Higher RMPS Morality in the Modern World Euthanasia

What is Euthanasia? Euthanasia is the deliberate killing of a person for the benefit of that person. In most cases euthanasia is carried out because the person who dies asks for it, but there are cases of euthanasia where a person can't make such a request. A person who undergoes euthanasia is usually terminally ill, but there are other situations in which some people want euthanasia.

The ethics of Euthanasia Euthanasia raises agonising moral questions like these: is it ever right for another person to end the life of a terminally ill patient who is in severe pain or enduring other suffering? if euthanasia is sometimes right, under what circumstances is it right? is there any moral difference between killing someone and letting them die?

At the heart of the ethical and religious arguments over euthanasia are the different ideas that people have of the meaning and value of human existence (sanctity of life v quality of life argument), and of whether human beings have the right to decide issues of life and death for themselves (argument from personal autonomy). There are also a number of arguments based on practical issues. Some people think that euthanasia shouldn't be allowed even if it was morally right, because it would be abused and used as a cover for murder (slippery slope argument).

Killing or letting die Euthanasia can be carried out either by doing something, such as giving a lethal injection (active), or by not to do something necessary to keep the person alive (passive)-for example failing to keep their feeding tube going.

Mercy killing Very often people call euthanasia 'mercy killing', perhaps thinking of it for someone who is terminally ill and suffering prolonged, unbearable pain. The word euthanasia comes from the Greek and means easy death.

Euthanasia and Pain Relief It's not considered euthanasia to give a drug in order to reduce pain, even though the drug causes the patient to die sooner. This is because the doctor's intention was to relieve the pain, not to kill the patient. This argument is sometimes known as the Doctrine of Double Effect. (DDE)

This is because the doctor is not aiming directly at killing the patient - the bad result of the patient's death is a side-effect of the good result of reducing the patient's pain. Many doctors use this doctrine to justify the use of high doses of drugs such as morphine for the purpose of relieving suffering in terminally-ill patients even though they know the drugs are likely to cause the patient to die sooner

Why people want euthanasia Most people think unbearable pain is the main reason people seek euthanasia, but some surveys in the USA and the Netherlands showed that less than a third of requests for euthanasia were because of severe pain. Terminally ill people can have their quality of life severely damaged by physical conditions such as incontinence, nausea and vomiting, breathlessness, paralysis, difficulty in swallowing. Psychological factors that cause people to think of euthanasia include depression, fear of loss of control or of dignity, feeling a burden, or dislike of being dependent.

Types of Euthanasia

Voluntary Euthanasia The person wants to die and requests to do so. This includes cases of:  Terminally ill (e.g. Diane Pretty-motor neuron’s disease) clipclip  Poor quality of life due to disability, pain etc. (e.g. Dan James – rugby player)  asking for help with dying  refusing burdensome medical treatment  asking for medical treatment to be stopped, or life support machines to be switched off

Voluntary Euthanasia Benefits Gives control over all aspects of life Quality of life seriously affected- e.g. severe pain To die with dignity Feel a burden to their family Fear of death, i.e. the process, pain, leaving family and friends Save valuable medical resources if going to die anyway Dangers Doctors are healers not killers Is everyone who requests euthanasia of sound mind? Society has a duty to protect people Could be a cry for help Open to abuse People should not be a burden –should be cared for in a Hospice

In-voluntary euthanasia The person cannot make a decision or cannot make their wishes known, therefore euthanasia is carried out without consent, e.g.:  the person is in a coma  the person is too young (eg a very young baby)  the person is senile  the person is mentally retarded to a very severe extent  the person is severely brain damaged  the person is mentally disturbed in such a way that they should be protected from themselves

In-Voluntary Euthanasia Benefits Last act of kindness If made legal would remove fear of prosecution Medical controlled avoids botched jobs Death in dignity Free up much needed medical resources Dangers Doctors might feel pressurised to free up medical resources Doctors can make mistakes Being too hasty doesn’t give friends and family time to adjust It’s illegal Could make society a less caring place

Ways of Administering Euthanasia Active a person directly and deliberately causes the patient's death.  Administering lethal drugs or injection  suffocation Passive occurs when the patient dies because the medical professionals either don't do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive.  switch off life-support machines  disconnect a feeding tube  don't carry out a life-extending operation  don't give life-extending drugs

Assisted suicide This usually refers to cases where the person who is going to die needs help to kill themselves and asks for it. It may be something as simple as getting drugs for the person and putting those drugs within their reach. Taking someone to Switzerland to die is considered assisted suicide

The Doctrine of Double Effect This doctrine says that if doing something morally good has a morally bad side-effect it's ethically OK to do it providing the bad side-effect wasn't intended. This is true even if you foresaw that the bad effect would probably happen. The principle is used to justify the case where a doctor gives drugs to a patient to relieve distressing symptoms even though he knows doing this may shorten the patient's life.

