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A growing debate within the medical community centers on the surprising lack of robust scientific data surrounding the drugs used in assisted dying. While stringent standards govern drug development and approval in most medical contexts, the practice of euthanasia and assisted suicide appears to operate with significantly less rigorous evidence.
“It’s very hard to do scientific research with regard to the usage of drugs for euthanasia,” Steven Pleiter, former managing director of the Dutch Center of Expertise for Euthanasia, told Medscape Medical News. “If you apply euthanasia, you want to be successful, and you can’t use any other drugs than the drugs we know work. But the evidence is based on years and years of experience.”
This reliance on “years of experience” contrasts sharply with the demands for evidence-based practice in other medical fields. Dr. Claud Regnard, a retired palliative medicine consultant, expressed similar concerns, stating, “The amount of evidence supporting the use of these drugs is astoundingly small. The last study looking at efficacy and side effects was published 25 years ago, using data from 10 years earlier.”
In countries where assisted dying is legal, such as the Netherlands and Switzerland, protocols involve potent drugs like thiopental, propofol, and pentobarbital, often administered at doses far exceeding those used in standard medical procedures. However, the pharmacokinetics and pharmacodynamics of these drugs at such high doses remain poorly understood.
“We extrapolate from therapeutic doses, but we have no proper data on what happens at lethal doses,” Dr. Regnard explained. “That’s not science — that’s guesswork.”
Moreover, the lack of standardized data collection and publication across jurisdictions exacerbates the issue. While Oregon provides some transparency, their data remains incomplete, with significant gaps in complication reporting. Reports of complications like vomiting, aspiration, agitation, and even patients regaining consciousness after ingesting lethal doses raise further concerns.
The variability in time to death, ranging from minutes to hours, also presents challenges. This uncertainty can be distressing for patients and their families, especially when a swift and peaceful death is anticipated.
The absence of comprehensive data also raises ethical questions about informed consent. “How can you get informed consent from a patient when the data isn’t there?” Dr. Regnard questioned.
Despite these concerns, practitioners like Dr. Mario Riccio, who has overseen assisted dying cases in Italy, maintain that the drugs are safe and effective, drawing on established guidelines and personal experience. “I know these drugs are used elsewhere. I know they are safe. I know they work,” he stated.
However, the lack of rigorous scientific evaluation remains a point of contention, highlighting the need for more comprehensive research and data collection in this sensitive area of medicine.
Disclaimer: This news article is for informational purposes only and does not constitute medical or legal advice. The information presented is based on reports and interviews cited, and individual experiences may vary. The topic of assisted dying is highly sensitive and ethically complex. Readers are encouraged to consult with qualified healthcare professionals and legal experts for personalized guidance.
