Physician Assisted Dying Assisted dying sometimes also assisted

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Physician Assisted Dying

Physician Assisted Dying

• Assisted dying (sometimes also assisted death) is where the patient himself or

• Assisted dying (sometimes also assisted death) is where the patient himself or herself ultimately takes the medication. • Euthanasia, by contrast, is usually where the doctor administers the medication to the patient. • Assisted suicide includes people who are not terminally ill, but who are being helped to commit suicide, whereas assisted dying refers to people who are already dying. • “euthanasia” can sometimes be used as a broad term to cover a range of actions.

• United States: PAD: Oregon, Washington, Vermont, California, Colorado and the District of

• United States: PAD: Oregon, Washington, Vermont, California, Colorado and the District of Columbia: • The Netherlands: Assisted suicide and voluntary euthanasia are legal where a person has lasting and unbearable suffering. • Belgium: Voluntary euthanasia is legal for patients who suffer untreatable, constant and unbearable physical or mental suffering. • Luxembourg: Voluntary euthanasia is legal for patients who suffer a terminal or incurable illness. Assisted suicide is also legal. • Canada: In June 2016 the Canadian Parliament passed Medical Assistance in Dying Bill • Colombia: Voluntary euthanasia is legal for terminally ill patients • Switzerland: voluntary euthanasia and assisted suicide are illegal under Swiss criminal law, but assisted suicide routinely occurs (assisted suicide will only be an offence if it is carried

• Public support in the United States has plateaued since the 1990 s

• Public support in the United States has plateaued since the 1990 s (range, 47%-69%) • In Western Europe, an increasing and strong public support; in Central and Eastern Europe, support is decreasing • In the United States, less than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or less have complied • In Oregon and Washington state, less than 1% of licensed physicians write prescriptions for physician-assisted suicide per year • In the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such requests • Between 0. 3% to 4. 6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal

• More than 70% of cases involved patients with cancer • Typical patients

• More than 70% of cases involved patients with cancer • Typical patients are older, white, and welleducated • Pain is mostly not reported as the primary motivation. • A large portion of patients receiving physicianassisted suicide in Oregon and Washington reported being enrolled in hospice or palliative care, as did patients in Belgium • In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.

Eligibility: ALL of • Age 18+ • Ordinarily resident in Victoria, hold citizenship or

Eligibility: ALL of • Age 18+ • Ordinarily resident in Victoria, hold citizenship or PR • Have capacity with respect to VAD (decision is their own, voluntary, not due to undue influence or coercion) If assessing practitioner uncertain re capacity: must refer to appropriate specialist for Ax • Dx with an incurable disease, illness or medical condition that is advanced, progressive and will cause death expected within weeks or months, not longer than 12 months • Causes suffering that cannot be relieved in a manner the person deems tolerable

• Cannot request VAD in an ACF – safeguard • Capacity requirement likely

• Cannot request VAD in an ACF – safeguard • Capacity requirement likely to exclude eg. persons with dementia - felt to be a necessary safeguard • Mental illness alone does not satisfy criteria • Disability alone does not satisfy criteria- although mental illness or disability, in the setting of meeting other eligibility criteria, is not a reason for exclusion • Suffering judged by the individual - physical, psychological, social, spiritual, loss of autonomy & control

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