Efficacy and safety of drugs used for ‘assisted dying’

BACKGROUND: ‘Assisted dying’ is practiced in some European countries and US states. Legislation suggests that there exists an easily prescribed drug which consistently brings about death quickly and painlessly. Evidence from jurisdictions where ‘assisted dying’ is practiced, however, reveals that hastening patient death is not so simple. SOURCES OF DATA: This report is a collation of assisted suicide and euthanasia drug protocols published by the Canadian Association of MAiD Assessors and Providers and the Royal Dutch Medical Association, annual data reports from the USA and Canada and relevant academic publications pertaining to methods of ‘assisted dying’ in the USA, Belgium, Canada and Switzerland. AREAS OF AGREEMENT: A wide variety of lethal drug combinations are used for people who want their life ended, and the prevalence of complications and failures in intentionally ending life suggest that ‘assisted dying’ applicants are at risk of distressing deaths. AREAS OF CONTROVERSY: The efficacy and safety of ‘assisted dying’ drugs are currently difficult to assess, as clinician reporting is often very low. GROWING POINTS: The findings from this report reveal that little attention has been given to the problem of unmonitored prescribing and administering of lethal drug combinations, whose mode of action is unclear. AREAS TIMELY FOR DEVELOPING RESEARCH: In order to properly assess the efficacy and safety of ‘assisted dying’, a more thorough means of data collection regarding the drugs used must be implemented and research is urgently needed into their mode of action.