EUTHANASIA – THE SCIENTIFIC PROCEDURE Currently illegal in most countries, euthanasia is one of the most debatable issues. Euthanasia is derived from the Greek words ‘eu’ meaning ‘good’ and ‘thanatos’ meaning death. It is further defined as the way in which one can deliberately end one’s life in order to relieve the person of suffering, such as in the case of terminally ill patients. There are two types of euthanasia, passive and active. Active euthanasia occurs when a person aids another person to end his/her life, via several means, such as through lethal injections. On the other hand, passive euthanasia is one where a person causes someone’s death by withdrawing the necessary treatment he/she requires, such as withholding antibiotics if the person needs them. Furthermore, euthanasia can also be described as voluntary, involuntary and non-voluntary. Voluntary euthanasia occurs when the person makes a conscious decision to end his or her own life. On the other hand, involuntary euthanasia occurs when a person’s life is ended without the person specifying his or her desire to die. Finally, non-voluntary euthanasia, is described as the procedure carried out to end a person’s life, without his/her own consent, in cases when the person is in a coma or has a severe brain injury. Usually, non-voluntary euthanasia is employed if the person would have previously expressed their wish for assisted death, in previous occasion. Active euthanasia is legal in the following countries: Belgium, Holland and lastly, Luxembourg. Euthanasia in these countries takes the form of ‘assisted death,’ in which the person’s life is deliberately ended via an overdose of muscle relaxants or sedatives which a health care professional or a medical paramedic administers. There are many methods by which euthanasia may be initiated. The first method describes the withdrawal or withholding of treatment administered to a terminally ill patient. In this case, the person may opt to refuse the treatment being given in order to hasten death. Another method which may be administered by a medical professional, is known as the ‘lethal injection.’ This injection is given a dose of 5 grams and generally consists of sodium thiopental or sodium pentothal. These 2 compounds are described short acting barbiturates which are drugs which target the central nervous system. They are hence described as
depressants which in this case play a role in anaesthesia and to induce coma. Once administered, the person experiences loss of consciousness within a period of 10 seconds,
since the dose injected is approximately 14 times as potent as the normal dose administered as a normal anaesthetic. In euthanasia, the dose of thiopental administered is 20mg/kg of weight of the person, thus if considering a man weighing 91kg, the man would receive 1.82 grams of the thiopental. Euthanasia, according to the protocol established by the Netherlands, can be administered by multiple ways via oral, intravenously or else intramuscular drugs. Intravenous-induced death proceeds as follows; 1 gram of sodium thiopental is administered firstly, however if necessary, this may be increased further to 1.5 up to 2 grams of the injection, in the case of the person being highly tolerable to barbiturates. Moreover, following the first injection, 45 milligrams of alcuronium chloride or 18 milligrams of pancuronium bromide is then injected. Pancuronium bromide and alcuronium chloride are both muscle relaxants. Pancuronium bromide acts in such a way as to competitively inhibit a receptor at the neuromuscular junction, known as the ‘nicotinic acetylcholine receptor’ hence preventing acetylcholine to bind successfully. Moreover, this chemical also induces an increase in heart rate as a side effect. This chemical in euthanasia is used following sodium thiopental administration to stop the person’s breathing once he/she is in the induced coma. In this case, thus the individual experiences death due to anoxemia caused by the sodium thiopental. Anoxemia is defined as lack of oxygen in blood directed to the arteries. If death, is delayed, Dutch doctors may also opt to administer intravenous potassium chloride (KI) which functions in such a way as to induce hyperkalaemia in the blood, causing the heart’s resting electrical activity to be higher than usual, leading to death. Other methods by which euthanasia may take place is by starvation and dehydration. This is often promoted by ‘right-to-die’ activists. This form of euthanasia is performed by withdrawing food and water from the
individual in order to hasten death. Moreover, at times the withdrawal of food and water from a patient is combined with the administration of terminal sedation which is a means by which sedatives and analgesics (central nervous system drugs which alleviate pain) in order to control symptoms developing due to this treatment, such as pain, anxiety and agitation.
Currently euthanasia in Malta is being discussed by a parliamentary committee after recently a petition in favour of euthanasia was launched online. References http://www.life.org.nz/euthanasia/abouteuthanasia/methods-of-euthanasia/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612319/ http://www.nhs.uk/Conditions/Euthanasiaandassistedsuicide/Pages/clinicaltrial.aspx http://www.pbs.org/newshour/bb/right-die-belgium-inside-worlds-liberaleuthanasia-laws-2/