EUTHANASIA

• Euthanasia


  Comes from Greek, originally meant "good or happy death"
• Modern Interpretation of Euthanasia

  In the twentieth century, interpreted as "mercy killing," legally a form of murder in most countries
• Dr. Richard Lamerton's View


  • Criticizes the use of "euthanasia" for both mercy killing and allowing natural death
  • Argues for distinguishing between murder and good medical practice (allowing people to die naturally)
• Revised Terminology


  Avoids using "euthanasia" due to ambiguity<|>Substitutes with three terms: "allowing someone to die," "mercy death," and "mercy killing"<|>Emphasizes the necessity of clear definitions for each term to address moral issues effectively
• Allowing Someone to Die


  Recognizes terminal illness reaches a point where curative treatment is futile<|>Advocates for natural death in comfort, peace, and dignity<|>Not active termination but refusal to start or halt futile treatments<|>Allows natural death without intrusive medical interventions<|>Ensures patient care without abandonment to pain
• Mercy Death


  Coined to denote direct action to end a patient's life upon their request<|>Often referred to as assisted suicide<|>Requested by chronically or terminally ill patients unable to end their lives themselves<|>Patients give explicit permission or request for termination
• Mercy Killing


  Refers to direct action to end a patient's life without their permission<|>Typically assumes the patient's life lacks meaning or assumes the patient would desire death<|>Involuntary action without the patient's consent<|>Contrast with mercy death, which is with patient permission or request
• Mercy Death is prohibited in 32 states and generally illegal under homicide statutes worldwide
• Mercy Killing is outlawed in all U.S. states and most countries globally
• Recent legal actions in New York and Washington have complicated the legal landscape regarding euthanasia
• U.S. courts of appeal have questioned the prosecution of doctors prescribing lethal drugs for terminally ill patients seeking suicide
• Ninth Circuit Court of Appeals in California recognized physician-assisted suicide as a constitutional right under the 14th Amendment's guarantee of liberty
• Brain Death


  Advanced medical technology and procedures in the twentieth century have introduced new moral dilemmas, such as irreversible brain damage known as "brain death"<|>Previously, when a patient's heart or lung failed, their brain would soon follow. Modern technology, however, can sustain heart and lung function despite irreversible brain damage
• In 1968, an ad hoc committee at Harvard Medical School established criteria for determining brain death, including unreceptivity and unresponsiveness, absence of spontaneous movements or breathing, lack of reflexes, and a flat EEG
• Disconnecting life support from brain dead patients does not constitute allowing to die or mercy killing
• Persistent Vegetative State (PVS) or Irreversible Coma


  Results from damage to the cerebral cortex, or neocortex, controlling cognitive functions<|>Brain stem functions, including breathing and heartbeat, continue<|>No conscious interaction with surroundings or self-awareness<|>Lacks ability for any human interaction
• Allowing Someone to Die

  Allowing a terminally ill patient to die a natural death without any interference on the part of medical science<|>The issues surrounding allowing someone to die, along with mercy death and mercy killing, have become more prevalent in the twentieth century due to advances in medical technology<|>Advancements such as respirators, heart pumps and pacers, miracle drugs, organ transplants, kidney dialysis machines, etc., can now keep people alive almost indefinitely<|>Despite these medical advancements being beneficial, they have also raised concerns about the quality of life extended to patients<|>There is a significant ethical dilemma in deciding whether to legalize methods like allowing patients to die, mercy death, or mercy killing, preferably in a painless manner, administered by doctors or with their assistance, to end lives perceived as miserable and meaningless with dignity
• Arguments Against Allowing Someone to Die

  • Abandonment of Patients
  • Possibility of Finding Cures
  • Impossibility of Opting for Death
  • Interference with God's Divine Plan
• Arguments for Allowing Someone to Die

  • Individual Rights over Bodies and Lives
  • Shortening of Suffering
  • Right to Die with Dignity
• Ordinary and Extraordinary Means


  Pope Pius XII distinguished between "ordinary means" and "extraordinary means" to determine the extent to which doctors are justified in preserving life<|>Extraordinary means involve significant burdens and are not obligatory indefinitely in hopeless cases<|>Ordinary means include treatments that sustain comfort without aggressive interventions
• Patient Self-Determination Act (PSDA)


  The U.S. Congress passed the PSDA in 1990, requiring healthcare providers to inform patients of their rights to make healthcare decisions and execute advance directives<|>It also mandates education for staff and the community about these rights<|>Key patient rights include: Considerate and respectful care, the right to collaborate with physicians in making healthcare decisions, and the right to acquire necessary information to make informed treatment decisions
• Notable Cases


  • Karen Ann Quinlan
  • Nancy Cruzan
• Advance Directives


  Address the moral issue of allowing individuals to die naturally<|>Assert patients' rights over their own bodies and medical decisions<|>Relieve families and medical professionals of the burden of decision-making<|>Types include Living Will, California Natural Death Act Declaration, and Durable Power of Attorney for Health Care (DPAHC)<|>DPAHC is considered more effective due to its legal standing and ability to designate a decision-maker<|>None of these documents authorize mercy death or euthanasia; they solely pertain to decisions about allowing natural death
• Hospice Approach to Care for the Dying

  Focuses on providing comfort rather than curing, aiming to help patients live as comfortably and meaningfully as possible until death<|>Involves a diverse team including patients, family, friends, medical professionals, clergy, social workers, therapists, psychologists, and volunteers<|>Addresses mental, emotional, social, and spiritual needs of patients and their families
• Mercy death


  Synonymous with assisted suicide, where a person requests that their life be ended, typically in a painless manner
• Motives for mercy death


  Patients may seek it because they are in severe pain, lack the ability to end their own lives, or feel they do not have the courage to commit suicide
• Allowing a patient to die

  Typically involves withdrawing or withholding life-sustaining treatment
• Mercy death


  Involves a deliberate act to end life directly at the patient's request
• Courts have wrestled with whether denying access to lethal medication constitutes unjustifiable discrimination under constitutional guarantees
• From a moral standpoint, mercy death raises complex issues about autonomy, suffering, quality of life, and the responsibilities of healthcare providers
• Arguments against mercy death

  • The irrationality of mercy death
  • The religious argument
  • The domino argument
  • The justice argument
  • The possibility of finding cures
  • The hospice alternative
• Mercy killing


  Also known as euthanasia, involves ending someone's life without their explicit consent, usually based on the belief that the person's life is no longer worth living due to extreme suffering or a perceived "meaningless existence"
• The primary ethical issue with mercy killing is the absence of informed consent from the individual whose life is being ended
• Mercy killing


  Contrasts with mercy death, where the individual explicitly requests to end their own life due to unbearable suffering or other reasons
• Arguments against mercy killing

  • Direct violation of the value of life principle
  • The domino argument
  • The possibility of finding cures
• Arguments for mercy killing

  • Mercy for the "living dead"
  • Financial and emotional burdens
  • The patient's desire to die
  • The possibility of legal safeguards