Euthanasia drugs: What is needed from medications for assisted deaths?
Generally speaking, medical care is intended to alleviate pain and suffering.
This is also the motivation behind euthanasia: the end of life itself, usually in the case of a terminal illness characterized by excruciating pain.
There has been a debate in Victoria about the drugs that should be used to end life if euthanasia is legalized.
So what medications can we ensure that facilitate the best medically supervised death?
Medicine as a poison
When it comes to what medications can, or even are, meant to kill us, the most important thing to remember is the old adage “the dose makes the poison.”
This concept is one on which the entire discipline of toxicology and drugs is based.
This is the meaning of the well-known symbol of the serpent, wound around the bowl of Hygeia (the Greek goddess of health), which represents medicine, which is seen in pharmacies and medical centers around the world.
The intertwining of poison and health care is an ancient concept in the therapeutic use of drugs.
This is a very complex science and the reason why we do clinical research. We need to test different doses of new drugs to meticulously establish a safe but effective threshold for their use.
In more practical terms, this means that too much medicine can cause harm.
Take, for example, the humble paracetamol. When taken following the correct guidelines, it is a perfectly safe and effective pain reliever used by millions of people around the world.
But taken in excessive amounts, it can cause irreparable liver damage, and if the patient does not receive an antidote in a hospital, it could lead to death.
What drugs are used in assisted death?
The group of drugs most commonly used to end life is called barbiturates. They cause brain and nervous system activity to decrease.
These medicines, used for medicinal purposes in small doses, can be taken short-term to treat insomnia or seizures in emergencies.
In different doses and administration techniques, these preparations can also be used as anesthesia, to make us sleep during surgery.
An overdose of barbiturates is fatal. A large dose will effectively slow the brain down to the point where it stops telling the body to keep the respiratory system working and breathing stops.
Both secobarbital capsules and pentobarbital liquid (generally known as the brand name, Nembutal) – (not to be confused with phenobarbital for epilepsy) have been used alone or in combination for physician-assisted suicide or Euthanasia. They are also used in injectable forms for animal euthanasia.
These two products are tried and tested, they have the advantage of years of use with the benefit of knowing the exact dose range needed and with few reported adverse effects (such as unexpected pain, prolonged death, or failed death).
Its safety and efficacy in inducing a peaceful, rapid, and incident-free death has been proven worldwide. These are the preferred drugs in the Netherlands, Belgium, Switzerland, and some American states. The USA Where euthanasia is legal.
Other options exist, either in combination or alone, but they have limited evidence of use in euthanasia. Some medications that cause excessive muscle relaxation and respiratory distress can end life, as do some pain relievers that are commonly used in palliative care.
Medications that fatally lower blood sugar levels, cause heart attacks, or block messages from the brain to the muscles can also be used, causing paralysis.
While all of these drugs are legally available in Australia, they could cause prolonged and prolonged death, with many more side effects that could cause distress and suffering at the end of life.
Nembutal and her family are less likely to do so, with more evidence of international practices than any other drug that can end life.
The “best” death
In Australia, Nembutal and secobarbital can be used for animals, but are prohibited for human use. This makes the implementation of the new proposed euthanasia law in Victoria a little more difficult.
The proposed legislation does not seek to legalize the use of Nembutal and its relatives, but suggests that a compound pharmacist invent a “drug cocktail.”
The Victorian government has reportedly approached the Monash University pharmacy department to investigate the type of pill that could be developed if the legislation is passed. Therefore, the final description of this product has not been published.
Some have suggested that the mixture will be in powder form made with pain relievers to induce a coma and eventually cause respiratory arrest.
You can also use sedatives and muscle relaxants, a medicine to slow down the heart, and an antiepileptic to prevent seizures and induce muscle relaxation. Constituents and doses have not yet been determined.
At this early stage, it is difficult to predict how this mixture would work and whether it would be easier or safer to use than the tried drugs.
This proposed product would need to be tested and the results compared, as are all new drugs.
What is needed is a drug or a mixture of drugs that produce a painless, relatively quick, and peaceful passage.
We do not want to see more suffering in the form of prolonged seizures, anguish, and pain.
If there is no safe solution, it would be advisable to simply resort to the legalization of what has already been proven.