Euthanasia – Definitions of Commonly Used Terms

The word “EUTHANASIA” comes from two Greek words, “eu” (good or easy) and “thanatos” (death) – or good death.

Traditionally, euthanasia has meant an easy, painless death. Now the term is used to mean “mercy killing,” “assisted suicide,” or “involuntary euthanasia.”

It is our observation that those who espouse “euthanasia” in reality favor an imposed death – not a good death. More accurately, the practice should be called “epivalothanasia,” which means “imposed death.”

Euthanasia is often defined by its supporters as helping an individual who is suffering to die with dignity. It is often considered the merciful thing to do. It is referred to as physician assisted suicide, mercy killing, physician aid in dying, imposed death or other names.

Euthanasia: An act or an omission which, of itself or by intention, causes death in order to eliminate suffering.

“An act”— may involve a lethal injection or some other form of poisoning; smothering; shooting; etc.

“An omission”— withholding or withdrawal (w/w) of medical treatment and/or care that is necessary and ordinary (available, beneficial, and not overly burdensome for the patient).

“Of itself”— this is an important distinction. It is sometimes argued that, even though death will be the result when medical treatment and/or care (often even food and fluids) are withheld, death is not intended. The intention, it is claimed, is to end the patient’s suffering. But, intentionally withdrawing a patient’s medication or nutrition itself will, in most cases, cause death!

“By intention”— intention is important. It is impossible to know others’ intentions unless they tell us. However, when YOU make a medical decision, for yourself or another, it is important to examine your intention.

Euthanasia, as practiced today, is not just “in order to eliminate suffering.” Patients are sometimes made to die

• Because their lives are viewed as “not worth living”
• In order to save money
• To relieve others of the burden of caring for them

Euthanasia may be

• Voluntary—the patient requests or gives consent. In practice, truly voluntary euthanasia requests may be very rare, since the patient rarely gives informed consent because the alleged consent is influenced by depression, improperly treated pain or other factors that are not controlled but could be controlled.
• Involuntary—the patient is killed against his/her wishes or without his/her consent; commonly known as “mercy killing,” as in the case of children or incompetent adults.
• Non-voluntary— the patient is incapable of giving consent. “Mercy-killing” is just another name for euthanasia. “Mercy” is the presumed motive. “Killing” is the act.
• Active, direct or positive euthanasia – direct killing of the patient by administering lethal drugs or other direct means of ending life, or by withholding or withdrawing ordinary means of sustaining life such as food and water, protection from exposure and so on.
• Passive, indirect or negative euthanasia – these are ambiguous terms meaning that a decision can be made by the patient, the parent or guardian and the physician to withhold or withdraw extraordinary means of sustaining or prolonging life, such as deciding against high-risk surgery for a patient dying of cancer or kidney failure.When the intent is not to cause death but rather to reject extraordinary treatment, the result is the acceptance of death or continued life, whichever occurs, but it is not true euthanasia. The terms “passive,” “indirect” or “negative euthanasia” should not be used since they play into the hands of euthanasia advocates by confusing legitimate actions with euthanasia, thereby desensitizing people to the fact that euthanasia is killing.More importantly, passive euthanasia is sometimes defined by others as the withholding of lifesaving treatment with the intention and result of causing the patient’s death. This is the equivalent to active, direct euthanasia.Ordinary means – food, drink, rest, medicines, treatments and operations which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain or other inconvenience.
• Extraordinary means – those treatments, medicines and operations which are gravely burdensome to the patient, and which cannot be obtained or used without excessive expense, pain or other inconvenience or which, if used, would not offer a reasonable hope of benefit to the patient. A court recently has defined extraordinary means to include food and has ordered the removing of food from a patient for the purpose of killing the patient.

Euthanasia is the killing of people whose lives have value. These people all have immeasurable value because they have been created in the image and likeness of God. Unfortunately, these people, either alone or with the help of their close family and friends, have been convinced that their lives have no meaning and are no longer worth living.

Usually, individuals who have life-threatening illnesses or other life-altering physical ailments are targeted for imposed death. The use of assisted suicide is now being expanded to include many other individuals-people whose lives, in the eyes of society, are not worth living.

Euthanasia is claiming the lives people whose “quality of life” has been judged by others to be worthy only of death-whether they have an illness, a handicap, or severe mental illness. Legal or not, euthanasia is murderous, immoral and unethical.

