Transcript The Right to Die

*
Lisa Whitlatch
SHU- LDR 650 Medical Law
March 2, 2015
Dr. Shanna R. Reed, Esq.
*Definition:
* Right-to-Die
* Adjective
* Adjective: Right-to-Die
* Pertaining to, expressing, or advocating the right to refuse
extraordinary measures intended to prolong someone's life when
they are terminally ill or comatose. (Dictionary.com, 2015).
(Google, 2015)
*History: How the “Right to Die” Came to America
* The very first U.S. court case:
Karen Ann Quinlan; 1976 New Jersey state court case
Karen became the first icon of the modern “right to die” movement
* Facts:
On April 15, 1975, Karen Ann Quinlan, only 21, collapsed, stopped breathing, and slipped into a
coma.
* The Request:
After months with no progress, Karen Ann’s family saw no hope for their adopted daughter’s
recovery and they did not want to keep her alive artificially; the hospital fought back, they went
to court and they family won their case.
* The courts decision:
The New Jersey Supreme Court’s unanimous decision to permit Karen Ann’s ventilator to
be removed was widely interpreted by those promoting euthanasia as the “right to die” for
the terminally ill or, in Karen’s case, for the severely disabled (NCLL, 2013).
Followed by: Nancy Cruzan, Estelle Browning and Terri Schiavo
Let the Movement Begin…
*Introduction
* Targeted Audience: The general public but more specific
to the terminally ill patients and their families that are
affected by crippling and disabling diseases.
(Google, 2015)
*Description of Topic
Different Debatable Topics:
*Why should we have the option to have the right to die?
*Why do we want the right to die?
*What guidelines if any are there to even be given this
option to have the right to die?
*Is the Right to Die Act motivational to others in this
situation; patient empowerment?
*Is this ethical?
(Google, 2015)
*Description of Topic
My Position:
*I think it is an honor to be able to grant the individual
the right to die and end their pain and suffering. I
believe in choices and giving a patient a choice when
that is all they have left to me provides them with
some control over something they cannot control.
*The Right to Die Act is great for lives that are of the
poorest quality or are going to end up that way sooner
than later. I want awareness to be raised.
*I agree that people should have the right to die and
they should be able to determine this if they want too
and on their own time
*Communicating my Message:
*Even though many feel this is an unethical practice to
practice however, I feel awareness needs to be raised
to give these certain candidate’s options when they
are left with nothing.
*Discussing viewpoints from a patient’s standpoint
really can make a difference in hopes to change the
options of others who do not believe in this type of
practice.
*Lets take a look…
(Google, 2015)
*YouTube Videos:
*The two links below are real stories from real
patients and their family members that decided to
honor the Dying with Dignity Act:
*http://www.youtube.com/watch?v=2_TlRnqcjMo
&
*http://www.youtube.com/watch?v=Dy6QJsV60_k
Again, why is this anyone else's choice but the
effected patient and their families? Would you not
want to honor your loved ones last request? After all
it is their life not ours…
*Analysis
* Living Will: A written statement detailing a person's desires
regarding their medical treatment in circumstances in
which they are no longer able to express informed consent,
especially an advance directive.
* Due to past court arguments and disputes “There is a
growing movement to encourage all adults to prepare a
document that would prove guidance, if necessary, for
their families and doctors (Angell, 1991, p. 511).”
* Living wills and durable power of attorney is greatly
encouraged:
* In December of 1991, it was made legal that healthcare
facilities must provide an opportunity for patients to prepare
these documents (Angell, 1991).
*Analysis
* Research Support: http://www.finalexitnetwork.org/
(Google, 2015)
*The Final Exit Network is an American organization
that offers counseling, support, and guidance in a
successful suicide to individuals who are suffering
from an intolerable illness:
“Supporting the Human Right to a Death with Dignity”
(Google, 2015)
(Final Exit Network, 2015).
*Our Mission- Final Exit Network
*To raise the awareness of all Americans concerning this
basic human right.
*To offer free service to all who qualify, providing
relevant information, home visits if possible and a
compassionate presence for individual and family.
*To promote the use of advance directives and other
related legal instruments to document the intentions of
any individual.
*To sponsor research into new peaceful and reliable
methods to end life.
*To vigorously defend our guiding principles in a court of
law when necessary. (Final Exit Network, 2015).
*Our Guiding Principles
* We hold that mentally competent adults who suffer from a
fatal or irreversible physical illness, from intractable
physical pain, or from a constellation of chronic, progressive
physical disabilities have a basic human right to choose to
end their lives when they judge the quality of their life to
be unacceptable.
