Euthanasia - Julei Arliss

PP produced by Julie Arliss Academy Conferences

Euthanasia

See the Academy Conferences website for this year’s conference details:

http://ethics.academyconferences.com


Key Issue 1.

Is killing somebody, who is in the process of dying, morally the same as allowing them to die?


An elderly patient in some pain with 2 weeks to live. Morphine is given to control the pain. Is there any moral difference between allowing the elderly

patient to die, without pain, over a period of two weeks, and giving the patient a lethal injection which will kill them tonight?


Key Issue 2Rights of Patient•or

Rights of Medics

“WE PREFER NOT TO KILL OUR PATIENTS”


Key Issue 3

HOW ARE THE ‘PREFERENCES’ OF THE INDIVIDUAL TO BE BALANCED AGAINST THE PERCEIVED RISKSTO COMMON GOOD?


Key issue 4

Are humans animals really? If so then, we put animals down, why not humans?


INDIVIDUAL

RIGHTS PRIMARY

KILLING IS THE

SAME AS ALLOWING TO DIE

HUMANS ARE

ANIMALS AND

NOTHING MORE

EUTHANASIA


INDIVIDUAL

RIGHTS CAN BE LIMITED.

ALLOWING TO DIE

IS MORALLY DIFFERENT FROM KILLING

HUMANS ARE FAR

MORE THAN

ANIMALS

NO EUTHANASIA


Active Euthanasia

Voluntary

Lilian Boyes vs Dr Cox – Potassium choloride1992

Non Voluntary

John Pearson a downs child DF118

Involuntary

Dr Shipman 1999 Diamorphine (Heroin)


Non-voluntary Active Euthanasia

The person is unable to express their wishes.

A person in a coma, given a lethal injection.

A baby, perhaps with Downs or disabled, given a lethal injection.


Involuntary Active Euthanasia

Nellie ‘Mary’ Pickford and 5 others ‘died’ unexpectedly at Parkfields Care home.

Rachel and Leigh Baker arrested.

Dr Harold Shipman killed 215 – 250 people

The person is able to express their wishes but Is not consulted.


Legislation

Current legislation forbids all forms of active euthanasia.

The Netherlands has the most developed active euthanasia programme in the world.

Only voluntary euthanasia comes under their legislation but, in practise, according to their own reports, all forms of active euthanasia are done.


Passive Euthanasia

Voluntary

Patient decides to refuse treatment.

Non Voluntary – patient cannot be consulted.

Intensive care patient has medical support withdrawn.

Involuntary – patient not consulted.

Medical decision not to offer treatment.


Non-voluntary Passive Euthanasia

The person is unable to express their wishes.

Tony Bland PVS patient

Baby Doe - parents refusedTreatment for tracheoesophageal fistula.

XX


Involuntary Passive Euthanasia

An elderly patient with 2 weeks to live. Passes out of consciousness. Medical decision not to resuscitate.


Legislation Current legislation allows all sorts of ‘passive

euthanasia’. It is not usually called euthanasia, but ‘allowing to die’. The pro-euthanasia lobby argue that euthanasia goes

on all the time. They are referring to passive euthanasia, whereby a

decision is made not to treat, or to withdraw treatment.

UtilitarianismUtilitarianismand euthanasiaand euthanasia


Utilitarianism

Utilitarianism is an ethical theory which claims that the morality of our actions depends on their consequences.

If an elderly person is in the final stages of life and has 2 weeks to live, is there any difference between giving a lethal injection tonight or letting them die slowly?

The Utilitarian argues NO! They are the same, because the consequences are the same. The person dies.


James Rachels 30 May 1941 - 5 Sep 2003

Smith and Jones stand to gain a great deal of money on the death of their 6 year old cousin

Imagine they plan separately to kill their cousin.


Smith goes up and drowns their cousin in the bath.

(Active euthanasia – the doctor takes positive action to kill.)


Jones goes up with the intention of drowning his cousin, but finds the boy has banged his head, fallen and is unconscious drowning in the bath. Jones does nothing and the boy dies.

Passive euthanasia – the doctor omits treatment and allows to die.


James Rachels

Rachels uses this example to show that it would be ridiculous to say that Smith is a murderer and Jones not.

The consequences of their acting/not acting makes them morally the same because the result is the same.

IF consequences are the only morally relevant factor he is right.

Once you say this there is no difference between active and passive euthanasia.


ACTIVE / PASSIVE No Moral Significance

“Stripped of all other differences, what remains is…a difference that has no moral significance. In active euthanasia the doctor initiates a course of events that will lead to the patients death. In letting die (or passive euthanasia) the agent stands back and lets nature take her sometimes cruel course. Is letting die morally better than active euthanasia? I think not. Very often it is much worse.”

Helga Kuhse; Case for Active Vol. Euth. 87

Passive euthanasia, or allowing to die, happens all the time so why not active euthanasia? Peter Singer also argues for this.


Utilitarianism

For utilitarian's the good action is that which brings about the greatest good for the greatest number.


Greatest good for greatest number?

John Pearson was born with Down’s on 28.7.1980. His mother remarked “I don’t want it, duck”

Down’s apart there were no clinically detectable abnormalities

Dr Arthur recorded: “Parents do not wish baby to survive. Nursing care only.”

Dr Arthur prescribed DF118,the infant was given water but no nourishment and antibiotics were withheld

when broncho-pneumonia developed John Pearson died three days after birth Dr Arthur charged with murder, changed to attempted

murder, as DF118 may not have caused death.


Retarded or ‘unfit to breed’. Homosexuals.Disabled.Gypsies.Jews.

Greatest Goodfor Greatest number?


Utilitarian contribution

Consequences are vital. For the Utilitarian human life is not sacred – we put

animals out of their misery. Consider how best to reduce pain and create

pleasure. Stress on pleasure over pain may mean helping to

die rather than prolonging suffering. Creating the greatest good for the greatest number

may mean carefully evaluating the use of medical resources, and helping to die.


There are already some utilitarian voices suggesting that treatment for the elderly be restricted.


Rule Utilitarianism - Mill Euthanasia IS against the LAW and the rule

utilitarian will not break the law but work to change it if needed.

Any higher pleasures which can be experienced by the sick person must be weighed into a decision.

The long term consequences of allowing euthanasia would also be put into a decision.

The German experience and the Dutch experience might well persuade a utilitarian not to opt for the legalisation of active euthanasia.

Holland

‘Abuse is the norm.’


"LEBENSUNWERTES LEBEN" – Life Unworthy of Life. HELNWEIN'S OPEN LETTER TO EUTHANASIA DOCTOR HEINRICH GROSS

Once active euthanasia isaccepted the question is then one of quality oflife. Which life issufficientlyworthy of being lived? Which life is not?

Austria's number one forensic psychiatrist admitted putting poison in children’s food.


The Missing Link in Utilitarian Case.

Smith and Jones intended to murder and inherit from their cousin.

WHAT IF we change the story.


Winston NesbittWhat if Jones did not want to inherit from his cousin, and had no intention of killing his cousin in the bath. He went up and found him unconscious in the water and did nothing, because he thought there was nothing to be done. Is he still a murderer?


Jones is now far more representative of our doctors.


The Missing Link in Utilitarian Case.

The consequences of Jones’ actions are the same as before – the cousin dies.

Jones’ different motive means he is not a murderer.

This means that morality is not to be judged solely on the basis of consequences as James Rachels, and Utilitarianism claims.

Motive is a vital indicator.

Education

Euthanasia - Julei Arliss