Euthanasia is a polarizing term that confuses the debate about dying and should no longer be used by physicians, say the authors of an editorial in the Canadian Medical Association Journal.

"The end of life debate seems particularly burdened by confusion over the term 'euthanasia'," the authors write. "Both sides use it to further their ideological views: one side says murder, the other mercy; the right to live versus the right to die with dignity; selfishness versus compassion."

The term, euthanasia, is from the Greek and was coined in 1646. It was intended to mean a gentle and easy death. A nuance was introduced, by 1742, referring to the means of bringing about such a death and, in 1859, to the action of inducing such a death. Modern dictionaries have a variety of definitions, but they all imply the same meaning, an intentional action to bring about death in someone who is suffering.

"Euthanasia's broad meaning has inadvertently enveloped a set of actions that also involve the relief of symptoms in dying people," write the authors. "For example giving enough narcotic to relieve pain in cancer patients and adding enough sedation to enable comfort and minimize agitation is appropriate and compassionate care, even when the amounts required increase the probability of death. "

"It can be argued that, in such circumstances, death becomes an acceptable side-effect of effective palliation. But, in our view, it is not euthanasia."

They say that physicians can help by not using "euthanasia" to refer to actions taken to assist dying patients and instead, can clearly name and define each action as well as its possible repercussions.

Citation: Ken Flegel, Paul C. Hébert, 'Time to move on from the euthanasia debate', CMAJ, March 2010; doi:10.1503/cmaj.100338