End of Life

Question 1

Euthanasia KU

Answer 1

• When a persons life is ended by another individual with the intention of relieving pain and suffering
• This can be both voluntary, when the patients life is ended at their own request, or non-voluntary, when a person is no longer able to make a meaningful choice and the decision is made on their behalf
• This is further categorised into passive, intentionally letting a patient die by withdrawing artificial life support such as a ventilator and active, death brought about by a direct act for example an overdose of pain killer
• All forms of euthanasia besides passive are illegal in the UK under the 1961 Suicide Act however there has been attempted legalisation in recent years (eg. Richard Shelley)

Question 2

Assisted Dying KU

Answer 2

• When a person who is terminally ill or experiencing excruciating suffering requests aid to end their own life
• Physician assisted dying is when a medical professional provides the means for the patient to end their life

Question 3

Other Care KU

Answer 3

• Palliative care is holistic care that aims to improve terminally ill patients quality of life by addressing their physical, intellectual, emotional, social and spiritual needs.
• Similarly hospice care aims to improve a terminally ill patients quality of life typically those with less than 6 months to live. This form of care is provided when curative and life prolonging treatment ceases.

Question 4

Sanctity of Life Basics

Answer 4

• Sanctity of life is the belief that human life is sacred and should be preserved due to the intrinsic value it possesses for the below reasons:

1. It is a gift from God
2. We are created in His image
3. God has a purpose (plan) for all life
4. All life is created by God

• As a result of these beliefs Christians think the following:

1. All humans are to be valued irrespective of age, race, sex and ability
2. Human life is a basic good as opposed to an instrumental good meaning it is a good in itself rather than a means to an end
3. Human life is sacred because it’s a gift from God
4. The deliberate taking of life should be prohibited except in self defence or the legitimate defence of others

Question 5

Richard Selley Paragraph (pt. 2 of intro)

Answer 5

• Any form of euthanasia/assisted dying administration, even in a medical environment, is illegal in the UK under the 1961 Suicide Act however there has been attempted legalisation in Scotland in recent years
• Richard Selley suffered from motor neuron disease and campaigned for this legalisation in the last years of his life before travelling to a euthanasia clinic in Switzerland where his life was ended.
• He stated “knowing that I will die very soon is a surreal experience, but it is my choice”
• Richard believed that the decision to die should remain in the individuals hands, not the governments therefore this process should be as accessible as possible
• Providing a clinic within close proximity to him and his loved ones would have hugely impacted Selleys final months by allowing him to rest comfortably in familiar surroundings knowing that his and his family’s care was assured, inspiring many to follow him and demand reform.

Question 6

Moral Issues

Answer 6

• As demonstrated in the above case there is many problems that stem from the topic of euthanasia/assisted dying however there are 4 central moral issues: autonomy, compassion, dignity, and control
• Autonomy is the right that everyone possesses to self-govern what happens to them and as an extension, their body, leading to conflicting views on whether this should provide us with the ability to choose what we do with it or, if matters of life and death exist as a separate natural process that should not be interfered with.
• Compassion is the concern for the well-being of others. For some this means to reduce societal suffering by providing ways for individuals to end their pain however others would argue that assisting people during this period, for example through palliative care, is much more compassionate.
• The largest factor contributing to the desire for euthanasia/assisted dying and perhaps the most complex is dignity, the value and respect a person receives. Many people would rather avoid getting to the point of incapability that requires assistance for basic tasks leading to the view that assisted death is the most dignified solution but religious people, particularly Christians, would see this as disrespect to the value of the patients life.
• Lastly control references the power that the country and its law possess over euthanasia/ assisted dying and whether such change would be appropriate for an issue with so much ambiguity surrounding it.

Question 7

Christianity Sanctity of Life

Answer 7

• Christians use their belief in sanctity of Life as their main source of determining the acceptability of euthanasia/assisted dying
• This is the view that all life is sacred as God created it both in His image and with purpose, making it hold intrinsic value.
• The most used argument against euthanasia/ assisted dying from this perspective is that “life is a gift from God” Genesis 2:7
• It is widely thought that upon Gods creation of mankind he gifted everyone with a part of his soul meaning that it should be cared for with the upmost respect and further no one possesses the right to take it away other than God himself.
• This results in the idea that euthanasia/ assisted dying is immoral as it disrupts Gods plan for the individual and destroys a piece of God in the process. This leads to the removal of the patients authority on decisions regarding their body by believing God has control over all human autonomy.
• Although I agree with the view that life is special and should be protected where possible, I do not think forcing individuals to endure suffering shows true respect for the patient or consequently their loved ones as it only extends the inevitable making this an ineffective approach.
• This way of thinking is made even less valid due to its contradiction of everything Christians know about the nature of God, (that he is omnipotent, omniscient and omnibenevolent), the qualities required for a higher beings existence.
• For example if humans do not possess autonomy and God is omniscient it would follow that God has chosen some to follow religion and maintain a relationship with him and left others damned before they even began therefore he cannot be truly omnibenevolent.

