1. Medical Ethics – the end of life
Assisted dying, euthanasia and palliative care
Religious and secular perspectives
Legal position
Issues – rights, responsibilities, choices, personhood and human nature

2. Discussion 1: Dying What is “dying”?
At what point is somebody “dying”?
Does the value of your life change if you are dying?
Are there different moral rules/expectations for people who are dying?

3. Discussion 2: rights, responsibilities & choices
Do we have a right to life? If yes, what does this mean?
Do we have a right to choose our death? If yes, why?
What do you understand by the phrase “dying with dignity”? Is this possible?

4. Definitions Voluntary euthanasia
Non-voluntary euthanasia (sometimes called involuntary)
Assisted suicide/ assisted dying
Advance Directive (also called a Living Will)

5. Active Euthanasia
Passive Euthanasia
Omission
Palliative care (vs. acute care)
Hospice

6. The legal position - UK
There is currently no law that directly addresses euthanasia. If someone actively and intentionally causes someone’s death, that is classed as murder, and doctors and/or relatives responsible can be charged with murder in these situations.
If a decision is taken to stop someone’s treatment (for instance by turning off a life-support machine) and this causes their death, this is not classed as murder.
Law follows the Acts & Omissions Doctrine
Where an act and an omission both result in death, the act is morally worse because it does so more directly.
Can you think of an example that illustrates the Acts & Omissions Doctrine?

7. Is one morally worse than the other?
Smith stands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.
Jones also stands to gain if anything should happen to his six-year-old cousin. Like Smith, Jones sneaks in planning to drown the child in his bath. However, just as he enters the bathroom Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he stands by, ready to push the child's head back under if it is necessary, but it is not necessary. With only a little thrashing about, the child drowns all by himself, "accidentally," as Jones watches and does nothing.
Is one morally worse than the other?
(Get ready to say )
Extension questions: How would a Christian answer this question?
How would a Utilitarian answer this question?

8. So if passive euthanasia is acceptable, active should be too.
“I can understand why some people are opposed to all euthanasia, and insist that such infants be allowed to live. I think I can also understand why other people favour destroying these babies quickly and painlessly. But why should anyone favour letting dehydration and infection wither a tiny being over hours and days? The doctrine that says that a baby may be allowed to dehydrate and wither, but may not be given an injection that would end its life without suffering, seems so patently cruel as to require no further refutation.” (James Rachels)
Rachels’ conclusion is that active euthanasia is not morally worse than passive.
So if passive euthanasia is acceptable, active should be too.

9. The legal situation - Holland
Euthanasia is legal with the following conditions:
Suffering must be continuous and unbearable
Patient must be of sound mind
Doctor must get second opinion
Lethal drug can only be given by doctor - family cannot help

10. Changing legislation?
What might be the bad consequences of legalising euthanasia?
Guernsey “suicide-clinic” proposals
The slippery slope argument
The Slippery Slope argument says that if we allow some forms of euthanasia, that will inevitably lead to other things being allowed which are not acceptable. So to avoid the unacceptable things, we should not allow euthanasia.
It doesn’t matter whether euthanasia itself is actually right or not. If it leads to things we don’t want, then we can’t allow it.

11. Possible Consequences?
Old or ill people feeling pressured into requesting death
Families of old or ill people actually pressuring them into asking for death
Murderers will easily use it as a way to kill people
A general feeling that life is not important
Doctors killing off old and ill people to save money or free up beds
Doctors not properly checking whether patients are really making the choice to die
People having an easy way of killing relatives for their inheritance

12. Personhood/ human nature & euthanasia
Christian Views
Secular Views
Sanctity of Life
Quality of Life
Peter Singer
Jonathan Glover

13. Research Task Find about the life, work and beliefs of Dame Cicely Saunders.
Make sure you can answer these questions:
What was her job/ background?
When and how did she found the first hospice?
What exactly is a hospice?
What is meant by palliative care?
What was her view on palliative care? (How did she think we should treat people who are dying?)
How did her Christian beliefs affect her approach to palliative care?

14. In favour of euthanasia:
Video 1 – woman explaining why she wants euthanasia
Video 2 – man going over to Dignitas
Video 3 – man dying in Dignitas (upsetting scene)

15. Anthology Text here