ASSISTED DEATH

Zenebou Abalo-TogaJenna SwisherBeti KercelliJivata RajaMaria Bagnato

TERMINOLOGY

The term Assisted death is a model that includes both what has been called physician-assisted “suicide” and

euthanasia.

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Physician-assisted suicide A physician provides necessary lethal means-drugs-

or information to a patient The patient performs the act at a time of their own

choosing

Euthanasia-Greek term for “Good death” The physician taking an active role in performing or

carrying out a patient’s request for life termination.

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EUTHANASIA-CLASSIFICATION

Active To end one’s life with a physician intervention using drugs or

lethal injection Passive

To end one’s life by withholding necessary actions-medical treatments, food, water-to maintain that life

Voluntary When a competent person makes a conscious and enduring

decision to die or to be helped to die Involuntary

To end someone’s life with the knowledge or consent Non-voluntary

when a person is unable to give his/her consent, but gives another person the power to make that decision for them.

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WHY EUTHANASIA?

66% of people choosing Euthanasia have social/personal reasons, not pain

Some reasons include: not wanted to be a burden on their family, feelings of apathy and a defeated outlook

55% of deaths in hospitals are painful

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METHODS

Drugs Anti-emic drug followed by life ending prescription

drug

Injection Injection to render a patient comatose, followed by

an injection to stop heart

Starvation and Dehydration Withdrawal from food and water to hasten death

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DELIVERANCE MACHINE

EXIT BAG WITH NITROGEN GAS

Dr Philip Nitschke

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EUTHANASIA DEVICES

Thanatron

Jack Kevorkian

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MERCITRON

THANATRON

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DR. JACK KEVORKIAN 1928-2011 Pathologist who

assisted people suffering from acute medical conditions in ending their lives.

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IN THE UNITED STATES OF AMERICA:IT’S YOUR CONSTITUTIONAL RIGHT!!

Amendment IX

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage

others retained by the people.

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ANCIENT PHILOSOPHICAL VIEWSSupport of Euthanasia Plato Aristotle The Stoics

Against Euthanasia Hippocrates Pythagoreans Epicureans

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ANCIENT GREEK/ROME(5TH CENTURY B.C. – 1ST CENTURY B.C.)

Largely in SUPPORT of euthanasia despite the Hippocratic Oath which prohibited assisted-suicide

In ancient times physicians had a dual role: one to cure, the other was to kill

Eugenics

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THE MIDDLE AGES(1ST CENTURY A.D. – 16TH CENTURY A.D.)

The ascendancy of Christianity led to a strong OPPOSITION toward any form of suicide

Death is for God to decree, not man

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AGE OF ENLIGHTENMENT(17TH – 18TH CENTURY)

Renaissance and reformation writers challenge the church in SUPPORT of euthanasia

No widespread interest in the topic, but achieved short-term toleration of suicide near the end

Church still AGAINST

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TERRI SCHIAVO

1963 – 2005 Right to Die case

in Florida

Famous Cases

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LEGALITY U.S.A

1997-Supreme Court Ruled for No constitutional right to assisted suicide,

leaving sates free to pass laws specifically prohibiting it.

Oregon and Washington's death with dignity Act

Vermont (Patient’s Choice and Control at the end of Life Act) and Montana

• All 4 states allows terminal-ill patients to end their lives through self administration of lethal prescribed medications.

Euthanasia is legal in Belgium, Netherlands, and Luxembourg

Assisted Suicide legal in Switzerland Z. A

EUTHANASIA IN THE UNITED STATES

Montana (2009) Vermont (2013) Washington (2008) Oregon (1994)

Oregon, Vermont and Washington require that the patient be 18 years old, have 6 or less months to live, and have two oral requests (15 days apart) and one written request to the physician

Montana requires that a case by case basis is approved through court

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THE LAW – US American criminal law currently considers

euthanasia to be willful homicide. If an individual performs a voluntary

termination of an incurably ill or a suffering human being, even with an altruistic motive, under the present U.S. system of jurisprudence, this constitutes murder in the first degree.

