Euthanasia Flashcards
Euthanasia
Inducing a painless death, by agreement and/or with compassion, to ease suffering. from Greek “Good death”
Active euthanasia
The deliberate act of bringing about death
Advance directive or ‘Living Will’
-Drawn up by patient when competent, for the event that they are not competent and wish that their medical treatment preferences be known
Assisted Suicide
-Competent patient has formed desire to end their life, but needs help to carry out the act
DNR
‘Do not resuscitate’. At the request of a patient or their family
Double effect
Some cases of incurable illness, drugs administered to relieve suffering but will have unintentional side effect of shortening life
Involuntary euthanasia
Killing of a person who is competent to request/consent to euthanasia but does not (ie with holocaust)
Medical Futility
-Treatment is achieving no positive medical results or is against the patient’s best interests, ie with prolonged and burdensome treatment
Non-voluntary euthanasia
- Killing of a patient who does not have the capacity to understand euthanasia or give informed consent
- Normally in a PVS, or babies born with severely debilitating illness, kinder to actively give medicine to kill, or to withdraw treatment
Palliative care
Curing/Long term disease control is not possible so palliative care increases the quality of life, reduces symptoms and alleviates pain for the patient. Does not prolong life or hasten death - PAIN RELIEF
Persistent Vegetative State (PVS)
-A condition where the patient remains unconscious, and the chances of them regaining consciousness become more remove
Voluntary euthanasia
The patient’s death is brought about at his or her own request
Arguments for voluntary euthanasia - Not murder
- It is not malicious or with bad intent. They are already dying and wish to die, so you are helping them
Arguments for voluntary euthanasia - Merciful
- Patients suffering from intolerable pain that will not get better
- Thomas More ‘Utopia’ “…choose rather to die, since they cannot live but in such misery’
- Offered to animals, why not humans?
Arguments for voluntary euthanasia - Gives people autonomy
- Mill: In matters that do not concern others, people should have full autonomy
- “In the part which merely concerns himself, his independence is, of right, absolute”
- Argued that for a competent adult it should be a right to die, as much as people are entitled to hospices/palliative care
Arguments for voluntary euthanasia - Euthanasia goes on already
- 1994 BMJ: some doctors already aid patient death
- Doctors may already prescribe pain treatment that will quicken death and may withhold/withdraw treatment to kill
- Would be much safer if voluntary euthanasia was legalised as it would be easier to regulate
- No difference between active and passive for consequential thinkers as result is the same
Arguments for voluntary euthanasia - Maintains quality of life
- Humans should, for the whole of their lives, be entitled to dignity
- If living becomes undignified then humans should be able to end their lives and have help doing so
- Quality of life worth living is a subjective thing, ie Daniel James and Matt Hampson
Arguments against voluntary euthanasia - Motives
- Momentary suicidal thought may not be tantamount to feeling suicidal overall. Thoughts may pass
- If euthanasia was legalised then it would have to be established whether or not people truly wanted to die, very prone to misinformation
Arguments against voluntary euthanasia - Mistakes
- We cannot predict the future, and it may occur that a supposedly terminal illness was an incorrect diagnosis
- Keeping voluntary euthanasia illegal safeguards us against this
Arguments against voluntary euthanasia - Abuse of the system
- Elderly people may feel that they are a burden on their families, and may ask for voluntary euthanasia out of a sense of duty
- Scheming relatives could manipulate the elderly?
- Harold Shipmann, Serial killer, highlights issue
Arguments against voluntary euthanasia - Impact on the community
-Legalisation could lead onto other forms of euthanasia, ultimately (worse case scenario) leading to Nazi t4 type extermination of the elderly and disabled
-Reduces value of life, slippery slope
BUT hasn’t happened in the Netherlands?
Ethical issues: Non voluntary euthanasia
- Withdrawal of burdensome treatment is not contraversial
- However withdrawl of food and water is debated
- -> Tony Bland, Hilsborough PVS
- Court ruled food/water were treatment that could be withdrawn
- Seems like a step towards active non-voluntary, not passive, even involuntary
- Does it show lesser or greater respect for the value of human life to sustain the life indefinitely?
