1
Q
dont start an essay with all of this
Introduction
A
- Euthanasia being morally acceptable or not will depend on which view of the value of life is correct
- ethical questions depending on end of life
- Whether individuals should be allowed to end their lives if not worth living.
- The distinction between forms of euthanasia: active euthanasia, assisted suicide.
- The ethical considerations of withholding or withdrawing medical treatment, known as Non Treatment Decisions.
- Euthanasia is illegal in the UK but permitted in some countries like the **Netherlands.
- Ethical debates around euthanasia typically explore:
- The religious concept of the sanctity of life vs the secular idea of quality of life.
- Voluntary euthanasia, where individuals choose to end their lives painlessly at their request.
- Non-voluntary euthanasia, where decisions are made for individuals unable to decide for themselves, often involving brain-dead
2
Q
Key terms
Non treatment decision
A
the descision medicals s make to withhold medical treatement that is keeping a person alive because they are not going to get better = sometimes refered to as passive euthanaisa
3
Q
key terms
active euthanasia
A
- a deliberate action performed by a third party to kill a person, for example by lethal injection = illegal in the UK
4
Q
key term
dignity
A
the worth or quality of life, which can be linked to sancity or freedom.
5
Q
Sanctity of life
& its relevance to the modern world
A
- God created human life, only God has the right to end it. Humans were created in God’s image,(Genesis 1:27) further suggesting that human life is especially valuable = SPARK OF DIVINITY
- Catholics would also think that Natural Law ethics provides justification for the conservative sanctity of life principle.
- SOL: supreme and intric value - life is the foundation of human experience and the protection of life. = there is specialness in humanity
- “Your body is a temple of the holy spirit, who lives in you and was given to you by God. You do not belong to yourself” (1 Corinthians 6:19).
- suggests our bodies is sacred and destroying it would be like destroying a temple. Gods gift,, therefore do not have the right to take our own life.
- some protestant traditions hold that the dignity, the image and likeness of God that human beings has at creation was largely lost due to the sin of Adam and Eve = suggests that human beings do not have the power of rational thought and will
- weak (life is a gift - not a burdern) vs strong (no expections) scancity of life
6
Q
other religious orgins of sancity of life
A
- Hebrews scriptures contain examples where the sancity of life might be questioned: such as God’s desctruction of Sodom and Gommorah, the command to Joshua to destroy the inhabitants of the Promised land because they were evil in God’s sights/command
- preserving the scancity of life may be a matter of obedience to religious authority = features free will, capacity for compassion
7
Q
problems with sanctity of life
A
- Alternatively, there is an overriding reason why euthanaisa particularly bad,such that there can be no qualifitying or justifying reason for permitting the breaking of a taboo - perhaps the conern should be the status of life and what the unintended consequences might be
- The weak sanctity of life view: believe the problem with the strong sanctity of life view is that it allows unnecessary suffering and is uncompassionate, seeming to ignore the demands of compassion. In some cases, then, compassion for the quality of life might outweigh the sanctity of life
- e.g. self-sacrificial acts = such as soliders fighting to protect others
8
Q
Types of Euthanasia
A
- Euthanasia the Greek translation means ‘good death’.
- Voluntary Euthanasia often called ‘assisted suicide’.
- Non-voluntary Euthanasia is when other people decide that it would be best if someone’s life ends- might have been in a coma for a long time
- Active Euthanasia is when action is taken to end a life e.g. Administering a lethal dose of pain killers.
- Passive Euthanasia Switching off life support
9
Q
The law on Euthanasia
A
- Suicide has been decriminalised.
- It is legally wrong to carry out active euthanasia – to perform an action that leads to the death of a person.
- It is also illegal to assist someone to commitsuicide.
- Currently, assisting a suicide is a crime in England and Wales and is punishable by up to 14 years in jail.
- Intentionally helping another person to kill themselves is known as assisted suicide - this can include buying someone a ticket to Switzerland - where assisted suicide is legal - to end their life.
10
Q
Quality of life
A
- other ideas have influenced the debate about euthanasia, particularly conneted with the notion of the quality of life. - an alternative thinking to the scanity of life
- this refers to certain attributes a person might have in order to have value.
- this arises the question of whether a life has personhood or automony
- Proponents of the quality of life in relation to euthanasia regard it as a valid ethical consideration because they think that life has to be of a certain quality in order for it to count as worth living. (the expereince, not the intristic qualities)
- it may seem the most compassionate thing to end life/stop the pain as intolerable pain, in most cases, (paralysed/suffer deterioration) adds nothing
- there is no hope of recourse, ending a life is the most compassionate thing
11
Q
the secular (non-relgious) origns of the concept of the quality of life
PERSONHOOD
A
- Peter Singer believes the quality of life to be an important factor in euthanasia.
