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Right to Die. Right to Die. Choices for dying patients and their families due to technology What constitutes a “good death” Most people die in hospitals with staff trying to keep patient alive until no chance of recovery Most people want total effort to fight off death.
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Right to Die • Choices for dying patients and their families due to technology • What constitutes a “good death” • Most people die in hospitals with staff trying to keep patient alive until no chance of recovery • Most people want total effort to fight off death
Some are facing a terminal illness There may come a point when the fight no longer seems worth it Those patients may find their wishes and those of their families overlooked as physicians juggle medical, legal and moral considerations
Patients undergoing minor surgical procedures are routinely asked if they would like to fill out a document, known as an “advance directive” or “living will”
Living Will • Every state now allows people to issue form of directive • Specifies what course of action they want if they are unable to communicate • Only 40% of people have living wills • Not always binding
Court rulings have firmly established a patient’s legal right to discontinue life sustaining treatment, such as respirators or artificial nutrition Debate over these decisions is far from settled- Terri Schiavo’s case went on for 12 years
Another issue is whether individuals should be able to ask physicians to hasten their deaths- in effect, help them end their lives- and whether it is morally acceptable for physicians to do so
Right to Die • Should individuals be able to ask doctors to hasten their deaths? • Who decides whether life is worth living or not? • Should others (families, doctors, government) be able to decide for them?
Many people say they would rather die than suffer in great pain or endure life trapped in a vegetative state Should individuals have the right to decide when and how they will die?
What is considered unbearable? Terminal illness? Chronic physical pain? Debilitating, although not fatal, illness?
Right to Die • Euthanasia: hastening the death of a terminally ill patient- • Is it mercy and respect? • Or is it murder?
Right to Die • Euthanasia: • Is it a measure of control over timing, or is it a slippery slope of neglect of old, poor, disabled, emotionally distraught, seriously ill?
Right to Die • Religious and moral questions: • Life and death should be left for God, not human beings • Life is to be cherished, not abandoned
Right to Die • Netherlands, Belgium, Switzerland, Luxembourg- physician assisted suicide is legal • United States: Oregon and Washington permit physician assisted suicide- Montana and Massachusetts have tried to make it legal but so far it has failed
“Death with Dignity Act” • 1994 • Oregon • Doctors can prescribe lethal dose but not give it • Ensure patients seeking this to be mentally competent, in great pain, intent on ending their life
Dr. Jack Kevorkian • Michigan • Helped 130 people commit suicide • Sentenced to prison for 10-25 years • Served 8 years in a Michigan prison for administering a fatal injection to a terminally ill man
Karen Ann Quinlan • 21 yrs old • April 15, 1975, took alcohol and drugs • Full blown coma • Doctors pronounced her condition a “persistent vegetative state”
Karen Ann Quinlan • Doctors said most basic life processes could be kept going, but she had ceased to be a human being • Or had she? • EEG detected traces of electrical activity in her brain • Machine said she was not “brain dead”
Karen Ann Quinlan • Her parents were deeply religious • Felt that she had the right to “die with dignity” • Tried to get respirator turned off • New Jersey Superior Court rejected plea after 7 months on respirator
Karen Ann Quinlan • “This is not a court of love, of compassion, but a court of law. You can’t just extinguish life because it is an eyesore.” said her court appointed guardian • New Jersey Supreme Court overturned decision March 31, 1976
Karen Ann Quinlan • Everyone thought she would die very soon from brain death • She lived for 10 years without a respirator • Died in 1986 from pneumonia
Terry Schiavo • Brain damaged patient • No living will • Family was divided • Years of litigation • Husband eventually won to have feeding tube removed
Terry Schiavo • Increased public interest in living wills • 20 states have issued bills to clarify laws about living wills
Right to Die • Perspective 1 • Recognize the right to die with dignity, with a physicians assistance • Permit people to have a “humane” death • Individuals have the right to determine the time and circumstances of their death
Right to Die • Perspective 2 • Focus on giving comfort and recognizing the patient’s preferences • Recognize patient’s right to control the treatment they receive- relieve pain and ease the depression the patient is experiencing
Improve the quality of life for the patient Allow patient to issue directives, not just preferences, about end of life care and treatment Expand hospice care Remove barriers to effective pain management- such as overly restrictive regulation of narcotics
Right to Die • Perspective 3 • Reaffirm the commitment to preserve life • Condemn practice of physician assisted suicide • It should be illegal • Unconditional value of human life
Except when patients explicitly decline further treatment, physicians must make every effort to sustain life Any compromise in the commitment of medical professionals to protect and extend life would undermine the public’s faith in the medical profession
