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  • Created on: 01-05-13 19:07

Different types of Euthanasia

Greek= good death. it is the practice of ending life to reduce pain and suffering.

VOLUNTARY euthanasia = when a patient's death is caused by another person, eg a doctor with the explicit consent of the patient.

The patients request must be:

-voluntary (acting without coercion pressure)

- enduring (lasts some time or is repeated over time)

- competent (they have the mental capacity to choose)

A variation on euthanasia is PHYSICIAN-ASSISTED SUICIDE, this differs from euthanasia as the doctor will help the patient commit suicide (eg set up the apparatus), but the final act of killing is done by the patient. 

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different types continued

NON - VOLUNTARY euthanasia is done WITHOUT the patients consent, because they are not competent or able to give the consent (eg in a coma, or on a life support machine). The doctor and/or the family may take the decision.

INVOLUNTARY euthanasia is performed AGAINST the wishes of the patient. This is widky opposed and illegal in the uk. 

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active or passive

ACTIVE euthanasia is the DIRECT and DELIBERATE killing of a patient 

PASSIVE euthanasia is when life-sustaing treatment is withdrawn or withheld. 

This distinction may also be described as the difference between an ACT and an OMISSION (failing to act) and between KILLING and ALLOWING TO DIE.

some such as JAMES RACHELS, argues that there is no real difference - if anything passive euthanasia (withdrawal of treatment) is worse because it leads to a longer, drawn out death and so more suffering potentially. 

DAME CICELY SAUNDERS (who founded the hospice movement) argues that it is unnecessary for anyone to suffer a painful death with modern drugs. A counter argument is that mant doctors already hasten death (e.g by doubling a morphine dose): under the DOCTRINE OF DOUBLE EFFECT if the intention is to alleviate pain and a secondary effect to kill someone, the doctor is not guilty of any crime. 

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Lega position

UNDER 1961 suicide was illegal in the uk. the 1961 SUICIDE ACT legalised suicide but made it illegal to assist.

the NEVERLANDS and SWITZERLAND allow voluntary euthanasia (active and passive) and physician- assisted suicide. The DIGNITAS clinic in Switzerland helped 107 British people to die in 2010.

DR ANNE TURNER (agged 66) was one such person in 2009 - subject to a documentary 'a short stay in switzerland'. 

No-one has ever been prosecuted in the UK for helping a relative or friend go to Switzerland. 

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Legal position 2

In 2010, the director of public prosecutions confirmed that relatives of people who kill themselves will not face prosecution as long as they do not maliciously encourage them and assist only 'a clear settled and informed wish' to commit suicide. 

The move came after the law lords backed multiple sclerosis Debbie Purdy's call for a policy statement on whether people who help someone commit suicide should be prosecuted. 

HOWEVER  in August 2012 Tony Nicklinson, with 'locked in syndrome', failed in his legal attempt to end his 'intolerable life'.

The director of public prosecutions concluded "THERE ARE NO GUARANTEES against prosecution and it is my job to ensure that the most vulnerable people are protected while at the same time giving enough infomation to those people like MRS PURDY who want to be able to make informed decisions about what actions they may choose to take"

the OREGON RULES are another attempt to legalise assisted suicide by laying down conditions under which it will be allowed in US laws.

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The Bible argues that life is a gift from God. Humans are created in the IMAGE OF GOD (genesis 1:27) and the INCARNATION (God taking human form JOHN 1:14) shows the sacred value of human life.

Human life is a GIFT or LOAN from God (JOB:1-21 'the lord gave and the lord takes away')

We should also show RESPECT for human life 'thou shall not murder' (EXODUS 20:13)

We should also 'choose life' (DEUTERONOMY 30).

Finally, the christian love agape love is crucial. 

We should protect human life paticularly as God gave his only son to redeem us (bring us back from sin and death) and give us the gift of 'life in all its fullness'. 

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Sanctity of life - NATURAL LAW

The natural law argues that there is a PRIMARY PRECEPT to 'preserve life' and views life as intrinsic good. Euthanasia is therefore wrong and the Catholic Church forbids both active and passive euthanasia as 'contrary to the dignity of the human person and the respect due to God, his creator' (CATECHISM OF THE ROMAN CATHOLIC CHURCH) 

However the DOCTRINE OF DOUBLE EFFECT might accept the shortening of human life (eg if the intention is to relive pain, secondary effect to kill) so long as it is only in the FORSEEN but UNITENDED RESULT.

The Catholic Church also makes a distinction between ORDINARY MEANS (ordinary, usual medical treatments) and EXTRAORDINARY means (treatments that are dangerous,a huge burden, or disproportionate). it is morally acceptable to stop extraordinary means, as 'it is the refusal of over zealous treatments'.

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Quality of life

JAMES RACHELS argues that the santity of life tradition places too much value on human life and there are times (eg with abortion and with euthanasia) when this is unhelpful.

He makes a distinction between BIOLOGICAL LIFE (being alive = functioning biological organism) and BIOGRAPHICAL LIFE (having a life = everything that makes us who we are). He says that what matters is biographical life and if this is already over (for example in PERSISTENT VEGETATIVE STATE), then taking away biological life is acceptable. 

PETER SINGER argues that the worth of human life varies (the value of human life is not a sacred gift but depends on the quality) A low quality of life (judged by the patient) can justify them taking their life or justify someone else doing it for them. 

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JOHN STUART MILL argues that individuals should have full AUTONOMY (the freedom to make decisions without coercion) so long as it does not harm other people .

Individuals cannot be compelled to do things for their own good -" over his own mind-body the individual is sovereign'. Those who support voluntary euthanasia believe that personal autonomy and self-determination (choosing what happens to you) are crucial. Any competent adult should be able to decide on the time and manner of their death. 

KANT assumes autonomy as one of his three key postulates (with God and immortality). We are self legislating, free moral beings. However, he argued in an essay on suicide, that suicide was self- contradicting as, if it was universalised, the human race would die out. 

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Arguments against Euthanasia

PALLATIVE CARE - DAME CICELY SAUNDERS argues that there is a better alternative for euthanasia in providing a pain-free death for terminally ill patients. 

The hospice movement may be seen as alternative, but, the euthanasia supporter might argue, this level of care is not available to everyone, its expensive and cannot fully relieve a patient's suffering (eg someone who cannot breathe unassisted) 

VOLUNTARY AND COMPETENT - some raise questions about voluntary euthanasia. Can the patient ever be free from coercion (eg relatives who want an inheritance or doctors who want to free up resources?) Is the patient likely to be competent, when under high doses of medication, or when depressed, or senile. Responses would be that there are at least some clear cases when patients ARE clearly voluntary (not coerced) and competent. Guidelines such as the STARMER'S OR OREGON RULES require a certain time period for repeated requests to different people, which are then independently confirmed. 

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Slippery slope

This is an argument that once allowed, the outcome will be a process of a further decline in respect for human life and will end with the practice of non-voluntary euthanasia for the elderly seen as 'unaffordable' by the working majority. 

A response might be that there is a clear difference between voluntaryb and non-voluntary euthanasia. Is there any evidence of a slippery slope in the state of Oregon or Switzerland? The rules on assisted suicide are drawn up precisely to stop the slide into widespread disrespect for human life. 

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Some argue that doctors have a duty to preserve life (the HIPPOCRATIC OATH). Euthanasia will undermine the trust between patient and doctor if there is a fear that they will seek to end their life. 

However as with abortion, there will remain doctors opposed to euthanasia which a patient could always choose, and it is highly unlikely that GPs will have any say in the process of mercy killing. 

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