Assisted Death as a Last Resort

This chapter presents lessons that can be learned from the four regimes of assisted death examined in this study. The number of individuals who have sought aid in dying has been relatively small and for the most part has been limited to cases of intractable suffering in terminal illness. As knowledge of this remedy spreads, the idea of assisted death becomes more acceptable to both doctors and the public and the number of cases increases. Hence, the number has ranged from 0.19% of all deaths in Oregon to 2.2% in the Netherlands. Contrary to earlier concerns, the enactment of legislation allowing assisted death has everywhere given to a boost to palliative care. Assisted death thus has functioned not as an alternative to the best end-of-life care available, but as a way out for those who suffer inordinately despite all efforts to palliate. The scope of these laws varies. The three European regimes require merely the presence of lasting and unbearable suffering, while Oregon insists that patients be in the terminal phase of their illness. The chapter examines the downside of each approach. It also presents a model statute for the regulation of physician-assisted suicide prepared by specialists in the fields of law and medicine. It concludes that the prolonged experience with assisted death in the four national entities examined makes it possible to develop a regime that will satisfy the need for dignity in dying, assure accountability, and provide adequate safeguards against abuse.