People often call euthanasia “mercy killing” this phrase probably would be used if the patient were terminally ill, and suffering prolonged, unbearable pain. The word euthanasia comes from the Greek and means “easy death.” Most people think the main reason for euthanasia is unbearable pain but according to survey’s in the USA and the Netherlands less than a third of requests for Euthanasia where because of unbearable pain. Terminally ill people can have their quality of life severely damaged by physical conditions such as incontinence, nausea and vomiting, breathlessness, paralysis, difficulty in swallowing etc. Psychological factors that cause people to think of euthanasia include depression fear of loss of control or of dignity, feeling a burden or dislike of been dependent.
Euthanasia is illegal in the United Kingdom, as well as it is illegal in other European countries and the Netherlands. Diane Pretty a woman wishing to be allowed euthanasia in 2002 and her husband fought for a right to die in the courts rather then break the law but was unsuccessful due to the strictness of the law on euthanasia, however many people believe euthanasia will become widely tolerated in due time. In England and Wales there is a possibility of up to 14years imprisonment for anyone assisting a suicide. In Scotland suicide has never been against the law. There is no Scots authority of whether it is criminal to help another person commit suicide and it has never been tested in court.
Acts and Omissions: The official policy of the British Medical Association is to oppose all forms of euthanasia. However, many doctors and medical ethicists would say that there is a difference between committing an act that results in a patient’s death, and omitting to carry out an act that would save a life.
C2 & E3
Diane Pretty was terminally ill with Motor Neurones Disease. Diane wanted her husband to help suicide at the time of her choosing, but section 2 of the Suicide Act 1961 makes it a criminal offence to aid, abet, counsel or procure the suicide of another. Diane spent a year fighting her case to be allowed her husband to help her commit suicide at the time of her choosing, and die with dignity. Diane’s husband said that he would not break the law for her to commit suicide and Diane did not want him to so they both fought for her case which was dismissed. Diane asked the Director of Prosecutions, High Court Judge, Five Law Lords and the ECHR (European Court of Human Rights) for her husband to be allowed to assist her suicide and not be prosecuted, but her case failed with all. There was many reasons why Diane Pretty’s case was dismissed some are… The Medical Ethics Alliance said that it would put many elderly and disabled people at risk if euthanasia was legalised, they also said “if you give someone rights, it means someone else has a duty. A right to die means someone has a duty to kill.” Also if doctors do this (as in Holland) they would loose their patient’s trust. Many doctors said that sometimes drugs fail, what would be done if it doesn’t work first time because the patient would be in more pain. Many people would get away with killing someone by saying its euthanasia. The five law lords rejected her appeal saying that the human rights legalisation should protect life not end it, but Lord Justice Tuckey said her human right was "to live with dignity, not die with dignity." Diane died shortly after the judgement she died of natural causes due to Motor Neurones Disease, she died on 11th May 2002 but her case made legal history and received global coverage and over 50,000 signed her petition that her husband is still running on Diane’s website so that all her campaigning does not go to waste. Diane was 43years old and had suffered from Motor Neurones Disease for 2years. Diane was refused the right to die by three different judges. The outcome was that Diane Pretty’s case was dismissed and this is ethically right in the eyes of the law.
C3
Key Ethical Principals and Concepts
Rights, obligations and duties: Moral rights can be understood as freedoms, the freedom to do something, or freedom from something. By contrast, as we have seen, moral ,duties and obligations can be understood as the opposite as the requirement to do something. Many moral (and legal) obligations and duties arise in direct response to the rights possessed by others. E.g. your right to freedom is balanced by my duty not to interfere with you: your client has the right to confidentiality, and you have a duty to respect that confidentiality. Unlike moral rights and obligations and duties, legal ones are publicity acknowledged and legally enforceable e.g. thee right not to be discriminated against in employment. However, although an attempt has been made here to separate ethical and legal issues formally, in practice they are often difficult to distinguish, and health and social care workers will face many situations where both legal and ethical rights, duties and obligations come into conflict.
Autonomy: this literally means ‘self-rule’ and refers to the degree to which an individual can think, decide and act independently. For many respect for the autonomy of the individual is a good key goal of ethical practise. The thought behind the high regard afforded to autonomy is the uniqueness of each individual human being and the belief that to remove the individual the opportunity foe self-determination is fundamentally to compromise their humanity. Respect for the autonomy of the individual provides some protection in cases where the needs and wishes of the majority may override those of the individual or minority. This relates to euthanasia because its discussing how an individual can think, decide and act independently, but according to the law this is not allowed when concerning euthanasia because they are not allowed to die if they want to because somebody else would have t o help them and this would be classed as murder even though the patient wants to die.
