1. Running Head: DEATH BY ASSISTANCE 1
Death by Assistance: Euthanasia and Physician Assisted Suicide
Kumiko Sasa
Colorado Mesa University

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For some the dying process comes natural, but for others an earlier death may feel more
suitable. This argument has become one of the more pronounced challenges in today’s society. Is
it ethically and/or morally right to assist in someone’s death? Social workers, politicians and the
general public are working to address this particular question; this is primarily due to the fact that
more individuals, with debilitating illnesses or limitations, are starting to feel that death, at a
certain point, is more appropriate for them under such circumstances, than living any longer.
This perspective creates various arguments for and against procedures like euthanasia and
Physician Assisted Suicide (PAS) that allow individuals to choose their time of death.
First, looking at euthanasia, there are two types: active and passive. This distinction is
also argued over regarding the actual difference between the two actions. For active euthanasia,
BBC News explains that this “occurs when the medical professionals, or another person,
deliberately do something that causes the patient to die” (2014). This is similar to their definition
of passive euthanasia, which states that “the patient dies because the medical professionals either
don’t do something necessary to keep the patient alive, or when they stop doing something that is
keeping the patient alive” (2014). This includes things such as taking an individual off their life-
support machine or feeding tube, and not carrying out a specific life-extending procedure or
giving them life-extending drugs. Given these two definitions, it’s important to clarify what
euthanasia actually means. Boudreau and Somerville (2014) examine this particular word
through historical context. Originally, euthanasia had the meaning of “a good, gentle, and easy
death” (Boudreau & Somerville, 2014, p.2). Today, this word has taken on the meaning “to
euthanize,” which the Oxford Dictionary indicates as the action of “putting (a living being,
especially a dog or cat) to death humanely” (2015). Overall, Boudreau and Somerville (2014)
believe that the appropriate definition physicians should use comes from the Canadian Senate’s

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report in 1995; which states that euthanasia refers to “the deliberate act undertaken by one person
with the intention of ending the life of another person in order to relieve that person’s suffering”
(Parliament of Canada, 2000). This definition can often be confused with that of physician
assisted suicide.
Physician Assisted Suicide (PAS), also known as Physician Aid-in-Dying, has the same
objective as euthanasia: causing the death of a person. By definition, it “refers to the practice in
which a physician provides a competent, terminally ill patient with a prescription for a lethal
dose of medication, upon the patient’s request, which the patient intends to use to end his or her
own life” (Starks, Dudzinski & White, 2014). “Upon the patient’s request” is an important part
of this definition as it gets at “the dying person’s bill of rights.” According to a variety of
resources, this bill developed from a workshop hosted by Amelia Barbus in 1978 (as cited in
Home Health, and Hospice Care, Inc., 2014). Under this bill, it includes the right to:
 be treated as a living human until I die.
 maintain a sense of hopefulness, however changing its focus may be.
 be cared for by those who can maintain a sense of hopefulness, however changing this
may be.
 express my feelings and emotions about my approaching death in my own way.
 participate in decisions concerning my care.
 expect continuing medical and nursing attention even though “cure” goals must be
changed to “comfort” goals.
 not die alone.
 be free of pain.
 have my questions answered honestly.
 retain my individuality and not be judged for my decisions, which may be contrary to the
belief of others.
 expect that the sanctity of the human body will be respected after death.

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 be cared for by caring, sensitive, knowledgeable people who will attempt to understand
my needs and will be able to gain some satisfaction in helping me face my death.
From a social work perspective, the definitions of both Euthanasia and PAS, present a variety
of bioethical issues, in regards to an individual’s decision to end their own life. According to “the
dying person’s bill of rights,” individuals have the right be free of pain, whether that’s a mental
illness, or life altering disease; they have the right to “express their feelings and emotions about
their approaching death in their own way,” as well as “participate in decisions concerning their
own care.” Under this bill, it appears that the autonomy and respect of an individual’s decision
for death, is highly regarded. In addition, it represents the role of social workers to a certain
degree, as they are to respect an individual’s autonomy and self-determination. However, the
conflicting question to answer is what about beneficence? When the individual’s action is to
harm themselves, is it legal for a social worker to limit the individual’s self-determination? With
physician assistance, the life of an individual can be taken away either through the lack of or halt
of care, or the prescription of a lethal dose of medication upon patient’s request. According to
section one in the Code of Ethics of the National Association of Social Workers, “social workers
may limit clients’ right to self-determination when, in the social workers’ professional judgment,
clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves
or others” (National Association of Social Workers, 2008). This presents one of the many
challenges social workers may face, as well as physicians who are a part of a client’s decision for
Euthanasia or PAS.
However, this challenge doesn’t end with social workers or physicians, it presents itself to
the general public as well. Numerous arguments are made against PAS as are arguments for it.
First, one of the primary arguments against PAS, is because it includes the word suicide which

