Transcript Revision of facts on Euthanasia

Revision of Facts on
Euthanasia
Euthanasia
• Euthanasia literally means a gentle or
easy death
Why is it a moral issue?
• "right to life" and the "right to die
• right to life is generally protected by the laws of a
country.
• do people have a right to die as well?
• some people sometimes wish to commit suicide but do
not have the physical strength or the means to do it
painlessly. Should society allow doctors or others to help
them to die (assisted suicide)?
• All doctors as well as many other people agree that we
should preserve life whenever possible – Hippocratic
Oath
V.E.
• Voluntary euthanasia means that you
decide the time, place and method of your
own death.
• Voluntary euthanasia is where you have
expressed the choice that in a certain
range of circumstances you think that your
life is no longer worth living and that you
should be helped to “die with dignity”.
Types
• Active – where a person may be given
drugs by a doctor which will kill them,
• or they may be able to take them
themselves with a doctor’s help.
• Supporters of voluntary euthanasia have
even designed “euthanasia machines”
which work by allowing people to
administer deadly drugs to kill them
without the involvement of anyone else.
• Passive – where treatment to save
someone from dying may be withheld.
• In some countries a DNR (Do Not
Resuscitate) order can be requested by a
patient. This means that at the patient’s
request, life-saving treatment will not be
given - resulting in their death
Legal Distinction
• Law makes a distinction between active
and passive: to turn off a machine is
active, not to put a patient onto a life
support machine is passive
• Legally there is a difference
• But is there morally, as both result in
death?
Involuntary euthanasia
• Involuntary when the ill person may be
unconscious or otherwise unable to make
a meaningful choice between living and
dying. (babies, dementia patients, etc)
• In this case, an appropriate person would
take the decision to end the patient’s life
on their behalf (doctor, close relative).
• involves much legal debate as to who has
the right to make such a decision.
UK Law
• Euthanasia is illegal in Britain. To kill another
person, even if the other person asks you to kill
them, is classed as murder. This also applies to
doctors and their patients.
• It is a criminal offence in the UK, punishable by
up to 14 years' imprisonment, to assist, aid or
counsel somebody in relation to taking their own
life. (March 2002.)
• It is not illegal for someone to commit suicide or
to attempt to commit suicide.(since 1961)
Acceptable Euthanasia
• 1 Active euthanasia by side effect
• Active euthanasia by side effect is permitted in
one special case. A terminally ill patient may
have their death hastened by a medical
treatment that is primarily given to relieve pain.
This would have the double-effect of being
given to relieve pain, but actually killing the
patient at the same time. The doctor must be
able to prove that the lethal dose was required
to relieve the patient’s suffering. It appears that
this approach is actually allowing euthanasia to
take place under the guise of double effect.
• 2 Voluntary passive euthanasia
• As a patient has an absolute right to
refuse medical treatment, if a patient says
to his/her doctor, "I want to die, please do
not give me any medical treatment that
would prolong my life,” the doctor cannot
legally override the patient's wishes.
• By contrast, voluntary active euthanasia is
not legal. If the patient says to his doctor,
"I want to die. Please give me a lethal
injection,” then the doctor cannot
Law in Netherlands
• Euthanasia was only officially made legal in the
Netherlands in 2002.
• Only a doctor may carry out euthanasia
• There should be an explicit request of the patient leaving
no room for doubt about the patient’s desire to die
• The patient should be in a situation of unbearable pain,
either physical or mental, and suffering with no prospect
of change
• The doctor should be very careful in making the decision
and should consult at least one other physician
• The death must be reported to the authorities as a case
of euthanasia or physician-assisted suicide
• It should be noted that citizens from other countries
are not eligible for euthanasia in Holland.
Problems with the Dutch system
• The Rimmelink Report (1990)
• 1040 died from in/non-voluntary euthanasia. That is an
average of almost three people a day put to death by
their doctors without their knowledge or consent. Of
these, 72% had never said they wanted to end their
lives.
• 8100 died as a result of drugs that were given, not
primarily to control pain, but to speed up the patient’s
death.
• The main reasons given for the decision to end these
lives were:
• low quality of life of the ill patient
• the family could not cope anymore
• no prospect of the patient’s improvement
Dutch Authorities find Euthanasia on the Rise (May
2006)
• A new report showed that for the third year in a row,
medical authorities in the Netherlands have reported an
increase in the number of legal euthanasia cases. Many
studies have shown that the number of actual cases of
doctors killing their patients is roughly twice what is
officially reported, despite laws making the practice legal.
• at least 50% of patients requesting euthanasia were
seriously depressed, with 44% of those suffering from
cancer suffering signs of clinical depression when they
asked for euthanasia.
• While the “safeguards” in the Dutch euthanasia program
do require doctors to determine that a patient asking for
euthanasia is “of sound mind,” there is no requirement
that they are not suffering from depression.
BMA
• In the year 2,000 the BMA opposed the legalisation of
euthanasia or physician-assisted suicide.
However
• If some doctors, who have exhausted all other
possibilities for ensuring a patient's comfort, see the
deliberate termination of life (euthanasia) as the only
solution to relieving physical pain and suffering in an
individual case, the doctor should be accountable to the
law and to the General Medical Council and be obliged
to defend such an action to those Authorities.
• In other words, doctors could help a patient to end their
life by passive euthanasia, or death by side-effect, but
would be subject to close investigation to ensure that no
other solution to the patient’s problem was possible.
Reasons for their views
• The protection of vulnerable people
• Practical considerations. – how do you set
safeguards to make sure it is always voluntary
• If doctors were authorised to carry out
euthanasia or assisted suicide, they would be
given an additional role opposed to the
traditional one of healer
• Also, the psychological relationship between
doctors and patients would also change,
especially with those who suffer long-term illness
or disability and who require substantial health
resources to keep them alive.
Changes in views of BMA
• 2005 – voted to support a change in the Law to
allow a change in the law to allow terminally ill
patients to be helped to die by assisted suicide.
• But BMA conference in 2006, doctors again
changed their views on euthanasia. 65% of
doctors voted against physician-assisted dying
• Because "If good palliative (pain controlling)
care is provided, requests for euthanasia are
extremely rare. We should be doing all we can to
make sure that this care is made more widely
available."
Hospices
• Hospices are special hospitals that take care of the
dying in their last few weeks of life. Hospices were
concerned not only with the patient’s physical wellbeing, but with their mental and emotional well being
as well.
• The aim of the hospice is to give the patient a good
death, but not through euthanasia.
• Hospices place great importance on pain relief – when
people are in severe pain they are not themselves and
are not comfortable with themselves or their
surroundings. Hospices say that it is important to
make the patient feel comfortable and at peace with
themselves in order for them to have a good death.
• Hospices have their emphasis on the patient rather
than the disease, and they take time to work through
the roots of anxiety with the patient and their
family. As a result, the patients learn to cope with
dying.
Arguments against euthanasia by
hospices
• No-one should suffer unbearable pain if they are
treated correctly – doctors should know how to
treat pain better
• One of the main dangers of legalising
euthanasia is the ‘slippery slope’ argument – if
euthanasia is allowed for patients near to death,
it could be extended to people who are not so ill
• Some people could feel they have a duty to die
rather than a right to live (elderly, disabled, etc)