User:HG1/Euthanasia

Terminology
Euthanasia of humans as a topic is often highly-charged&mdash;emotionally, politically, and morally. Terminology and laws change over time, geographically and globally, causing a great deal of confusion.

Following the broad definition of euthanasia as outlined by James Rachels, euthanasia may employ methods such as taking a patient off life support. Both active and passive euthanasia can be voluntary, nonvoluntary or involuntary. (See Karl Binding and Alfred Hoche for one of the first uses of the three types of euthanasia.)

Euthanasia by consent: There is involuntary and voluntary. Involuntary Euthanasia is euthanasia against someone’s will and is often considered murder. This kind of euthanasia is usually considered wrong by both sides and is rarely debated. Voluntary Euthanasia is euthanasia with the person’s consent, but is still controversial.

Euthanasia by means: There is passive, non-aggressive, and aggressive. Passive euthanasia is withholding common treatments (such as antibiotics, drugs, or surgery) or giving a medication (such as morphine) to relieve pain, knowing that it may also result in death (principle of double effect). Passive euthanasia is currently the most accepted form as it is currently common practice in most hospitals. Non-aggressive Euthanasia is the practice of withdrawing life support and is more controversial. Aggressive Euthanasia is using lethal substances or force to kill and is the most controversial means

Physician assisted dying is where doctors provide a prescription for a terminally ill patient to hasten their death. This is seen as morally distinct from euthanasia because the physician does not cause the patient's death but gives the patient choice of the time and circumstances of his or her own death. Physician assisted dying is the terminology used by the state of Oregon to describe the action of its Death With Dignity law. Possibly the most famous physician related to euthanasia is Dr. Jack Kevorkian. He was imprisoned in March of 1999. He was paroled in 2006 because he is near death with Hepatitis C.

Responding to requests from Oregon patients and their families, the Oregon Health Division changed their usage in October 2006 from "physician-assisted suicide" to "physician-assisted death." The American Public Health Association made the same change in November 2006.

Voluntary euthanasia occurs with the fully informed request of a decisionally-competent adult patient or that of their surrogate (proxy). (Example: Thomas Youk with ALS was assisted by Jack Kevorkian.) This should not be confused with death after treatment is stopped on the instructions of the patient himself, either directly or through a do not resuscitate (DNR) order. Enforcing a DNR order has never been considered assisted suicide or suicide of any kind, at least in the eyes of the law. Patients with healthy minds have always had the right to refuse treatment; this could be defined as a happy death.

Nonvoluntary euthanasia occurs without the fully informed consent and fully informed request of a decisionally-competent adult patient or that of their surrogate (proxy). An example of this might be if a "patient" has decisional capacity but is not told they will be euthanized; or, if a patient is not conscious or lacks decisional-capacity and their surrogate is not told the patient will be euthanized.

Involuntary euthanasia occurs over the objection of a patient or their surrogate (proxy). An example of this might be if a patient with decisional capacity (or their surrogate) is told what will happen. The patient (or surrogate) refuses yet the patient is euthanized anyway. This is generally considered murder. If a patient slated for euthanasia changes his or her mind at the last minute, the doctor is categorically required by law to honor that wish. In most countries removing or denying treatment without the clear instructions of the patient is usually seen as murder.

Terminal sedation is a combination of medically inducing a deep sleep and stopping other treatment, with the exception of medication for symptom control (such as analgesia). There is now increasing evidence that the use of sedatives and analgesics as recommended by palliative care physicians, do not shorten life or hasten death (see opioids). Consequently the use of such drugs by physicians trained in palliaitve care can no longer be viewed as euthanasia or physician assisted suicide as has been claimed, but simply effective symptom control without harming the patient.

Animal euthanasia is commonly referred to by the euphemism "put down" or "put to sleep".

Mercy killing (Coup de grâce) is a term used for some cases of euthanasia. Typically it refers to euthanasia by someone other than a doctor, such as a parent, who perceives the individual to be suffering. In some cases, the individual cannot consent. In other cases, the individual can consent, but is not asked or refuses. Lastly, in some cases the individual consents, and it may even be the individual who initiates the discussion.