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insists the action of taking one’s life. Boudreau and Somerville (2014) highlight how suicide
carries a heavy stigma. Society tends to associate it with the concept of failure, either in
community support, mistreatment of mental health issues, or individual shortcomings. Further,
the action presents itself as a scapegoat from reality and life. Marilyn Golden, a policy analyst,
discusses that the free choice of physician assisted suicide is illusory. That many other things can
push people, especially elderly to choose assisted suicide. This includes feelings of being a
burden on the family and elder abuse. She states that “such abuse could easily lead to pressures
on elders to ‘choose’ assisted suicide” (Golden, 2014). This pressure to choose, as she
continually mentions in her article, is due to the problems in managed care. It’s cheaper to
provide assisted suicide than better preventative care. Advocates of Life (2011), a non-sectarian
organization, makes a similar argument, in that physician assisted suicide and Euthanasia are
completed on a variety of individuals who hadn’t made those decisions themselves. In short, the
health care system can unethically have the power to end someone’s life who may not have
wanted that decision for themselves.
In contrast, a variety of organizations, families and individuals are pro-PAS. Primary
arguments, in favor of PAS, are based on the principles of respecting autonomy, justice,
compassion, honesty and transparency (Starks, Dudzinski, & White, 2014). First, some
individuals feel it should be a competent individual’s right to choose when and how they die.
Second, under such circumstances of mental illness and prolonged pain, PAS allows individuals
to relieve such anguish. As one website states, PAS allows patients the opportunity to “die with
dignity rather than have the illness reduce them to a shell of their former selves”
(Balancedpolitics.org, 2014). Third, PAS is also argued to lessen the anguish of the patient’s
family and friends, along with preparing them for saying goodbyes. Rather than a sudden death,

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PAS allows family members the opportunity to be prepared emotionally, mentally, and
physically for a loved one’s death. Fourth, others state that by making PAS legal, more open
discussions may occur regarding end-of-life care, including an individual’s options and concerns
for a particular care. Then finally, some argue for PAS because it can reduce health care costs,
“which would save estates and lower insurance premiums,” along with freeing up nurses and
doctors “to work on savable patients” (Balancedpolitics.org, 2014).
In all, Euthanasia and Physician Assisted Suicide present a variety of challenges both
ethically and physically. Each deal with ending a person’s life, whether that means withholding
care from them or providing them the means necessary to end their life. As a result of such
actions, people are both for the idea of Physician Assisted Suicide and against it for various
reasons. For some, they feel that the autonomy and right of an individual to end their life should
be respected. Others see it as an increased opportunity for abuse and harm to individuals with
disabilities.

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References
Advocates of Life. (2011). Euthanasia. Retrieved February 16, 2015 from
http://www.advocatesoflife.com/euthanasia.htm
Balancedpolitics.org. (2014). Should an incurably-ill patient be able to commit physician
assisted suicide? Retrieved February 17, 2015, from
http://www.balancedpolitics.org/assisted_suicide.htm
BBC News. (2014).Active and passive euthanasia. Retrieved February 11, 2015, from
http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_1.shtml
Boudreau, J. and Somerville, M. A. (2014). Euthanasia and assisted suicide: A physician’s and
ethicist’s perspectives. Medicolegal and Bioethics, 4(4), 1-12. Retrieved from Academic
Search Complete.
Home Health and Hospice Care, Inc. (2014). The Dying Person's Bill of Rights. Retrieved
February 16, 2015, from http://www.3hc.org/services/hospice/dying-persons-bill-of rights
Golden, M. (2014, January 1). Why Assisted Suicide Must Not Be Legalized. Retrieved
February 16, 2015, from http://dredf.org/assisted_suicide/assistedsuicide.html
National Association of Social Workers,(2008). Code of Ethics of the National Association of
Social Workers. Retrieved February 16, 2015, from
http://socialworkers.org/pubs/code/default.asp
Oxford Dictionary. (2015), Definition of euthanize in English. Retrieved February 11, 2015,
from http://www.oxforddictionaries.com/us/definition/american_english/euthanize?q=toeutha ize.

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Parliament of Canada. (2000).Quality end-of-life care: the right of every Canadian. Retrieved
February 10, 2015, from
http://www.parl.gc.ca/Content/SEN/Committee/362/upda/rep/repfinjun00-e.htm
Starks, H., Dudzinski, D., & White, N. (2014). Physician Aid-in-Dying. Retrieved February 16,
2015, from http://depts.washington.edu/bioethx/topics/pad.html