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Euthanasia. Decisions at the end of life. What is Euthanasia?. Euthanasia means “a good death,” or “dying well.” What is a good death? Peaceful Painless Lucid With loved ones gathered around. Some Initial Distinctions. Active vs. Passive Euthanasia

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Presentation Transcript

  1. Euthanasia Decisions at the end of life

  2. What is Euthanasia? Euthanasia means “a good death,” or “dying well.” • What is a good death? • Peaceful • Painless • Lucid • With loved ones gathered around

  3. Some Initial Distinctions • Active vs. Passive Euthanasia • Voluntary, Non-voluntary, and Involuntary Euthanasia • Assisted vs. Unassisted Euthanasia

  4. Active vs. Passive Euthanasia • Active euthanasiaoccurs in those instances in which someone takes active means, such as a lethal injection, to bring about someone’s death; • Passive euthanasiaoccurs in those instances in which someone simply refuses to intervene in order to prevent someone’s death.

  5. Criticisms of the Active/Passive Distinction in Euthanasia • Vague dividing line between active and passive, depending on notion of “normal care” • Principle of double effect • Does passive euthanasia sometimes cause more suffering?

  6. Compassion for Suffering • The most important question when lives are ending is: how do we respond to suffering? • Hospice and palliative care • Aggressive pain-killing medications • Sitting with the dying • Euthanasia

  7. The Sanctity of Life • Life is a gift from God • Respect for life is paramount • Importance of personhood • The approach of Natural Law • Importance of ministering to the sick and dying • See life as “priceless” (Kant) • Respect for life once the dying process has begun

  8. The Quality of Life • Peter Singer – low quality of life justifies ending a life • BUT what is quality of life – is it more than can be judged medically? • Would extraordinary means improve the quality of life of a patient? • Refusal of medical treatment

  9. The Right to Die • Do we have a right to die? • Negative right (others may not interfere) • Positive right (others must help) • Do we own our own bodies and our lives? If we do own our own bodies, does that give us the right to do whatever we want with them? • Isn’t it cruel to let people suffer pointlessly?

  10. Two ethical approaches • A Utilitarian approach, which emphasises consequences • A Kantian approach, which emphasises autonomy, rights, and respect

  11. The Utilitarian approach • Goes back at least to Jeremy Bentham (1748 – 1832) and John Stuart Mill (1806-73) • The greatest good for the greatest number

  12. Main Tenets • Morality is a matter of consequences • We must count the consequences for everyone • Everyone’s suffering counts equally • We must always act in a way that produces the greatest overall good consequences and least overall bad consequences.

  13. The Calculus • Morality becomes a matter of mathematics, calculating and weighing consequences • Key insight: consequences matter • The dream: bring certainty to ethics

  14. What is a good death? • Jeremy BenthamHedonistic utilitarians: a good death is a painless death. • John Stuart Mill Eudaimonistic utilitarians: a good death is a happy death.

  15. Euthanasia and personal autonomy • John Stuart Mill – in matters which do not concern others, individuals should have full autonomy • Should a competent adult be allowed to decide the time and circumstances of their death?

  16. The Kantian Model • Central insight: people cannot be treated like mere things. • Key notions: • Autonomy & Dignity • Respect • Rights

  17. Autonomy & Respect • Kant felt that human beings were distinctive: they have the ability to reason and the ability to decide on the basis of that reasoning. • Autonomy = freedom + reason • Autonomy for Kant is the ability to impose reason freely on oneself.

  18. Protecting Autonomy • Advanced Directives are designed to protect the autonomy of patients • They derive directly from a Kantian view of what is morally important.

  19. Autonomy: Who Decides? • Kantians emphasize the importance of a patient’s right to decide • Utilitarians look only at consequences – but it can justify too much, as there is no protection for the minority or safeguarding of the individual’s rights

  20. Conclusion • Many of the ethical disagreements about end-of-life decisions can be seen as resulting from differing ethical frameworks, especially Kantian vs. Utilitarian. • or Quality of Life vs. Sanctity of Life

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