Euthanasia and Physician Euthanasia and Physician Assisted SuicideAssisted Suicideby Kirin Kennedyby Kirin Kennedy

Euthanasia and Physician Euthanasia and Physician Assisted SuicideAssisted Suicide

Euthanasia and PAS is the most Euthanasia and PAS is the most controversial issue of the legal and controversial issue of the legal and medical professionmedical profession

By Greek definition Euthanasia By Greek definition Euthanasia means a “Good Death”.means a “Good Death”.

EuthanasiaEuthanasia

EuthanasiaEuthanasia-- is the is the painlesspainless ending of a ending of a person’s life for reasons of person’s life for reasons of mercymercy..11

Physician Assisted Suicide-Physician Assisted Suicide- is the act in is the act in which a physician provides the means which a physician provides the means for suicide of the incurably ill. The for suicide of the incurably ill. The patient must take the final action that patient must take the final action that causes his or her death such as causes his or her death such as swallowing lethal drugs.swallowing lethal drugs.22

But What about Euthanasia Is But What about Euthanasia Is a Good Deatha Good Death

Is it a good and painless death Is it a good and painless death when the life in someone's body is when the life in someone's body is squeezed from them due to lethal squeezed from them due to lethal drugs?drugs?

EuthanasiaEuthanasia

Euthanasia is controversial and Euthanasia is controversial and viewed by many as unconstitutional viewed by many as unconstitutional immoral and a harm to societyimmoral and a harm to society..

EuthanasiaEuthanasia

Euthanasia and physician assisted Euthanasia and physician assisted suicide (PAS) suicide (PAS) must be initiated by must be initiated by the person who whishes to die.the person who whishes to die.

Four Types of EuthanasiaFour Types of Euthanasia

ActiveActive Passive Passive VoluntaryVoluntary InvoluntaryInvoluntary

Definitions Active EuthanasiaDefinitions Active Euthanasia

Active euthanasia-Active euthanasia- involves involves “causing death of a person through “causing death of a person through a direct action and response to the a direct action and response to the person and their request person and their request

Example injecting a lethal drug to Example injecting a lethal drug to end the person’s life, for the end the person’s life, for the purpose of reliving sufferingpurpose of reliving suffering

The Oregon ApproachThe Oregon Approach

The Us state of Oregon legalized physician assisted The Us state of Oregon legalized physician assisted suicide in 1998suicide in 1998 A patient must be resident in Oregon.A patient must be resident in Oregon. Patient must be aged over 18.Patient must be aged over 18. Patient must make 2 oral and 1 written request for Patient must make 2 oral and 1 written request for

euthanasia.euthanasia. There must be at least 15 days between the first and There must be at least 15 days between the first and

the last request.the last request. Patient must be terminally ill with a life expectancy of Patient must be terminally ill with a life expectancy of

less than 6 moths.less than 6 moths. This prognosis must be confirmed by a second This prognosis must be confirmed by a second

consultant physician.consultant physician. Both doctors must confirm that the patient is capable Both doctors must confirm that the patient is capable

of making this decision.of making this decision. Both doctors must confirm that the patient does not Both doctors must confirm that the patient does not

have medical condition that impairs their judgment.have medical condition that impairs their judgment. Patient must self-administer the lethal medication.Patient must self-administer the lethal medication.

The Oregon ApproachThe Oregon Approach

About 30% of patient who started the About 30% of patient who started the process died before it was completed.process died before it was completed.

19 patients in the period who were given 19 patients in the period who were given access to lethal medication decided not to access to lethal medication decided not to use it.use it.

45% of patients who were given good 45% of patients who were given good palliative care changed their mind about palliative care changed their mind about euthanasia.euthanasia.

The Oregon Health Division similar terminal The Oregon Health Division similar terminal illnesses would have prescribes a lethal illnesses would have prescribes a lethal medication if asked.medication if asked.

Passive Euthanasia Passive Euthanasia

Passive Euthanasia-Passive Euthanasia- is refraining is refraining from or stopping an action, such as from or stopping an action, such as life- sustaining medical treatment life- sustaining medical treatment in order to let a terminally ill in order to let a terminally ill person die naturallyperson die naturally..

