Legal principles for end of life Flashcards
What is active euthanasia? Is it legal?
To take active steps w/ the intention of causing someone to die/ shortening their life
- e.g. giving a lethal injection.
- murder - even if patient requests it.
ILLEGAL
What is passive euthanasia? Is it legal?
To withhold or stop medical treatment that could prolong someone’s life (allowing to die) e.g. stopping life support.
Not normally illegal for a doctor to withhold or withdraw treatment (such as ventilation) if treatment is not in patient’s best interests, or if patient w/ capacity does not consent to it.
What is Intending relief of distress, but foreseeing death? Is it legal?
To take an active step w/ intention of relieving the patient’s distress, but with theforeseen result that it is likely to shorten life
- e.g. giving morphine for pain, but knowing it causes respiratory depression.
Normally LEGAL
What is assisted sucide? Is it legal?
Suicide & attempting suicide are not criminal offences, however, to “assist or encourage” the suicide of someone else is.
- e.g. if a patient committed suicide by taking an overdose of tablets that the doctor had left by the bedside for that purpose, the doctor could be found guilty of assisting suicide.
Some patients travel overseas to access assisted suicide- family members who help patient travel will not necessarily be prosecuted.
Health professionals who provide advice or assistance to a patient in their care (including travel support for assisted suicide) could be prosecuted.
CRIMINAL OFFENCE
Is a patient who refuses life-saving treatment committing suicide?
If patient has capacity= NOT suicide
A patient with capacity can refuse any, even life-saving, treatment.
The doctor would be committing battery if they give treatment when patient has refused
How should a patient who lacks capacity be treated?
Should be treated w/ BEST INTEREST
No obligation to prolong life in all circumstances; it is not always in a patient’s best interest to keep them alive.
Patient’s best interests are understood to include “medical, emotional & all other welfare issues” - includes consideration of patient’s wishes, lifestyle & values
E.g. a court might be persuaded that a patient w/ strong religious views in support of the sanctity of life would want to be kept alive unless the treatment was clearly futile.
Can you withdraw treatment if patient has prolonged disorders of unconsciousness?
Treatment CAN be w/drawn
Life-prolonging treatment is not necessarily in the best interests of a patient.
No longer an obligation to obtain a court order authorising the withdrawal of treatment from such patients, where both clinical team & patient’s family agree that it would be in the patient’s best interests.
What are the 3 moral principles relevant to end-of-life decisions?
- The principle of Sanctity of life
- Life as intrinsically valuable but not an absolute good.
- Preserving life does not necessarily outweigh all other considerations.
- There is value to a person simply being alive, no matter what state that person is in, even if their in a state of permanent unconsciousness. - The moral distinction between foresight & intention: the doctrine of double effect.
- Performing a bad act in order to bring about good consequences is always wrong: the end does not justify the means.
- Performing good act that may to lead to bad consequences is right i.e:
- If doing something morally good has morally bad side-effect, it is ethically okay providing the bad side-effect was not intended. This is true even if you foresaw that the bad side effect would probably happen. - The moral distinction between acts and omissions
- Failure to perform an act, w/ foreseen bad consequences of that failure, is morally less bad than to perform a different act which has the identical foreseen bad consequences.
- I.e It is worse to kill someone than to let them die in regards to giving them treatment
- the law regards both withdrawing & withholding as ‘omissions’
- Acting to kill a patient, even for good reasons, may seem wrong, whereas omitting to act, for example by withholding life-saving treatment, may seem the right thing to do.
Define voluntary euthanasia, non-voluntary euthanasia & involuntary euthanasia
Voluntary euthansia- Euthanasia at the request of a conscious patient with capacity.
Non-voluntary euthanasia:Euthanasia performed for a patient who is not conscious or who lacks capacity.
Involuntary euthanasia: Euthanasia performed for a conscious patient w/ capacity, despite their request to continue to live.
