Debate: Physician Assisted Suicide Flashcards
what are the professional and ethical repsonsibilities of a doctor?
b) Demonstrate compassionate professional behavior and their professional responsibilities in making sure the fundamental needs of patients are addressed
c) Summarise the current ethical dilemmas in medical science and healthcare practice; the ethical issues that can arise in everyday clinical decision making; and apply ethical reasoning to situations that may be encountered in the first years after graduation
J) Recognise the potential impact of their attitudes, values and beliefs, perceptions and personal biases (which may be uncounscious) on individuals and groups and identify personal strategies to deal with this
k) Demonstrate the principles of person-centred care and include patients and where appropriate their relatives, carers or other advocates in decisions about healthcare needs
whata re the legal responsibilities of a doctor?
Newly qualified doctors must demonstrate knowledge of the principles of the legal framework in which medicine is practiced in the jurisdiction in which they are practicing, and have awareness of where further information on relevant legislation can be found
what is the definition of euthanasia?
euthanasia - (also sometimes referred to as ‘mercy killing’) the deliberate taking of another person’s life to relieve their suffering
what is the definition of assisted suicide?
assisted suicide - the situation where a competent person ends their own life but with the assistance of another person to perform the act, for example by providing the means to do so
• Physician assisted suicide
what is an advanced decision/advanced directive?
- An advanced decision / advanced directive (in Scotland) can detail treatment refusal where it would not be possible to communicate wishes
- Treatments being refused must be named in the advance decision
- Situations in which the treatment would or wouldn’t be acceptable must be named
In Scotland, the ‘Adult with Incapacity (Scotland) Act 2000’ requires the past and present wishes of the person must be taken into account and this would require taking account of any advanced directive an individual had made
what is an advanced statement?
- An advanced statement explains an individual’s wishes by talking or writing about them to anyone involved in their care or their family
These are not legally binding
This is Figure 1 from the SPICe (Scottish Parliament Information Centre) briefing on Assisted Suicide (Scotland) Bill, January 2015
where is assisted suicide legal?
Forms of assisted suicide are legal in a growing number of countries:
- In Europe: Switzerland (since 1942), Albania, Colombia, Japan, Belgium, Luxembourg, Finland, Austria, Germany, the Netherlands
- In the US are 7 states & Washington DC
- In Canada legalised in April 2016 - Excludes non Canadians, Excludes mental illness/psychiatric decisions, Bans advanced consent (i.e. an advanced directive for assisted suicide)
- Voluntary assisted suicide legal since 2019 under some circumstances in Victoria State, Australia and potentially Western Australia from 2021
where is euthanasia legal?
Euthanasia, where there is capacity, is now legal in Netherlands, Colombia, Belgium and Netherlands
what is the law on euthanasia/assisted suicide in the UK?
- Euthanasia is considered to be manslaughter or murder – illegal in England and Wales
- Suicide no longer a criminal act (E&W Suicide Act 1961)
- But it remains a criminal offence for a 3rd party to assist / encourage another person to commit suicide in England and Wales - The law is almost identical in Northern Ireland and There is no specific law in Scotland
- Prosecutions can only be brought with the consent of the Director of Public Prosecutions
Current situation: the UK – Two recent polls by Royal Colleges
- Royal College of Physicians
- Respondents n=6885
- Option 1 – RCP should be opposed to a change in the law on assisted dying 43.4% (44.4% in 2014)
- Option 2 – RCP should support a change in the law on assisted dying 31.6% (24.6% in 2014)
- Option 3 – RCP should remain neutral for the law on assisted dying 25%
- Asked if respondents would personally support a change in the law on assisted dying?
- Those for increased to 40.5% (32.3% in 2014)
- Those against fell to 49.1% (57.5% in 2014)
Current situation: the UK – Two recent polls by Royal Colleges
- Royal College of General Practitioners
- Respondents n=6674
- Option 1 – RCP should be opposed to a change in the law on assisted dying = 47%
- Option 2 – RCP should support a change in the law on assisted dying = 40%
- Option 3 – RCP should remain neutral for the law on assisted dying = 11%
- Conclusion that the results did not support a change in the college position and therefor would continue to oppose a change in the law.
What are some commonly advanced arguments?
how are attitudes and practice changing?
Euthanasia and physician assisted suicide are increasingly being legalised
Both remain relatively rare and primarily involve patients with cancer
Existing data do not indicate widespread abuse of these practices
Some areas for reflection
There are very many perspectives to consider in this ongoing debate. Here are just a few you may wish to explore:
- Even if it is legal is physician assisted suicide or euthanasia ethical?
- How might assisted suicide impact on the grieving process of friends and family?
- What is the impact on physicians who are involved in or deal with a request for physician assisted suicide or euthanasia?
- Is physician assisted suicide a ‘slippery slope’?
- What part does the media play in changing public perceptions?
