Lecture 3 - Ethical And Legal Issues At The End Of Life

Question 1

What are the different ways we can consider the definition of death?

Answer 1

Ontological
Biological

Question 2

What do we consider ontological death?

Answer 2

Brainstem damage so are in a vegative state and can no longer perform conscious human function

Question 3

What do we consider biology death?

Answer 3

Cessation of life/biological function like respiratory failure or major organ damage

Question 4

What is actus reus?

Answer 4

Proof of conduct and proof that the doctors conduct is what caused the death
(Can be an accident/manslaughter)

Question 5

What is Mens rea?

Answer 5

Intention to kill or cause grievous bodily harm

Question 6

What 2 conditions are satisfied if a doctor deliberately ends a patients life?

Answer 6

Actus reus
Mens rea

Question 7

What is Article 2 of the Human Rights act 1998?

Answer 7

People have the right to life and the sate must take steps to prevent People being killed without their consent

Question 8

What is Article 8 of the Human Rights act 1998?

Answer 8

State must:
Protect the right of a person to decide manner and time of death
Protect the interests of vulnerable people
Considers current law does strike a balance

Question 9

What are some key ethical issues surrounding end of life care?

Answer 9

Justifications for non treatment:
-ordinary and extraordinary treatment
-futility (is there any point)
-advance directives

QOL
Best interests (patients beliefs, what do relatives say in terms of patients wishes)
Problem cases
DNRCPR
Doctrine of double effect

Question 10

What is the doctrine of double effect?

Answer 10

When drugs are given which are intended to help the patient but may contribute to their death (higher doses of opiates for analgesia but cause resp depression)

Should always state why you are increasing doses/what your intentions are

Question 11

What is considered passive euthanasia in the UK?

Answer 11

You are able to withdraw treatment from a patient which will lead to their death

Question 12

What are the 2 components to futility?

Answer 12

Physiological
Normative/evaluative

Question 13

What is the physiological part of futility?

Answer 13

Treatment is useless or ineffective or treatment does not offer a reasonable chance of survival

Question 14

What is the normative component to futility?

Answer 14

The treatment may not offer a certain quality of life
Treatment may not meet patients goals

Question 15

What is advance directives?

Answer 15

The respect for autonomy, where there’s a refusal or request for treatment

Question 16

Why may a patient want DNR/CPR?

Answer 16

Likely hood of good recovery unlikely
Autonomy

Question 17

Arguments against righ to die

Answer 17

Not our life. To dispose of
Life precious
Devalues human life
Slippery slopes?
Publics views of end of life experience
People don’t want to burden their family if euthanasia is an option