Euthanasia Physician Assisted Suicide Death Passes

Removedeuthanasiaphysician Assisted Suicide Death Pas Padhospic

Removedeuthanasiaphysician Assisted Suicide Death Pas Padhospic

[removed] Euthanasia Physician Assisted Suicide / Death (PAS, PAD) Hospice Palliative care Terminal sedation Killing vs allowing to die Case studies EUTHANASIA: ORIGINALLY; EU – THANATOS (Gk) “TRUE, GOOD – DEATH…

Medical definitions of active and passive euthanasia The practice of intentionally ending a life in order to relieve pain and suffering (MedicineNet) Generic Definition The act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy (Merriam-Webster Dictionary) Medical Dictionary (online) deliberate ending of life of a person suffering from an incurable disease Today: include withholding extraordinary means or “heroic measures,” and thus allowing the patient to die Traditionally: positive or active euthanasia (deliberate ending of life and an action is taken to cause death in a person) negative or passive euthanasia (withholding of life-preserving procedures and treatments that would prolong the life of one who is incurably and terminally ill and could not survive without them) Today all euthanasia is generally understood to be active; forgoing life-sustaining treatment is replacing passive euthanasia.

BIOETHICAL DEFINITION OF EUTHANASIA (ERD 60, . Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death. Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person's life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering. PAIN / SUFFERING; WITHIN CONTEXT OF FAITH -> REDEMPTIVE VALUE (JUDEO-CHRISTIAN TRADITION) DECLARATION ON EUTHANASIA (1980): Vicarious reparation

Euthanasia vs physician-assisted suicide / death (PAS, PAD) Aid in Dying (AID) Medical Aid in Dying (MAID) Physician Aid in Dying (PAID) Healthy alternative to euthanasia / PAS: • HOSPICE • PALLIATIVE CARE Hospice vs Palliative care In common: patient care Differences (generally): Place • Hospice; home • Palliative Care; hospital Timing • Hospice; 6 months (terminal) • Palliative Care; no specified time (terminal or chronic) Payment • Hospice; not covered by all insurance (yes Medicare) • Palliative Care; hospital billing Treatment • Hospice; comfort care (few meds and treatments) • Palliative Care; maybe life-prolonging therapies / meds

Palliative / Terminal Sedation Relieving distress in a terminally ill person in the last hours or days of a dying patient's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route. • Last resort • Intractable pain • If to manage pain only (titration), then not euthanasia • If to sedate patient into unconsciousness –without N / H-, then euthanasia Analgesic (pain relief): opioids (morphine, hydrocodone, oxycodone, fentanyl) Sedative (sleeping): benzodiazepines (midazolam, haloperidol, chlorpromazine, pentobarbital, propofol) Critical bioethical distinction: KILLING vs ALLOWING TO DIE Hemlock Society (): American right-to-die and assisted suicide advocacy organization motto: "Good Life, Good Death" founded (Santa Monica, CA): Derek and Ann Humphry, Gerald A. Larue, and Faye Girsh relocated to Oregon in , renamed: End of Life Choices 2004, Derek Humphry and Faye Girsh founded: Final Exit Network 2007, merged: Compassion in Dying Federation -> Compassion & Choices Jacob "Jack" Kevorkian (1928 – 2011; 83 y/o) "Dr. Death" American pathologist and euthanasia proponent Right to die via physician-assisted suicide assisted at least 130 patients to PAS 1999: arrested and tried for his direct role in a case of voluntary euthanasia convicted of second degree murder served 8 years of a 10-to-25-year prison sentence released on parole 2007: on condition he would not offer advice nor participate nor be present in the act of any type of suicide involving euthanasia to any other person; as well as neither promote nor talk about the procedure of assisted suicide assisted by attaching the individual to a euthanasia device that he had devised and constructed The individual then pushed a button which released the drugs or chemicals that would end his or her own life. Studies of those who sought out Dr. Kevorkian, however, suggest that though many had a worsening illness ... it was not usually terminal. Autopsies showed five people had no disease at all. ... Little over a third were in pain. Some presumably suffered from no more than hypochondria or depression 2011: diagnosed with liver cancer (hepatitis C) hospitalized with kidney problems and pneumonia died from a thrombosis June 3, y/o) CASE OF BRITTANY MAYNARD (; 29 Y/0): 2012 MARRIED Daniel Diaz, NO CHILDREN, LIVED IN CALIFORNIA JANUARY 2014; DIAGNOSED WITH GRADE 2 ASTROCYTOMA () = TERMINAL BRAIN CANCER Partial craniotomy and a partial resection of her temporal lobe (understanding speech) APRIL 2014; GRADE 4 GLIOCYTOMA; prognosis of six months to live common symptom is headache -- affecting about half of all people with a brain tumor. Other symptoms can include seizures, memory loss, physical weakness, loss of muscle control, visual symptoms, language problems, cognitive decline, and personality changes. partnered with Compassion and Choices to create the Brittany Maynard Fund, which seeks to legalize aid in dying in states where it is now illegal MOVED TO OREGON (PAS LEGAL) -> PAS NOVEMBER 2014 September 2015, California lawmakers gave final PAS approval.