- Babies: can be kept alive but detrimental to family. Others concerned that euthanasia at young age will cultivate culture with lesser respect for the value of early life
Hospice care
- Worldwide movement to provide palliative care to the terminally ill and aiding the families of the patients
- Example, Arthur Rank Hospice in Cambridge, charity
- Care offered during and after death for bereaved
- Allow patient to die with dignity, will not feel like a burden, will not be a burden, and will receive proper care
-ALTERNATIVE to euthanasia offering a good quality of life
Palliative care
- Care of someone nearing end of life due to old age/terminal illness
- Symptom control, counseling, self help and total care
- Focus on pain relief rather than prolonging/ending life
- Improving quality of life with physical and psychological well being
- Helps prepare them spiritually for passing and achieve full potential before they do
-Means terminally ill may enjoy good quality of life for longer, so ALTERNATIVE to euthanasia
Christian perspective on Euthanasia
FOR
- Compassionate “love thy neighbour”
- Jesus cared for the sick
- Example of euthanasia in Samuel, “…for I am in terrible pain. So I killed him”
AGAINST
- Do not kill
- Care for weakest in society (do not force them)
- Sanctity of life, temple to God who is lord of all life
Roman Catholic view on Euthanasia
- Declaration on Euthanasia (1980) , Life is a gift from God, live it according to Gods plan, wrong to ask for assisted death. Violates divine law and the dignity of the person
- Suffering death as Jesus did allows us to establish a closer and more personal relationship with God
- Hans Kung: Assisted suicide can be the ultimate, final form of helping in life (compassionate)
- Some grounds for euthanasia as removal of burdensome excessive treatment that will not cause a recovery
Protestant view on Euthanasia
Liberal protestant:
- Fletcher’s “right to die”
- Death is not the end, and is a friend to terminally ill
- Quality of live > biological life
Conservative protestant:
- Withdrawing (passive) treatment is acceptable but active euthanasia creates class of humans treated as less valued
- Retarded child isn’t dying, in pain or consenting
Hindu view on Euthanasia
FOR
- We want to escape life, and departure of soul from body seen as positive in Upanishads
- Body is limitation for those seeking Mocksha
- Jainism, wise man should know when death approaches and can commit suicide (sallekhana) to achieve it
- Seen as heroic, Indian soldiers favoring death at hands of worthy opponent (like a disease)
- Self willed death
AGAINST
- Ahimsa, no harm, harming body is wrong
- Suffering must be accepted, as must bad Karma to move onto the next life
- Bhagavad-Gita disapproves of mindless starvation of the body
- four stages of life must be completed to fulfil dharma
Utilitarian views on euthanasia
Mill:
- Victimless crime as the patient wishes to die
- Adverse effect on society, as the value of human life is lessened with euthanasia
- Slippery slope, may lead to massive persecution of the disabled, ill and elderly
- Personal autonomy is a higher pleasure, right to choose
Bentham:
- Acceptable if person’s continued existence brings more pain and suffering to them/family than if life could be ended
- Resources spent keeping them alive to die anyway may be used in other ways
- BUT if enough people gain happiness from death, no protecting rights of individual
- Hard to predict consequences, opinions may change, disease may be curable
- Extinguishes any further potential happiness that may have been achieved –> with palliative care. Pain relief, good quality of life. Ie Stephen Hawking
- Utilitarian thinking in practice with QUALY system
Situationist views on euthanasia
- Fletcher’s “right to die”
- Consequential, active and passive are the same as same result
- Not intrinsically wrong, only wrong based on outcome
- Ending life may be more compassionate and loving than continued suffering for the person. Double effect may be acceptable
Daniel James + Matt Hampson
- Both paralyzed Rugby players
- Daniel decided to receive assisted suicide and Matt wanted to live
- Shows how acceptable quality of life is subjective
Assess the view that euthanasia can never be Good
NEVER
-Violates sanctity of life, body is temple, God has plan
- Violates absolute Biblical law thou shalt not kill
- Can’t guarantee consequences are good, can guarantee it will extinguish any potential happiness that person could have felt
- Adverse effect on society means no isolated incident where it can be good, all effects the majority
-Violates UK law
SOMETIMES
-Subjective Quality of Life ie Daniel James/Matt Hampson
-Can be compassionate, loving
-For situationist can’t be absolute as not intrinsically bad
-Free will (Hans Kung, “all merciful…” would allow us to die
-Varies on situation, may sometimes bring best happiness
Do we have a right to life?
YES
-No murder
-Sanctity of life, God given
-Evangelical Xns “God is the supreme lord of life”
Human rights: most basic right, protected in wartime
-Abortion illegal from 24 weeks as then, independent, recognised as person with own rights and RIGHT to life
BUT
- Foetus not yet a person, no person=no right
- Viability: exceptions to the rule (self defense)
- Some foetuses are less developed than primates, fewer rights, some would argue not HUMAN
