slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Assisted Suicide and Euthanasia PowerPoint Presentation
Download Presentation
Assisted Suicide and Euthanasia

Loading in 2 Seconds...

play fullscreen
1 / 17

Assisted Suicide and Euthanasia - PowerPoint PPT Presentation


  • 122 Views
  • Uploaded on

Assisted Suicide and Euthanasia. Michael Wassenaar, PhD February 16, 2012. Goals. Identify arguments on both sides of ethical debate Understand significant ethical distinctions Practice respectful conversation. 2. Withholding/withdrawing life support.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Assisted Suicide and Euthanasia' - demetrius-daniels


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Assisted Suicide and Euthanasia

Michael Wassenaar, PhD

February 16, 2012

slide2

Goals

Identify arguments on both sides of ethical debate

Understand significant ethical distinctions

Practice respectful conversation

2

withholding withdrawing life support
Withholding/withdrawing life support
  • No ethically relevant distinction between withholding and withdrawing.
    • Both are question of harms and benefits.
  • W/w life support is not assisted suicide or euthanasia.
    • Intention matters: intention is not to kill, but to prevent harm and allow disease/condition to run its course
  • Killing vs. letting die
slide4

“[W]hen a patient refuses life-sustaining medical treatment, he dies from an underlying fatal disease or pathology; but if a patient ingests lethal medication prescribed by a physician, he is killed by that medication.”

  • US Supreme Court, Vacco v. Quill, 1997
slide5

The principle of double effect

Is it ever morally acceptable to administer a drug that may hasten the patient’s death?

Does this count as assisted suicide?

5

slide6

Principle of double effect

EFFECT 1

(intended)

ACT

EFFECT 2

(unintended)

Principle of double effect: there is a morally significant difference between A-E1 and A-E2.

6

slide7

Principle of double effect

Relieve symptoms

Administration of IV morphine

Hasten death

7

continuous deep sedation
Continuous deep sedation
  • Evidence suggests CDS hastens death
  • Does the principle of double effect apply?
  • It depends: Is unconsciousness, or death, the means to symptom relief?
  • If death is intended as the means, then it counts as killing (ie, double effect does not exonerate).
  • Palliative vs. terminal sedation
slide9

Terminology

Suicide: Intentionally ending one’s own life

Assisted suicide: Clinician assists patient to perform an act that is intended to end his/her life

Euthanasia: Clinician acts intentionally to end a patient’s life

  • From the Greek: eu (good) + thanatos (death)

9

slide10

Historical context

  • Ancient Greece and Rome tended to be tolerant
  • Hippocrates represented the minority view:
    • “I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect” (Hippocratic Oath)
  • Historically, Christianity opposed suicide and endorsed Hippocratic view

10

slide11

Contemporary context

  • Legal in 6 countries: Albania, Switzerland, Belgium, Netherlands, Luxembourg, Columbia
  • Legal in 3 US states: Oregon (1994), Washington (2008), Montana (2009)
  • Between 1994 and 2010, there were 75+ legislative bills to legalize assisted suicide in at least 21 states
  • AMA, ACP, ASIM do not support legalization
  • MedScape.com survey, 2010

“Should physician-assisted suicide be allowed in some situations?”

Yes: 45.8% No: 40.7% It depends: 13.5%

11

motivations
Motivations
  • Loss of autonomy
  • Loss of dignity
  • Inadequate pain/symptom control
  • Depression
  • Abandonment
  • Burden on family
  • Self-image
  • Prospect of long-term care
  • Finances
slide13

In Oregon

Oregon Death with Dignity Act passed in 1994, implemented in 1997.

Safeguards:

  • Terminally ill (6 month prognosis)
  • Mentally competent
  • Confirmed by a second opinion
  • Waiting period of two weeks

Lower rates than rest of nation (?)

13

slide14

Main arguments: Pro

Killing is not always murder (e.g. self-defense, warfare, capital punishment).

Respects the patient’s autonomy.

Relieves the patient’s suffering.

Safeguards can mitigate abuse.

14

slide15

Main arguments: Con

It is not our right

Corrupts traditional role of health provider

Erodes trust

Risks abuse

Slippery slope

15

ethical vs legal
Ethical vs. Legal
  • If one believes assisted suicide may be justified in some cases, it does not necessarily mean it should be legal.
  • Recall utilitarianism: What would the consequences be if something became a general rule?
slide17

How to respond?

Clarify the Request

Determine the Root Causes

Affirm Your Commitment to Care for the Patient

Address the Root Causes of the Request

Educate the Patient About Legal Alternatives for Control and Comfort

Consult With Colleagues

Source: Endlink Resources for End of Life Care Education. http://endoflife.northwestern.edu/eolc_physician_assisted_suicide_debate.cfm

17