EUTHANASIA-

THE RIGHT TO CONTROL TIME OF DEATH

BY GRAVES KRAH AKORTSU

 OUTLINE

• CASE STUDY
• DEFINITION
• TYPES OF EUTHANASIA
• HISTORY OF EUTHANASIA
• FACTS ABOUT EUTHANASIA RELATED TO BIOETHICS
• ETHICAL PRINCIPLES OF EUTHANASIA
• PROS AND CONS ARGUMENT RELATED TO EUTHANASIA
• PERSONAL FEELING RELATED TO EUTHANASIA
• REFERRENCES
 CASE STUDY

• Patient A is 59years old, a retired college professor who lives in Britain and diagnosed
with motor neuron disease(MND), a degenerative kind that affects the nervous system
and could lead to difficulty gripping, walking, swallowing , speaking and breathing
• He decides to end his life rather than spend the rest of his life in a living tomb. Since
euthanasia is illegal in Britain , he travelled to Switzerland to die assisted by the
Diginitas clinic in Zurich in September 2006
• He was already 5months paralyzed prior to his televised death, his last moment was
shown on the sky real lives channel live, he first said goodbye to his wife, drunk the
poison, asked for an apple juice, requested for Beethoven’s symphony no.9, said thank
you , and died peacefully
 DEFINITION

• The term euthanasia is derived from the Greek, literally meaning good death or easy
death; taken in its common usage however it refers to the termination of a person's life,
to end the suffering , usually from an incurable or terminal condition.
• Some school also call it mercy killing
• The painless killing of a patient suffering from an incurable and painful disease or in a an
irreversible coma or
• the practice of intentionally ending a life to relieve pain and suffering.
• In many cases it is carried out at a patient’s request but there are times when they may
be too ill and the decision is made by relatives medics or in some instances the courts.
 TYPES OF EUTHANASIA

• Active euthanasia; ending life of a suffering patient on his own request by another person, mostly by a doctor
or it refers to the deliberate act to end an incurable or terminally ill patients life e.g. usually through the
intentional administration of lethal drugs. This form has varieties such as;
I. Voluntary euthanasia; this is euthanasia performed at the request of the patient.
II. Non-voluntary; euthanasia is performed when the patient is incapable of consenting
III. Involuntary/ indirect euthanasia; this is euthanasia performed when the patient does not request it, but has
the intent of relieving suffering which in effect amounts to murder
• Passive euthanasia; the deliberate withholding or withdrawal of life-prolonging medical treatment resulting in
the patients death
• Assisted suicide; refers to when a suffering person dies with the help of another person
 HISTORY

• The first apparent usage of the term euthanasia belongs to the historian
Suetonius who described how the emperor Augustus , dying quickly and
without suffering in the arms of his wife Livia, experienced the euthanasia
he had wished for
• It was first used in a medical context by Francis bacon in the 17th century, to
refer to the easy, painless, happy death, during which it was a physician’s
responsibility to alleviate the physical sufferings of the body
• 1828:the first law against assisted killing was passed in New York
 HISTORY cont’d
• In 1870, Samuel Williams first proposed using anesthetics and morphine to
intentionally end a patient’s life
• 1885: the American medical association strongly denied the use of analgesic
for euthanasia.
• 1994: Netherlands becomes the first country where euthanasia was allowed
• 2001: the law is adopted in Belgium with definition of conditions for doctors
to avoid penal punishment
 FACTS ABOUT EUTHANASIA

• Euthanasia is illegal in most of the states of the united states; However physician aid in dying
or assisted suicide is legal in the states of Washington dc, Oregon, Vermont and Washington
• Several major court cases advanced the legal rights of patients or their guardians, to practice
at least voluntary passive euthanasia( physician assisted death). E.g. Karen Ann Quinlan case
(1975), Brophy and Nancy Ruzan cases
• case involving Karen Ann Quinlan in 1975: Because Quinlan was in a persistent vegetative
state(PVS); a coma state of wakefulness without detectable awareness, her parents asked for a
respirator to be removed. After much controversy, the new jersey supreme court ruled that the
respirator could be discontinued . Quinlan died in 1985
 FACTS ABOUT EUTHANASIA cont’d

• Case involving Terri Schiavo; in 1990 Schiavo then 26, collapsed at her home in st
Petersburg, Florida and never recovered. She entered a coma and was kept alive by the
tools of modern medicine. She had experienced respiratory and cardiac arrest and
remained in coma for 10 weeks. She did not have a living will. After 3 years she was
diagnosed as being in a persistent vegetative state(PVS)
• This condition of wakefulness persuaded her parents that she will recover. In 1998 her
husband who was also the legal guardian, petitioned the state courts to remove her feeding
tube, but her parents objected. She died 13 days later of dehydration on march 31 2005 at
the age of 41 in a Pinellas park hospice facility after the state ordered she cease to receive
life support
 FACTS ABOUT EUTHANASIA cont’d

• In 2004, Arizona, Hawaii and Vermont introduced state bills to allow physician
assisted suicide(pas). At the same time, john Ashcroft, then united states attorney
general, issued a directive making it illegal for doctors to prescribe controlled
narcotics to help terminally ill patients die. In 2006, supreme court ruled (6-3 in
Gonzales vs Oregon) that Ashcroft had overstepped his authority
• This growing capability to forestall death in patients who were dependent on
mechanical ventilation and patients receiving artificial nutrition support has
contributed to the increased attention to medical decisions near the end of life
(CEJA,1992,p.2229)
 ETHICAL PRINCIPLES OF EUTHANASIA

