1. Revision of Facts on Euthanasia

2. Euthanasia
Euthanasia literally means a gentle or easy death

3. Why is it a moral issue? "right to life" and the "right to die
right to life is generally protected by the laws of a country.
do people have a right to die as well?
some people sometimes wish to commit suicide but do not have the physical strength or the means to do it painlessly. Should society allow doctors or others to help them to die (assisted suicide)?
All doctors as well as many other people agree that we should preserve life whenever possible – Hippocratic Oath

4. V.E.
Voluntary euthanasia means that you decide the time, place and method of your own death.
Voluntary euthanasia is where you have expressed the choice that in a certain range of circumstances you think that your life is no longer worth living and that you should be helped to “die with dignity”.

5. Types
Active – where a person may be given drugs by a doctor which will kill them,
or they may be able to take them themselves with a doctor’s help.
Supporters of voluntary euthanasia have even designed “euthanasia machines” which work by allowing people to administer deadly drugs to kill them without the involvement of anyone else.

6. Passive – where treatment to save someone from dying may be withheld.
In some countries a DNR (Do Not Resuscitate) order can be requested by a patient. This means that at the patient’s request, life-saving treatment will not be given - resulting in their death

7. Legal Distinction
Law makes a distinction between active and passive: to turn off a machine is active, not to put a patient onto a life support machine is passive
Legally there is a difference
But is there morally, as both result in death?

8. Involuntary euthanasia
Involuntary when the ill person may be unconscious or otherwise unable to make a meaningful choice between living and dying. (babies, dementia patients, etc)
In this case, an appropriate person would take the decision to end the patient’s life on their behalf (doctor, close relative).
involves much legal debate as to who has the right to make such a decision.

9. UK Law
Euthanasia is illegal in Britain. To kill another person, even if the other person asks you to kill them, is classed as murder. This also applies to doctors and their patients.
It is a criminal offence in the UK, punishable by up to 14 years' imprisonment, to assist, aid or counsel somebody in relation to taking their own life. (March 2002.)
It is not illegal for someone to commit suicide or to attempt to commit suicide.(since 1961)

10. Acceptable Euthanasia
1 Active euthanasia by side effect
Active euthanasia by side effect is permitted in one special case. A terminally ill patient may have their death hastened by a medical treatment that is primarily given to relieve pain. This would have the double-effect of being given to relieve pain, but actually killing the patient at the same time. The doctor must be able to prove that the lethal dose was required to relieve the patient’s suffering. It appears that this approach is actually allowing euthanasia to take place under the guise of double effect.

11. 2 Voluntary passive euthanasia
As a patient has an absolute right to refuse medical treatment, if a patient says to his/her doctor, "I want to die, please do not give me any medical treatment that would prolong my life,” the doctor cannot legally override the patient's wishes.
By contrast, voluntary active euthanasia is not legal. If the patient says to his doctor, "I want to die. Please give me a lethal injection,” then the doctor cannot

12. Law in Netherlands
Euthanasia was only officially made legal in the Netherlands in 2002.
Only a doctor may carry out euthanasia
There should be an explicit request of the patient leaving no room for doubt about the patient’s desire to die
The patient should be in a situation of unbearable pain, either physical or mental, and suffering with no prospect of change
The doctor should be very careful in making the decision and should consult at least one other physician
The death must be reported to the authorities as a case of euthanasia or physician-assisted suicide
It should be noted that citizens from other countries are not eligible for euthanasia in Holland.

13. Problems with the Dutch system
The Rimmelink Report (1990)
1040 died from in/non-voluntary euthanasia. That is an average of almost three people a day put to death by their doctors without their knowledge or consent. Of these, 72% had never said they wanted to end their lives.
8100 died as a result of drugs that were given, not primarily to control pain, but to speed up the patient’s death.
The main reasons given for the decision to end these lives were:
low quality of life of the ill patient
the family could not cope anymore
no prospect of the patient’s improvement

14. Dutch Authorities find Euthanasia on the Rise (May 2006)
A new report showed that for the third year in a row, medical authorities in the Netherlands have reported an increase in the number of legal euthanasia cases. Many studies have shown that the number of actual cases of doctors killing their patients is roughly twice what is officially reported, despite laws making the practice legal.
at least 50% of patients requesting euthanasia were seriously depressed, with 44% of those suffering from cancer suffering signs of clinical depression when they asked for euthanasia.
While the “safeguards” in the Dutch euthanasia program do require doctors to determine that a patient asking for euthanasia is “of sound mind,” there is no requirement that they are not suffering from depression.

15. BMA
In the year 2,000 the BMA opposed the legalisation of euthanasia or physician-assisted suicide.
However
If some doctors, who have exhausted all other possibilities for ensuring a patient's comfort, see the deliberate termination of life (euthanasia) as the only solution to relieving physical pain and suffering in an individual case, the doctor should be accountable to the law and to the General Medical Council and be obliged to defend such an action to those Authorities.
In other words, doctors could help a patient to end their life by passive euthanasia, or death by side-effect, but would be subject to close investigation to ensure that no other solution to the patient’s problem was possible.

16. Reasons for their views
The protection of vulnerable people
Practical considerations. – how do you set safeguards to make sure it is always voluntary
If doctors were authorised to carry out euthanasia or assisted suicide, they would be given an additional role opposed to the traditional one of healer
Also, the psychological relationship between doctors and patients would also change, especially with those who suffer long-term illness or disability and who require substantial health resources to keep them alive.

17. Changes in views of BMA
2005 – voted to support a change in the Law to allow a change in the law to allow terminally ill patients to be helped to die by assisted suicide.
But BMA conference in 2006, doctors again changed their views on euthanasia. 65% of doctors voted against physician-assisted dying
Because "If good palliative (pain controlling) care is provided, requests for euthanasia are extremely rare. We should be doing all we can to make sure that this care is made more widely available."

18. Hospices
Hospices are special hospitals that take care of the dying in their last few weeks of life. Hospices were concerned not only with the patient’s physical well-being, but with their mental and emotional well being as well.
The aim of the hospice is to give the patient a good death, but not through euthanasia.
Hospices place great importance on pain relief – when people are in severe pain they are not themselves and are not comfortable with themselves or their surroundings. Hospices say that it is important to make the patient feel comfortable and at peace with themselves in order for them to have a good death.
Hospices have their emphasis on the patient rather than the disease, and they take time to work through the roots of anxiety with the patient and their family. As a result, the patients learn to cope with dying.

19. Arguments against euthanasia by hospices
No-one should suffer unbearable pain if they are treated correctly – doctors should know how to treat pain better
One of the main dangers of legalising euthanasia is the ‘slippery slope’ argument – if euthanasia is allowed for patients near to death, it could be extended to people who are not so ill
Some people could feel they have a duty to die rather than a right to live (elderly, disabled, etc)