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right to die
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{{Other uses}}(File:David - The Death of Socrates.jpg|thumb|210x210px|Death of Socrates){{Suicide sidebar}} The right to die is a concept based on the opinion that a human being is entitled to end their life or undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, or without the will to continue living, should be allowed to end their own life, use assisted suicide, or to decline life-prolonging treatment. The question of whom, if anyone, should be empowered to make this decision is often central to the debate.Some academics and philosophers, such as David Benatar, consider humans to be overly optimistic in their view of the quality of their lives, and their view of the balance between the positive and the negative aspects of living.BOOK, The human predicament : a candid guide to life's biggest questions, David, Benatar, vanc, 9780190633844, New York, 969543345, 2017, This idea can be considered in terms of antinatalism and the lack of agency regarding one's birth and who should have authority over one's choice to live or die.Proponents typically associate the right to die with the idea that one's body and one's life are one's own, to dispose of as one sees fit. However, a legitimate state interest in preventing irrational suicides is often up for debate. Pilpel and Amsel wrote: Contemporary proponents of "rational suicide" or the "right to die" usually demand by "rationality" that the decision to kill oneself be both the autonomous choice of the agent (i.e., not due to the physician or the family pressuring them to "do the right thing" and commit suicide) and a "best option under the circumstances" choice desired by the stoics or utilitarians, as well as other natural conditions such as the choice being stable, not an impulsive decision, not due to mental illness, achieved after due deliberation, etc.WEB, What is Wrong with Rational Suicide, A Pilpel, L Amsel,weblink {{inconsistent citations, }}Hinduism accepts the right to die for those who are tormented by terminal diseases or those who have no desire, no ambition or no responsibilities remaining. Death, however, allowed by non-violent means such as fasting to the point of starvation (Prayopavesa).WEB,weblink Hinduism — Euthanasia and Suicide, 2009-08-25, BBC, Jainism has a similar practice named Santhara. Other religious views on suicide vary in their tolerance and include denial of the right as well as condemnation of the act. In the Catholic faith, suicide is considered a grave sin.WEB,weblink Catholic Digest - The Magazine for Catholic Living - Do people who commit suicide go to hell?, 14 December 2014, yes,weblink" title="web.archive.org/web/20141219215546weblink">weblink 19 December 2014,

Ethics

The preservation and value of life have led to many medical advancements when it comes to treating patients. New devices and the development of palliative care has allowed humans to live longer than before. Prior to these medical advancements and care, those who were unconscious, minimally unconscious, and in a vegetative state life span was short due to no proper way to assist them with basic needs such as breathing and feeding. With the advancement of medical technology, it raises the question about the quality of life of a patient when they are no longer conscious. The right to self-determination and of others emerged and questions the definition of quality and sanctity of life; if one had the right to live, then the right to die must follow suit.JOURNAL, Calabrò RS, Naro A, De Luca R, Russo M, Caccamo L, Manuli A, Bramanti A, Bramanti P, The Right to Die in Chronic Disorders of Consciousness: Can We Avoid the Slippery Slope Argument?, Innovations in Clinical Neuroscience, 13, 11–12, 12–24, December 2016, 28210521, 5300707, JOURNAL, Johnson LS, The right to die in the minimally conscious state, Journal of Medical Ethics, 37, 3, 175–8, March 2011, 21084355, 10.1136/jme.2010.038877, There is a question in ethics as to whether or not a right to die can coexist with a right to life. If it is argued, the right to life is inalienable, it cannot be surrendered, and therefore may be incompatible with a right to die.WEB, Feinberg J, 1 April 1977,weblink Voluntary Euthanasia and the Inalienable Right to Life, The Tanner Lecture on Human Values, The University of Michigan, A second debate exists within bioethics over whether the right to die is universal, only applies under certain circumstances (such as terminal illness), or if it exists. It is also stated that 'right to live' is not synonymous to 'obligation to live.' From that point of view, the right to live can coexist with the right to die.{{nl}} Humanistisch Verbond: 'Recht op leven, plicht tot leven' (translated: Dutch Humanist Association: 'Right to live, obligation to live')The right to die is supported and rejected by many. Arguments for this right include:
  1. If one had a right to live, then one must have the right to die, both on their terms.
  2. Death is a natural process of life thus there should not be any laws to prevent it if the patient seeks to end it.
  3. What we do at the end of our lives should not be of concern to others.
  4. If euthanasia is strictly controlled, we can avoid entering a slippery slope and prevent patients from seek alternative methods which may not be legal.
Arguments against include:
  1. It can lead to a slippery slope; if we allow patients this right, it can expand and have dire consequences.
  2. Give rise in pressuring those to end their lives or the lives of others; ethically immoral in human and medical standards.
  3. "Throwing away" patients who are deemed no longer capable to be part of society.
  4. Decrease in palliative of life care due to the expectation of terminal patents to exercise their right to die.JOURNAL, McCormick AJ, Self-determination, the right to die, and culture: a literature review, Social Work, 56, 2, 119–28, April 2011, 21553575, 10.1093/sw/56.2.119,
A court in the American state of Montana for example, has found that the right to die applies to those with life-threatening medical conditions. Suicide advocate Ludwig Minelli, euthanasia expert Sean W. Asher, and bioethics professor Jacob M. Appel, in contrast, argue that all competent people have a right to end their own lives. Appel has suggested that the right to die is a test for the overall freedom of a given society.NEWS,weblink Next: Assisted Suicide for Healthy People, The Huffington Post, 14 December 2014, 16 July 2009, The 1991 Patient Self-Determination Act passed by the US Congress at the request of the financial arm of Medicare does permit elderly Medicare/Medicaid patients (and by implication, all "terminal" patients) to prepare an advance directive in which they elect or choose to refuse life-extending and/or life-saving treatments as a means of shortening their lives to shorten their suffering unto certain death. The treatment refused in an advance directive under US law, because of the 1991 PSDA, does not have to be proved to be "medically futile" under some existing due-process procedure developed under state laws, such as TADA in Texas.JOURNAL, Kelley K, The Patient Self-Determination Act. A matter of life and death, Physician Assistant, 19, 3, 49, 53–6, 59–60 passim, March 1995, 10141946,

