- Hospice and Assisted Suicide/Euthanasia One Work Cited This essay will present the views of that worldwide organization named Hospice which has seen the quiet, natural death of millions of terminally ill patients - without the use of physician-assisted suicide. Physician Assisted Suicide Physician assisted suicide is an issue that has been debated over for many years. Many argue that people have the right to Many argue that people have the right to/5(1). The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Essay: End of life, euthanasia and assisted suicide In the UK today, around three quarters of deaths are ‘predictable’ and follow a periodic trend of chronic illnesses such as cancer or heart diseases. SAMPLE ARGUMENTATION ESSAY Research Question: Should assisted suicide be legal? Assisted Suicide: Rights and Responsibilities A woman suffering from cancer became the first person known to die under the law on physician-assisted suicide in the state of Oregon when she took a lethal dose of drugs in March,
End of life, euthanasia and assisted suicide Essay: Euthanasia and assisted suicide arouses deep moral beliefs about the value of life that are held by society. It will also consider the ethical issues involved such as autonomy, paternalism, sanctity of life versus quality of life, utilitarianism, deontology and the slippery slope doctrine. Patients approaching the end of life have advanced and incurable conditions like cancer, motor neurone diseases, etc and acute conditions caused by sudden disastrous events.
The provision of treatment and care towards the end of life often involve clinically complex and emotionally distressing decisions involving ethical issues and uncertainties about the law.
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These decisions may include whether they wish to participate in medical research or they want a life saving treatment. In order to make an informed decision, the person making the decision must understand the reality of the situation and the consequences of their actions. As provided by section 24 1 of the Mental Capacity Act , an advanced decision spells out the treatments and procedures that the patient consents to and those that are against their wishes.
The Act further provides that any adult who has mental capacity can choose a personal welfare lasting power of attorney who will decide on their future medical treatment if they do not have the mental capacity to do so. The attorney may discuss about treatment options but cannot request for treatment that is clinically inappropriate. The advance decision must be valid and applicable.
Once there is any doubt about this decision, the case can be sent to the Court of Protection the legal body that supervises the Mental Capacity Act The fact that Sarah was in the last stages of motor neurone disease meant that she may be experiencing shortness of breath and paralysis which she did not want her family to witness.
Most people with motor neuron diseases like Sarah may think about ending their life at some point but it is not a common outcome especially in cases where there is a strong family and community support.
Legal Position of End of Life Issues An act which causes death would be murder and an omission could be murder or manslaughter depending on whether or not there was a duty to continue with treatment.
Thus a doctor may face criminal prosecution in situations where he owes a duty to the victim but fails to act accordingly. In R Jenkins v HM Coroner for Portsmouth and South East Hampshire, however, it was held that no crime was committed if help was not offered to a dying patient who categorically refuses medical intervention.
A doctor will not breach his duty by failing to provide treatment if a competent patient does not approve the treatment. In the case of Ms B v An NHS Trust, doctors refused to switch off the ventilator that kept her alive for ethical reasons, despite being pronounced capable of making a decision on whether or not to continue her medical treatment.
It has been argued that a competent person will never refuse basic care and for a person to be denied this, amounts to torture and inhumane treatment under Article 3 of the European Convention on Human Rights ECHR. Furthermore, if the treatment is not in the best interest of the patient, a doctor is not required to do so as shown in Airedale NHS Trust v Bland.
Here, a court order was granted for the withdrawal of treatment for Bland because he was in a persistent vegetative state and there was no hope of recovery. It is important to note that in this case the medical treatment was not against his best interest but it did not promote them.
Although there is no cure for motor neurone disease, medical treatment can help relieve the symptoms and slow down the progression of the condition. Sarah is not likely to succeed with her request even if she should take the matter up legally as the treatment she is being given will help reduce the symptoms. Also, under sections of the Mental Capacity Act , once an incompetent patient has issued an effective advance directive stating that he does not want to receive life-sustaining treatment; it would be unlawful for the medical team to administer treatment.
Most people with motor neurone disease prepare an advance decision. Sarah has the option of preparing an advance decision stating the kind of treatment she would like to receive in the very final stage of her disease. Euthanasia Euthanasia is an exceedingly controversial and divisive topic, which raises an array of complex ethical, social, moral, legal and religious concerns.
Euthanasia is illegal in England and is treated under UK law as either murder or manslaughter depending on the circumstances. In certain cases it results in a mandatory life sentence. Euthanasia can be classified in different ways according to whether the patient gives an informed consent. These are voluntary, non-voluntary and involuntary euthanasia.
These can also be divided into passive or active euthanasia. Passive euthanasia occurs when the patient dies because the medical professionals withheld or withdrew treatment such as life support machines, ventilators, etc, that is necessary to keep the patient alive. For the purpose of the discussion of this case, I will focus on voluntary and active euthanasia. Voluntary euthanasia occurs where the patient makes an informed decision to die and asks for help to do so.
Dr Cox was charged with attempted murder. For a person to be guilty of this offence, he must intend to assist or encourage another person to commit suicide. However from most reported cases of doctors charged with murder or administering pain-relieving drugs, judges avoid giving direction on oblique intention as stated in criminal law. After the House of Lords decision in R v Purdy, the Crown Prosecution Service produced a list of factors to consider when deciding which case of assisted suicide to prosecute.
These factors explain that suspects would not be charged unless evidence shows that the victim was forced into killing themselves or that the suspect intends to profit from their death.
