Revision of Facts on Euthanasia

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Revision of Facts on Euthanasia
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Euthanasia

• Euthanasia literally means a gentle or easy death

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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

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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.

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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 doctors 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.

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• 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 patients request, life-saving
  treatment will not be given - resulting in their
  death

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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?

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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 patients life on their
  behalf (doctor, close relative).
• involves much legal debate as to who has the
  right to make such a decision.

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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)

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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
  patients suffering. It appears that this
  approach is actually allowing euthanasia to take
  place under the guise of double effect.

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• 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

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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
  patients 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.

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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 patients 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 patients improvement

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• 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.

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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 patients problem was possible.

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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.

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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."

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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
  patients physical well-being, 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.

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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)