- He goes as far as recommending non-voluntary euthanasia for babies whose potential quality of life is low,
- the idea of personhood seeks to individualistic
- Quality of life is often tied to personhood, raising questions about the worth of individuals with severely diminished higher functions.
- Ethical debates consider whether euthanasia is justified for those in irreversible comas or with effectively dead brains.
- The loss of self-awareness and consciousness could warrant euthanasia, especially in cases where technology artificially prolongs life.
- While turning off life support machines is not typically considered euthanasia, there’s debate over who defines personhood and its reliability.
- human development and potentiality poses challenges to defining personhood, especially in cases like newborns or indiviudals with different inner expereince. Judging the interior personhood of another is diffiuclt and may not be possible with confidence or accuracy
12
Q
Autonomy - and the right to end life
A
- Autonomy in end-of-life decisions allows individuals to choose their own path, including the option of assisted dying.
- John Stuart Mill advocated for individual autonomy in matters that do not harm others.
- Supporters of euthanasia argue for the same control over death should be the same as over life, emphasising personal autonomy and self-determination.
- theologian Hans Küng support the idea that individuals should have the responsibility to make conscientious decisions about the timing and manner of their deaths, reflecting on personal autonomy and freedom.
- opponents of euthansaia argue that the autonomous ‘right to die’ could become an indirect threat to others, epescially with those with low self-esteem = the ‘right-to-die’ might encourage them to do the action
- freedom comes with reasonable limitations and responsibilities
- If someone wants euthanasia then that is up to them, no matter the reason - thus voluntary euthanasia is wrong
13
Q
links to autonomy
Voluntary Euthanasia
A
- Voluntary euthanasia is often requested in difficult circumstances, such as progressive paralysis or loss of bodily functions.
- Requests may stem from serious distress or a perceived lack of quality of life.
- alternative to violent suicide methods.
- It allows individuals to maintain autonomy and enjoy life until they can no longer act meaningfully
- Proponents such as Glover argues against these objections, suggesting they stem from misconceptions or misapplications
- While morally permissible in principle, any system for voluntary euthanasia must carefully consider potential side effects and be legally regulated to prevent abuse and ensure patient safety.
14
Q
Voluntary Euthanasia
Acts and Omissions – The Hippocratic Oath
A
- Hippocrates wrote the Hippocratic Oath state: *I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies ofman or woman,’ The Hipocratic oath has informed the ethical code of doctors.
- However, in other writings he alsosuggested a doctor should ‘refuse to treat those who are overmastered by their disease realising that in such cases, medicine is powerless’
- This provides the basis for the modern distinction between acts and omissions.
- An act is one which causes death is morally and legally wrong.
- An omissionis where treatment isstopped or withdrawn so as not to prolong theinevitable death of the patient.
- there is moral difference brtween carrying out an action and merely omitting (stopping/refraining) carrying out an help - we are not legally obliged to help = peter - drowning kid
- Thishas led to thedevelopment of non-treatment decisions which areconsidered by many to be legal and ethical, although some are hotly contested.
15
Q
Non-voluntary euthanasia
A
- Non-voluntary euthanasia occurs without the individual’s request, with someone else deciding to end their life in their best interest.
- It raises ethical questions about compassion and the justification for taking a life.
- Options for moral framing include preserving life at all costs, limiting treatment to ordinary steps, or refraining from intentional killing.
- The distinction between removing burdensome treatment and deliberate killing is debated.
- Concerns about the slippery slope argue against unintended consequences and the potential for abuse.
- Singer describes an examples like the Alkmaar case in the Netherlands highlight legal and ethical dilemmas surrounding euthanasia.
- The desire for control over death challenges traditional ethical norms, with increasing acceptance of euthanasia in modern democracies.
- Slippery slope arguments raise concerns about potential future ethical dilemmas and the uncertainty of irreversible decisions.
16
Q
slippery slope argument
A
- Claims that if a rule is weakened even for good reasons, it can be weakened again through less justified reasons and it could eventually get out of hand (because the outcome is already accepted – so intention does not matter as much
- If euthanasia is permitted for those that requested, then logically it could be permitted for those that cannot request it
17
Q
Applying ethical theories to euthanasia
Natural law - Aquinas
A
- concerned with morally good actions and the goodness of those actions is determined by the divine-eternal law.
- Violating the sanctity of life, such as by allowing euthanasia, also violates the primary precept of maintaining an orderly society
- Natural law is the idea that God designed all things, including humans, with the potential to be in harmony if they follow God’s natural law, such as the preservation of human life
- Failure to follow this will therefore cause disharmony. Our society will break down because living contrary to God’s design is unnatural and thus leads to immorality and social disorder.
