Euthanasia: Terms and Definitions
Voluntary Euthanasia: The person who is killed has requested to be killed. (This may involve physician-assisted suicide if a physician is assisting in the death.)
Non-Voluntary Euthanasia: The person who is killed made no request and gave no consent. (See also "Involuntary Euthanasia.")
Involuntary Euthanasia: The person who is killed made an expressed wish to the contrary. (See also "Non-Voluntary Euthanasia.")
Assisted Suicide: Someone provides an individual with the information, guidance, and means to take his own life with the intention that these tools and information will be used for the commission of suicide.
Physician-Assisted Suicide: A licensed physician provides the means for someone to kill himself through the use of legally prescribed drugs, instructing the person on how to use them. (Physicians may also speed a patient to his death by denying or withdrawing life-saving treatment; however, this is considered euthanasia by omission, not physician-assisted suicide, even though the physician is involved in the denial or withdrawal of treatment.)
Euthanasia by Action: Intentionally causing a person's death by performing an action, such as by giving a lethal injection.
Euthanasia by Omission: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water. This is usually done against the will of the patient and the patient's family.
Nutrition and Hydration: Food and fluids. (See also "Artificial Nutrition and Hydration.")
Artificial Nutrition and Hydration: Food and fluids administered by artificial means used when a patient cannot feed himself or receive regular food and water through the mouth.Artificial nutrition and hydration, often referred to as ANH,are food and fluids administered by feeding tubes, through IV, through a gastro-intestinal tube inserted surgically, or by other means. The term "artificial" is a misnomer, seeming to imply that the nutrition is artificial; however, "artificial" refers to the means by which the patient is nourished.
Brain Dead: The term "brain death" is often used to describe patients perceived as being in a persistent vegetative state (PVS) or who have experienced severe brain impairment (usually from trauma or stroke). Even though this term is widely used, there is no universal agreement within the international medical community as to the criteria to pronounce a person as brain dead. Tests measure some of the following in assessing the condition of the brain:
- Spontaneous response to outside stimulus
- Oxygen flow to the brain
- Brain stem activity
However, the degrees to which some of these are present vary with each patient. Therefore, one can never confidently ascertain that all brain activity has ceased. "Brain death" is not a precise term and should not be used; rather, "PVS with qualifications" of the patient's condition is a more helpful approach and accurate diagnosis for a patient with impaired (even acutely impaired) brain function. (See also " Persistent Vegetative State .")
Brain Damaged: With brain damage, brain waves can be detected, response to outside stimulus occurs, and the brain stem continues functioning to control heart rate, breathing, and other spontaneous functions. These functions could be assisted by mechanical devices, but the patient is very much alive as indicated by circulatory, respiratory, brain, or brain stem activity.
Persistent Vegetative State (PVS): Describes a condition in which a person exhibits no recognizable psychological adaptive responses to the environment1. A person in a PVS state experiences wake and sleep cycles and is not terminally ill. A patient in this condition is often erroneously called comatose and frequently prematurely diagnosed as "brain dead." (See also "Brain Dead.")
Medical Treatment: Any procedure or care prescribed, authorized, ordered, or approved by a physician or licensed or certified health care professional.
Palliative Care: Care designed to relieve, reduce, and manage pain or uncomfortable symptoms but not to produce a cure.
Again as with brain death, there will be varying determinations of recognizable psychological adaptive responses to the environment. One doctor may consider blinking or turning one's head to follow the voice of a loved one as a recognizable response while other doctors may require different or additional responses to stimuli (such as a reaction when a foot is tickled). There are varying standards of what constitutes recognizable responses when applying the diagnosis of PVS.