Healthcare Providers

&
the Ethics of Cooperation
in Suicide

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 DIGNITY AND THE RIGHT TO DIE WITH DIGNITY

◉ Dignity and dying does not necessarily entail

choosing death over the artificial prolongation of
life.
◉ The demand to respect and maintain a person’s
dignity might equally entail respect for a person’s
autonomous wish to prolong or sustain his or he
life
◉ It is important to understand that the ethical
controversies surrounding the care of dying
patients are not just about management at a
technological, medical or institutional level.
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 SUFFERING AND THE DEMAND TO END IT

◉ Suffering is not just a medical problem; it is also

an existential problem involving profound
questions concerning the meaning and purpose
of human life and destiny.
◉ To ‘end suffering by killing the sufferer’ is, to
borrow from Campbell (1992, p.276), to
misunderstand ‘both suffering and ourselves in a
way that threatens [infinitely] our moral intergrity.

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 THE KILLING/LETTING DIE DISTINCTION

◉ Opponents of euthanasia claim that so-called

passive euthanasia is merely ‘letting die’; it is not
euthanasia at all, and is therefore morally
permissible.
◉ It is sometimes suggested that where medical
treatment is relatively ‘expensive, unusual,
difficult, painful or dangerous’ (sometimes
referred to as ‘extraordinary’ treatment), no moral
obligation exists to use it in order to prolong a
person’s life

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 THE KILLING/LETTING DIE DISTINCTION

◉ The view that withholding or withdrawing life-

saving treatment is tantamount to intentional
killing becomes even more compelling when
considering the very nature of medical/healthcare
contexts, which generally have the facilities to
restore and/or prolong life.
◉ Failing to treat in a medical setting is one way of
killing precisely because in such settings there are
the means to prolong life

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INTENTIONAL
KILLING
VS
ALLEVIATING
PAIN
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 ADMINISTRATION OF NARCOTICS

◉ many cases of medically prescribed narcotic

administration are not cases of intentional killing,
and in fact may prolong life.
◉ it is also likely that some cases fall somewhere
between prolonging life and intentional killing.
◉ it is probably true that some cases of medically
prescribed narcotic administration are cases of
intentional killing.

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 IMPLICATIONS FOR NURSES

◉ sound knowledge of the principles of pain

management, proper pain assessment, and
correct drug administration will help to reduce the
likelihood of moral dilemmas ocurring.
◉ the position nurses are morally obliged to take is
clear; the patients are always the nurses’ primary
concern.

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 ‘NURSING CARE ONLY’ DIRECTIVES

◉ A common, though not acknowledged, euthanatic

practice is that of doctors prescribing ‘nursing
care only’ for patients deemed ‘medically
hopeless’.
◉ This medical prescription has become a
euphimisim and for nonvoluntary and involuntary
passive euthanasia since what is in fact being
ordered is not nursing care, but rather withdrawal
of both competent nursing care and life sustaining
care.

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Case Scenario

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Question:
Were the nurse’s actions in this case
tantamount to an act of euthanasia,
assisted suicide, mercy killing, or
homicide?

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