Voluntary and involuntaryVoluntary and involuntary

Voluntary- Voluntary- Is the same as active Is the same as active euthanasia but the patient has to be euthanasia but the patient has to be willing to have a physician assist willing to have a physician assist him/her in their demise.him/her in their demise.

IInvoluntary-nvoluntary- Is when the patient who is Is when the patient who is in a persistent vegetative state (deep and in a persistent vegetative state (deep and usually permanent state of un awareness usually permanent state of un awareness caused by damage to the higher brain caused by damage to the higher brain AKA coma.)AKA coma.)

Two important legal Two important legal documentsdocuments

Advance Directive Advance Directive Living willLiving will

Advance Directive Advance Directive

Is a document that competent Is a document that competent adults may use to state their wishes adults may use to state their wishes about health care decisions on their about health care decisions on their behalf if they become behalf if they become incompetent.incompetent.

Living WillLiving Will

A document in which a competent adult A document in which a competent adult specifies medical treatment to be given specifies medical treatment to be given or withheld if he or she becomes or withheld if he or she becomes incompetent.incompetent.

I.E. I.E. ventilatorventilator Heart and lung machine( total sustained lifeHeart and lung machine( total sustained life Food and water Food and water medicinemedicine

Euthanasia is immoralEuthanasia is immoral

Every major organized religion Every major organized religion such as Christians, Muslims, Jews, such as Christians, Muslims, Jews, Hindus, and Buddhists, vehemently Hindus, and Buddhists, vehemently oppose Euthanasia.oppose Euthanasia.

And believe that the Euthanasia And believe that the Euthanasia “Violates the Patients natural “Violates the Patients natural Right and desire to live”.Right and desire to live”.

ReligionReligion

St. Thomas Aquinas St. Thomas Aquinas Scottish philosopher David HumeScottish philosopher David Hume Both believed that euthanasia is a Both believed that euthanasia is a

violation of human rightsviolation of human rights Which makes this an age old conflict Which makes this an age old conflict

and controversy.and controversy.

The Roman Catholic ViewThe Roman Catholic View

““Euthanasia is a grave violation of the law of God, Euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable since it is the deliberate and morally unacceptable killing of a human person (killing of a human person (Pope John Paul II: Pope John Paul II: evangelium vitae, 1995)evangelium vitae, 1995)

Thou shall not KillThou shall not Kill Life is a thing of value in it’s self and it’s value Life is a thing of value in it’s self and it’s value

doesn't depend on the extent that it brings pleasure doesn't depend on the extent that it brings pleasure and well-beingand well-being

So suffering and pain so not stop life being valuable So suffering and pain so not stop life being valuable and are not a reason for ending life.and are not a reason for ending life.

The church believes that each person should enter The church believes that each person should enter the dying process with all it’s mysteries with trust in the dying process with all it’s mysteries with trust in God and in solidarity with their fellow human beings God and in solidarity with their fellow human beings they should die with the dignity of letting themselves they should die with the dignity of letting themselves be loves unconditionally.be loves unconditionally.

The Roman Catholic ViewThe Roman Catholic View

““As Catholic leaders and moral teachers we believe As Catholic leaders and moral teachers we believe that life is the most basic gift of a loving God– a gift that life is the most basic gift of a loving God– a gift over which we have stewardship but not absolute over which we have stewardship but not absolute dominion” ( National Conference of Catholic dominion” ( National Conference of Catholic Bishops (USA) 1991Bishops (USA) 1991

Euthanasia and suicide are both a rejection of Euthanasia and suicide are both a rejection of God’s absolute sovereignty over life and death.God’s absolute sovereignty over life and death.

The church believes that each human life is The church believes that each human life is manifestation of god in the world, a sign of his manifestation of god in the world, a sign of his presence a trace of his glory.presence a trace of his glory.

““The Life which god offers to man is a gift by which The Life which god offers to man is a gift by which God shares something of himself with his creature.”God shares something of himself with his creature.”

