Euthanasia is not the "panacea" to improving end-of-life care as the "media frenzy" suggests, says US bioethicist Dr Ezekiel Emanuel.

The case for legalising euthanasia and physician-assisted suicide (PAS) in Australia is less compelling when the scientific evidence is considered, says American oncologist and bioethicist Dr Ezekiel Emanuel.

In an editorial for the Medical Journal of Australia, Dr Emanuel - chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania - writes euthanasia and PAS are not always quick and painless.

A 2000 study in the Netherlands, he says, showed 5.5 per cent of all euthanasia and PAS had a technical problem and 3.7 per cent had a complication.

"An additional 6.9 per cent of cases had problems with completing euthanasia or PAS. Technical problems, including difficulty finding a vein and administering oral medications, occurred in 4.5 per cent of euthanasia cases and in 9.8 per cent of PAS cases, wrote Dr Emanuel.

"Moreover, 3.7 per cent of euthanasia cases and 8.8 per cent of PAS cases had complications, such as nausea, vomiting and muscle spasms."

The scientific evidence also shows that pain is not the primary reason why people seek help in dying.

Instead, psychological suffering is the driving factor, writes Dr Emanuel.

"Two decades ago, research with patients who had cancer or HIV showed that those who were interested in euthanasia or PAS were not those who were experiencing pain."

This has been confirmed multiple times, wrote the doctor.

US data "shows that fewer than 33 per cent of patients are experiencing - or fearing - inadequate pain control."

"In the states of Oregon and Washington, the reasons for wanting PAS were: 90 per cent of patients reported loss of autonomy, 90 per cent were less able to engage in activities that make life enjoyable and 70 per cent declared loss of dignity."

Euthanasia is not the panacea to improving end-of-life care as the "media frenzy" in favour of the controversial issue suggests, says Dr Emanuel.

"Instead, we need to focus on improving the care of most of the patients who are dying and need optimal symptom management at home."