Euthanasia and assisted suicide don’t guarantee a dignified death

Sean Riley wrote in the Journal of Law and the Biosciences [1],

“The pervasive belief that these, or any, noxious drugs are guaranteed to provide for a peaceful and painless death must be dispelled; modern medicine cannot yet achieve this. Certainly some, if not most, executions and suicides have been complication-free, but this notion has allowed much of the general public to write them off as humane, and turn a blind eye to any potential problems. Executions or PAS [physician-assisted suicides] have never been as clean as they appear, even with the US’s medicalization efforts during the 1980s.”


In response to the observation on our 8 Dangers flyer that neither euthanasia nor assisted suicide guarantees a dignified death, the Voluntary Euthanasia Society agrees but attempts to qualify the statement by asserting that the proper training of doctors and nurses administering the drugs makes complications ‘rare’. The drugs used are identical with those used in anaesthetics they say, and one doesn’t stop anaesthetics because the occasional patient vomits during their use.

‘Dignity in dying’ is one of the chief selling points of pro-euthanasia activists. They insist that it can only be achieved by euthanasia or assisted suicide. The idea is so important that several of the Bills seeking to legalise these entities are officially named “Death with Dignity Bills,” and the resulting Acts as “Death with Dignity” Acts. Moreover it is rare to find a pro-euthanasia exposition without some mention of dignity. More often than not, the problem of being undignified largely focuses on the possible lack of ability to perform one’s own ablutions especially after defaecation so that someone else has to do it. A few people are unhappy about being unconscious for hours or days waiting for death.

Contrary to the assurances given by advocates of legalised euthanasia, complications of euthanasia and assisted suicide are relatively frequent. Several of these complications are arguably more undignified than having to depend on another for one’s ablutions. For example, a six-year study from the Netherlands showed that 13.3 % of those seeking termination by euthanasia and 32.5 % of people seeking termination by assisted suicide experienced undesirable complications including shortness of breath, muscle spasm, vomiting, confusion, difficulty swallowing the drugs, failure to become unconscious and waking up from a coma not dead [2]. There are in addition, anecdotal reports of people failing to die [3]. or taking an abnormal length of time to do so [4].  In some of these cases the onlookers were severely traumatised. The following is an example.

In Portland, Oregon, a man named David Prueitt was given a big dose of barbiturate drugs mixed with applesauce as prescribed by his doctor to enable him to commit suicide. Within minutes he slipped into unconsciousness as his wife sat by his side. He should have passed away quite quickly, but after three days in deep coma he suddenly woke up. “Honey”. He said to his wife:” What the hell happened? Why am I not dead?” He survived another 13 days before dying naturally [5].  In our opinion, if one’s definition of ‘dignity’ is about saving ‘face’ or self – pride, then such events hardly equate to ‘dying with dignity’.

The drug regime used to procure euthanasia is the same as that used in United States penitentiaries to execute prisoners convicted of serious crime against the person. Recent accounts of the spectacular failure of these drugs to produce rapid humane death do little to inspire confidence in them. (For example, on 16 January 2014 Dennis Mcguire was executed in Ohio for murder, using a cocktail of drugs including midazolam. He was reported to have gasped and struggled for 25 minutes before expiring. also, Clayton Lockett was executed in Oklahoma on 29 April 2014 using a lethal drug (pentobarbital) by injection. He failed to die when a vein ruptured but died later that day of a heart attack.) The situation has become so embarrassing that some drug companies are no longer willing to allow their products to be used for drug-induced executions in the USA.

The VES in rebutting our argument states that the drugs used to euthanize individuals are the same as those used in general anaesthesia and that one does not stop anaesthetics just because the occasional patient vomits. This is a naïve statement. First, sodium pentobarbital (Nembutal) is not used for human anaesthesia, although vets use it to euthanize animals. Nembutal can only be obtained from overseas sources and if it is detected in mail, it would likely be confiscated.  Second, the two situations (euthanasia and anaesthesia) are vastly different.

Anaesthetics are performed in order to allow surgery that will hopefully save a person’s life. Precautions are taken when possible to ensure that vomiting does not occur operating on an empty stomach; or if it does, that the vomitus cannot be inhaled, by inserting an oro-tracheal tube as soon as the patient is asleep. The object is that the patient will return to consciousness well along the road to recovery and healing. Dignity is preserved as much as possible given the need to allow a clear field of vision for the operator but no-one on the staff would consider promising to preserve a patient’s dignity at the expense of a successful operation.

On the other hand, administering euthanasia has as its purpose: killing the patient. The pro-euthanasia movement promises “death with dignity.” It is not negotiable. Yet, despite the fact that it can be clearly shown that the promise is null and void, it is still enthusiastically promoted. A little more honesty and less cynicism would be appropriate.


[1]  Riley, S. (2017, August 1). Navigating the new era of assisted suicide and execution drugs. Journal of Law and the Biosciences. 2017; 4 (2), 424–434. Retrieved from

[2]  Groenewoud, J., Van den Heide, A., Onwuteaka-Philipsen, B.P. et al. Clinical problems with the performance of euthanasia and assisted suicide in the Netherlands. New Eng. J Med. 2000; 342, 551-556.

[3]  Assisted suicide attempt fails. (2005, March 4). Assoc. Press.

[4]  Fagge, N. (2011, June 27). ‘My brother took 90 minutes to die at Dignitas’: What the BBC didn’t reveal in controversial Pratchett documentary. Retrieved from

[5]  Ertelt, S. (2005, March 7). Patient’s assisted suicide bid fails, prompts concerns about Oregon law. Life News. Retrieved from