““True Compassion leads to sharing another’s pain; True Compassion leads to sharing another’s pain; it does not kill the person whose suffering we it does not kill the person whose suffering we cannot bear.”( Pope john Paul II ) cannot bear.”( Pope john Paul II )

The Hindu ViewThe Hindu View

Most Hindu's would say that a doctor should not Most Hindu's would say that a doctor should not accept an patient’s request for euthanasia this will accept an patient’s request for euthanasia this will cause the soul and body to be separated at an cause the soul and body to be separated at an unnatural time. The result will damage the Karma of unnatural time. The result will damage the Karma of both doctor and patient.both doctor and patient.

Other believe that euthanasia cannot be allowed Other believe that euthanasia cannot be allowed because it breaches the teaching of ahimsa (doing because it breaches the teaching of ahimsa (doing no harm)no harm)

Karma :Karma : Hindus believe in the reincarnation of the Hindus believe in the reincarnation of the soul the ultimate aim of life is to achieve soul the ultimate aim of life is to achieve Moksha Moksha or or liberation from the cycle of death and rebirthliberation from the cycle of death and rebirth

By helping to end a life, even one filled with By helping to end a life, even one filled with suffering a person is disturbing the timing of the suffering a person is disturbing the timing of the cycle of death and rebirth.cycle of death and rebirth.

Christian ViewChristian View

Most Christian are against euthanasiaMost Christian are against euthanasia Because Life is given by God and that human beings are Because Life is given by God and that human beings are

made in god’s imagemade in god’s image No human being had the authority to take the life of an No human being had the authority to take the life of an

innocent person even if the person want to die innocent person even if the person want to die Human’s are valuable because they are made in the Human’s are valuable because they are made in the

image of God. image of God. The process of dying is spiritually important and should The process of dying is spiritually important and should

not be disruptednot be disrupted Patients in a persistent vegetative state although seriously Patients in a persistent vegetative state although seriously

damaged remain living human beings and the life remain damaged remain living human beings and the life remain valuable valuable

It’s wrong to treat them as worthless and conclude that It’s wrong to treat them as worthless and conclude that they are better off deadthey are better off dead

The bible say that you should have life and life more The bible say that you should have life and life more abundantly as well as it is a sin to kill “Thou shall not kill”abundantly as well as it is a sin to kill “Thou shall not kill”

The Muslim ViewThe Muslim View

Muslims are against euthanasiaMuslims are against euthanasiaThey believe that all life is given by Allah and that Allah They believe that all life is given by Allah and that Allah

chooses hoe long each person shall livechooses hoe long each person shall live ““do not tale the life which Allah made sacred other do not tale the life which Allah made sacred other

than in the course of justice” (Qur’an 17:33)than in the course of justice” (Qur’an 17:33) ““of anyone kills a person – unless it be for murder or of anyone kills a person – unless it be for murder or

spreading mischief in the land – it would be as if he spreading mischief in the land – it would be as if he killed the whole person” (Qur’an 5.32each of us will killed the whole person” (Qur’an 5.32each of us will live)live)

Allah decides how long each of us will liveAllah decides how long each of us will live ““when their time comes they cannot delay it for a when their time comes they cannot delay it for a

single hour nor can they bring it forward by a single single hour nor can they bring it forward by a single hour” (Qur’an 3.145)hour” (Qur’an 3.145)

“ “ And no person can ever die except by Allah's leave And no person can ever die except by Allah's leave and at an appointed term.” (Qur’an 3.145)and at an appointed term.” (Qur’an 3.145)

The Muslim ViewThe Muslim View

Suicide and euthanasia are explicitly Suicide and euthanasia are explicitly forbiddenforbidden ““destroy not yourselves. Surely Allah is destroy not yourselves. Surely Allah is

ever merciful to you.” (Qur’an 4.29)ever merciful to you.” (Qur’an 4.29) The prophet (Pbuh) said: “amongst the The prophet (Pbuh) said: “amongst the

nations before you there was a man nations before you there was a man who got a wound, and growing impatient who got a wound, and growing impatient (with it’s pain), he took a knife and cut (with it’s pain), he took a knife and cut his hand with it and the blood did not his hand with it and the blood did not stop till he died. Allah said, “my Slave stop till he died. Allah said, “my Slave hurried to bring death upon himself so I hurried to bring death upon himself so I have forbidden Him Paradise.’” ( Sahih have forbidden Him Paradise.’” ( Sahih bukhari 4.56.669)bukhari 4.56.669)

