II.

Circumstances and Methods

Some people who face acute illness wish to refuse treatments offered by doctors, even if refusing such treatment may cause them to die. Like people who commit suicide, patients who refuse treatment often intend to end their lives because of their grim prospects for a healthy recovery. On the other hand, many people who desire assisted suicide seek relief from their suffering and do not seek death as an end in itself. Therefore, distinguishing a suicide from a refusal of treatment merely by the patient’s intention can be difficult. Nonetheless, the belief that those who commit suicide with a physician’s assistance are in a very different category from those who simply refuse treatment is widely held.

Assisted suicide also differs from euthanasia, in which a person other than the patient ends the patient’s life as painlessly as possible for merciful reasons. Euthanasia may be active, such as when a doctor administers a lethal dose of medication to a patient, or passive, such as when life-sustaining treatment is withheld or removed. In either case, someone other than the patient is the final cause of the patient’s death. Assisted suicide involves a more direct action by the person who dies than does euthanasia. For example, in a case of assisted suicide, although a physician may prescribe a lethal dose of medication, the patient administers the medication to himself or herself.