Advances in Medical Ethics
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Evolution of Euthanasia and Assisted Suicide Requests from Terminal Patients Hospitalized in Palliative Care Units

Charlotte Olivier^{* *}Correspondence: Charlotte Olivier, Department of Geriatric Medicine, Kent State University, Kent, USA, Email:

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Euthanasia, also referred to as "mercy killing," is the act or practice of ending the lives of those who are physically ill or who suffer from a painful, incurable ailment without causing them any pain, or enabling them to fade away by postponing treatment or turning off artificial life support. The act of ending a patient's life to eliminate their suffering is known as euthanasia. Normally, the patient would have a serious illness or be in excruciating agony, euthanasia would allow the patient to have a comparatively "good death," as opposed them to a slow, agonizing, or indignified demise. The medication class utilized for general anesthesia includes barbiturates, which are typically employed as the euthanasia solution. Similar to general anesthesia, this solution causes loss of consciousness and loss of pain perception. However, at much higher dosages, it also impairs the circulatory and breathing systems. For euthanasia, the majority of veterinarians use the seizure medication pentobarbital. The individual eventually loses unconscious after taking large amounts. Within one to two minutes, it usually causes their heart and brain to stop beating. In veterinary End of Life (EOL) care and animal hospice, euthanasia and hospicesupported natural dying are both morally and physiologically acceptable options. A dialogue between the caregiver and the animal hospice team should determine if humane euthanasia or hospice-supported natural dying is preferable.

The principles of animal hospice oppose a pet owner's decision to allow their animal companion to pass away while under the supervision of a licensed veterinarian without applying adequate palliative measures. Withholding palliative sedation or euthanasia is regarded as immoral and inhumane if the patient's pain and suffering cannot be eased in any other way. Euthanasia is prohibited by legislation and is often punishable by imprisonment. Euthanasia is carried out on a person who is incapable of giving consent because of their current state of health. In this case, another suitable person makes the choice on the person's behalf based on their quality of life. It is typically recognized as either murder (if committed by another) or suicide (if committed by the patient) because most legal systems lack a particular provision for it. Doctors, however, are legally permitted to opt not to prolong a patient's life when they are experiencing extreme pain and to provide them medications even if doing so shortens the patient's life. Several European nations' criminal codes included unique clauses for mild punishment and taking into account mitigating circumstances in euthanasia proceedings at the end of the 20th century.

There is a difference between withholding life support and withdrawing it (removal of the patient off life support), according to certain ethicists. The ability of contemporary medicine to extend life through technological methods has risen the issue of what options should be offered to the doctor and the patient's family in times of acute physical or emotional pain, particularly if the patient is incapable of making their own decisions. On the other hand, the families of comatose and seemingly terminal patients have instituted legal action against the medical establishment to force them to stop using extraordinary life support. Criminal charges have been brought against physicians for passively doing nothing to prolong life or withdrawing lifesupport measures. Sometimes patients are transferred to smaller facilities or even their homes, with the unspoken understanding that this will speed up the inevitable.

Cortical electrical activity stopped during or 52 seconds after the euthanasia solution was infused. Following that, the Brainstem Auditory Evoked Response (BAER) vanished and brainstem function was lost, as seen by the absence of brainstem reflexes. As the initial phase in this slow euthanasia procedure, expensive medication and assistance are frequently stopped.

There are several categories for euthanasia, including voluntary, non-voluntary, and involuntary. Euthanasia that is requested voluntarily by the patient is permitted in an increasing number of nations. Non-voluntary euthanasia, which can take place in both active and passive forms and occurs when a patient's permission is not possible, is permitted in several nations under specific restrictions. All nations consider involuntary euthanasia, which is carried out against the patient's will or without their agreement.