What is assisted dying?

Assisted dying is an umbrella term used to describe the process whereby an individual can legally request and receive medically administered or self-administered medication from a doctor or nurse prescriber to end their own life.

Around the world, different terms are used. Sometimes this is for historical reasons or because it is derived from the name given to the legislation which made the practice lawful in the first place e.g. Death with Dignity or ‘DWD’ in Oregon. Other times, the name given to the act indicates how it is administered e.g. by a physician. Here is a list of some of the terms used in different countries:

• Euthanasia (Netherlands, Belgium, Luxembourg)
• Assisted Suicide (Switzerland)
• Physician-Assisted Suicide (Netherlands, Belgium, Luxembourg, previously America)
• Assisted Dying (Australia)
• Death with Dignity (America)
• Medical Aid in Dying (MAiD) (Canada)

The two types of assisted dying

In terms of the life-ending act itself, the key distinction is between whether the final, fatal act which is being requested by the patient is administered by a doctor or by the patient themselves. In some jurisdictions, both actions – medically administered and self-administered assisted dying – are permitted e.g. the Netherlands and Canada. In other places in the world, only one or the other action is permitted e.g. in the American states which have legalised, only self-administered assisted dying is permitted, whereas in Quebec province in Canada or in Belgium, only assisted dying permitted by a doctor or nurse practitioner is legally administered.

The ethical distinction of assisted dying

The key ethical distinction here is between who has responsibility for the final, fatal act – a doctor (or nurse practitioner in Canada) or the patient herself. For some people, this distinction has ethical significance in that when the life-ending medication is patient administered, it offers greater assurance that the decision to die is freely chosen. For other people, both doctor/nurse administered and patient-administered options are ethically sound, the only difference being the patient’s personal preference.

Different types of assisted dying

Another key distinction in the different types of assisted dying offered around the world, is whether the patient is already actively dying and has a terminal prognosis or whether assistance is offered on the grounds of the severity of the person’s suffering. In the American states which have legalised, a person needs to have a six-month prognosis from a doctor in order to qualify for medical assistance to end their own life.