Should People Be Able to Choose The Manner In Which They Prefer to Die? Americans Are Divided

A new report ("Dying in America: Improving Quality and Honoring Individual 
Preferences Near the End of Life") from the Institute of Medicine's Committee on Approaching Death calls for broad changes in the way this country handles end-of-life care.  The 21-member nonpartisan panel composed of doctors, nurses, insurers, religious leaders, lawyers and experts on aging calls for a "major reorientation and restructuring of Medicare, Medicaid and other health care delivery programs" and the elimination of "perverse financial incentives that encourage expensive hospital procedures when growing numbers of very sick and very old patients want low-tech services like home health care and pain management" (quoted in this New York Times article).

Americans seem to agree: two thirds of respondents to a Pew Research Center survey believe that there are circumstances in which doctors should not do everything possible to save a patient's life and the patient should be allowed to die.  But the minority who say that medical professionals always should do everything possible to save a patient’s life is growing (from 15 percent in 1990, to 31 percent in 2013).  A deeper look at the data reveals that views about euthanasia and doctor-assisted suicide are influenced by race/ethnicity, religion, political ideology, as well as by the circumstances (does the person suffer from an incurable disease?  Is she suffering?  Is she a burden to her loved ones?).

When it comes to doctor-assisted suicide, the public is evenly divided according to the Pew survey: 47% approve and 49% disapprove of laws that would allow a physician to prescribe lethal doses of drugs that a terminally ill patient could use to commit suicide.

Dr. Victor J. Dzau, the Institute of Medicine’s president, said that "patients don't die in the manner they prefer."  But the Pew survey results indicate that attitudes about end-of-life care and decisions are complicated.  If this country is to develop a "modernized end-of-life care system," the law may need to accommodate the wide range of end-of-life choices that an increasingly diverse American population wants.

Euthanasia can be classified as either active or passive and as either voluntary or involuntary. In active euthanasia, specific steps are taken to cause the patient's death, such as injecting her with poison, or giving her an overdose of pain-killers. In contrast passive euthanasia refers to the withdrawal of medical treatment or the withholding of food and fluids with the deliberate intention of causing the patient's death. Voluntary euthanasia is when the patient requests that action be taken to end her life, or that life-saving treatment be stopped. Involuntary euthanasia is when a patient's life is ended without the patient's knowledge and consent, usually because she is unconscious, or too weak to communicate. Euthanasia differs from assisted suicide, where a physician provides lethal medications but the patient decides whether and when to ingest them.

Read more: resources:
Euthanasia: A Data-Driven Learning Guide (
Frederique Laubepin

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