In this article, we consider the arguments for and against physician-assisted suicide (AS) and physician-assisted euthanasia (Eu). We assess the evidence around law and practice in three jurisdictions where one or both are legal, with emphasis on data from Oregon. We compare the eligibility criteria in these different regions and review the range of approved disorders. Cancer is the most common cause for which requests are granted, with neurodegenerative diseases, mostly motor neurone disease, ranking second. We review the issues that may drive requests for a physician-assisted death, such as concerns around loss of autonomy and the possible role of depression. We also review the effectiveness and tolerability of some of the life-ending medications used. We highlight significant variation in regulatory oversight across the different models. A large amount of data are missing or unavailable. We explore physician-AS and physician-assisted Eu within the wider context of end-of-life practice.
- evidence-based neurology
- health policy & practice
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Contributors UN drafted the manuscript and subsequent revisions and conceived and designed the review. CR sourced information and provided the figures. KAL provided advice relating to ethics and logical argumentation. All authors critically appraised and revised the manuscript for important intellectual content and approved the final version of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests CR and ML are the members of the Association of Palliative Medicine. CR manages the KADOH website (www.kadoh.uk).
Provenance and peer review Commissioned; externally reviewed by Martin Turner, Oxford, UK.