Articles on assisted suicide, and especially in the comments to online articles, often assert that giving people enough medication to provide effective pain relief in terminal illness is the same, or almost the same, as prescribing medication for the purpose of committing suicide, because doses of painkillers high enough to control the pain of dying hasten death. The assumption is false. Good pain relief may extend life. It does not shorten it.
As early as 2003, The Lancet medical journal published a review of the scientific evidence for the assumption that pain medication in adequate doses hastens death. It found that increased use of pain killers like morphine at the end of life does not hasten death (http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2803%2901079-9/fulltext.).
Other studies have shown that good pain relief for patients believed to be terminally ill may actually extend life.
In September 2010 The New York Times reported on a study which found that patients receiving palliative, or concurrent, care –combining treatment aimed at curing disease with medication adequate to control pain and other symptoms– lived longer than a control group of patients receiving only curative treatment (http://www.nytimes.com/2010/08/19/health/19care.html).
A study published in The Journal of Pain and Symptom Management in 2007 found extended life in patients receiving hospice care, which is aimed only at relieving suffering. These patients had given up curative care and were only receiving support services and all the medication needed to control pain, yet they still lived longer than patients receiving only curative care (http://www.hpccr.org/pilotFiles/resourceLibraryFiles/files/Comparing%20hospice%20and%20nonhospice%20survival-JPSM-Connor-2007.pdf.).
Dr. Pippa Hawley (http://palliativecare.med.ubc.ca/about-us/people/), a palliative care specialist at the University of British Columbia Medical Center, wrote the following in a December 30, 2010 letter to Vancouver’s online newspaper Straight.com.
As a medical professional experienced in the care of cancer patients, I can advise that though a very large single dose of a highly potent opioid such as heroin may suppress respiration sufficiently to cause death in a person who is not used to it or who does not have pain, when opioids are used appropriately for patients with pain due to advanced illness such as cancer, survival is actually longer.
These medications are commenced in low doses,usually in long-acting or slow-release formulations, and the dose can be
gradually and safely increased as much as necessary to keep pain controlled, without any respiratory depression(http://www.straight.com/article-366028/vancouver/pain-medication-can-extend-cancer-patients-lives).
Using doses of medication adequate to control pain has long been considered ethical under the principal of double effect, which considered hastened death an unintended side effect. Now physicians no longer have to fall back on this principle, because its underlying assumption about hastened death is false. Once again: adequate pain relief does not shorten life and may extend it. Giving a patient doses of painkillers high enough to make him comfortable does not even approach the ethical line separating it from assisted suicide. Assisted suicide eliminates suffering by eliminating the sufferer, sometimes long before he is suffering, and without certain knowledge of whether he ever would suffer, simply because he fears his possible suffering or has been taught by our culture that his care would be a burden to his family or the state.
There is no way assisted suicide can ever be made either ethical or safe. That is why it is illegal in all except two US states and four European countries and why it should be illegal everywhere.