Euthanasia

Explain the sanctity of life approach(es)

• religious origins in the idea that human life is made in God’s image, so it has sacred value

• Catholics support an “absolute inviolability” of human life (natural law)

• In Judaism - holiness is achieved through actions and moral behaviour. This is sanctifying God’s name

Explain the quality of life approach(es)

Peter Singer argues that whether a person’s life is worth living is based on their wellbeing

• a poor quality of life might be due to intense pain, or a terminal illness with no known cure

• e.g. motor neurone disease. Over time, pain increases (both mentally and physically). Effectiveness of pain-reducing treatment wears thin.

What are some examples of countries that have legalised voluntary euthanasia

Describe one of the approaches

Netherlands, Belgium, Luxembourg, Canada.

e.g. Netherlands “Assisted dying” for patients with unbearable suffering with no hopes for improvement. Decision to perform euthanasia is a joint decision between doctor and patient. Another physician is consulted, has to give permission. There must be “no reasonable alternative”.

Increasing numbers of deaths in Netherlands from psychiatric reasons.

What is voluntary vs non-voluntary euthanasia

Voluntary - life ended at their request or with their consent

Non-voluntary - a person’s life is ended when they are unable to consent

What is an advance directive

A legally binding document in which a patient expresses which treatments they wish to refuse if they become unable to communicate.

(e.g., withdrawing life-sustaining treatment)

What is a persistent vegetative state? Give added details

PVS - a person is awake but shows no signs of consciousness, lacking cognitive function.

Since 2018, it is no longer necessary in UK to apply to Court of Protection to withdraw treatment from PVS patients.

For some patients, doctors are unable to brush their teeth. They may suffer seizures. Tormenting experience for the family who have to support this.

What are ordinary means vs extraordinary means? Give examples of both.

Ordinary - actions intended to relieve suffering that may unintentionally bring about harmful side effects (e.g. painkillers).

e.g. respiratory depression under the use of opioids.

Extraordinary - treatments considered disproportionate or overly burdensome to the patient, or financially ruinous.

e.g. chemotherapy, can lead to fatigue, an increased risk of infection. Sometimes it is only aimed to prolong life.

What are the pillars of medical ethics?

Beneficence: commitment to improving patient’s wellbeing

Non-maleficence: do no harm

Justice: fair distribution of resources

Autonomy: respect for patient’s choice

What is palliative care?

Give examples of what this might involve

Aims to relieve pain instead of curing disease. Can be delivered at homes, hospices or hospitals.

Might involve spiritual support, pain-killer administration, physical therapy, counselling.

What is the principle of double effect?

When faced with a moral dilemma where a good actions has negative side effects, DoDE intended to help guide through understanding whether one should go through with it.

four conditions:

1. action must be intrinsically good or indifferent

2. must be a serious reason for the bad effect

3. the good effect must not be obtained by means of the bad effect

4. the bad effect must not be intended

Apply the DoDE to issues surrounding euthanasia-based decisions.

• primary precept of preservation of life —- can ending a life ever be good?

• this might prevent any form of euthanasia, but prevents natural law from being a consequentialist theory. There is consistent dignity given to every person

• can justify palliative care that may accelerate the end of one’s life, e.g. through pain medication that shortens one’s life. But this is not permissible if that is the intention.

When might situation ethics not permit euthanasia?

• when there are better, more loving options exist e.g. palliative care

• when based on temporary feelings, like a cry for help. There needs to be some rational thinking.