Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in the 21st century, surrounding the idea of a right to die.
[13] For example, Swiss law allows assisted suicide while all forms of active euthanasia (like lethal injection) remain prohibited.
In an article in the Bulletin of the History of Medicine, Brown University historian Jacob M. Appel documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906.
[21] Appel indicates social activist Anna Sophina Hall, a wealthy heiress who had watched her mother die after an extended battle with liver cancer, was the driving force behind this movement.
[21] According to historian Ian Dowbiggin, leading public figures, including Clarence Darrow and Jack London, advocated for the legalization of euthanasia.
[15][23] During this same era, US courts tackled cases involving critically ill people who requested physician assistance in dying as well as "mercy killings", such as by parents of their severely disabled children.
[citation needed] During the post-war period, prominent proponents of euthanasia included Glanville Williams (The Sanctity of Life and the Criminal Law) and clergyman Joseph Fletcher ("Morals and medicine").
[25] The Supreme Court of Western Australia ruled that it was up to Christian Rossiter, aged 49, to decide if he was to continue to receive medical care (tube feeding) and that his carers had to abide by his wishes.
[33] In New Zealand's 2020 general election the country included a binding referendum asking voters if the End of Life Choice Act 2019 should pass.
[35] 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.
[36] On 7 January 2022, Victor Escobar became the first person to undergo voluntary euthanasia without a terminal illness in the country; he had been suffering from chronic obstructive pulmonary disease.
A key turning point in the debate over voluntary euthanasia (and physician assisted dying), at least in the United States, was the public furor over the Karen Ann Quinlan case.
For example, in Shanghai a 67-year-old man was sentenced to five years in prison when he euthanized his 92-year-old mother when she emerged from a hospital procedure only able to move one finger and one toe.
[44] Chinese culture, with its emphasis on filial piety and a taboo surrounding discussions of death, poses significant obstacles to the development of euthanasia.
However, Buddhism, the predominant religion in China, views euthanasia as a means to achieve a peaceful and suffering-free death, making it more acceptable to some.
If there is some reason to believe the cause of a patient's illness or suffering is or will soon be curable, the correct action is sometimes considered to attempt to bring about a cure or engage in palliative care.
[16] Feasibility of implementation: Euthanasia can only be considered voluntary if a patient is mentally competent to make the decision, i.e., has a rational understanding of options and consequences.
Poor or uninsured patients may not have the money or no access to proper care will have limited options, and they could be pressured toward assisted death.
Those that are deemed ineligible are required to wait months for care through the public or private health system and at times at their own financial costs.
[60] Debilitating chronic pain and disease is heavily assessed when considering patients for assisted dying and for people over the age of 65, even if several medical conditions are present, it does not mean the person is eligible for this procedure.
[60] Poor mental health, geriatric syndromes, falls, delirium are underlying conditions that have the potential to exarate one’s pain and suffering in this age group, this also does not guarantee access to assisted dying.
[61] Chronic and acute conditions are common amongst elderly Australians that can range from mild to debilitating pain levels, limiting physical abilities, and taking large mental tolls on individuals.
Only for pancuronium bromide (Pavulon) are there substantial indications that the agent may also be given intramuscularly in a dosage of 40 mg.[62] In other jurisdictions (such as Australia and New Zealand), voluntary assisted dying uses 30 mL oral suspensions containing pentobarbital and an anti-emetic to induce a coma leading to respiratory arrest.
However, if the person is too ill to administer the medication themselves, a typical surgical anesthesia induction is performed (midazolam + propofol) and then once a coma is achieved, pancuronium or vecuronium is used to paralyse the diaphragm and induce respiratory arrest.
Apart from The Old Law, a 17th-century tragicomedy written by Thomas Middleton, William Rowley, and Philip Massinger, one of the early books to deal with euthanasia in a fictional context is Anthony Trollope's 1882 dystopian novel, The Fixed Period.
The films Children of Men and Soylent Green depict instances of government-sponsored euthanasia in order to strengthen their dystopian themes.
The protagonist of the film Johnny Got His Gun is a brutally mutilated war veteran whose request for euthanasia furthers the work's anti-war message.
The recent films Mar Adentro and Million Dollar Baby argue more directly in favor of euthanasia by illustrating the suffering of their protagonists.
[65] Thrash metal band Megadeth's 1994 album Youthanasia (the title is a pun on euthanasia) implies that society is euthanizing its youth.
[66] In the House episode "Known Unknowns", Dr. Wilson plans to deliver a speech at a medical conference in which he admits to having euthanized a terminally ill patient.