By country

{{See also|Voluntary euthanasia#By country}}As of June 2016, some forms of voluntary euthanasia are legal in Canada, Colombia, Belgium,NEWS,weblink Euthanasia and the law, BBC News, 23 December 2002, Ursula, Smartt, vanc, Luxembourg,WEB,weblink Euthanasia & Physician-Assisted Suicide (PAS) around the World - Euthanasia - ProCon.org, 2016-07-20, euthanasia.procon.org, 2017-04-19, the Netherlands, and Switzerland.

Belgium

In 2002, Belgium parliament legalized euthanasia.JOURNAL, Wal, Gerrit van der, Deliens, Luc, 2003-10-11, The euthanasia law in Belgium and the Netherlands,weblink The Lancet, English, 362, 9391, 1239–1240, 10.1016/S0140-6736(03)14520-5, 0140-6736, 14568754,

Canada

As of August 2011 a British Columbia Supreme Court judge had been requested to speed up a right-to die lawsuit so that Gloria Taylor could have a doctor assist her in committing suicide. She suffered from Lou Gehrig's disease.NEWS,weblink B.C. court asked to fast-track right-to-die lawsuit, 2 August 2011, 14 December 2014, CBC News, She died of an infection in 2012.A British Columbia civil liberties lawsuit is representing six plaintiffs and challenges the laws that make it a criminal offence to assist seriously and incurably ill individuals to die with dignity.{{citation needed|date=October 2015}}On 6 February 2015 the Supreme Court of Canada ruled that denying the right to assisted suicide is unconstitutional. The court's ruling limits physician-assisted suicides to "a competent adult person who clearly consents to the termination of life and has a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." The ruling was suspended for 12 months to allow the Canadian parliament to draft a new, constitutional law to replace the existing one.Supreme Court rules Canadians have right to doctor-assisted suicide Sean Fine, Globe and Mail 6 Feb. 2015The court decision includes a requirement that there must be stringent limits that are "scrupulously monitored." This will require the death certificate to be completed by an independent medical examiner, not the treating physician, to ensure the accuracy of reporting the cause of death.NEWS, Guichon J, Alakija P, Doig C, Mitchell I, Thibeault P,weblink Assisted dying: Four problems, one simple solution, 28 December 2015, Globe and Mail, Toronto, Canada, 2 January 2016, The Canadian Medical Association (CMA) reported that not all doctors were willing assist in patient's death due to legal complications and went against what a physician stood for. Many physicians stated that they should have a voice when it comes to helping a patient end their life.JOURNAL, Vogel L, Top court hears right-to-die appeal, CMAJ, 186, 17, 1284, November 2014, 25332368, 4234712, 10.1503/cmaj.109-4923, However, the belief in late 2015 was that no physician would be forced to do so but the CMA was offering educational sessions to members as to the process that would be used.WEB,weblink Canadian doctors express mixed opinions on assisted dying, 27 December 2015, CTV News, Bell Media, 2 January 2016, The Canadian Press, On 17 June 2016, legislation passed both houses of the Parliament of Canada and received Royal Assent to allow euthanasia within Canada.WEB,weblink Canada legalises euthanasia for the terminally ill, Keane, Rebecca, vanc, 20 June 2016, Her.ie, Maximum Media; Dublin, Ireland, 22 June 2016, WEB,weblink Assisted dying to become law after Senate backs Liberals' bill, MacCharles, Tonda, vanc, 17 June 2016, thestar.com, Toronto Star, 16 July 2016,

