Euthanasia
· 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)