Suicide – the act and intent of a person to cause death to himself by direct killing (such as by lethal drug) or by withholding or withdrawing ordinary means (self-starvation).

The following is based on a legal analysis of suicide by Robert M. Byrn, professor of law at Fordham University School of Law, in an article, “Compulsory Lifesaving Treatment for the Competent Adult,” Fordham Law Review, Volume 44, October 1, 1975.

Suicide had at one time been a crime with a penalty of “ignominious burial” and forfeiture of property. In the U.S. this penalty was abolished so that suicide is no longer strictly speaking a crime. But that does not make it lawful “in the sense that a right has been conferred.”

Professor Byrn cites a 16th-century judge’s legal objections to suicide:

1. It is an unnatural violation of the rules of self-preservation, because a “right” to suicide is the “apparent contradiction in a claim of right to destroy the life from which all rights flow.”
2. It is a breach of (God’s) commandment, “Thou shalt not kill.” In modern law, “the value of human life qua human” means that killing oneself shows disvalue for human life qua human. This constitutes aggression against life, and treats life as property rather than unalienable.
3. Suicide is “against the King,” depriving him of a subject, “transformed in American law to an inherent function of government to protect human life and not allow its destruction by legally permitting self-destruction.
4. It is an “evil example” to the King’s subjects. So modern government “retains the power to bar conduct which will encourage suicide as an ’evil example’ to other susceptible members of society.”

Attempted suicide – in some states a crime but not punished.

Aiding and abetting a suicide or a suicide attempt – in many states a crime.

Preventing another from committing suicide (or from inflicting serious harm to himself) by the use of reasonable force – legal in many states.

Physician-Assisted Suicide (PAS) – A physician provides the means for a person to commit suicide (self-murder). In the U.S., PAS is legal only in Oregon where a physician is permitted to write the prescription for a lethal dose of drugs at the request of a patient whose life expectancy is six months or less.

Aid-in-dying— A euphemism (soft, nice-sounding term used in place of an unpleasant sounding term) for euthanasia and PAS.

Imposed Death— an umbrella term covering all acts of killing human beings either to end their suffering or to relieve others of the inconvenience/burden/cost of caring for them.

Advance Directives for Health Care— legal documents by which individuals express their wishes about medical treatment in case they are ever unable to make health care decisions for themselves. Advance directives can be used to license euthanasia.

Legally Competent Adult Patients – Medical care per se – according to Anglo-American law every competent adult has the freedom to seek or not to seek medical care and to refuse to consent to any specific treatment proposed, under the common law right of bodily integrity and intangibility.

Lifesaving Medical Care

1. Competent adults may reject even lifesaving care under the right of bodily integrity and intangibility and also, if applicable, under the constitutional right of free exercise of religion (e.g., a Jehovah’s Witness refusing a blood transfusion because it is against his religious beliefs).
2. They may not refuse lifesaving care if there is a compelling state interest in requiring treatment for the common good (e.g., immunization to prevent the spread of communicable disease).
3. A parent might be required to undergo lifesaving treatment if there is a compelling state interest in protecting the welfare of a child from being deprived of his needed caretaker.
4. Suicide attempts which result in life-threatening injuries may require lifesaving treatment which is given without requiring the patient’s consent.
5. Rejection of lifesaving medical care is not legally equivalent to suicide because in those cases decided by the court none of the patients had a specific intent to cause his own death, but simply to accept the consequences of the life-threatening illness, “to let nature take its course” rather than undergo the burden of treatment.

Legally Incompetent Patients – patients who lack the ability to make legal choices, so that no right to refuse consent is involved. Therefore court-ordered life-saving treatment is not a subordination of patient choice. The court will usually order lifesaving or ordinary care, but treatment that is extraordinary is not required.

Minor Children – Prof. John A. Robertson, of the Wisconsin University Law School, wrote an article on medical care for children (“Involuntary Euthanasia of Defective Newborns – A Legal Analysis,” Stanford Law Review, Vol. 27, 1975). He stated:

“Under traditional principles of criminal law the omission of ordinary care by parents, physicians and nurses creates criminal liability. The crimes committed may include murder, involuntary manslaughter, conspiracy and child abuse or neglect.

“Generally a person is criminally liable for homicide by omission if: 1) He has a legal duty to protect another; 2) with knowledge or gross negligence he fails to act; 3) and such failure proximately causes the death of the other.

“The pervasive practice of withholding ordinary medical care from defective newborns demonstrates we have embarked on a widespread program of involuntary euthanasia.”