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BARBARA MANCINI Philadelphia—Feb. 2013

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Current Case

INTERNATIONAL LEGALIZATION

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Country Euthanasia Status Physician-Assisted Suicide Status

Australia Illegal Illegal

Belgium Legal (2002) Legal (2002)

Canada Illegal Illegal

Colombia Unclear Illegal

Germany Illegal Legal

India Illegal Illegal

Israel Illegal Illegal

Italy Illegal Illegal

Japan Unclear Illegal

Luxembourg Legal Legal

The Netherlands Legal Legal

Russia Illegal Illegal

Spain Illegal Illegal

Switzerland Illegal Legal

United Kingdom Illegal Illegal

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EUTHANASIA INTERNATIONALLY

More than 20,000 deaths registered in six countries: Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Half of the deaths reviewed were of people aged 80 and over

Passive non-voluntary euthanasia (withholding life support) is legal in India, Albania, and many parts of the United States and is practiced in English hospitals

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DENMARK The national Danish law on patient rights from

1998 states that passive euthanasia, such as stopping a terminally ill patients treatment, is legal. Active euthanasia and assisted suicide is not legal

The law allows the withholding of treatment and withdrawing treatment in terminally ill patients

One implication of this rule is that the patient can always reject treatment and can for example avoid being kept alive artificially

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NETHERLANDS

First nation to permit euthanasia The law allows medical review board to suspend prosecution

of doctors who performed euthanasia when each of the following conditions is fulfilled: the patient's suffering is unbearable with no prospect of

improvement the patient's request for euthanasia must be voluntary and

persist over time the patient must be fully aware of his/her condition, prospects and options

there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above

the death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present

the patient is at least 12 years old

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CHILD EUTHANASIA The name given to the organized murder of severely

mentally and physically handicapped children and young people up to 16 years old during the Nazi era in over 30 so-called special children's wards

"if the newborn child is suspected of being afflicted with the following congenital disorders:  Idiocy and mongolism (especially cases combined

with blindness and deafness),  Microcephaly  Hydrocephalus, to a severe or advanced degree Malformations of all kinds, particularly the absence of

limbs, severe midline defects of the head and spine, etc. Paralysis, including cerebral palsy.

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CHILD EUTHANASIA Extremely premature births, where children suffer brain damage from

bleeding and convulsions; and diseases where a child could only survive on life support for the rest of its life, such as rare blistering illness.

Severe hydrocephalus. Infants like this can be subject to non-voluntary euthanasia in the Netherlands if the parents and doctors decide it is the best choice for their child. In other jurisdictions, the doctors involved may be prosecuted.

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EUGENICS Eugenics: the belief and practice of improving the genetic quality of the human

population. -the improvement of human genetic traits through the promotion of higher

reproduction of people with desired traits (positive eugenics), and reduced reproduction of people with less-desired or undesired traits (negative eugenics). 

developed by Francis Galton. Implementations:

genetic screening birth control promoting differential birth rates marriage restrictions segregation (both racial segregation and segregation of the mentally ill from the

rest of the population) compulsory sterilization, forced abortions forced pregnancies, genocide 

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THE ECONOMIC ARGUMENT

"Right-to-die" advocates claim that the elderly and those with disabilities fear becoming a financial burden on their loved ones and would rather chose death. They state that next to pain and suffering this is the second most important reason people want to die by euthanasia.

