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End of life
Published in Gary Chan Kok Yew, Health Law and Medical Ethics in Singapore, 2020
One core issue is whether the objections against killing of a person will apply equally to voluntary euthanasia. Singer (1993, at pp. 194–196) examined four arguments against killing a person: (a) classical utilitarianism (that the potential victim would fear his own death); (b) preference utilitarianism (that killing thwarts a victim’s desire to continue living); (c) theory of rights (that one’s desire to continue living corresponds with his right to life); and (d) respect for the autonomous choice of a rational agent. He contended that the four objections to killing are not applicable to voluntary euthanasia where the person in question who is mentally capable wants to die. It may be countered that there are limits to respect for autonomy and that what amounts to preferences and rational judgement is a matter for debate.
Medico-legal issues at the end of life
Published in Peter Hutton, Ravi Mahajan, Allan Kellehear, Death, Religion and Law, 2019
Peter Hutton, Ravi Mahajan, Allan Kellehear
Euthanasia is the term given to a situation in which another person, e.g., a doctor, nurse or relative, intentionally ends a patient’s life. It should be emphasized that this is a deliberate act by a different individual from the patient, and so is distinct from the assisted dying and assisted suicide that are described below. There are two broad categories. Voluntary euthanasia is usually defined as terminal illness, intolerable suffering or an incurable condition affecting a patient whose life is ended on their request by a clinician administering lethal drugs. This is legal in the Netherlands, Belgium and Luxembourg.Involuntary euthanasia is when the clinician takes the decision to end their life without the permission of the patient. This is illegal everywhere, but there is evidence from anonymous surveys that it happens on occasions.3
Paternalism and consent
Published in Andreas Müller, Peter Schaber, The Routledge Handbook of the Ethics of Consent, 2018
Similar dignitarian concerns manifest themselves in some arguments for voluntary euthanasia. Arguments against voluntary euthanasia sometimes see it as incompatible with a person’s dignitarian status; those who favor it also appeal to dignity and the importance of “death with dignity”, linking death to a concern that it not be marked by events that are seen as degrading to our persons – loss of control, humiliating situations, etc.
In response to Campbell: Letter to the Editor
Published in Progress in Palliative Care, 2020
Far from seeking to promote euthanasia or represent it as part of palliative care practice, the intent was merely to make an observation of what is occurring in multiple countries: voluntary euthanasia or assisted dying is being implemented or otherwise debated in the context of legislative bills. Beyond this, the key point being made was that the voice of palliative care must be heard to ensure that it does not lose its clinical relevance or precious resource funding where euthanasia or assisted dying, however named, is legalized.
Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?
Published in The American Journal of Bioethics, 2019
Brent M. Kious, Margaret (Peggy) Battin
Thus, we think it is clear that the justification for PAD laws in the United States, as elsewhere, depends in large part on the recognition that suffering—whether due to painful sensations or to the loss of dignity, self, or independence—can sometimes be an adequate reason to end one’s own life, and that persons who suffer severely because of a terminal physical illness and who retain decision-making capacity should be allowed to pursue PAD. Either kind of suffering, though, could plague persons afflicted by mental illnesses, even in the absence of any physical illness. It is true, of course, that fewer people with mental illness would suffer as severely as they do if they had better access to psychiatric care and other services, and true as well that existing psychiatric treatments are not as effective as anyone would like. Still, we think it is clear that the suffering associated with mental illnesses can sometimes be as severe, intractable, and prolonged as the suffering due to physical illnesses. Accordingly, it seems to us that if severe suffering can justify PAD for some persons with terminal physical illnesses, it should justify PAD for some persons with mental illnesses, too. Call this the parity argument. As Ogilvie and Potts, writing in the United Kingdom and hence in the proximity of countries where euthanasia is legal, say regarding persons with depression, “The intensity of psychic pain suffered by some patients with severe affective disorders must be acknowledged. In moments of candor some professionals may admit sympathy for the view that in severe and persistent depressive illness, when all appropriate physical treatments, including polypharmacy, electroconvulsive therapy, and psychosurgery, have apparently been exhausted, voluntary euthanasia may sometimes seem to be as justifiable an option as it does in intractable physical illness” (Ogilvie and Potts 1994).
The ongoing discussion on termination of life on request. A review from a German/European perspective
Published in International Journal of Psychiatry in Clinical Practice, 2021
The main features of the extreme position of the Australian philosopher Peter Singer may also have influenced discussions on euthanasia. About 10 to 20 years ago, Singer’s views received some interest worldwide; however, in Germany his ideas were mainly criticised, particularly in the media. He describes his philosophy of ‘practical ethics’ (which is also the title of one of his books; Singer 2011) as ‘utilitarian’ and bases his arguments on a certain hierarchy of value among living beings. In his philosophy, he not only supports ‘voluntary euthanasia’ but even justifies ‘non-voluntary euthanasia’ in cases in which ‘a human being is not capable of understanding the choice between life and death’. He considers in particular severely disabled infants, accident victims and senile people with severe mental disabilities to be candidates for ‘non-voluntary euthanasia’. Fortunately, Singer's extreme and shocking position found hardly any followers in Germany, although sometimes it is supported indirectly in a watered-down form in certain, usually cautious statements, which are often described as a pragmatic philosophy of daily life. For example, the public discussion in the media about the dementia of the famous university professor for philology, Walter Jens, included questions about whether a person with dementia can still participate in life at all and whether that person still has any personal dignity. This attitude can go all the way to the conviction, which is even presented by well-known (often philosophically and sometimes even theologically shaped) personalities or intellectuals, that in the case of serious dementia termination of life on request could be the effective or indicated remedy. Thus, another famous university professor, the professor of theology and close friend of Walter Jens, Hans Küng, made a kind of pact with Walter Jens that they would request death by euthanasia if either of them developed dementia (Jens and Küng 1995). This was years before Walter Jens was affected by dementia. The perspective of euthanasia in case of dementia is probably primarily a reaction to the severe intellectual deficits and the extreme need for care in the late stages of the disease; however, it does not attach enough importance to the personal dignity that still exists, despite all the person’s deficits, and completely contradicts what I, like most physicians who care for people with dementia and their relatives, experience in my daily work. Time and again, we are impressed by patients’ and caregivers’ positive attitude to life ‘despite everything’ and the extraordinary care given to people with dementia. In this context, it is interesting that ultimately Walter Jens did not request death by euthanasia and actually expressed great fear about it.