Paternalism: The principle of paternalism is more authoritarian. This holds that decisions can frequently best be taken on behalf of others by those who have the best interests of those others at heart and who are in possession of all the facts. In a medical context this may take the form of ‘the doctor knows best’ view. This principle will result in a denial of the patients autonomy and right to play a full part in decisions about their treatment but will be justified by the belief that patients cannot possibly be as well informed as their doctor and can therefore make no useful contribution to decision making. Some argue that its never ethically acceptable because it violates the right to autonomy and independence but others believe that sometimes it is necessary when working with those who are vulnerable or in danger of harming themselves or others. This relates to euthanasia because this is saying that the patient cannot make their own decision about their treatment even though were meant to make an independent choice about how we live, but a patient would have to have treatment to stop the disease killing them because they are not in the right state of mind to decide for themselves of they have euthanasia.
The sanctity of life: The belief that life is intrinsically valuable or sacred is a widely held moral principle. Most people think that its wrong to kill most of the time, and this is reflected in laws throughout the world which prohibit indiscriminate killing. However the principle of the sanctity of life is in fact rather ambiguous. For example it does not necessarily mean that killing is always wrong; many people believe that sometimes overriding moral principles such as self defence make it right. Others say that only the life of persons is sacred, and where that someone has lost or has no consciousness or self-awareness, objections to killing do not apply. For others again, life is only sacred where a person has a desire to live, or where they have a certain quality of life. Potential Ethical Conflict: Euthanasia, Euthanasia or “mercy killing” illustrates clearly the potential ethical conflict between the principle of the value or sanctity of life and other ethical principles we have considered. A number of surveys have shown that doctors regularly receive requests for voluntary euthanasia, and that a sizeable number have carried it out. This relates to euthanasia because it is saying that life is sacred therefore euthanasia cannot be permitted because this would not be treating life as sacred.
E4
The Hippocratic oath is one of the oldest binding documents in history. Written in antiquity, its principles are held sacred by doctors to this day: treat the sick to the best of ones ability, preserve patient privacy, teach the secrets of medicines to the next generation, and so on. There are two versions of the oath a classical version and a modern version. Below is the modern version o f the oath.
- I swear to fulfil, to the best of my ability and judgment, this covenant
- I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
- I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of over treatment and therapeutic nihilism.
- I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
- I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
- I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
- I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
- I will prevent disease whenever I can, for prevention is preferable to cure.
- I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
- If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
Out of these rules I can see two specific ones that relate to euthanasia these been…
- I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of over treatment and therapeutic nihilism.
- I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
Number 1 slightly contradicts number 2 as number 1 says that they have to take all measures which are required to benefit the sick, but number 2 says that they only treat a sick human been whose illness effects the family and economic stability.
C1
The Analytical Approach: This approach is divided into smaller parts so closer examination can take place to determine their relationship e.g. you may need to look at the many components of the ethical issue (in this case euthanasia) and consider their relative importance.
The Consequentialist Perspective: This is where decisions are guided by the likelihood of achieving ‘best outcome’ e.g. by taking an economic view point which is to obtain the best value for money (working for the greater good).
Deontological Perspectives: This is where decisions are based on duties e.g. maintain confidentiality of information, respect autonomy, to promote anti-discriminatory practice, acknowledge personal beliefs and practice and empowerment.
There are strengths and weaknesses to each of these approaches: Strengths and weaknesses for euthanasia)
The Analytical Approach: Strength: Each case is broken down for the individual patient, so that each patient gets an individual point of view from a doctor depending on their circumstances, this reflects on different treatment for different patients, presumably the right treatment for the individual. Also they have to take into consideration what the family is going threw as ell as the patient, and for example say the patient was granted euthanasia would the family be able to cope after the death and would it have a good or bad effect on them. This is a strength as it does not just take the patients view into consideration but other views as well. Weakness: because different doctors diagnose different patients, two patients with a similar or the same case could get an overall different outcome as doctors don’t all have the same opinion and could therefore make a different decision. This is very different compared to the prescriptive approach as that is just one set of rules to follow by.
The Consequentialist Perspective: Strength: they take the ‘best outcome’ on the situation so they have to take into consideration many things before making a decision. For example how much money is it costing the NHS to keep this person alive, how much money are they going to have to spend before this patient dies of natural causes. So a strength would be if the patient is granted euthanasia it would save the NHS a lot of money to spend on patients that are going to live for a longer period of time but need treatment. Weakness: This is not really an ethical point as euthanasia is still illegal in the United Kingdom so the NHS would not be able to use this as a valid point to be able to grant a patient euthanasia.
Deontological Perspectives: Strength: they take into account personal beliefs so that the patient can say what they believe in so it could be in their beliefs that euthanasia should be permitted to take place, therefore move to another country where this is legal and they use autonomy in this perspectives which literally means self rule so the patient should be allowed to ‘self rule’ there body which means they should be allowed to commit the crime euthanasia and in autonomy it mentions self determination which means that they have the ability to make their own decisions and act on them so again this should entitle them to euthanasia. Weakness: as euthanasia is a crime it would not be allowed so I don’t think this is relevant to euthanasia as whatever happens it is still illegal and will not be allowed in the United Kingdom which sort of contradicts the laws above.
Bibliography
- Further Studies for Health and Social care, Caroline Golden, Carolyn Meggit, Dawn Collard, Chrissie Rycroft
-
-
www.plato.stanford.edu/entries/euthanasia-voluntary/