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POLITICAL VIEWS

Liberal

Legalize euthanasia Right to die with dignity, by

his/her own choice Terminally ill should have right

to chose to end pain and suffering

Government should not withhold this right

Will not lead to doctor-assisted suicides of non-critical patients

Reduces health care costs; funds can be made available to someone who can truly benefit from medical care

Conservative Should not be legalized Immoral and unethical Goal should be compassionate

care and easing the suffering of terminally ill

Will lead to doctor-assisted suicides of non-critical patients

Insurance companies will pressure doctors to withhold life-saving treatment for dying patients

Against many religions Devalues human life

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RELIGIOUS AND SOCIAL VIEWS IN THE US

Catholicism Episcopal Evangelical Baptist Presbyterian Mormon Judasim Hinduism Islam Unitarian Universalism

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2009 CBS NEWS/NEW YORK TIMES POLL

“If a person has a disease that will ultimately destroy their mind or body and they want to take their own life, should a doctor be allowed to assist the person in taking their own life, or not?"

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CELEBRITY SUPPORTERS

Sir Patrick Stewart (actor) Sir Terry Pratchett (author) Stephen Hawking (theoretical physicist)

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PHYSICIAN OPINION 31% had no objection to physician assisted

suicide 82% had no objection to terminal sedation 95% had no objection to withdrawal of life

support 53% support physician assisted suicide when the

patient would experience excruciating pain 37% support physician assisted suicide in

terminally ill cancer pains who would not experience pain

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PHYSICIAN INTERVIEWS Emergency room nurse: “The concept of

Euthanasia goes against the basis of medicine, keeping people alive…”

Oncologist: “Euthanasia is a personal choice, sometimes patients have gone through enough and are too tired to go on. That is understandable.”

Osteopath: “Though I rarely deal with terminal patients, it is hard for me to imagine supporting ending a life, no matter what the person is going through.”

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“I think that assisted death (without the physicians) should not be considered legal. What would happen if the person undergoing the procedure had a medical complication of some kind and didn't die in a humane manner? I think that physician-assisted death (euthanasia- as you describe it) sounds as if it should be permissible. I know that there are a lot of different medical disorders (such as ALS) that cause extreme physical deterioration as the disease progresses. I do not think that people should be forced to undergo the horrifying deterioration process.... they will end up being dependent----in ALS the disease progresses to the point where the person loses muscle function so that they cannot swallow or breathe---sometimes they choke on their own mucus and die that way-----this is terrible! ----These people should have a choice to "die with dignity" at their own time rather than suffer needlessly in the end! (I don't like the idea of non-voluntary euthanasia--------but this is why it is so important for everyone to complete a living will---so we know their final wishes.  However, there are a lot of difficulties regarding living wills----are they really able to convey what we wish to happen? Are their loop holes?” A.B, Hospital Volunteer

  

INTERVIEWS

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“I Believe that No one-regardless of your profession, race, religions, ethnicity, nationality-Should be given the power to kill when asked to. And no one should choose to end their life regardless of their circumstances. The least you can do out of respect to God, the woman and the man that gave you life is try to hold on to that life with all your might until it fades away naturally.” E.M, Doctor.

“I do not think assisted death or euthanasia should be permitted.  I understand why people would want to end their suffering but, as a Christian, I do not believe that human beings should take the life of another or take their own life. Besides the religious implications, I also feel this issue is too complex to have set guidelines or rules.  I believe that the lines would get blurred regarding who decides who should be euthanized.  I do not believe there is a human being on the planet that can be entrusted to make such profound decisions.” H.S, Doctor

INTERVIEWS

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PUBLIC OPINION

In males under 50, 87% support euthanasia while in males over 50 only 82% support it

In females under 50, 63% support euthanasia and in females over 50, 69% support it

65% of Republicans and 79% of Democrats

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PROS AND CONS

Some observers argue that if the practice of euthanasia were legal, physicians would exercise their medical judgment in an unrestrained fashion, increasing the possibility of abuse of discretion in relation to a very serious matter -life or death.

In contrast to this opinion, other observers believe that the maintaining of an incurably ill patient and the prolongation of that individual’s suffering is far more offensive than allowing a patient to die peacefully.

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WHAT IS YOUR STAND ON ASSISTED DEATH?