Colombia

On 20 May 1997, the Constitutional Court of Colombia decriminalised piety homicide, for terminally ill patients, stating that "the medical author cannot be held responsible for the assisted suicide of a terminally ill patient" and urged Congress to regulate euthanasia "in the shortest time possible".WEB,weblink REPÚBLICA DE COLOMBIA Corte Constitucional Sentencia No. C-239/97, Constitutional Court of Colombia, 20 May 1997, 24 November 2016, (in Spanish)On 15 December 2014, the Constitutional Court had given the Ministry of Health and Social Protection 30 days to publish guidelines for the healthcare sector to use in order to guarantee terminated ill patients, with the wish to undergo euthanasia, their right to a dignified death.WEB,weblink Los principios para regular la eutanasia, ElEspectador.com, 19 February 2015, Redacción Salud, Spanish,

India

Since 2018, the Supreme Court of India has legalized passive euthanasia in India during a case involving Aruna Shanbaug under strict conditions, namely that the patient's consent (or relatives) is needed, and that the patient must be terminally ill or vegetative state.

Netherlands

The Netherlands legalized voluntary euthanasia in 2002 and is one of the few countries in the world to have done so. Under current Dutch law, euthanasia by doctors is only legal in cases of "hopeless and unbearable" suffering. In practice this means that it is limited to those suffering from serious medical conditions (including mental illness) and in considerable suffering like pain, hypoxia or exhaustion. Helping somebody to commit suicide without meeting the qualifications of the current Dutch euthanasia law is illegal.JOURNAL, Buiting H, van Delden J, Onwuteaka-Philpsen B, Rietjens J, Rurup M, van Tol D, Gevers J, van der Maas P, van der Heide A, Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study, BMC Medical Ethics, 10, 18, October 2009, 19860873, 2781018, 10.1186/1472-6939-10-18, These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the absence of reasonable alternatives, consultation of another physician and the applied method of ending life.In February 2010, citizens' initiative called Uit Vrije Wil (Out of Free Will) further demanded that all Dutch people over 70 who feel tired of life should have the right to professional help in ending it. The organization, initiated by Milly van Stiphout and Yvonne van Baarle, started collecting signatures in support of this proposed change in Dutch legislation. A number of prominent Dutch citizens supported the initiative, including former ministers and artists, legal scholars and physicians. Among them were former politicians Frits Bolkestein, Hedy d'Ancona and Jan Terlouw, as well as television personality Mies Bouwman.WEB,weblink Citizens group argues 'right to die', 14 December 2014, WEB,weblink 'Right to die' for elderly back at centre of Dutch debate, 14 December 2014, yes,weblink" title="web.archive.org/web/20140303182919weblink">weblink 3 March 2014, WEB,weblink 70-plus eist zachte dood, Het Parool, 2007-02-10, Frans Bosman en Corrie Verkerk, nl, This initiative has never been legalised.

New Zealand

Euthanasia is illegal in New Zealand. In 2015, lawyer and cancer sufferer Lecretia Seales brought a case (Seales v Attorney-General) to the High Court to challenge New Zealand law for her right to die with the assistance of her GP, asking for a declaration that her GP would not risk conviction.NEWS, Lecretia Seales: Lawyer with cancer embarks on challenge to New Zealand's euthanasia laws,weblink 5 June 2015, Australian Broadcasting Corporation, NEWS,weblink Judge thanks woman for right-to-die case, 5 June 2015, Radio New Zealand,

United States

The term right to die has been interpreted in many ways, including issues of suicide, passive euthanasia, active euthanasia, assisted suicide, and physician-assisted suicide.WEB,weblink Due Process of Law, Justia Law, 17 February 2019,

