What Is the Approach to the Patient Seeking a Hastened Death?

Terminology

Hastened death occurs when people wish to act on their desire to control the circumstances of their death with or without assistance from another individual. Thus hastened death can refer to multiple scenarios.

Physician aid in dying refers to a physician providing at the patient’s request a lethal prescription which the patient self-administers to end their life. The term medical aid in dying is preferred by many as it is inclusive of the nonphysician clinicians who prescribe the lethal medicines. The practice is perhaps better known by the public as physician-assisted suicide . Some advocates prefer not to use the term “suicide” as they contend that aid in dying is a medical practice and is distinct from the act of suicide by a depressed patient, while others argue that suicide is the more descriptive term. Further complicating matters, the term “medical assistance in dying,” under Canada’s 2016 law (formerly Bill C-14), is used to refer to the act of both aid in dying and voluntary euthanasia. The term “aid in dying” has been criticized by some as it may be misconstrued to include hospice or palliative care, which provide interventions to ease the dying process without hastening death.

Euthanasia refers to the administration of a lethal agent by another person (usually a physician) to a patient for the purpose of causing death and is illegal in the United States.

Withdrawal of life-sustaining treatment refers to halting active interventions that may prolong a patient’s life. The American Medical Association’s (AMA) position is that the principle of patient autonomy requires that physicians must respect the decision to forgo life-sustaining treatment of a patient who possesses decision-making capacity and that the decision to withdraw treatment is ethically the same as the decision to withhold treatment. The AMA defines “life-sustaining treatment” as any medical treatment that serves to prolong life without reversing the underlying medical condition, such as mechanical ventilation, renal replacement therapy, chemotherapy, antibiotics, and artificial nutrition and hydration.

Voluntary stopping of eating and drinking is the deliberate choice of an individual with advanced illness to stop ingesting food and water with the intent of hastening death.