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Is assisted dying a treatment?
Gareth S Owen1, Maria Koniarz2, Alex Ruck Keene3
1Professsor of Psychological Medicine, Ethics and Law, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
None:
This paper focuses on the nature of the assisted dying (AD) decision including the object of the mental capacity test. Specifically, we inquire into whether AD is a treatment decision. In Part I, we analyse how the AD decision is characterised in all international AD statutes also analysing what government guidance says when the primary legislation is ambiguous. In Part II, we address the question normatively: firstly, from the perspective of clinical ethics and secondly from the perspective of legal rules (the doctrine of informed consent and the duties of governments in states with socialised healthcare laws). We found that the nature of AD is variably characterised across international laws with a significant number (10/32) framing AD as a healthcare or treatment decision. In laws where the characterisation is ambiguous (14/32) government guidance tends toward a treatment characterisation. We argue in Part II that AD should not be classified as a treatment for reasons of clinical intelligibility, legal coherence and unintended policy consequences. We conclude with some recommendations, notwithstanding complexities, on a better characterisation of the decision to inform future AD policy research.
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