2 questions
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Whose Life Is It Anyway?
Euthanasia, Assisted Suicide,
SuicideChapter 8
Learning Objectives
After reading this chapter, you w ill be able to:8.1 Discuss the morality of mercy killing and assisted suicide.8.2 Critically analyze the relation between what is legal and what is moral in end -of-life care. 8.3 Articulate the utilitarian and Kantian arguments about suicide, assisted suicide, and euthanasia.
Legalization
The law s regulating w hat doctors may or may not do to end a life vary from state to state in the U nited States as w ell as from country to country. I n 2001, the Netherlands became the first country to legalize euthanasia, allowing doctors to end the life of adult patients at the patient’s request. I n 2008, the law w as amended to allow parents to give consent for doctors to kill infants w ho are terminally ill and in severe pain. This new measure, know n as the Groningen Protocol , is the first to allow euthanasia for new born babies . 2/23/2017
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5 Different Types
Active Euthanasia Voluntary EuthanasiaActive
Non - voluntary Active X
PassiveEuthanasia Voluntary EuthanasiaPassive
Non - voluntaryPassive
Involuntary EuthanasiaPassive
Active Euthanasia
Something is done to the patient to hasten DeathNot legal in the U nited StatesLegal in Netherlands and AustraliaExamples: drugs are administered at lethal levels.
Passive Euthanasia
Patient is allowed to die. Only medication help ease patient’s pain is administered.Examples:Turning off respirator, refusing chemotherapy. 2/23/2017
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Voluntary Euthanasia
Patient request treatment to be stopped.Examples: chemotherapy, dialysis & living w ill.
Non -Voluntary
Patient cannot decide for themselves . Someone makes the decision for them . Examples: children, comatose patients, or individuals not mentally competent
Heath Care Surrogate
You can appoint someone, to act as your representative in the event you are mentally incapacitated.Terri Schiavo did not have a Heath Care Surrogate. I f you do not have one, by default it is your spouse. I f you are unmarried, it is your parents or next of kin. 2/23/2017
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Involuntary
Patient is refused a life sustaining treatment.Examples: Drugs are too costly, limited supply of organs.About 13,000 patients are on w aiting list in the U S.
Assisted Suicide
Someone helps you to take your ow n life.I n 1994 Oregon passed “Death w ith Dignity law ” becoming the first state to legalize Assisted Suicide.
History
400 B. C. -The earliest recorded reference to Euthanasia comes from Hippocrates, the father of medicine. He is quoted as saying “I w ill give no deadly medicine to any one if asked, nor suggest any such counsel”673 –England prohibits suicide. 1647 –the Providence Plantations (Rhode I sland) declared that if an individual committed suicide his/her possessions w ould become the property of the King of England.1800s –Law s of Connecticut essentially states that any person w ho aids another individual in committing suicide is guilty of murder if the advisee actually goes through w ith suicide. 2/23/2017
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History (continued)
1828 –“The earliest American statute explicitly to outlaw assisted suicide w as enacted in New York….Between 1857 and 1865, a New York commission drafted a criminal code that prohibited ‘aiding’ suicide and, specifically, ‘furnishing another person w ith any deadly w eapon or poisonous drug, know ing that such person tends to use such w eapon or drug in taking his ow n life.”1850 –“The California legislature adopted the English common law, under w hich assisting suicide w as… a crime.”
History (continued)
1920 –“The book "Permitting the Destruction of Life not Worthy of Life" w as published. In this book, authors Alfred Hoche , M.D., a professor of psychiatry at the University of Freiburg, and Karl Binding, a professor of law from the University of Leipzig, argued that patients who ask for "death assistance" should, under very carefully controlled conditions, be able to obtain it from a physician. This book helped support involuntary euthanasia by Nazi Germany.”
Nazi Germany
1939 –I n “Nazi Germany…Hitler ordered w idespread ‘mercy killing’ of the sick and disabled.”1935 –“The Euthanasia Society of England w as formed to promote euthanasia.” 2/23/2017
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History (continued)
1995 –Australia's Northern Territory approved the “Rights of the Terminally I ll Act . “ I t w ent into effect in 1996 and w as overturned by the Australian Parliament in 1997.”
Oregon Law
I n 1994 voter in Oregon passed an Assisted Suicide law .The law w as held up in litigation until 1998 w hen Attorney General Janet Reno decided to permit the law to go into effect.I n 2001 Attorney General John Ashcroft said “assisting suicide is not a "legitimate medical purpose" under federal drug -control law and that the Drug Enforcement Administration could strip the prescribing rights of any physician w ho authorized drugs to help someone die .” On January 17, 2006, the U nited States Supreme Court ruled 6 –3 in favor of Oregon, upholding the law .
Oregon’s Death with Dignity
I n 1994 voter in Oregon passed an Assisted Suicide law . According to the Oregon Death With Dignity Act, “An adult w ho is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and w ho has voluntarily expressed his or her w ish to die, may make a w ritten request for medication for the purpose of ending his or her life in a humane and dignified manner “ 2/23/2017
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Supreme Court Said Up to States
I n 1997 Ballot Measure 51 w as introduced to overturn the Death With Dignity Act. The people of Oregon turned dow n the measure by a vote of 60% to 40%Ballot Measure 51 came about due to tw o court cases in w hich theU .S. Supreme Court ruled in assisted suicide w as not a Constitutional right. How ever, the Court instructed that the issue w ould be best addressed in the "laboratory of the states."
Ashcroft Directive
I n 2001 Attorney General John Ashcroft said “assisting suicide is not a "legitimate medical purpose" under federal drug -control law and that the Drug Enforcement Administration could strip the prescribing rights of any physician w ho authorized drugs to help someone die.”