* This right by its nature implies that the ending of one’s life
is one’s choice, including the timing and persons present,
and should be free of any restrictions by the law, clergy,
medical profession, and even friends and relatives no matter
how well-intentioned. We do not encourage anyone to end
their life, are opposed to anyone’s encouraging another to
end his life, do not provide the means to do so, and do
not assist in a person’s death. (Final Exit Network, 2015).
*Analysis
* Public Opinion Polls:
* Most people would not want their lives maintained in a
persistent vegetative state (Angell, 1991, p. 512).” Reasons
to consider end of life assistance:
* poor quality of life;
* a good quality of death;
* potential abuse of assisted dying’
* the importance of individual stance.
* Research:
* Has shed light on ordinary people’s perspective about assisted
dying, when they are suffering from an illness, are disabled,
or experiencing unbearable suffering (Hendry, Pasterfirld,
Lewis, Carter, Hodgson, & Wilkinson, 2012). “Modern medical
developments have changed the way people think about
death such as technological advances making it possible to
keep the human body alive. (Bell, 2006).
*Analysis
* Organ’s Death with Dignity Act was approved in 1994 but not
enforced until 1997. A physician can prescribe Schedule II
medications under their Controlled Substance Licenses.
* In order to be a candidate you must be able to communicate
one’s health care decisions;” be at least 18 years age, be a legal
resident in Oregon, be diagnosed with a terminal illness, and
have fewer than six months to live.
* This must be voluntary and consist of one written and two verbal
requests within 15 days apart. The terminal diagnosis must be
confirmed by a consulting physician; this rules out depressed
patients and a complete psychiatric examination must be
conducted; Veterans Administration can’t participate. (Ball,
2006).
(Google, 2015)
*Examples of the Right to Die Forms:
* Patient Request From:
http://public.health.oregon.gov/ProviderPartnerResources/Eval
uationResearch/DeathwithDignityAct/Documents/pt-req.pdf
* Attending Physician Form:
http://public.health.oregon.gov/ProviderPartnerResources/Eval
uationResearch/DeathwithDignityAct/Documents/at1form.pdf
* Pharmacy Dispensing From:
http://public.health.oregon.gov/ProviderPartnerResources/Eval
uationResearch/DeathwithDignityAct/Documents/pharform.pdf
* Chronology and Death Certificate Extract Form:
http://public.health.oregon.gov/ProviderPartnerResources/Eval
uationResearch/DeathwithDignityAct/Documents/dcrptdat.pdf
*Analysis
* “Legislatures in 38 states passed laws to prohibit physician-
assisted suicide, and seven others ruled it a homicide
(McCormick, 2011, p. 2).” This practice is very influenced by
cultures as well as laws. Many patients now feel continuing
their care may cause more harm to them than allowing their
life to end (McCormick, 2011).
* Most states find this practice illegal; five states legal.
* Many people find this quite unethical and many religious groups
disagree with this practice, however, is it fair that that we let
these individuals suffer like this?
*Discussion
Death with Dignity Act
*The five legal states are: Organ, Washington, Vermont,
New Mexico, and Montana
*February 5, 2015: a Lawsuit asks New York Supreme
Court to rule that aid in dying to terminally ill patients is
legal in the state:
*A group of patients and doctors filed a lawsuit
*End of life does not fall under the states current
assisted-suicide ban
*Violation of the states constitution’s equal
protection clause
(Google, 2015)
*Top 10 Pro’s to support the Right to Die (ProCon.org)
* 1) Right to Die; "The right of a competent, terminally ill person to avoid excruciating
pain and embrace a timely and dignified death; the concept of ordered liberty.”
* 2) Patient Suffering at End-of-Life; "At the Hemlock Society we get calls daily from
desperate people who are looking for someone like Jack Kevorkian to end their lives
which have lost all quality...
* 3) Slippery Slope to Legalized Murder; "Especially with regard to taking life, slippery
slope arguments have long been a feature of the ethical landscape, used to question the
moral permissibility of all kinds of acts...
* 4) Hippocratic Oath and Prohibition of Killing; "Over time the Hippocratic Oath has
been modified on a number of occasions as some of its tenets became less and less
acceptable.
* 5) Government Involvement in End-of-Life Decisions; "We'll all die.
*Top 10 Pro’s to support the Right to Die (ProCon.org)
* 6) Hospice (End-of-Life) Care; "Assisting death in no way precludes giving the best hospice
care possible but rather integrates compassionate care and respect for the patient's autonomy
and ultimately makes death with dignity a real option...
* 7) Healthcare Spending Implications; "Even though the various elements that make up the
American healthcare system are becoming more circumspect in ensuring that money is not
wasted, the cap that marks a zero-sum healthcare system is largely absent in the United
States...
* 8) Social Groups at Risk of Abuse; "One concern has been that disadvantaged populations
would be disproportionately represented among patients who chose assisted suicide.