The Buddhist ViewThe Buddhist View

Most Buddhists are against involuntary euthanasiaMost Buddhists are against involuntary euthanasia The most common position is that voluntary The most common position is that voluntary

euthanasia is wrong because it demonstrates that euthanasia is wrong because it demonstrates that one’s mind is in a bas state and the one has one’s mind is in a bas state and the one has allowed physical suffering to cause mental allowed physical suffering to cause mental sufferingsuffering

Mediation and the proper use of pain killing drugs Mediation and the proper use of pain killing drugs should enable a person to attain a state where they should enable a person to attain a state where they are not in mental pain, and so no longer are not in mental pain, and so no longer contemplate euthanasia or suicidecontemplate euthanasia or suicide

Buddhist argue that helping to end someone’s life is Buddhist argue that helping to end someone’s life is likely to put the helper into a bad mental state, and likely to put the helper into a bad mental state, and this too should be avoided.this too should be avoided.

Buddhism places great stress on non-harm and on Buddhism places great stress on non-harm and on avoid the ending of life,avoid the ending of life,

Medical EthicsMedical Ethics

Hippocratic oath ( suspended)Hippocratic oath ( suspended) Written by Greek physician Written by Greek physician

HippocratesHippocrates Lived in the 4Lived in the 4thth century century Considered a major statement of Considered a major statement of

medical ethics and physicians often medical ethics and physicians often recite it at graduation from med recite it at graduation from med schoolschool

Basis of Oath is to do No HarmBasis of Oath is to do No Harm

Hippocratic OathHippocratic Oath

The Hippocratic oath states “I will The Hippocratic oath states “I will use treatment to help the sick use treatment to help the sick according to my ability and according to my ability and judgments… I will not give poison judgments… I will not give poison to anyone asked for nor will I make to anyone asked for nor will I make suggestion to that effect.”suggestion to that effect.”

Is Euthanasia Constitutional Is Euthanasia Constitutional and Should it be Legalizedand Should it be Legalized

The justices of the Supreme Court The justices of the Supreme Court unanimously decided that PAS is unanimously decided that PAS is not a constitutionally protected not a constitutionally protected right of the terminally ill.right of the terminally ill.

Supreme Court set precedent in Supreme Court set precedent in these two cases. these two cases.

Washington v. GlucksbergWashington v. Glucksberg Quill v. VaccoQuill v. Vacco

LegalizationLegalization

Mr. Wesley J. Smith a California attorney said it best Mr. Wesley J. Smith a California attorney said it best “ “ That the legalization of physicians Assisted suicide That the legalization of physicians Assisted suicide would create and unethical dangerous and controlling would create and unethical dangerous and controlling policy that would adversely affect society… In addition policy that would adversely affect society… In addition the health care industry having millions of dollars at the health care industry having millions of dollars at stake would have a tremendous and unrestricted stake would have a tremendous and unrestricted incentive to encourage premature deaths in order to incentive to encourage premature deaths in order to avoid the costs of lengthy treatments and that the avoid the costs of lengthy treatments and that the legalization of assisted suicide will come at an enormous legalization of assisted suicide will come at an enormous cost to society. It must be prevented.”cost to society. It must be prevented.”

Slippery Slope Slippery Slope

Euthanasia does not always occur in Euthanasia does not always occur in right to die casesright to die cases

Infants (premature)Infants (premature) Mentally ill and handicapMentally ill and handicap Elderly Elderly MinoritiesMinorities Uninsured as well as underinsuredUninsured as well as underinsured ImpoverishedImpoverished

Protection of Life vs. DeathProtection of Life vs. Death

Law presumes lifeLaw presumes life It affirms the right to dieIt affirms the right to die And provides no safe guard to And provides no safe guard to

preserve life.preserve life.

