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· Passive

· Is the allowance of the dying process to continue without intervention beyond palliative care?

· It is the process of doing nothing to preserve life.

· Passive euthanasia is a generally accepted practice in cases of futility, and where no possibility of patient benefit exists.

· Active

· Where the health care provider takes actions that speeds the process of dying does not have ethical or legal support in the United States.

· You are initiating a process that brings about death.

· Active euthanasia is against the law and is contrary to professional and ethical standards of health care practice.

· It is the intentional killing of the terminally ill such as by injection if a lethal dose of medication.

· Active euthanasia is illegal in all jurisdictions in the United States, with the exception of the State of Oregon and The State of Washington

· The voters in Oregon have twice voted to give terminally ill patients, under carefully limited circumstances, the right to ask for a doctor’s prescription to end their lives.

· The Oregon law requires a second medical opinion and the determination that the patient is in fact terminally ill and not just depressed.

· There has not been a stampede demanding death by prescription in Oregon, however, from 1970-2001 only 70 people in Oregon used this law.

· This law in Oregon is still being challenged and allows physician-assisted suicide (PAS) but not homicide.

· The State of Washington became the second state to legalize active euthanasia in November 2008.

· Patient assisted suicide

· Some physicians have sought to engage a patient-assisted suicide.

· In this case the physician provides a patient with the medical know how or the means (a prescription) to enable a patient to end his or her own life.

· Jack Kevorkian first gained notoriety in June 1990 when he assisted in the suicide of Janet Adkins, a Michigan woman who was in the early stages of Alzheimer’s disease.

· Since that time he has assisted in the suicides of many other patients.

· The State of Michigan enacted a law making assisted suicide a felony punishable by up to four years in prison.

· Jack Kevorkian is presently serving a sentence in a Michigan prison.

· Voluntary

· The Netherlands is the only modern industrial nation that has legalized voluntary active euthanasia.

· Involuntary

· Where the patient has not indicted a desire to be assisted in death is not easily differentiated from murder

Euthanasia Arguments

Arguments in Favor of Euthanasia

· Respect for patient self-determination. Individuals should have the right to determine the outcomes of their lives.

· Euthanasia provides a means for harvesting viable organs.

· It provides relief for the family of a patient with an irreversible condition or terminal disease.

· It provides a means to end a terminally ill person’s suffering.

Arguments in Opposition to Euthanasia

· There is no certainty regarding death. Many terminally ill patients have been known to recover.

· Modern technology may find a cure for a terminal disease.

· Families who are undergoing stress due to the financial burden of a dying relative nay be examining euthanasia just to relieve that burden.

· If euthanasia is allowed, than it might be used indiscriminately.

· It is not good for society to have physicians kill patients or for patients to kill themselves.

· There is value and dignity in every human life.

· When physicians and other healthcare professionals become involved in any form of euthanasia, it erodes the ethical basis of the professions.

· The sick and dying may have a fear of involuntary euthanasia if euthanasia is legalized.

· Only G-d has domination over life.

An Ethic of Euthanasia

1. An individual’s life belongs to that individual to dispose of entirely as he or she wishes such as:

· the dignity that attaches to personhood by reason of the freedom to make choices demands also the freedom to take one’s own life;

· there is such a thing as life not worth living whether the cause be distress, illness, physical/mental handicaps, or even sheer despair for whatever reason;

· What is supreme in value us the human dignity that resides in the human’s rational capacity to choose and control death.

Experience of Holland/Netherlands

· It is the only modern nation to fully sanction the practice of physician–assisted euthanasia.

· Process.

· Patient must request

· Patient must be terminally ill, with no hope of improvement and in severe pain.

· Consultation with second physician and reporting of event.

· Procedural review mechanism.

Oregon Death with Dignity Act

· Criteria

· Capable and competent adult

· Oregon resident

· Have terminal illness with less than six months to live

· Must consult two physicians

· Voluntary request a prescription for lethal drugs

· Request must be both orally and in writing

· Must be able to take the medication by themselves (not injected)

· This law is being challenged in 2005 by John Ashcroft as violating the FDA laws. (Discussion Board)

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