Since , numerous assisted suicide cases have been passed to the Crown Prosecution Service CPS of which no one has been prosecuted. A small number of files are however being reviewed. The need to amend these factors became eminent following the case of R Nicklinson v Ministry of Justice.
Here, the Court of Appeal explained that it is wrong to say that there is a right to commit suicide.
Decisions regarding end of life issues of patients must be made in a fair, transparent and justifiable way as the Act allows consideration of a decision and the decision-making process by the courts.
Articles 2, 3,5,8,9 and 14 of ECHR are the most relevant to decisions regarding care and treatment towards the end of life of a patient. Article 8 2 of the ECHR also provides that: Public authorities therefore have an obligation to prevent people from committing suicide.
In R Pretty v DPP, Diane Pretty who suffered motor neurone disease wanted to end her life due to the pains and suffering she endured because of her illness. She used the Human Rights Act to argue that the Director of Public Prosecutions should promise not to sue anyone who helped or assisted her to die. The case was however rejected by the House of Lords. It was held that Article 2 impressed a duty on the state to protect life. She also used Article 3 to argue that by forbidding her husband to help her die; the state was imposing torture and degrading treatment on her.
The ECtHR however, held that her medical condition was not caused by the state and it was the medical condition which imposed the degrading treatment. Ethical Issues Autonomy The key ethical aspect to proponents of euthanasia is autonomy. The ultimate denial of respect for a person is denying that person respect for his views. Such respect is very vital especially when it concerns personal and intimate matters such as when to die. Also there are moral values that balance the autonomy right which should be upheld by the law even if it infringes on the autonomy rights of members of the society.
They also argue that it is impossible to make an informed autonomous choice to die as most patients are often unaware of the availability of rehabilitative care for people with disabilities and terminal illness and so are unable to make properly informed decisions.
There are a range of treatments available that can relieve most of the symptoms of motor neurone disease and with the right medication the disease can be controlled and Sarah can have the best quality of life.
Many of those seeking death suffer depression and once provided with medication for depression, their number falls. Hence these autonomous decisions are not carefully thought-out.
Physician Assisted Suicide
Others argue that it is impossible to justify euthanasia using autonomy. Most supporters of euthanasia do not agree that anyone who wishes to be killed should be allowed to do so. However, they respect the wishes of a person only if they think his decision is reasonable. Utilitarianism This doctrine holds that an act is right or wrong based on whether it maximises happiness or benefit the society. Paternalism Paternalism can be said to be the forceful intervention to the behaviour of a person or group which limits their freedom for their own good.
The paternalism approach to patients is barely practised in modern medicine. Under this doctrine, Sarah with the help of her Doctor could decide on the best possible treatment available so she can live comfortably. Paternalism tends to deny individual autonomy.
A hard form of paternalism promotes coercion to protect able adults against their voluntary self-harming decisions like active voluntary euthanasia.
Hence, this doctrine will morally protect able patients like Sarah from active euthanasia and assisted suicide.
Deontology The doctrine of deontology holds that some acts are always wrong even if they achieve ethically worthy ends. This includes killing of human beings, lying and not keeping promises. It makes no ethical distinction between murder and suicide. Some killings of human beings are morally accepted provided it was not intended. For instance, the death of the patient is foreseen and not a desired outcome if he dies after being given a painkiller.
This may be morally accepted as the intention is to kill the pain and not the patient. This doctrine however prohibits the situation where a patient can ask a doctor or family to actively and intentionally kill them or assist them in dying.
Sanctity of life versus quality of life Sanctity of life values the good of life which exists in a person independent of any disability. This principle is supported by both religious groups who believe that each person is made in the image of God and non religious groups who are drawn by its insistence of the equal value of every human life. The principle of sanctity of life has been approved by the judiciary and this was demonstrated in Airedale NHS Trust v Bland.
The opponents also stress that the things that make life valuable are what people do with their lives. Quality of life however, holds that some lives are just not worth living and is therefore right to end them. Therefore a life without these values has lost its goodness. Based on this doctrine, Sarah may argue that since she would be experiencing severe pain during the final stages of her illness she should be assisted to die.
The slippery slope doctrine From the euthanasia debate, the slippery slope argument claims that if society accepts certain practices like voluntary euthanasia or physician-assisted suicide, a line is crossed and a dangerous precedent could be set.
This means that if society should legalise voluntary euthanasia, it will gradually include non-voluntary and involuntary euthanasia. The opponents of this doctrine argue that a well drafted legislation can draw a firm wall across the slippery slope. Once the law is changed and voluntary euthanasia is legalised, it cannot be controlled. Proponents of euthanasia however, argue that euthanasia would never be legalised unless there is proper regulation and control mechanisms in place.
Those people, who are very ill and need constant care or those with severe disabilities, may feel pressured to ask for euthanasia so they do not become a burden on their family. Also research into palliative treatments may be discouraged, and this may prevent the discovery of cures for people with terminal illnesses. Conclusion Several attempts have been made over the years to legalize euthanasia and assisted suicide but none have proven successful.
The balance between ethical views and belief systems versus legal system is difficult to reconcile and may result in the implementation of the slippery slope doctrine. Autonomy and various human rights impose limits on euthanasia and assisted suicide thus impinging on other human rights and protecting the poor. Furthermore, with the advancement in palliative care and mental health treatment, patients are less likely to suffer unbearably and given the right care in a safe environment, a patient can have a dignified and less painful natural death.