Ethics at the End of life Flashcards
What is the definition of death?
Irreversible loss of the capacity for consciousness, combined with irreversible loss of the capacity to breathe (so brainstem death = death of the individual)
What if a person is in a permanent vegetative state?
1993 still alive:
cerebral cortex loses function and activity; patients retain brainstem function, able to breathe unassisted, normal sleep-wake cycles, periods of wakeful eye-opening, irreversible, no evidence of awareness, swallowing reflex may be preserved
May survive for many yrs
Do you need to always provide treatment?
Invasive/hazardous procedures may lead to prolonged but poor quality of life – may not be in best interests
Where treatment is futile, there is no duty to initiate or continue treatment
Can you withdraw treatment?
Withdrawal of treatment is an omission rather than an act
LAW: it is lawful to cease giving medical treatment, considering that treatment involves invasive manipulation of the patient’s body to which he has not consented, and which offers him no benefit
Explain the sanctity of life argument?
It is intrinsically wrong to end human life, independent of the capacities of the individual person. This may allow treatment withdrawal if there is no hope of benefit. §
Explain the quality of life argument?
Life has instrumental value rather than intrinsic value – experiences and interactions make the life valuable so there is a ‘difference between having a life and being alive’ (James Rachels, philosopher)
Explain the vitalism argument?
human life has absolute moral value and it is wrong to shorten or to fail to strive to lengthen life regardless of pain, suffering or cost. Human life must be preserved at all costs
Explain the futile treatment argument:
If it fails to meet its own objective (e.g. chemo in someone who’s not responding) or it is undesirable in a particular case due to the quality of life, which results following treatment
What is the religious views argument?
Life is a gift from God, we have a duty to preserve it, not dispose of it
What is the doctrine of double effect?
It is always wrong to do a bad act even though it may have a good result.
But it is sometimes permissible to do a good act that may cause harm as a result.
We are justified in carrying it out as long as the bad consequence is not intended.
What is the suicide act 1961?
suicide and attempted suicide are no longer crimes
BUT you cannot aid, abet, counsel or procure suicide (e.g. giving encouragement or support). In favour of prosecution: victim < 18 yrs, victim did not have capacity, the suspect was not wholly motivated by compassion, the suspect pressured the victim
What is euthanasia?
killing someone because, in light of their distressing condition, it is thought to be in their best interest (illegal in the UK)
What are the arguments for euthanasia?
dignified death, autonomous choice by the patients
What are the arguments against euthanasia?
doctor performing the euthanasia may feel guilt, palliative care may provide a more dignified death, sanctity of life, slippery slope, lead to mercy killing being viewed as acceptable
