Medical aid in dying is fundamentally different from euthanasia.
While both practices are designed to bring about a peaceful death, the distinction between the two comes down to who administers the means to that peaceful death. Euthanasia is an intentional act by which another person (not the dying person) administers the medication. By contrast, medical aid in dying requires the patient to be able to take the medication themselves and therefore always remain in control. Euthanasia is illegal throughout the United States.
State legislatures and courts in states where the practice is authorized recognize medical aid in dying as differing from suicide, assisted suicide or euthanasia.
Euthanasia and assisted suicide are both illegal in jurisdictions where medical aid in dying is authorized. Medical aid-in-dying laws on the books in California, Colorado, the District of Columbia, Hawai‘i, Maine, Oregon, Vermont and Washington expressly state: “Actions taken in accordance with [the Act] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide.” And in Montana, where assisted suicide is specifically illegal, the Montana Supreme Court ruled in Baxter v. Montana that medical aid in dying provided to terminally ill, mentally competent adult patients in no way violates established state law [including Montana’s assisted suicide statute] or the principles of public policy.”
The American Association of Suicidology (AAS) recognizes that the practice of medical aid in dying is distinct from the behavior that has been traditionally and ordinarily described as “suicide.”
People who seek medical aid in dying want to live but are stricken with life-ending illnesses. They feel deeply offended when the medical practice is referred to as suicide or assisted suicide.
Leading medical organizations reject the term “physician-assisted suicide.”
The American Academy of Hospice and Palliative Medicine, American Medical Women’s Association, American Medical Student Association, American Public Health Association and American Academy of Family Physicians have all adopted policies opposing the use of the terms “suicide” and “assisted suicide” to describe the medical practice of aid in dying. And the American Association of Suicidology, a nationally recognized organization that promotes prevention of suicide through research, public awareness programs, education and training comprised of respected researchers and mental health professionals, asserts medical aid in dying is fundamentally distinct from suicide and that the term “physician-assisted suicide” should not be used.
The most prominent professional society in the United States addressing issues that arise at the interface of law and medicine rejects the term “physician-assisted suicide.”
The American College of Legal Medicine filed an amicus brief before the United States Supreme Court in 1996 rejecting the term and adopted a resolution in 2008 in which they “publicly advocat[ed the] elimination of the word ‘suicide’ from the lexicon created by a mentally competent, though terminally ill, person who wishes to be aided in dying.”
- Oregon Death With Dignity Act. Oregon Revised Statute. Chapter 127. Enacted October 27, 1997. http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx
- Washington Death With Dignity Act. Complete Chapter 70.245 RCW, Complete Chapter. Enacted November 4, 2008. http://www.wsha.org/wp-content/uploads/Death-with-Dignity_i1000-text.pdf
- Vermont Patient Choice and Control at the End of Life Act. Act 039, Chapter 113. Enacted May 2013. http://www.leg.state.vt.us/docs/2014/Acts/ACT039.pdf
- California End of Life Option Act. ABX2-15 End of life. Enacted October 2015. http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15
- Colorado End of Life Options Act. Proposition 106. October 2016. Available from http://www.sos.state.co.us/pubs/elections/Initiatives/titleBoard/filings/2015-2016/145Final.pdf
- District of Columbia, Death with Dignity Act, Available from https://dchealth.dc.gov/sites/default/files/dc/sites/doh/page_content/attachments/Death%20With%20Dignity%20Act.FINAL_.pdf
- American Public Health Association, Patients’ Rights to Self-Determination at the End of Life. October 28, 2008, Policy No. 20086. Available from https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/29/13/28/patients-rights-to-self-determination-at-the-end-of-life
- American College of Legal Medicine, ACLM Policy on Aid in Dying. Effective October 6, 2008. Available from http://c.ymcdn.com/sites/www.aclm.org/resource/collection/11da4cff-c8bc-4334-90b0-2abbe5748d08/Policy_On_Aid_In_Dying.pdf?hhSearchTerms=%22%22aid+in+dying%22%22
- American Medical Women’s Association, Position Paper on Aid in Dying. Approved September 9, 2007. https://www.amwa-doc.org/wp-content/uploads/2018/09/Medical-Aid-in-Dying-Position-Paper.pdf
- American Medical Student Association, Principles Regarding Physician Aid in Dying. In: AMSA Preamble, Purposes and Principles, p.79. Available from http://www.amsa.org/wp-content/uploads/2015/03/PPP-2015.pdf
- American Academy of Hospice and Palliative Medicine, Statement on Physician-Assisted Death. February 14, 2007. Available from http://aahpm.org/positions/pad
- Reisch, T., et al. (1999) Efficacy of Crisis Intervention. J of Crisis Intervention and Suicide Prevention. 20(2): 78-85.
- Linda Ganzini et al., Physicians’ Experiences with the Death With Dignity Act, The New England Journal of Medicine 342 (8); Linda Ganzini et al., Mental Health Outcomes of Family Members of Oregonians Who Request Physician Aid in Dying, 38 J. of Pain and Symptom Management 807 (2009); Linda Ganzini, et al.,Oregon Physicians’ Attitudes About and Experiences With End-of-Life Care Since Passage of the Oregon Death with Dignity Act, J. of the American Medical Association 285 (2001)
- Neil, F.; Physician use of misinformation to speculate ‘assisted dying suicide contagion’ in Oregon, Journal of Assisted Dying 2016;1(1):1–6
- Ann M. Mitchell et al., Complicated Grief in Survivors of Suicide, 25 (1) J. of Crisis and Suicide Prevention 12-18 (2004).
- Orentlicher, D., Pope, T.M., Rich, B.A. (2015) Clinical Criteria for Physician Aid in Dying. Journal of Palliative Medicine. 18(x): 1-4. Available from https://www.compassionandchoices.org/wp-content/uploads/2016/04/Clinical-Criteria-for-Aid-in-Dying.pdf
- Statement of the American Association of Suicidology, "Suicide" Is Not the Same as Physician Aid in Dying." Approved October 30, 2017. Available from https://ohiooptions.org/wp-content/uploads/2016/02/AAS-PAD-Statement-Approved-10.30.17-ed-10-30-17.pdf