Major right to die cases

Karen Quinlan

The right to die movement in the US began with the case of Karen Quinlan in 1975 and continues to raise bioethical questions of one's quality of life and the legal process of death. Karen Quinlan, 21, lost consciousness after consuming alcohol and tranquilizers at a party.WEB, McFadden RD, Karen Ann Quinlan, 31, Dies; Focus of '76 Right to Die Case,weblink The New York Times, 12 June 1985, She soon began to experience respiratory problems which then prevented oxygen from flowing to her brain. This led her to slip into a comatose state in which a respirator and a feeding tube were used to keep her alive and breathing. Quinlan did not have a proxy or living will, and had not expressed her wishes if something ever happened to her to those around her, which made it difficult to decide what the next step should be.Karen Quinlan's parents understood that their daughter would never wake up and that prolonging her life may be more damaging and it would not be of quality life. Karen Quinlan's father sought out the right to be Karen's legal guardian and petitioned for the removal of the respirator that was keeping her alive. The court, however, argued that the removal of the ventilator, which would lead to Karen's death, would be considered unlawful, unnatural, and unethical. Quinlan's lawyer's counterargument stated that the removal of the respirator would allow Karen to have a natural death which is natural and ethical. The Quinlan won the court case and were appointed as the legal guardians of their daughter. The respirator was removed in 1976, but Karen continued to live without the ventilator until 1985.JOURNAL, Cornachio AW, The Right to Die in New York--the Controversy Lives., New York State Bar Journal, December 1989, 61, 8, 12–7, JOURNAL, Quinlan case set pace for bioethics debate, Hospitals, 59, 15, 36–7, August 1985, 4018757, This case to this day continues to raise bioethical questions of one's quality of life and the legal process of death. The Quinlan case brings up many important issues which are still being addressed til this day.WEB,weblink Wolters Kluwer Health - Article Landing Page, pt.wkhealth.com, 10.1097/00002727-200501000-00009, 2019-04-09, One of the critical point that the Quinlan case brings up is the patient's right to deny or withdraw treatment. Cases, where the patient was rejected or withdrew treatment, were unheard of during that period and it went against medical ethics in preserving one's life. Debates about allowing patients the right to self-determination was controversial, and it would be evaluated for the next couple of decades from state to state. It also brings up whether family members and those who are close to the patient are allowed in the decision-making process. Since Karen had no written documentation, voiced no decision, or appointed a proxy, this caused a lengthy legal battle between the Quinlan family and the state in determining Karen's best interest and determining if she would want to live or die. This had a significant influence on the use and establishment of advance directives, oral directives, proxies, and living wills.JOURNAL, Porter T, Johnson P, Warren NA, Bioethical issues concerning death: death, dying, and end-of-life rights, Critical Care Nursing Quarterly, 28, 1, 85–92, 2005, 15732427, 10.1097/00002727-200501000-00009,

Nancy Cruzan

(File:Nancy Beth Cruzan, gravestone Wellcome L0025849.jpg|thumb|207x207px|Nancy Cruzan's gravestone)Another major case that further propagated the right to die movement and the use of living wills, advance directives and use of a proxy were Nancy Cruzan. In 1983, Nancy Cruzan suffered a car accident which left her permanently in a vegetative state. Her status as an adult and lack of an advance directive, living will, or proxy led to a long legal battle for Cruzan's family in petitioning for the removal of her feeding tube which was keeping her alive since the accident. Nancy had mentioned to a friend that under no circumstances would she want to continue to live if she were ever in a vegetative state, but was not a strong enough statement to remove the feeding tube.WEB, Greenhouse L, Right-to-Die Case Gets First Hearing in Supreme Court,weblink The New York Times, 7 December 1989, Eventually, the Cruzan family won the case and had their daughter's tube removed. This case brought great debate if the right to die should be approved from state to state or as a whole nation.JOURNAL, Colby WH, From Quinlan to Cruzan to Schiavo: What have we learned?, Loyola University Chicago Law Journal, 2005, 37, 279,

Terry Schiavo

Terry Schiavo is the most recent right to die case, which occurred between 1990 and 2005. This case was controversial due to a disagreement between Terri's immediate family members and her husband. In the Quinlan and Cruzan cases, the family was able to make an unanimous decision on the state of their daughters. Schiavo suffered from a cardiac arrest which led to her collapse and soon after began to have trouble breathing. The lack of oxygen to her brain caused irreversible brain damage, leaving her in a vegetative state and required a feeding tube and ventilator to keep her alive. Terri left no advance directive or had a discussion with her parents or husband about what she may have wanted if something were to happen to her. Soon after, her husband was appointed as her legal guardian.Years later, her husband decided to remove Terri's feeding tube since the chances of her waking up were slim to none. Terri's family, however, argued against this decision and brought this case to court. The case was very turbulent and occurred over some years and involved the state and its legislators before a decision was made. This brought up bioethical debates on discontinuation of Schiavo's life vs. allowing her to continue living in a permanent vegetative state. Those who were for preserving Terri's life stated that removing the tube would be ethically immoral since they do not know what she would have wanted. They challenged her physical and mental state and stated that she might have some consciousness; thus she deserved to continue living. Those for removing the tube argued for self-determination and that her quality of life was diminished.JOURNAL, Koch T, The challenge of Terri Schiavo: lessons for bioethics, Journal of Medical Ethics, 31, 7, 376–8, July 2005, 15994353, 1734190, 10.1136/jme.2005.012419, JOURNAL, Weijer C, A death in the family: reflections on the Terri Schiavo case, CMAJ : Canadian Medical Association Journal = Journal de l'Association Medicale Canadienne, 172, 9, 1197–8, April 2005, 15805148, 557072, 10.1503/cmaj.050348, The Schiavo case is the most recent and significant right to die case in which propagate the thought of having an advance directive or living will. It also further looks into other complications that can arise, such as family disagreements, which should have been accounted for when dealing with a right to die case.