- Mother Theresa summed up this argument during her speech. She claimed “the greatest threat to world peace is abortion. If a mother can kill her own child in her own womb, what is left to stop us from killing one another?”
18
Q
Evaluation on natural law ethics and the sanctity of life is outdated
A
* Natural law ethics and the sanctity of life is outdated = it doesn’t actually come from God but was a reaction from Aquinas to socio-economic conditions that have changed overtime
* e.g. Medieval society had more chaotic, strict rules to hold society together = because people were not educated nor civilised enough to be trusted with the freedom.
* it made sense to create strict absolutist ethical principles to prevent society from falling apart. = such as the primary precept
* Applied to euthanasia, we can argue it was useful to simply ban all killing in medieval times, because violence and killing was much more common and therefore needed to be strongly restricted.
* The issue clearly is that all of these socio-economic conditions have changed. So, the primary precepts are no longer useful.
* They were designed for a different time and are now increasingly outdated.
* Society can now afford to gradually relax the inflexibility of its rules and think about how they might be reinterpreted to better fit modern society.
19
Q
Fletcher’s situation ethics on euthanasia
A
- Fletcher’s situation ethics prioritises individual situations and experiences over legalistic appraches to moral descion making
- It emphasises unconditional love and service to others as guiding principles in moral decision-making, including euthanasia.
- Fletcher argued that ethical decisions should be made based on understanding the situation fully, rather than relying on strict rules or regulations.
- He challenged traditional views by advocating for patient autonomy and dignity in death control, likening it to birth control.
- Fletcher believed that the quality of life was more important than the sanctity of life, identifying criteria for human personhood such as intelligence, self-awareness, and concern for others.
- Situation ethics could support different forms of euthanasia depending on the situation, but Fletcher did not promote euthanasia as a theory; rather, he advocated for moral decisions based on situational awareness and love, without strict adherence to legalism.
20
Q
Dscussing euthanasia
Is there a moral differnece between medical intervention to end a pateint’s life and non-medical intervention to end a pateints life?
A
- Non-treatment decisions involves withdrawing or refraining from administering medical interventions.
- Ethical behavior encompasses both actions and inactions, as failing to act can have moral consequences.
- all relies on the intention and nature of the action.
- Opponents of euthanasia argue that medical facilities seek to save or comfort life, whereas euthanasia clinics intend to end life, highlighting the distinction between refusing burdensome treatment and actively seeking death due to the perceived burdens of life itself.
- Refusal of non-painful, non-debilitating treatments differs from refusing basic care to hasten death, as it is based on alleviating suffering rather than viewing life as inherently burdensome.
21
Q
Does the religious concept of the sancity of life have any meaning in the 21st cent. medical ethics?
A
- Some argue that religious doctrines on sanctity have no place in modern moral decision-making, especially with advancements in medical science.
- However, others contend that sanctity serves to elevate the significance of life and reinforces the idea that every life should be respected and protected.
- The religious perspective holds that only God has the authority to give and take life, and intentionally causing one’s own death or suicide is seen as a rejection of God’s plan.
- While religious traditions emphasise the sanctity of life as a gift from God
- modern perspectives also recognise the intrinsic value of life and the importance of respecting and preserving it.
- The belief in the sanctity of life can extend beyond religious contexts, as many people view life as inherently valuable and deserving of protection, regardless of religious beliefs
22
Q
Discussing euthanasia
Should a person have complete autonomy over their life and the decisions made about it?
A
- Autonomy - our ability to make rational decisions
- Advocates of euthanasia argue that autonomy extends to the end of life, as choosing the circumstances of our death is seen as a fundamental aspect of human identity and freedom.
- However, there are challenges to this perspective. In many cases, death occurs beyond individual control due to illness etc leaving little opportunity for autonomous decision-making.
- such expereiences can overwhelm the idea of free decision-making at the end of life, which may undermine rationality.
- Additionally, there are concerns about the potential consequences of granting individuals the freedom to choose the time and manner of their death.
- This raises questions about the impact on others, the obligation of others to facilitate such choices, and the potential for abuse or misuse of the right to die.
23
Q
Case Studies
Dr Nigel Cox
A
- Dr Nigel Cox remains the only doctor ever to be convicted in the UK of attempting to perform a mercy killing. - he was found guilty of attempted murder after injecting 70-year-old with a lethal drug
- the medicine he had used would not alleviate pain, but instead stop Miss Boyes’ heart.
- The charge of attempted murder was brought because it could not be proved conclusively that the injection had killed her. Despite the verdict, Winchester Crown Court imposed a suspended sentence, while the General Medical Council let him off with a reprimand.
. During Dr Cox’s court case and subsequent appearance before the General Medical Council, Miss Boyes’ family never wavered in their support for the doctor’s actions.
Ethics
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