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Few people likes to discuss death. The concept makes most of us uncomfortable, and the discussion (in America, at least) is taboo to the degree that even discussing one’s advanced directives for end-of-life care is unsettling.

This needs to change.

The Greek word for death is thanatos, from which is derived the word “euthanasia.” A literal translation for euthanasia would be “good death,” and who among us wouldn’t want that? But what qualifies as “a good death?”

There are various nuances to euthanasia or, in effect, mercy killing — but the words are not interchangeable, even though the intent and the outcome is the same.

Mercy killing implies ending someone’s life to “put them out of their misery” without that person’s consent. On the other hand, the term euthanasia encompasses a spectrum of merciful deaths that revolve around the concept of consent.

Cases can be classified as voluntary, where people decides their fate and give consent; nonvoluntary, where the fate is chosen for a person incapable of giving consent; or involuntary, where the decision is against the will of the individual, ignoring the individual’s autonomy.

To further delineate these cases, there are active and passive classifications. An active form of euthanasia would involve introducing an agent to cause death as opposed to the passive form, which withholds agents that promote living, such as food, water or medical treatment.

Passive euthanasia is widely practiced in America when life-support machinery is turned off, comfort measures but not sustenance is provided, or pain medications are given even though they may hasten death. The remainder of this column deals with active, voluntary euthanasia.

Several European countries and a few American states — Montana, Oregon, Washington and, most recently, Vermont — have legalized euthanasia and/or physician-assisted suicide. The difference in terms refers to which person administers the lethal drug — the doctor (euthanasia) or the patient (physician-assisted suicide).

The most extensive research and experience come from the Netherlands, where euthanasia and physician-assisted suicide were legalized in 2002. For more than 20 years before that, though, there had been political, medical and social debate and research into the frequency and characteristics of these procedures, which had been widely practiced under fear of prosecution.

Since the passage of the law, the Dutch medical community is protected from prosecution when the following criteria are met: The patient’s suffering must be unbearable with no hope for its diminishment, and their request must be voluntary, be repetitive, and not be under the influence of drugs, psychoses or pressure from others. The individual also must be aware of the alternatives. At least one outside doctor must verify that the conditions above have been met. The death must be carried out in a medically appropriate way, either by the doctor or the individual (but with the doctor present). Finally, a multidisciplinary review board ensures after the fact that the due care criteria were met.

Since 2002, the Netherlands has not seen an increase in life-ending procedures. In effect, the law merely legalized what already was taking place.

Opposition to euthanasia and physician-assisted suicide takes many forms. The often-raised argument of a slippery slope has not been borne out by Dutch studies, where adhering to strict protocol has been followed in the vast majority of cases. There has been no evidence for increased euthanasia among vulnerable groups.

One may ask what the effect of causing death has upon the medical doctor, who swore to do no harm. While it’s agreed that performing euthanasia is not part of “normal medical practice,” physicians are not obligated to perform the procedure. Most foreign physicians studied view “minimizing suffering” as a higher goal than “doing no harm,” because most patients are terminal and the patient-physician relationship extends over many years. Furthermore, non-American cultures have different values than our religious and political framework permits.

Euthanasia does not devalue life. A 2005 Dutch study sited “pointless suffering” and “loss of dignity” as the most frequent reasons euthanasia was sought. When other alternatives are unavailable, why should we prolong someone else’s agony at their expense?

We should respect a person’s autonomy to end life when certain criteria have been met. This decision is too critical and irreversible; it needs to be handled on the personal level, with care and counsel. In addition to advanced directives, it’s time for our country to do its own studies, lead discussions and document the debate on dying well.

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Maria Runde is a member of the La Crosse Area Freethought Society.


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Digital news editor

(10) comments


With the technology we have today, why does anyone have to endure 'endless pain and suffering'?


Great article, Maria. Dr. Jack Kevorkian had it right. That he went to prison for the "crime" of enabling the end of suffering speaks volumes about the illogical ideology and fear-mongering of people like death panel Patssy.

Two years ago, I had to put my tumor-ridden dog down. He was in pain, could barely walk, and no longer enjoyed life. The death panel consisted of me and the vet. I hope those in charge are compassionate enough to give me a painless exit when the time comes.


Talk about death panels.


Talk about stupidity.....


One should be careful when using these buzzwords: death panels, death tax, welfare queens, and the like. When one cannot argue rationally and/or effectively to support their stand on these issues they resort to simplistic words or phrases instead. It is a dead give away for ideologically pure, black or white views that will gain little traction in the real world.


Euthenasia is not a solution to anything. Like abortion, the ramifications of this dignified death procedure will be disastrous. Who will determine when your quality of life is so bad that you must leave this earth? When will someone decide that you are no longer a functional human being? Who will decide that the baby in the Neo natal unit will need to die? We already have a procedure in place for all people to direct their end of life care. It's called a Living Will, or advance directive. If you don't know what it is go on line and look it up.


Me and me!


Excellent article, Maria.

I'm reminded of the well-known phrase, "A fate worse than death". Such a fate actually happens to many people everyday, and yet they are not allowed to make the rational, deeply personal choice of ending their suffering.

Forcing a person to endure endless pain and suffering is the opposite of "valuing life". It's a form of sadism. There is not much difference between actively enflicting great pain on a person and passively witholding the means to end such great pain. Both are forms of torture, and both involve one person putting his selfish needs above the needs of the victim.

The arguments against euthanasia or physician-assisted suicide are weak. They're often based on religious superstitions, such as: "You'll go to Hell if you do that!" They're also based on the arrogance of the medical community, which isn't too keen on surrendering their self-proclaimed "authority" over people's lives.

"Do no harm" is often a matter of opinion.


I suggest you read "How We Die" by Dr. Sherman Nuland. Great book and very tells it like it is. Discusses how "Do no harm" is greatly misunderstood. He also discusses assisted suicide.


Thank you for a timely and well researched opinion piece. It has always amazed this man that we treat animals and people so differently in this regard. It it long overdue for us to cast out the demons and embrace reality here. A little compassion for our fellow humans is the sensible and ethical path to tread.

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