Legislation

As the health of citizens is considered a police power left for individual states to regulate, it was not until 1997 that the US Supreme Court made a ruling on the issue of assisted suicide and one's right to die. That year, the Supreme Court heard two appeals arguing that New York and Washington statutes that made physician-assisted suicide a felony violated the equal protection clause of the Fourteenth Amendment.WEB, Vacco, Attorney General of New York, et al. v. Quill et al.,weblink United States Supreme Court, In an unanimous vote, the Court held that there was no constitutional right to physician-assisted suicide and upheld state bans on assisted suicide. While in New York this has maintained statutes banning physician-assisted suicide, the Court's decision also left it open for other states to decide whether they would allow physician-assisted suicide or not.Since 1994, five states in the US have passed assisted suicide laws: Oregon, Washington, Vermont, California, and Colorado passed legislation in 1994, 2008, 2013, 2015, and 2016, respectively, that provides a protocol for the practice of physician-assisted suicide.NEWS,weblink Time, Emily, Barone, vanc, See Which States Allow Assisted Suicide, 3 November 2014, The law in these five states allows terminally ill adult patients to seek lethal medication from their physicians. In 2009, the Montana Supreme Court ruled that nothing in state law prohibits physician-assisted suicide and provides legal protection for physicians in the case that they prescribe lethal medication upon patient request. In California, the governor signed a controversial physician-assisted-suicide bill, the California End of Life Option Act, in October 2015 that passed during a special legislative session intended to address Medi-Cal funding,WEB, Brown EG, A Proclamation by the Governor of California: Convene Extraordinary Session of the Legislature of the State of California,weblinkweblink 1 February 2016, yes, 16 June 2015, after it had been defeated during the regular legislative session.NEWS,weblink Assisted-death bill passes first Assembly committee, Alexei, Koseff, vanc, 17 February 2019, Sacramento Bee, Because the bill was passed during a special session, it did not take effect until June 2016.WEB,weblink How California's aid-in-dying law will work, Soumya, Karlamangla, vanc, latimes.com, 17 February 2019, NEWS,weblink Jerry Brown signs doctor-assisted death bill, David, Siders, Alexei, Koseff, vanc, 17 February 2019, Sacramento Bee, In early 2014, New Mexico Second District Judge Nan Nash ruled that terminally ill patients have the right to aid in dying under the state constitution, i.e., making it legal for a doctor to prescribe a lethal dose of medication to a terminally ill patient.NEWS,weblink Los Angeles Times, Saba, Hamedy, vanc, New Mexico judge affirms right to 'aid in dying', 19 January 2014, The ultimate decision will be made with the outcome of New Mexico's Attorney General's appeal to the ruling. Organizations have been continuously pushing for the legalization of self-determination in terminally ill patients in states where the right to ending one's life is prohibited.JOURNAL, Printz C, Death with dignity: young patient with brain tumor puts a face on the right-to-die movement, Cancer, 121, 5, 641–3, March 2015, 25703858, 10.1002/cncr.29283,

See also

{{Col-start}}{{col-break}}Initiatives Groups Films Books {{col-break}}Individuals {{col-break}}Other related {{col-end}}

References

{{Reflist}}

Further reading

  • JOURNAL, Shaw D, The body as unwarranted life support: a new perspective on euthanasia, Journal of Medical Ethics, 33, 9, 519–21, September 2007, 17761819, 2598200, 10.1136/jme.2006.020073,
  • JOURNAL, Appel JM, A suicide right for the mentally ill? A Swiss case opens a new debate, The Hastings Center Report, 37, 3, 21–3, May–June 2007, 17649899, 10.1353/hcr.2007.0035,
  • {{nl icon}} "Uit Vrije Wil — Burgerinitiatief voltooid leven"
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