Oregon v. Ashcroft
On November 6, 2001, Attorney General John Ashcroft issued a Directive stating that a doctor could lose his or her federal registration to prescribe controlled substances if the registration is used to prescribe federally controlled substances for assisted suicide. 2/23/2017
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Dr. Jack Kevorkian “Doctor Death”!
May 28, 1928Kevorkian is born in Pontiac, Michigan, the son of Armenian immigrants. 1952Graduates from U niversity of Michigan medical school w ith a specialty in pathology. 1956Publishes journal article, "The Fundus Oculi and the Determination of Death," discussing his efforts to photograph the eyes of dying patients, a practice that earned him the nickname "Doctor Death."
Kevorkian’s Definition of Death with Dignity“Well, let's take what people think is a dignified death. Christ was that a dignified death? Do you think it's dignified to hang from wood with nails through your hands and feet bleeding, hang for three or four days slowly dying, with people jabbing spears into your side, and people jeering you? Do you think that's dignified? Not by a long shot. Had Christ died in my van with people around Him who loved Him, the way it was, it would be far more dignified. In my rusty van.”-Jack Kevorkian; National Press Club -July 29, 1996
First 5 Assisted Suicides
1.Janet Adkins 1990 F 54 Alzheimer's Disease 2.Sherry Miller 1991 F 43 MS 3.Marjorie Wantz 1991 F 58 Abdominal and Pelvic Pain 4.Susan William 1992 F 52 MS 5.Lois F. Haw es 1992 F 52 Lung cancer 2/23/2017
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93 Known Deaths…
Kevorkian assisted in 93 reported deaths, but his lawyers says there are many more w here the person w ished to remain anonymous. November 22, 1998CBS's "60 Minutes" airs a videotape show ing Kevorkian giving a lethal injection to Thomas Youk , 52, w ho suffered from Lou Gehrig's disease. The broadcast triggers an intense debate w ithin medical, legal and media circles. Less than ½ of all of Dr. Kevorkian’s Assisted Suicides were of patients that were terminally ill.
Convicted in 1999
April 13, 1999Convicted of second -degree murder and delivery of a controlled substance in the death of Youk , a Michigan judge sentences Kevorkian to 10 -25 years in prison. He w as eventually paroled and passed aw ay in 2011.
Legalizing Death with Dignity:Karen Ann Quinlan
I n 1975 a 21 -year-old w oman named Karen Ann Quinlan suffered a respiratory arrest that resulted in severe and irreversible brain damage and left her in a coma. Several months later, after doctors informed them that their daughter's recovery w as extremely unlikely, Quinlan's parents requested that artificial means of life support be removed. The hospital refused this request. 2/23/2017
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Court Sided with Family
After a lengthy legal battle, in 1976 the Quinlans obtained a court order allowing them to remove the artificial respirator that w as thought to be keeping their daughter alive. The New Jersey Supreme Court ruled that the Quinlans could disconnect the device so that the patient could "die w ith dignity."
Turned off respirator
This decision spaw ned increased discussion of the scope of patients' rights to control their death. Although the respirator w as removed in 1976, Quinlan began to breathe on her ow n. She lived until 1985 w ithout ever regaining consciousness.
Terri Schiavo
I n the early 1990s Schiavo had a heart attack and collapsed incurring massive brain damage and slipping into a coma. She remained in this coma and after 3 years w as in a persistent vegetative state. (PVS) 2/23/2017
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Terri’s Husband
Beginning in 1998, Schiavo’s husband began petitioning the courts to remove the feeding tube that kept her alive claiming that she w ould not w ant to be kept on a machine w ith no hope for recovery. Her parents claimed that Schiavo w as a devout Roman Catholic w ho w ould not w ish to violate the Church's teachings on euthanasia by refusing nutrition and hydration .
Terri’s Never Had Treatment
Michael Schiavo had a girl friend and children, but he w as still the legal guardian of Terri.He restricted access by her parents -they had to go to court to get visitation.He refused to give her any medical treatment or to ask for a second opinion.
Terri’s Law
On October 15, 2003 Schiavo’s feeding tube w as removed. Six days later Terri’s Law w as passed and Gov. Bush sent armed men to take Schiavo to a hospital to have her feeding tube reinserted. A guardian ad litem w as also appointed that w as to report to Gov. BushOn May 5, 2004 Terri’s Law w as found to be unconstitutionalThe Supreme Court Refused to hear the case and March 18, 2005 it w as ordered that the feeding tube be removed again… 2/23/2017
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Dust in the Wind
Terri w as read her last rites on March 26, 2005 and died on March 31, 2005. Her “loving” husband refused to let here parents attend the funeral!He had the body cremated and spread the ashes in a secret location!
Baby “MB”
MB is a 19 month old baby boy.MB has a condition called spinal muscular atrophy w hich leaves him almost totally paralysed . He requires a ventilator to breathe and cannot cry, chew or sw allow.
Doctors -His life is not worth living!
All his doctors and the guardian appointed to represent the child's interest in court argued that the burdens of his existence outw eighed the benefits. 2/23/2017
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His Parents want to let him live
The parents love their child and w ant to keep him alive.MB's mother told the High Court in London that the child w as conscious. He responded to cartoon films ,such as Shrek and Finding Nemo , but did not appear to like the new s or the TV soap Eastenders .
Justice Holman said…
"I t must be assumed that he processes all of those sights and sounds like any child of his age and gains pleasure from them," said Justice Holman. "No court has yet been asked to approve, against the w ill of parents, the w ithdrawal of life support w ith the inevitable and immediate death of a conscious child w ith sensory aw areness and cognition, and no significant evidence of brain damage."
Do not resuscitate or medicate
The judge also said that if the child's heart stops, the hospital w ould not be required to resuscitate him or to give antibiotics if he develops serious infections. As reported by the BBC, Mar 15 2006
