intro to euthanasia

  • euthanasia: the act of bringing about an easy n painless death

  • assisted suicide: when a person dies as a direct result of their own voluntary action but with the help of another person. This is different from voluntary euthanasia, only in so far as the person may have many reasons for wanting to die, Their condition does not have to be life threatening.

  • passive euthanasia: where treatment that would help a person live longer is stopped with the idea of ending the life e.g. not using life support.

  • non-voluntary euthanasia: when a person’s life is ended without their consent but with the consent of someone representing their interests. For example a doctor or the courts may decide that a person who is in a persistent vegetative state (PVS) should have their life sustaining treatment removed. ​

  • voluntary euthanasia: when a person’s death is directly caused by another person (perhaps a doctor) at their request and with their consent. Most arguments today assume that the person wanting to die is suffering from an incurable and terminal illness and is in great pain​

  • Some doctors may give painkillers to ease suffering knowing that the dosage needed would eventually lead to death. This is known ​as ‘Double Effect’ and is the ​only form of euthanasia ​

    the Catholic Church ​will agree to

  • slippery slope effect: that the acceptance of certain practices, such as physician-assisted suicide or voluntary euthanasia, will invariably lead to the acceptance or practice of concepts which are currently deemed unacceptable, such as non-voluntary or involuntary suicide

 

Quality of Life​

Sanctity of Life​

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  • ​QoL refers to a person’s total wellbeing. In ethical and medical contexts the term Health related quality of Life (HRQoL) is sometimes used. This focuses on how an individuals wellbeing may be affected by disease, disability or a disorder. ​

  • Generally in the UK the way that QoL is assessed is by means of a concept called Quality Adjusted Life Years (QALY) This was set out by the National Institute for Health and Care excellence (NICE) who use an internationally recognised method of calculating an individuals QoL, considering factors such as the level of pain, their mobility and their general psychological state. They then look at available drugs and decide whether they will give good value for money in the treatment of a patient taking into account side effects of the drug and the cost. The QALY method gives an idea of how much extra time a patient may gain from treatment. However, if the medication costs more than £20,00-30,000 per QALY it would not be considered cost effective.​

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​- John Wyatt (2009) argues that if humans are made in the image of God it means:​

  1. Humans are dependent on God for their lives because God is in control of every individuals life. Jeremiah 10:23 ‘A man’s life is not his own..’​

  2. Humans live in a relationship with God​

  3. Every human life has a unique dignity as humans were created by God. Life is received as an entrusted gift not a possession.​

  4. All humans are equal as we are all made from God-like material. Proverbs 22:2, ‘rich and poor have this in common: the Lord is the maker of them all’​

  5. Patients in a PVS although seriously incapacitated are still living human beings, so their life should be prolonged​

  6. Elderly and sick patients have the same rights as any other human beings​

  7. Those with physical or mental handicaps have the same value as other human beings​

Autonomy​

Personhood​

  • dignity in dying pushes for choice and access in end-of-life services.

  • it supports assisted death for terminally ill adults under strict laws.

  • calls for universal, quality end-of-life care.

  • has 100,000+ supporters and relies on public donations.

  • 80% of UK backs a law change on assisted dying.

  • a dnr order means no attempt to restart a stopped heart.

  • seen as a form of passive euthanasia.

  • aims to prevent unnecessary patient suffering.

  • legally prevents cpr.

  • ethical concerns with dnr use.

  • 2011: dnr orders made without patient or relative knowledge.

  • termed 'euthanasia by the back door' by a charity.

  • nhs may use dnrs to cut costs.

  • bma found abuses in dnr use.

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  • ​personhood key in non-voluntary euthanasia debate.

  • killing another person generally seen as murder or homicide.

  • jack mahoney's criteria for personhood:

    • rationality: ability to reason and choose.

    • sentience: ability to sense and experience.

    • emotions: feel anger/happiness.

    • free-will: decide own actions.

    • continuity: sense of past, present, future.

  • previous criteria not exhaustive.

  • severe injury or disability may not meet criteria.

  • peter singer's distinctions:

    • person: shows rationality, self-consciousness.

    • human: homo sapiens life form

sanctity of life vs patient autonomy:

  • peter singer: sanctity of life principle shifting globally.

  • his five euthanasia commandments:

    • worth of life varies.

    • own decision consequences.

    • respect desire to live or die.

    • have wanted children.

    • no species discrimination.

  • mill: individuals best judge of own interests.

  • exceptions: selling oneself or suicide.

  • mental health patients may lack judgment.

  • uk: support and treatment for such patients.