* 9) Religious Concerns; "Guided by our belief as Universalists that human life has inherent
dignity, which may be compromised when life is extended beyond the will or ability of a
person to sustain that dignity
* 10) Living Wills; "Living wills can be used to refuse extraordinary, life-prolonging care and
are effective in providing clear and convincing evidence that may be necessary under state
statutes to refuse care after one becomes terminally ill.
*Hemlock Society Founded in 1980
(ProCon.Org)
* 46,000 Members
*Mission:
* Educate and advise
* Help given through specialized literature and moral support.
* Draft and launch the first model law governing euthanasia and assisted suicide
in America, 1986, from which many others which were to follow were refined.
* Financially assist; $3 Million in 2003
* Found and launch a national 'Caring Friends' program so that maximum
personal support and assistance in dying, within the law, could be ensured to
every member.“
(Google, 2015)
*Conclusion
(Google, 2015)
*Conclusion
(Google, 2015)
*By helping to raise awareness to the public about why this
practice is a good practice to fight for will hopefully
change enough minds to legalize this practice in every
state.
*I want the public to rethink their view on this issue from
the eyes of the terminally ill and not their own eyes.
*I want to help the public understand the need for this
practice.
*Conclusion
*Its an honor to be able to grant the individual the right
to die and end their pain and suffering isn’t it?
*Giving a patient a choice when that is all they have
left to me provides them with some control over
something they cannot control.
*The Right to Die Act is great for lives that are of the
poorest quality or are going to end up that way sooner
than later.
*Conclusion
*Not everyone who obtains the suicidal meds actually take
them, it is more about letting the patient be in control for
once since they cannot control their illness but at least they
can control their death.
*In January 2006, following a survey of 1,500 adults
reported that 84 percent of Americans supported right to
die laws, this was up 79 percent from 1990. (McCormick,
2011).
*We are making progress….
(Google, 2015)
*Statistics
(Google, 2015)
*Facts
Death with Dignity By the Numbers:
*In 2012, 77 people died under the Oregon Death
with Dignity Act.
*People who died under Oregon's law accounted
for 0.2% of all deaths.
*97% were enrolled in hospice at the time of their
deaths.
*Over 97% died at home. (Oregon Department of Health, 2015).
*Facts
*“Most U.S. doctors now favor allowing patients suffering
from an “incurable illness” to seek “a dignified death,”
according to a large survey of more than 21,000 medical
professionals.” (Ressler, 2014).
(Google, 2015)
*For More Information Contact or Call:
*Oregon Health Authority
Center for Health Statistics
PO Box 14050
Portland OR 97293-0050
Attn: Vivian Siu
Phone (971) 673-1150
*[email protected]
*References
* Angel, M., M.D. (1991). The case of Helga wanglie: A new kind of
“right to die” case. The New England Journal of Medicine,
325(7), 511-512.
Retrieved from
http://search.proquest.com/docview/223950683?accounted=28
644
* Ball, Susan C, MNSc,R.N., A.P.N. (2006). Nurse-patient advocacy and
the
right to die. Journal of Psychosocial Nursing & Mental
Health Services, 44(12), 36-42. Retrieved from
http://search.proquest.com/docview/225536802?accountid=28
644
* Death with Dignity: The Laws & How to Access Them. (2015, January
1). Retrieved from
https://www.healthlawyers.org/Pages/home.aspx
* Holden, C. M. (1996). The right to die: Exploring the issues in the
debate. Death Studies, 20(6), 611-615. Retrieved from
http://search.proquest.com/docview/231384446?accountid=28
644
* References
* How the “right to die” came to america. (2013, January 1). Retrieved from
http://www.ncll.org/liberty-centers/center-for-life-defense/cldarticles/57-how-the-right-to-die-came-to-america
* McCormick, A. J. (2011). Self-determination, the right to die, and
culture: A literature review. Social Work, 56(2), 119-28.
Retrieved from http://search.proquest.com/docview/863249483?acc
ountid=28644
* Ressler, T. (2014, December 17). Most Doctors In The United States Now
Support ‘Death With Dignity’ Laws. Retrieved from
* http://thinkprogress.org/health/2014/12/17/3604626/doctorsdeath-dignity-survey/
* Top 10 Pros and Cons. (2013, December 13). Retrieved from
http://euthanasia.procon.org/view.resource.php?resourceID=000126
* Showalter, J. (2015). The law of healthcare administration (Seventh ed.).
Chicago: Health Administration Press
* Yannacci, C. (2015, February 5). Lawsuit asks new york supreme court
to rule that aid in dying to terminally ill patients is legal in the state.
Retrieved from https://www.healthlawyers.org/Pages/home.aspx