Medico-legal issues at the end of life
Peter Hutton, Ravi Mahajan, Allan Kellehear in Death, Religion and Law, 2019
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
The Right to Die
Kant Patel, Mark E. Rushefsky in Health Care Policy in an Age or New Technologies, 2015
Active euthanasia involves administration of a lethal drug to terminate the life of a patient who has requested it. There are two possibilities here. The physician may simply supply drug/medication to the patient and the patient takes the drug on his own. Or, a physician actually administers the drug to the patient to hasten the death of the patient. Voluntary active euthanasia occurs at the patient’s request, while involuntary euthanasia occurs when a health care provider, generally a physician, hastens a patient’s death or terminates a patient’s life by administering a drug to the patient without such a request from the patient (Ho 1999). Active involuntary euthanasia has been universally condemned by most. Active voluntary euthanasia, or, physician-assisted suicide, has generated the most intense debate in the United States with many groups supporting legalization of physician-assisted suicide, while other groups strongly oppose such legislation. As we discussed, the U.S. Supreme Court in its rulings has indicated a preference for letting the states establish their own policies on physician-assisted suicide. More than thirty-five states have passed laws that prohibit physician-assisted suicide, while some states are considering legislation that would legalize physician-assisted suicide. Currently, Oregon is the only state that has legalized physician-assisted suicide.
Medical intervention, a life saver or a life changer?
Catherine Proot, Michael Yorke in Challenges and Choices for Patient, Carer and Professional at the End of Life, 2021
Some people feel overwhelmingly that if the experience of loving support and closeness with putting down a dog can be replicated in the case of a human relationship, with the proper criteria and real emotional support, that that must be right; that must be permissible. And in some countries, there are legal provisions to allow euthanasia under certain conditions. What is the difference between the dog’s death, the death of a child who is grievously ill in the womb or that of a child who is unwanted by a fornicating parent? What is the difference? Why can some people nod in the case of abortion pretty well on demand and agonise over assisted dying in an aged adult? Such reflection can be very unsettling. The human mind seeks to set priorities, and the main issue can become lost in the thinking, the discussion and the aims.
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
Hans-Jürgen Möller
If one wants to differentiate between the different types of euthanasia regarding their medical and ethical relevance, active euthanasia and assisted suicide should be considered to be the most serious forms because they are usually performed as a separate act beyond the normal physician-patient relationship and are an intentional termination of life without any human or medical relationship. In contrast, passive and indirect euthanasia are embedded in the context of a mature treatment relationship between a patient and their physician and could be seen as the closest form of such a relationship because these types of euthanasia are usually performed by a physician who knows the patient well and whom the patient trusts. However, all cases of euthanasia must respect the patient’s will, not only in the legal but also in the natural sense, including last-minute expressions of will.
Moralities of Method: Putting Normative Arguments in Their (Social and Cultural) Place
Published in The American Journal of Bioethics, 2019
Raymond De Vries
In the light of this discussion, it is interesting to point out that when the Dutch introduced the regulations governing the termination of life on request and assisted suicide, they seemed to be aware of the possibility that new policies may alter existing norms about the value of life. It is technically incorrect to say that euthanasia is “legal” in the Netherlands. It is not. It is legally protected. That is, euthanasia and physician-assisted suicide are still considered murder, but the assisting physician will not be prosecuted if she or he acts in accordance with the “due care” criteria, including, among others, the presence of a voluntary and “well-considered” request from the patient, the presence of hopeless and unbearable suffering, and consultation with another independent physician who has seen the patient and provided a written agreement that the due care criteria are met (Regionale Toetsing commissies Euthanasie [Regional Euthanasia Review Committees] 2018). Some might argue that this distinction is trivial, but it affirms that the taking of the life of another is a serious offense, a violation of a shared norm. It keeps the cultural prohibition against killing in place while allowing the merciful killing of those who face unbearable and hopeless suffering.
In response to Campbell: Letter to the Editor
Published in Progress in Palliative Care, 2020
Jason Mills
To be clear, the methods or outcomes of euthanasia mentioned in the letter were not discussed in the editorial, and nowhere was it stated, assumed or implied that these were, in any way, part of palliative care. Therefore, one cannot seek to answer a question that is in this way without basis. To further clarify, the paragraphs relevant to euthanasia as published within the broader editorial are quoted below: Adding to the clinical access-human rights milieu, are ethical and legislative debates around or implementation of legal access to assisted suicide or euthanasia (also referred to as voluntary assisted dying, medical assistance in dying or physician assisted dying, depending on jurisdiction), particularly in the United Kingdom (UK) and several States across Australia.While there is potential for division both between and within public and professional opinions, it is essential that all voices are included and heard in the debate; not only the loudest or most powerful. This includes those without a voice. The collective voice of palliative care must also be heard to ensure that its rightful place remains enshrined as an essential component of healthcare. As has been established in other countries, palliative care still plays a vital role in promoting quality of life and its advancement therefore should not suffer due to the implementation of assisted suicide or euthanasia. Careful stewardship is necessary if problems are to be avoided.2
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