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Euthanasia and Assisted Suicide

Patient L’s Autonomy

‘Patient L’ is a man in a vegetative state, under the care of Pennine Acute Hospitals Trust. The Trust has placed a Do Not Rescuscitate order in his notes, yet his family claim that he himself would want to be revived if his condition deteriorated, because of his faith in Islam. The court of protection has now decided in favour of the Trust.

The Trust’s claim is that it is in Patient L’s best interests to be allowed to die, whereas Patient L himself – if we are to believe his family (and there seems little reason not to) – would almost certainly disagree. Read More »Patient L’s Autonomy

Physician Assisted Suicide and the Conflict Between Autonomy and Non-Maleficence

In the run-up to the 6th November ballot in Massachussets concerning the prescription of medication to end life, two prominent US physicians, Dr. Ronald Pies and Dr. John Grohol, have been debating the pros and cons of physician assisted suicide (PAS). In his article, Dr Ronald Pies argues against the legalisation of PAS, claiming in the title of his essay that “medical ethics must sometimes trump patient choice”. Although Pies’ acknowledges that respect for autonomy is one of the four cardinal principles in medical ethics, he goes on to claim that “. . . medical ethics must set limits on a patient’s autonomous requests” in the light of another of these cardinal principles, namely the principle of non-maleficence. What are we to make of this claim?Read More »Physician Assisted Suicide and the Conflict Between Autonomy and Non-Maleficence

Euthanasia and Human Rights

Tony Nicklinson is 58, and suffers from locked-in syndrome. His mind is as sharp as it ever was, but for the last seven years, as the result of a stroke, he has been entirely physically dependent on others, able to move only his eyes and eyelids. Just recently, his condition has worsened, and he is… Read More »Euthanasia and Human Rights

How Tony Nicklinson Already Has the Right to Die

According to a BBC report, Tony Nicklinson, 58, from Melksham, Wiltshire, has “locked-in syndrome” after a stroke in 2005 and “is unable to carry out his own suicide.” “He is seeking legal protection for any doctor who helps him end his life.”

In fact, it is not quite correct that Tony Nicklinson “is unable to carry out his own suicide.” He could at present refuse to eat food or drink fluids. Hunger strikers do this for political reasons. He could do it for personal reasons. People should not be force fed against their own autonomous wishes.

Now suppose that Tony did refuse to eat or drink, because he wanted to die because he found a life locked-in to be intolerable. He would die in weeks, perhaps less. Given that he will die, he should be given medical treatment to make his last weeks as comfortable as possible. He should be given sedation and analgesia. He could even be given such doses that render him unconscious.

Such a process already happens, int he UK, in a slightly different way. In the famous case of Tony Bland, law lords authorized the removal of a feeding tube that was keeping Tony Bland, who was permanently unconscious. They, his family and doctors all judged that continued life was not in his interests.

Read More »How Tony Nicklinson Already Has the Right to Die

Nothing to lose? Killing is disabling

In a provocative article forthcoming in the Journal of Medical Ethics (one of a new series of feature articles in the journal) philosophers Walter Sinnott Armstrong and Franklin Miller ask ‘what makes killing wrong?’ Their simple and intuitively appealing answer is that killing is wrong because it strips an individual of all of their abilities – acting, moving, communicating, thinking and feeling.

So what, you might ask? If this is right, say Sinnott-Armstrong and Miller, it means that it would be just as bad to commit an act that caused someone to be in a permanent vegetative state, as it would to kill them.Read More »Nothing to lose? Killing is disabling

Ending life and end-of-life care

Eve Richardson, chief executive of the National Council for Palliative Care and the Dying Matters coalition, argues that the government needs radically to improve end-of-life care in the UK, and makes several excellent suggestions about how that might be done. I agree wholeheartedly, and would like to add a suggestion of my own: that end-of-life… Read More »Ending life and end-of-life care

Choosing To Die

Matthew Rallison is a sixth-form student who is visiting the Oxford Uehiro Centre for Practical Ethics for his work experience placement.

Sir Terry Pratchett’s documentary, “Choosing to die” and the recent deaths of Ann McPherson and Jack Kevorkian (inventor of the Mercitron) have recently raised the debate of the legalisation of euthanasia, alongside criticism of the BBC’s bias favour towards the subject.

The latter of these issues is, to an extent, accurate as the programme echoes Pratchett’s support of euthanasia. Yet the conclusion of the programme, for me, offered personal reflection, rather than an affirmation that euthanasia (or assisted suicide) is morally correct. Watching, on screen, the death of Peter Smedley was not a compelling argument but humbling. Peter was unassuming as he fell out of consciousness. “A good death,” as Pratchett describes it. The scene offered a powerful impression of human dignity and spirit, rather than promoting death, or suicide. It supported virtue in life (or in leaving it). I reject the ex-Bishop of Rochester, Michael Nazir Ali’s claim that it the programme depicted “glorified suicide.” It did not.

Read More »Choosing To Die

Suicide for sale in Oregon: a “valuable service”?

Oregon is currently the scene of a controversy about the sale of so-called “suicide kits” or “helium hoods” (see here and here). These kits are sold by mail by a two-person company called The Gladd Group; one of its owners is reported to be a 91-year-old San Diego County woman who has been selling the kits for four years. The device is now receiving increased media attention following the suicide, with the help of the helium hood kit, of 29-year old Nick Klonoski, who had health-related issues that had brought him into depression, but was not terminally ill. His tragic death has now sparked a movement to outlaw the sale of those kits in Oregon. However, the woman selling the kits protests that she is providing a valuable service, and is quoted as saying that “[i]t is not my intention to hurt anybody, but to offer people comfort when they die”. Is the sale of those suicide kits a legitimate form of business, or should it be banned?

Read More »Suicide for sale in Oregon: a “valuable service”?

The patient vanishes

by Dominic Wilkinson

If a patient’s family refuse to allow withdrawal of breathing machines should doctors provide long-term support in an intensive care unit for a patient who is clinically brain dead? Should doctors provide heart-lung bypass (ECMO) for a child with anencephaly? Should doctors perform a tracheostomy and provide a long-term breathing machine for a patient in a documented persistent vegetative state?Read More »The patient vanishes