1. Right to Die

2. Right to Die
Choices for dying patients and their families due to technology
What constitutes a “good death”
Most people die in hospitals with staff trying to keep patient alive until no chance of recovery
Most people want total effort to fight off death

3. Some are facing a terminal illness
There may come a point when the fight no longer seems worth it
Those patients may find their wishes and those of their families overlooked as physicians juggle medical, legal and moral considerations

4. Patients undergoing minor surgical procedures are routinely asked if they would like to fill out a document, known as an “advance directive” or “living will”

5. Living Will Every state now allows people to issue form of directive
Specifies what course of action they want if they are unable to communicate
Only 40% of people have living wills
Not always binding

6. Court rulings have firmly established a patient’s legal right to discontinue life sustaining treatment, such as respirators or artificial nutrition
Debate over these decisions is far from settled- Terri Schiavo’s case went on for 12 years

7. Another issue is whether individuals should be able to ask physicians to hasten their deaths- in effect, help them end their lives- and whether it is morally acceptable for physicians to do so

8. Right to Die
Should individuals be able to ask doctors to hasten their deaths?
Who decides whether life is worth living or not?
Should others (families, doctors, government) be able to decide for them?

9. Many people say they would rather die than suffer in great pain or endure life trapped in a vegetative state
Should individuals have the right to decide when and how they will die?

10. What is considered unbearable?
Terminal illness?
Chronic physical pain?
Debilitating, although not fatal, illness?

11. Right to Die
Euthanasia: hastening the death of a terminally ill patient-
Is it mercy and respect?
Or is it murder?

12. Right to Die Euthanasia:
Is it a measure of control over timing, or is it a slippery slope of neglect of old, poor, disabled, emotionally distraught, seriously ill?

13. Right to Die Religious and moral questions:
Life and death should be left for God, not human beings
Life is to be cherished, not abandoned

14. Right to Die
Netherlands, Belgium, Switzerland, Luxembourg- physician assisted suicide is legal
United States: Oregon and Washington permit physician assisted suicide- Montana and Massachusetts have tried to make it legal but so far it has failed

15. “Death with Dignity Act”
1994
Oregon
Doctors can prescribe lethal dose but not give it
Ensure patients seeking this to be mentally competent, in great pain, intent on ending their life

18. 60% say doctor assisted suicide not murder

20. Dr. Jack Kevorkian Michigan Helped 130 people commit suicide
Sentenced to prison for years
Served 8 years in a Michigan prison for administering a fatal injection to a terminally ill man

22. Should Kevorkian have been convicted of murder?

23. Karen Ann Quinlan 21 yrs old April 15, 1975, took alcohol and drugs
Full blown coma
Doctors pronounced her condition a “persistent vegetative state”

24. Karen Ann Quinlan
Doctors said most basic life processes could be kept going, but she had ceased to be a human being
Or had she?
EEG detected traces of electrical activity in her brain
Machine said she was not “brain dead”

25. Karen Ann Quinlan Her parents were deeply religious
Felt that she had the right to “die with dignity”
Tried to get respirator turned off
New Jersey Superior Court rejected plea after 7 months on respirator

26. Karen Ann Quinlan
“This is not a court of love, of compassion, but a court of law. You can’t just extinguish life because it is an eyesore.” said her court appointed guardian
New Jersey Supreme Court overturned decision March 31, 1976

27. Karen Ann Quinlan
Everyone thought she would die very soon from brain death
She lived for 10 years without a respirator
Died in 1986 from pneumonia

28. 60% say spouse should make decision for coma-like patient

29. Terry Schiavo Brain damaged patient No living will Family was divided
Years of litigation
Husband eventually won to have feeding tube removed

30. Terry Schiavo Increased public interest in living wills
20 states have issued bills to clarify laws about living wills

31. Right to Die Perspective 1
Recognize the right to die with dignity, with a physicians assistance
Permit people to have a “humane” death
Individuals have the right to determine the time and circumstances of their death

32. Right to Die Perspective 2
Focus on giving comfort and recognizing the patient’s preferences
Recognize patient’s right to control the treatment they receive- relieve pain and ease the depression the patient is experiencing

33. Improve the quality of life for the patient
Allow patient to issue directives, not just preferences, about end of life care and treatment
Expand hospice care
Remove barriers to effective pain management- such as overly restrictive regulation of narcotics

34. Right to Die Perspective 3 Reaffirm the commitment to preserve life
Condemn practice of physician assisted suicide
It should be illegal
Unconditional value of human life

35. Except when patients explicitly decline further treatment, physicians must make every effort to sustain life
Any compromise in the commitment of medical professionals to protect and extend life would undermine the public’s faith in the medical profession