or herself ultimately takes the medication.

Euthanasia

, by contrast, is usually where the doctor administers the medication to the patient

.

Assisted

suicide includes people who are not terminally ill, but who are being helped to commit suicide, whereas assisted dying refers to people who are already dying.

“

euthanasia” can sometimes be used as a broad term to cover a range of actions.

United States:

PAD: Oregon

, Washington, Vermont, California, Colorado and the District of Columbia

:

The

Netherlands: Assisted suicide and voluntary euthanasia are legal where a person has lasting and unbearable suffering

.

Belgium

: Voluntary euthanasia is legal for patients who suffer untreatable, constant and unbearable physical or mental suffering

.

Luxembourg

: Voluntary euthanasia is legal for patients who suffer a terminal or incurable illness. Assisted suicide is also legal

.

Canada

: In June 2016 the Canadian Parliament

passed Medical Assistance in Dying Bill

Colombia

: Voluntary euthanasia is legal for terminally ill

patients

Switzerland:

voluntary

euthanasia and assisted suicide are illegal under Swiss criminal law, but assisted suicide routinely

occurs (assisted

suicide will only be an offence if it is carried out for ‘selfish motives

’).

Public support

in the United States has

plateaued

since the 1990s (range, 47%-69%

)

In

Western Europe, an increasing and strong public

support;

in Central and Eastern Europe, support is

decreasing

In

the United States, less than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or less have

complied

In

Oregon and Washington state, less than 1% of licensed physicians write prescriptions for physician-assisted suicide per

year

In

the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such

requests

Between

0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are

legal

More than 70% of cases involved patients with cancer

Typical patients are older, white, and well-educated

Pain is mostly not reported as the primary motivation.

A large portion of patients receiving physician-assisted suicide in Oregon and Washington reported being enrolled in hospice or palliative care, as did patients in Belgium

In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.

Eligibility: ALL of

Age 18+

O

rdinarily

resident in Victoria, hold citizenship or

PR

H

ave capacity with respect to VAD

(decision is their own, voluntary, not due to undue influence or coercion

) If

assessing practitioner uncertain re capacity: must refer to appropriate specialist for

Ax

D

x

with an incurable disease, illness or medical condition that

 is

advanced, progressive and will cause death

 expected within

weeks or months, not longer than 12 months   

C

auses

suffering that cannot be relieved in a manner the person deems tolerable

Cannot request VAD in an

ACF – safeguard

Capacity

requirement likely to exclude

eg

. persons with dementia - felt to be a necessary

safeguard

Mental

illness alone does not satisfy

criteria

Disability

alone does not satisfy criteria- although mental illness or disability, in the setting of meeting other eligibility criteria, is not a reason for

exclusion

Suffering

judged by the individual -

physical

, psychological, social, spiritual, loss of autonomy & control