Question 8

Autonomy from Peter Singer

Answer 8

• I find the utilitarian response to autonomy from utilitarian Peter Singer much more effective
• Many Christians believe that euthanasia/ assisted dying is a form of murder/ murder by omission causing Singer to analyse what makes murder immoral, resulting in his conclusion that it is because it goes against an individuals autonomy, and deprives them of the good opportunities they could have experiences like having a family (which the majority of patients in need of end of life care are unable to have).
• Most forms of euthanasia/ all forms of assisted dying however supports patients bodily wishes as well as allowing the patient to judge whether their life has a positive balance of experiences that makes their quality of life justifiable for the suffering they are subject to therefore there is little ground for banning it and it should not be classified as a crime.
• Singer summarises this in Rethinking Life and Death “We should recognise that the worth of human life varies…instead focus on ethically relevant characteristics” which he argues to be enjoyment, social interaction, preferences, and consciousness. In short life must mean something to the person who is living it.
• I think this is an appropriate way of thinking as the ability to experience to me is a crucial aspect of living and by providing the patient (or a relevant loved one in dire circumstances) with the freedom to determine their level of happiness shows more respect, compassion and dignity to the patient in comparison to the sanctity of life argument.

Question 9

Essential Nature of Suffering

Answer 9

• A second belief held by Christians to aid them in discussions of euthanasia/ assisted dying is the essential nature of suffering
• Christians believe that God created suffering as a normal and necessary part of the world so it should be accepted instead of avoided following the Augustinian theodicy, the belief it’s existence is the result of human sin, as well as the irenaean theodicy that claims hardship allows humans to develop ‘higher qualities’ for example compassion.
• Joni Earckson Tada, a Christian woman who became paralysed at seventeen and was desperate to end her life now advocates against euthanasia/ assisted suicide out of a found appreciation for living
• Tada propositions that people’s fears are not a basis for forming rational social policy and we should instead support patients through their suffering while seeking to help the health of their soul
• Suffering again challenges the concept of euthanasia/ assisted dying as this could be seen as showing a lack of faith in Gods plan that has been set out for each individual.
• Christians believe that we are all born with the potential to become like God but if everyone attempted to escape the suffering that presents us with the opportunity to morally develop no one would progress to reach their full potential.
• The idea that we should not try to resist all suffering is reasonable to me as it is necessary to face adversity to fully develop as an individual in knowledge and personality.
• Despite this there are boundaries that must be considered for this perspective to be a compassionate act, that is in the best interests for the specific person involved.
• In the case of euthanasia/ assisted dying it is not a virtuous act to force someone to continue living when they are ready to die as the largest concern should be their physical, emotional, and spiritual well-being and not their current development.

Question 10

Humanist Paragraph

Answer 10

• Humanists believe life is very precious as it is the only life we have so feel it is their duty to help those who suffer in whatever way they can as their ethics are based on reason, empathy and concern for other human beings.
• Contrary to the Christian view that manmade suffering must be endured, Humanists take responsibility for humanities wrongdoings and take active steps to change them.
• They therefore believe that access to all forms of end of life care such as assisted dying and palliative care with appropriate preventative safe guards are essential as the choice to die a good death is a fundamental human right.
• This is observed in Humanist Society Scotlands website “My life, my death, my choice”
• I find this a good way of thinking as it creates understanding and acceptance that each person will choose the path best suited to their needs as not one treatment is effective to all

Question 11

Buddhism

Answer 11

• A Buddhist would use their belief in the five precepts on issues revolving around how to live
• These are part of right action in the eightfold path which presents practical ways to demonstrate the three good roots, kindness, wisdom and non attachment, and progress towards Nibbana which is the Buddhists ultimate goal.
• The precept focused on assisted dying is ‘do not kill’ stated in the dhammapada, as by doing so they are hindering a beings journey towards Nibbana and their opportunity to achieve positive Kamma for a better rebirth.
• Despite this the flipped version of these precepts that focus on good behaviours rather than negative, states that Buddhists should ‘preserve life’ meaning that euthanasia and assisted death could be justifiable in certain extreme circumstances with a life cannot be lived without dire circumstances such as unbearable pain and suffering as a Buddhist must also remain unattached to those close to them
• I therefore think that the belief in the five precepts is an efficient way to determine the morality of assisted dying in relation to medical integrity as they focus on kindness for other simultaneously with non-attachment allowing them to come to coherent and wise decisions relevant to the circumstances

Question 12

Conclusion

Answer 12

To conclude religious responses to assisted dying are structured on logical and reasoned viewpoints such as care for others however Christianity too often progresses into a religious bias that approaches the perceived best interest of the population, not specific individual needs, for example “you shall not murder” exodus 20:13 is righteous but refusing to relieve someone of their pain is simply cruel thus making their arguments invalid and Buddhism the best religious responses.
I think that the non religious responses from utilitarianism and humanitarians give the most reasonable explanations overall as they take each scenario and study their circumstances, happiness and well-being before coming to the conclusion of the morality of euthanasia/ assisted dying for that individual but still leave the final decision to the patient preserving personal choice.