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Study: Assisted Suicide Has Frequent Mishaps

BOSTON, Feb 24 (LSN.ca) - A Dutch study published in Thursday's edition of the New England Journal of Medicine (NEJM) has found that assisted suicide does not go smoothly for about 1 in 5 patients. The findings shatter the "death with dignity" mantra of an easy and peaceful death.

In 18 per cent of the 114 cases of assisted suicide studied, there were so many problems that the attending physician decided to see to the death of the patient personally by administering lethal drugs changing the cases to acts of euthanasia. Dr. Johanna Groenewoud of Erasmus University in Rotterdam found two people, of the 114 awoke from their coma and 14 either did not become comatose from the fatal drug or took longer to die than expected. CNN reported that "seven had difficulty swallowing the deadly drug prescribed by the doctor, four vomited after taking the drug, and three developed extreme gasping."

In the 535 cases of euthanasia studied, 5 patients awoke from the coma, and death took longer than expected in 23 cases. "In one case, that patient's eyes remained open, and in another case, the patient sat up," said the report. The NEJM editorial by Dr. Sherwin Nuland of Yale University School of Medicine noted that the numbers of complications reported were severely underestimated since "When outcomes are being carefully overseen by government and professional authorities, it seems likely that the physicians whose patients experienced the worst complications would be most reluctant to answer questions about untoward events."

"This is information that will come as a shock to the many members of the public - including legislators and even some physicians - who have never considered that the procedures involved in physician-assisted suicide and euthanasia might sometimes add to the suffering they are meant to alleviate and might also preclude the tranquil death being sought. Not only are patients hurt by such untoward events as those described by Groenewoud and colleagues, but so are the family members who witness or hear of them," wrote Nuland.

Instead of making the obvious conclusion that such situations compound the arguments against the legitimacy of euthanasia, he instead proposes that doctors be better trained at "ending life" and that euthanasia be advocated as a superior alternative to "assisted suicide". This mentality adds fuel to concerns that charitable end of life care (palliative care) and euthanasia are mutually exclusive approaches, that cannot be promoted alongside each other by medics and governments. That is to say that with the advancement of assisted suicide and euthanasia, support for palliative care alternatives will necessarily fall by the wayside.

In a related story the NEJM also reports that the number of legal assisted suicide victims in Oregon rose last year. Twenty-seven terminally ill people were aided by doctors under the assisted suicide law to kill themselves in 1999, an increase from 16 the year before.

For the NEJM abstracts on the Netherlands and Oregon see:
http://www.nejm.org/content/2000/0342/0008/0551.asp http://www.nejm.org/content/2000/0342/0008/0557.asp

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