About Euthanasia

What is euthanasia?

Defining euthanasia in the modern context can be challenging, but the general understanding is that voluntary euthanasia occurs when a person who is fully capable of making the decision to end their life requests assistance by a doctor or other individual to do so. This is also sometimes referred to as assisted suicide or physician-assisted suicide.

The literature also distinguishes between passive euthanasia (e.g. withholding treatment) and active euthanasia (e.g. intentionally administering a lethal substance). In the case of active euthanasia, the act has been further defined as either aggressive (use of lethal substances or force) or non-aggressive (removal of life-support).

Given this resource is interested in exploring the effect of portrayals of euthanasia on those who are actively able to make a conscious, informed and resolute decision about prematurely ending their lives, voluntary euthanasia, generally of an active and aggressive nature, is the focus.

Euthanasia and suicide

In recent years, there has been international interest in media portrayal of suicide and the impact this may have on community understanding, attitudes and behaviour. A critical review of the literature in 2001¹ concluded that certain representations of suicide may increase the risk of copycat behaviour among vulnerable people. Studies in Australia, USA, Hong Kong, Canada and Austria since that time have further supported the existence of this association^2345678.

In a systematic review of the literature, Pirkis and Blood (2001⁹) observed that the ‘Werther’ or ‘copycat’ effect was more evident under some circumstances than others. It varied as a function of time, peaking within the first three days and attenuating by about two weeks. It was related to the amount of coverage, with greater numbers of media items being associated with a stronger effect. It was influenced by the prominence of the item, with ‘high impact’ stories being most likely to lead to copycat behaviours. It was also moderated by the model/observer relationship, with the effect being greatest when the model was similar to the observer (e.g., in terms of age and sex), and/or when the model was revered in some way by the observer (e.g., because of his/her celebrity status). In addition, there was evidence that explicit media description of suicide by a particular method was associated with an increase in actual suicidal behaviour employing that method.

While the evidence is limited, there is some research showing links between the portrayal of explicit methods of euthanasia and associated deaths among people who are not aged or terminally ill¹⁰. This may be as a result of vulnerable people being exposed to explicit methods of suicide, the depiction of euthanasia as “acceptable suicide”, or positive framing or promotion of suicide as a right (^{11 12}).

Euthanasia and mental illness

Euthanasia is often portrayed an act of compassion for those who are terminally ill or suffering from severe physical illness or infirmity. However, a body of research has explored the possible link between a person’s desire for euthanasia and mental ill health, such as the existence of treatable depression (^{13 14 15 16}).

References

1. Pirkis, J., Blood, R. W. (2001). Suicide and the Media: A Critical Review. Canberra: Commonwealth Department of Health and Aged Care.

2. Jamieson, P., Jamieson, K. H., & Romer, D. (2003). The responsible reporting of suicide in print journalism. The American Behavioural Scientist, 46, 1643-1660.

3. Etzersdorfer, E., Voracek, M., & Sonneck, G., (2004). A dose-response relationship between imitational suicides and newspaper distribution. Archives of Suicide Research, 8, 137-145.

4. Chan, K. P., Yip, P. S., Au, J., & Lee, D. T. (2005). Charcoal-burning suicide in post-transition Hong Kong. British Journal of Psychiatry, 186, 67-73.

5. Stack, S. (2005). Suicide in the media: A quantitative review of studies based on nonfictional stories. Suicide and Life-Threatening Behavior, 35, 121-133.

6. Tousignant, M., Mishara, B. L., Caillaud, A., Fortin, V., & St-Laurent, D. (2005). The impact of media coverage of the suicide of a well-known Quebec reporter: the case of Gaëtan Girouard. Social Science & Medicine, 60, 1919-1926.

7. Pirkis, J. E., Burgess, P. M., Francis, C., Blood, R. W., & Jolley, D. J. (2006). The relationship between media reporting of suicide and actual suicide in Australia. Social Science & Medicine, 62, 2874 - 2886.

8. Romer, D., Jamieson, P., & Jamieson, K. (2006). Are news reports of suicide contagious? A stringent test in six US cities. Journal of Communication, 56, 253-270.

9. Pirkis, J., & Blood, R. W. (2001). Op cit.

10. Sack, M. H., & Kemperman, I. (1992). Final Exit as a manual for suicide in depressed patients. American Journal of Psychiatry, 149, 842.

11. Marsden, P. (2000). The Werther Effect – Fact or Fiction? Media contagion and suicide in internet age: Critical evaluation, theoretical reconceptualisation and empirical investigation. PhD Thesis. University of Sussex. Retrieved January, 31, 2007 from www.viralculture.com/pubs/PhD.pdf

12. Marzuk, P. M., Tardiff, K., & Leon, A. C. (1994). Increase in fatal suicide poisonings and suffocations in the year Final Exit was published: A national study. The American Journal of Psychiatry, 151, 1813-1814.

13. Conwell, Y. (1994). Physician-assisted suicide: A mental health perspective. Suicide and Life-Threatening Behavior, 24, 326-333.

14. Hendin, H. (1999). Suicide, assisted suicide, and euthanasia. Chapter in: Jacobs, D. G. (ed.). The Harvard Medical School Guide to Suicide Assessment and Intervention. San Francisco: Jossey-Bass.

15. Emanuel, E. J., Fairclough, D. L., & Emanuel, L. L. (2000). Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers. Journal of the American Medical Association, 284, 2460-2468.

16. Hicks, M. H. (2006). Physician-assisted suicide: A review of the literature concerning practical and clinical implications for UK doctors. BMC Family Practice, 7, 39-55. Retrieved February 6, 2007 from http://www.biomedcentral.com/1471-2296/7/39