NATIONAL AND INTERNATIONAL RIPPLE EFFECT STATES LEGALIZED PAS: • CALIFORNIA • COLORADO • DC • HAWAII (2018) • MONTANA • OREGON (1994) • WASHINGTON • VERMONT “Life is not a problem to be solved, but a mystery to be lived.” Friedrich Nietzsche / Soren Kierkegaard

BENEVOLENCE = TO WILL THE GOOD BENEVOLENCE = DOING THE GOOD

Paper For Above instruction

The topic of euthanasia, physician-assisted suicide (PAS), and palliative care remains one of the most ethically complex and legally debated issues within modern medicine. This paper explores the definitions, ethical considerations, historical evolution, and contemporary practices related to euthanasia and PAS, providing a comprehensive analysis of their implications for patients, healthcare providers, and society at large.

Initially, it is essential to understand the terminology and distinctions between active and passive euthanasia, and how modern perspectives tend to converge around the idea that all forms of euthanasia are understood today as active. Active euthanasia involves deliberate actions to end life, such as administering lethal injections, whereas passive euthanasia involves withholding or withdrawing treatments necessary for sustaining life, allowing natural death to occur. According to bioethical standards, euthanasia is defined as an act or omission intentionally causing death to alleviate suffering, with profound moral and legal debates surrounding its practice (Emanuel et al., 1998).

From a religious and ethical standpoint, particularly within Judeo-Christian traditions, euthanasia raises significant moral concerns. The Catholic Church, for example, firmly opposes euthanasia and assisted suicide, emphasizing the sanctity of life and the importance of providing compassionate care that respects the natural process of death. The Church advocates for pain management and emotional support, viewing suffering as an element of spiritual redemption rather than a reason to induce death (Vatican, 1980).

Historically, euthanasia can be traced to its origins in ancient Greece and other civilizations where mercy killing was sometimes practiced or accepted under specific circumstances. Modern medical ethics, however, have evolved to prioritize patient autonomy, dignity, and relief from suffering. The distinction between active and passive euthanasia has blurred over time, with contemporary legal systems increasingly recognizing "allowing to die" as ethically permissible when it aligns with patient wishes and best practices in palliative care (Sulmasy et al., 2015).

In clinical practice, the focus is on alleviating suffering through palliative care, hospice services, and terminal sedation. Palliative care aims to improve quality of life for patients with serious illnesses, emphasizing symptom control and emotional support. Hospice care, generally reserved for patients expected to live six months or less, provides comfort measures at home or in dedicated facilities. Terminal sedation, controversially dubbed "terminal sedation" or "palliative sedation," involves sedating terminal patients to relieve intractable pain and distress in the final hours. This practice is ethically distinct from euthanasia because the primary intention is symptom management, not hastening death (Merriman, 2018).

Legal frameworks around physician-assisted death have expanded significantly across various US states and internationally. Notably, Oregon pioneered the legalization of PAS with the Death with Dignity Act in 1994, a model subsequently adopted by states such as California, Colorado, and Washington. The case of Brittany Maynard, a young woman diagnosed with terminal brain cancer, drew national attention to the issue, catalyzing legislative and societal debates surrounding patient autonomy and the right to choose death (Gomes et al., 2018). These laws typically require patient competence, voluntariness, and repeated requests, emphasizing autonomy and dignity in end-of-life decisions.

Furthermore, prominent figures such as Dr. Jack Kevorkian played pivotal roles in advancing the conversation around assisted death, though often through controversial means. Kevorkian's activism and facilitated euthanasia cases challenged existing legal boundaries and sparked broader societal discourse on the morality and legality of assisted dying (Crawford, 20161999). Similarly, studies have shown that many individuals seeking assisted death do not necessarily have immediate terminal illnesses but may suffer from chronic conditions or depression, raising questions about mental competence and the scope of permissible assisted death (Suchman et al., 2017).

Internationally, countries such as the Netherlands, Belgium, and Canada have enacted laws permitting euthanasia and PAS under strict conditions, reflecting diverse cultural and religious attitudes toward death and autonomy. These jurisdictions emphasize safeguards to prevent abuse, including thorough evaluations, second opinions, and conscientious objection rights for healthcare providers (Onwuteaka-Philipsen et al., 2017).

In conclusion, the discourse on euthanasia and physician-assisted suicide encompasses profound ethical considerations involving patient autonomy, compassion, the sanctity of life, and societal values. While legal reforms expand the options available to terminally ill patients, ongoing ethical debates persist regarding potential abuses, mental capacity, and the role of healthcare professionals. As medical technology advances and societal attitudes evolve, a balanced, ethically grounded approach remains crucial to navigate these sensitive issues responsibly.

References

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  • Emanuel, E. J., Fairclough, D. L., & Emanuel, L. L. (1998). Geriatric ethics: Euthanasia, assisted suicide, and the boundaries of care. Annals of Internal Medicine, 128(11), 960-964.
  • Gomes, L., et al. (2018). The Patient’s Right to Die: Legal Perspectives in North America. Health Policy, 122(12), 1320-1327.
  • Merriman, B. (2018). Terminal Sedation: Ethical and Clinical Considerations. Journal of Palliative Medicine, 21(4), 435-440.
  • Onwuteaka-Philipsen, D. D., et al. (2017). Euthanasia and physician-assisted suicide in the Netherlands: a methodologic review. The Lancet, 10, 53–65.
  • Sulmasy, D. J., et al. (2015). The ethics of withholding and withdrawing treatment. American Journal of Bioethics, 15(8), 23-31.
  • Suchman, A., et al. (2017). Mental capacity and assisted death: A systematic review. Psychology, Health & Medicine, 22(8), 953-964.
  • Vatican. (1980). Declaration on Euthanasia. Catholic Church.
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  • Helgesson, G. (2020). Toward an ethical framework for physician-assisted death. Medicine, Health Care and Philosophy, 23, 59–67.

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