Palliative Care Ethics

Question 1

What is meant by assisted dying? Is it legal?

Answer 1

An umbrella term for euthanasia and assisted suicide is assisted dying. All forms of assisted dying are currently illegal in the UK.

Question 2

Euthanasia?

Answer 2

• Euthanasia, a type of assisted dying, is when the death of another person is intentionally hastened for their own benefit.
• The word ‘euthanasia’ itself means ‘good death’.
• There are different types of euthanasia, but all forms are illegal in the UK.
• There is no legal distinction between euthanasia and murder

Question 3

active vs. passive euthanasia?

Answer 3

In active euthanasia, death is hastened by an act. For example, being given a medication to cause death.

In passive euthanasia, death is hastened by not doing something and allowing the person to die. For example, withholding or withdrawing treatment that would prolong life.

Question 4

Definitions of Voluntary, Non-voluntary and Involuntary Euthanasia (can be active or passive)?

Answer 4

• Voluntary euthanasia is where someone with capacity makes the decision that they want to hasten their death.
• Non-voluntary euthanasia is where someone who lacks the capacity to decide, has their death hastened.
• Involuntary euthanasia is where someone who does not want to die has their death hastened. This is not truly a euthanasia; it is murder.

Question 5

assisted suicide? how long is the sentence?

Answer 5

Assisted Suicide is where someone (e.g. a spouse, or a doctor) assists the patient to commit suicide. Unlike euthanasia, it is not legally equivalent to murder because the final act is done by the patient themselves. However, it is still illegal in the UK under the Suicide Act 1961 and can result in a sentence of up to 14 years.

Assisted dying is legal in some countries (e.g. Switzerland), and so some people from the UK have been known to travel abroad to end their lives.

Question 6

Factors making prosecution less likely?

Answer 6

1) If the ‘suspect’ was a spouse, relative, or close friend of the ‘victim’
2) If the act was motivated by compassion
3) If the ‘victim’ had a clear, settled and informed wish to die
4) If the ‘victim’ had a terminal illness with no hope of cure, or a degenerative condition

Question 7

Factors making prosecution more likely?

Answer 7

1) If the ‘suspect’ was a healthcare professional and the ‘victim’ was in their care
2) If the act was no wholly motivated by compassion
3) If the ‘victim’ had no clear, settled or informed wish to die
4) If the ‘victim’ had not asked for help dying under their own initiative
5) If the ‘victim’ was under 18 years old, or otherwise lacked capacity

Question 8

If a patient asks about wanting to die, the doctor should:

Answer 8

1) listen and explore their reasons
2) sensitively explain you are unable to give information about how to hasten death
3) be alert to pain + depression - treat these!

To offer any more would breach the suicide act 1961