It is vital that the health professionals understand the cultural, legal, and ethical climate that may allow, forbid, or dictate the use of what is commonly called euthanasia.
For the purposes of this discussion, euthanasia is in context with patients that are terminally ill, have a poor prognosis, a very limited life span, in palliative care, and are suffering due to a low quality of life or intense pain. While euthanasia is a generic term often used by the public, it requires further definition. Voluntary euthanasia is done at the patient's request, while non-voluntary is committed when the patient may be incompetent to make the decision or in a comatose state and the decision is made by a surrogate (Cohen et al. 1099). Withholding treatment that could sustain life is a form of euthanasia, and may come at the request of a patient, a surrogate, a physician, or a medical review board (Cohen et al 1099). Terminal sedation is, "the practice of sedating a terminally ill competent patient to the point of unconsciousness, then allowing the patient to die of her disease, starvation, or dehydration" (Braddock and Tonelli). Physician assisted suicide (PSA) is the prescribing of a lethal dose of drugs with the knowledge that the patient intends to commit suicide (Cohen et al. 1099). Each form of euthanasia carries its own legal ramifications and is governed by its own set of ethical considerations.
While Belgium and the Netherlands in the European Union have enacted laws that permit euthanasia in a well-regulated setting, in the United States it is generally forbidden. From a legal standpoint, voluntary euthanasia (suicide) is allowed in only four states due to "neither statutory nor common law prohibitions against suicide" (Darr Part II 33-34). Non-voluntary euthanasia is outlawed in all fifty states and would fall under the statutes that prohibit murder (Cohen et al. 1099). While these forms of euthanasia are against the law in most US jurisdictions, other forms may be permitted in special situations.
Physician assisted suicide (PAS) is a topic that has gained wider discussion in recent years as medical treatments may prolong a person's life, but are unable to add to the quality of life. PAS came to the public's attention when Dr. Kervorkian admitted to assisting suicide in as many as 130 separate cases (Darr Part II 32). According to Darr Part II, "All his assisted suicides occurred in Michigan, which initially had no law banning it" (31). Michigan subsequently passed a law, but Dr Kervorkian continued the practice. He was eventually sentenced for murder and after exhausting his appeals the US Supreme Court denied his writ for certiorari in 2002 (Darr Part II 32). However, these actions opened the door for states to create legislation that would permit PAS. Currently only Oregon has a law that permits PAS. In Texas, PAS is governed under section 22.08 of the state penal code that states if, "the actor's conduct causes suicide or attempted suicide that results in serious bodily injury" it is considered a jail felony (Chapter 22).
The argument over PAS has been, and continues to be, controversial. Kervorkian's argument was predicated upon Roe v. Wade on the basis of individual autonomy and the right