Euthanasia Vs. MurderEuthanasia Vs. Murder

Serial killer physiciansSerial killer physicians Shipman Shipman Chris Cullen Chris Cullen

They are rarely caught They are rarely caught prosecuted ands executedprosecuted ands executed

Closing Closing

In closing the truth about euthanasia and In closing the truth about euthanasia and PAS is that in all actually if killing a PAS is that in all actually if killing a child is homicide then so is the untimely child is homicide then so is the untimely murder of an adult or child. and who is murder of an adult or child. and who is to distinguish the difference between to distinguish the difference between PAS and the murder of a family member PAS and the murder of a family member for the benefits of the dying. Yet isn’t it for the benefits of the dying. Yet isn’t it the doctors’ job to preserve life and not the doctors’ job to preserve life and not to take it.to take it.

As the Hippocratic oath states As the Hippocratic oath states I I Will use treatment to help the sick Will use treatment to help the sick according to my ability and according to my ability and judgment… I will not give poison to judgment… I will not give poison to anyone who ask for it, nor will I anyone who ask for it, nor will I make a suggestion to that effect.make a suggestion to that effect.

BibliographyBibliography

““Ethical issues in death and dying”Ethical issues in death and dying”, Beauchamp, L. Tom, Perlin, Seymour , Beauchamp, L. Tom, Perlin, Seymour prentice Hall © 1978 prentice Hall © 1978

““Euthanasia Contempory issues Companion”, Euthanasia Contempory issues Companion”, Yount, LisaYount, LisaGreenhaven Press © 2002Greenhaven Press © 2002 ““Physician-Assisted suicide”Physician-Assisted suicide” Leone, A. Daniel Leone, A. Daniel

Greenhaven Press © 1998Greenhaven Press © 1998 ““A time the place for to die physician assistance”A time the place for to die physician assistance” M.d. McKhann F. Charles M.d. McKhann F. Charles

Yale University press© 1999Yale University press© 1999 ““Physician assisted suicide and euthanasia Yount Lisa Physician assisted suicide and euthanasia Yount Lisa

Fact on file Inc, © 2002Fact on file Inc, © 2002

UB Center for clinical ethics and Humanities in health careUB Center for clinical ethics and Humanities in health careU.S. supreme Court Rules on Physician Assisted suicide CasesU.S. supreme Court Rules on Physician Assisted suicide Caseshttp://wings.buffalo.edu/faculty/research/bioethics/court.htmlhttp://wings.buffalo.edu/faculty/research/bioethics/court.html

Voluntary Euthanasia Stanford UniversityVoluntary Euthanasia Stanford Universityhttp://Plato.stanford.edu/entries/euthanasia-voluntary/http://Plato.stanford.edu/entries/euthanasia-voluntary/

Euthanasia and physician assisted suicideEuthanasia and physician assisted suicidewww.religioustolerance.org/euth1.htmwww.religioustolerance.org/euth1.htm

International taskforce on Euthanasia and assisted suicideInternational taskforce on Euthanasia and assisted suicidehttp://www.internationaltakforce.org/fctfla.htmhttp://www.internationaltakforce.org/fctfla.htm

Other Definations of Other Definations of EuthanasiaEuthanasia CompetenceCompetence- a patient who understands his or her - a patient who understands his or her

medical condition, what the likely future course of medical condition, what the likely future course of the disease is , the risks and benefits associated the disease is , the risks and benefits associated with the treatment of the condition with the treatment of the condition

Dignity- The value that a human being has simply Dignity- The value that a human being has simply by existing, not because of any property or action of by existing, not because of any property or action of an individualan individual

DNRDNR-DO Not Resuscitate- Instructions telling the -DO Not Resuscitate- Instructions telling the medical staff not to attempt the resuscitate the medical staff not to attempt the resuscitate the patient if the patient has a heart attackpatient if the patient has a heart attack

Palliative Care-Palliative Care- Medical, emotional psychosocial or Medical, emotional psychosocial or spiritual care given to a person who is terminally ill spiritual care given to a person who is terminally ill and which is aimed at reducing suffering rather than and which is aimed at reducing suffering rather than curing.curing.