The Debate A question of rights Does an individual who has no hope of recovery have the right to decide how and when to end their life?

Why euthanasia should be allowed

Those in favour of euthanasia argue that a civilised society should allow people to die in dignity and without pain, and should allow others to help them do so if they cannot manage it on their own. They say that our bodies are our own, and we should be allowed to do what we want with them. So it's wrong to make anyone live longer than they want. In fact making people go on living when they don't want to violates their personal freedom and human rights It's immoral, they say to force people to continue living in suffering and pain (Argument from Personal Autonomy). They add that as suicide is not a crime, euthanasia should not be a crime.

Why euthanasia should be forbidden

Religious opponents of euthanasia believe that life is given by God, and only God should decide when to end it (sanctity of life argument). Other opponents fear that if euthanasia was made legal, the laws regulating it would be abused, and people would be killed who didn't really want to die (slippery slope).

The Legal Position UK LAW

Euthanasia is illegal in Britain. To kill another person deliberately is murder, even if the other person asks you to kill them. It is also a criminal offence in Britain, punishable by 14 years' imprisonment, to assist, aid or counsel somebody in relation to taking their own life. (Legal position stated at March 2002) An application can be made to the courts requesting non-voluntary euthanasia on a case by case basis only.

The Dutch Approach The Law in the Netherlands

In the Netherlands voluntary euthanasia and assisted suicide are still criminal offences, but doctors are exempt from criminal liability in certain circumstances. Must meet the following criteria:

Doctor must be convinced that the patient has made a voluntary and well-considered request to die Doctor must be convinced that the patient is facing terminal and unendurable suffering Doctor has informed the patient about his/her situation and his/her prospects together with the patient, doctor must be convinced that there is no other reasonable solution Doctor has consulted at least one other independent doctor who has seen the patient and agrees to euthanasia 2 nd doctor has given his opinion in a written assessment Doctor has helped the patient to die with due medical care

The Dutch law also permits euthanasia for non-adults. Children of 16 and 17 can make their own decision, but their parents must be involved in the decision-making process regarding the ending of their life. For children aged 12 to 16, the approval of parents or guardian is required. If a patient can no longer express their wishes, but made a written statement containing a request for termination of life before they became incompetent, a doctor is allowed to carry out their request providing the other conditions are met.

Law in Netherlands Advantages It respects the rights of the individual It values the quality of life Strict rules prevent abuse Allows a person to end their life if they do not want to be a burden on others Dangers It de-values human life – life becomes disposable It does not prevent abuse- many cases are not reported Doctors are healers not killers Many elderly people may agree to being euthanized because they think they are a burden to their family.

BMA Guidelines

BMA makes it very clear that euthanasia is against the law.  Doctors prosecuted for assisting suicide or performing voluntary euthanasia can result in a prison sentence of up to 14 years. BMA has a clear policy opposing Euthanasia It is the duty of a doctor to ensure that a patient dies with dignity and with as little suffering as possible but not by deliberately killing them. BMA accepts that patients can refuse treatment that may prolong their lives and that medication designed to keep a patient pain-free and comfortable may reduce their life span (DDE)

Euthanasia or physician-assisted suicide is in tension with the traditional role of doctors as healers. BMA agrees with the House of Lords that although in individual cases euthanasia may seem appropriate it would be wrong for society as a whole as it could be abused. The interests of society must overrule those of individuals. Also, it is not possible to set secure limits on voluntary euthanasia. If doctors were involved in euthanasia it would change the way long-term illness, disability or needing substantial health resources was viewed by society.

BMA makes it clear that doctors may give large doses of drugs in order to keep a patient pain-free even if that means it speeds up the person’s death. However, it makes clear that they are not allowed to give out drugs with the intention of causing or speeding up death. (DDE) BMA advice is effective in that it leaves the doctor and patient in no doubt about their rights. It gives support ethically and legally