• In end of life situations one has an obligation to;

I. God; we are forbidden to abandon our station or post of life without the orders of our commander, that is
God; Whoever takes his own life sins against god, just as he who kills another’s slave sins against the slave
master, for it belongs to god alone to pronounce the sentence of death and life(st2.2.65.5) by Thomas
Aquinas(1225-1274)
II. Obligation to oneself
III. Obligation to society; by killing himself a person injures the society
• Some of the major principles are:
1. the principle of respect for autonomy(self rule); a competent person has the right to determine his or her own
course of medical action in accordance with a plan he or she chooses. It’s the duty of the physician and
society to respect the decisions, wishes and desires expressed by a competent decision maker who is the
patient
 ETHICAL PRINCIPLES OF EUTHANASIA cont’d

2 Principle of beneficence; we have an obligation to bring good in all our actions as health professionals.
one should act to further the welfare and benefits of another and to prevent evil or harm to that person. This
principle requires one to do something for someone
3 Principle of nonmaleficence; one should refrain from inflicting harm( or unduly risking the infliction of
harm)on another. Where harm cannot be avoided we are obligated to minimize the harm we do. It requires
one to refrain from doing harm to another. Its is wrong to waste the resources that could be used for good
4 Principle of justice; we have an obligation to provide others with whatever they are owed or deserve. We
have an obligation to treat all people equally, fairly and impartially. We are to impose no unfair burdens or
treatment as health professionals
5 principle of life preservation; we have a moral duty to protect and preserve human life whenever possible
ARGUMENTS FOR AND AGAINST EUTHANASIA
FOR
• Patients have the right to make the decision about
when and how they should die, based on the
principles of autonomy and self determination
I. Autonomy is the concept that a patient has the
right to make decisions relating to their life so
long as it causes no harm to others
II. Furthermore, it is augured that as part of our
human rights, there is a right to make our own
decisions and a right to a dignified death
AGAINST
• Euthanasia devalues human life; this is society’s view of the sanctity of life,
and this can have both a secular and a religious basis. The underlying ethos is
that human life must be respected and preserved
I. The Christian view sees life as a gift from God and should not be ended by
the taking of that life.
II. Similarly the Islamic faith says that “ it is the sole prerogative of God to
bestow life and to cause death”
III.The withholding or withdrawal of treatment is permitted when it is futile ,
this is seen as allowing the natural course of death
IV.Society views an action which has a primary intention of killing another
person as inherently wrong inspite of the patient’s consent
V. Request of euthanasia are rarely autonomous as most terminally ill patients
may not be of a sound or rational mind
ARGUMENTS FOR AND AGAINST EUTHANASIA
CONT’D
FOR
• it is said that relieving a patient from their
pain and suffering by performing
euthanasia will do more good than harm.
i. The fundamental moral values of society,
compassion and mercy require that no
patient be allowed to suffer unbearably
and mercy killing should be allowed
AGAINST
• Euthanasia undermine the doctor patient
relationship destroying the trust and
confidence built in such relationship
• Casting doctors or health professional
in the role of administering euthanasia
would undermine and compromise the
objectives of the medical profession
ARGUMENTS FOR AND AGAINST EUTHANASIA
CONT’D
FOR
• Euthanasia frees up medical funds to
help other patients
• Euthanasia is another case of freedom of
choice- the right to commit suicide
• Patients should not be forced to stay
alive
AGAINST
• Euthanasia can be a means of health care
containment
• Euthanasia will become non voluntary
• Euthanasia would not only be for people
who are terminally ill
 CONCLUTION

• Ethical behavior is defined by moral principles or values based on concepts of good or bad. The growing
difficulty and complexity as well as dangers of medical decision making have created the role of the
bioethicist, whose job is to help medical professionals and families make difficult medical decisions,
especially for people at the end of life
• All cultures have guidelines; codes, prayers, creeds or oaths to guide their healers. E.g. doctors by the
Hippocratic oath.
• Proponents of legalized euthanasia argue that the rights to self determination include the right to chose how
and when to die
• Opponents of legalized euthanasia also worry about the “slippery slope” wherein ending a life might be a
difficult decision at first but then become easier the more it is done
• Euthanasia could benefit suffering patients however there are too many risk and consequences
 REFERENCES

• Bartels L, Otlowski M. A right to die? Euthanasia and the law in Australia. J Law Med. 2010 Feb;17(4):532-55
• Walsh D , Caraceni AT, Fainsinger R, Foley K, Glare , Goh C, et al. Palliative medicine. 1 st ed. Canada: Saunders;2009.
chapter22, Euthanasia and physician assisted suicide; p.110-5
• American Medical Association(AMA), council on ethical and judicial affairs(CEJA). (2006-2007). AMA Code of
medical ethics
• Cordner, S(1995). Reaction to Australian's state’s euthanasia law. Lancet,345,1561-1562
• Beauchamp T, Childress J. Principles of Biomedical Ethics.7th edition. New York: Oxford University Press, 2013
• Harris, NM.(October 2001). “ The Euthanasia Debate”. JR Army Med Corps. 147(3):367-70.
• Francis Bacon: The Major Works by Francis Bacon, edited by Brian Vickers,p.630
• Beauchamp, Tom L; Davidson, Arnold I .(1979). “The Definition Of Euthanasia”. Journal of Medicine and Philosophy.
4(3):294-312.