Euthanasia and Assisted Suicide

Does euthanizing animals lead to the devaluing of human life?

by Russell Powell
March 8, 2011

Not long ago a study on British veterinarian suicide rates [Bartram, D.J. and Baldwin, D.S., ‘Veterinary surgeons and suicide: influences, opportunities and research directions’, Veterinary Record 162(2): 36-40] received a bit of media attention when it reported that veterinarians in Britain have a suicide mortality rate that is four times that of the general population and more than twice that of other high-risk healthcare professionals such as pharmacists, doctors and dentistsRead More »Does euthanizing animals lead to the devaluing of human life?

Ethical Lessons From Locked-In Syndrome: What Is a Living Hell?

by Julian Savulescu
February 25, 2011

A recent important study by Stephen Laureys and colleagueson what it is like to be to experience severe brain damage has been widely reported. (eg, http://abcnews.go.com/Health/Wellness/locked-patients-life/story?id=12984627). Laureys and colleagues surveyed the views of people with “locked-in” syndrome. This syndrome, which typically occurs after certain kinds of stroke, results in the person unable to move his arms or legs and unable to speak. In some cases, they can move their eyes and communicate through eye movements but in other cases, the eyes are paralysed. They are awake and aware.

Many people would think this is a living hell, imprisoned in one’s own body, with limited if any means of communication. But Laureys et al found differently when they actually asked patients who were in this condition. According to the ABC,

“More than half of patients coping with a form of nearly complete paralysis called locked-in syndrome indicated — through eye blinks in some cases — that they were getting some satisfaction in life, though 8 percent had often thought of suicide.

“Among 65 patients who had developed the syndrome a median of eight years previously, only 18 characterized their lives as “somewhat on the bad side” or worse… Seventeen patients indicated that they felt as well, or almost as well, as in their happiest times before becoming locked-in. Another 21 gave their overall quality of life lesser but still positive marks.”

So what can we learn from this study?Read More »Ethical Lessons From Locked-In Syndrome: What Is a Living Hell?

Greeks and geeks

by Charles Foster
July 15, 2010

At Harvard Medical School someone is screaming, reports the Boston Globe. ‘Death!’, he shrieks, ‘Why after all these years have you not appeared?’ He begs for euthanasia, tormented by his pain. Medical students listen to him.

His lines were written by Sophocles, and the students are listening because they have to: it is part of their curriculum.

The remarkable thing is not that Harvard medical students are being marinated in Sophocles, but that the Globe thought it worth reporting. Most medical students in mainstream western universities will get some ethics teaching. Sophocles is just one tool in the teachers’ toolkit. It’s a very effective one, by all accounts, but no different in kind from the lectures and seminars more conventionally deployed. Ethics teaching aims to teach students some problem-solving strategies, and to help them to recognise, evaluate, criticise, cull or cultivate the values that they themselves bring to the wards.

Between Life and Death…

by Practical Ethics
July 14, 2010

A powerful BBC documentary, “Between Life and Death”, screened this evening on BBC One. The documentary (which can be viewed online for the next week in the UK) examined the life and death decisions made for critically ill patients with severe brain injury. Neuro-intensive care provides a way to interrupt the process of dying for such patients. But it raises difficult questions for medical staff and for families about the wishes of patients, the wishes of family members, and about uncertainty. Should treatment continue at the risk of the patient surviving in a severely impaired state? Or should patients be allowed to die, with the risk that perhaps if treatment had continued they may have recovered?

Choosing how to live: death row inmates and terminally ill patients

by Practical Ethics
June 23, 2010

by Shlomit Harrosh

Convicted murderer Ronnie Lee Gardner was killed by gunfire on July 18, 2010. Given the choice between lethal injection and being shot, Gardner opted for the firing squad. This was the first firing squad execution in the state of Utah since 1996.

In the 37 states where the death penalty is in practice, lethal injection is the primary method of execution. Alternative methods are provided in 20 states, contingent upon the prisoner’s choice, the date of execution or sentence and the constitutional standing of the method used. In Virginia, for example, a convicted murderer can elect to be executed either by lethal injection or electrocution, while in Washington prisoners are executed by lethal injection unless they choose death by hanging.
Assuming that it is a good thing for prisoners to have some choice as to their method of execution, what does this tell us about the morality of voluntary euthanasia in terminally ill patients?

A costly separation between withdrawing and withholding treatment

by Practical Ethics
June 17, 2010

by Dominic Wilkinson

Television child star Gary Coleman died recently following a severe brain haemorrhage. He was taken to an intensive care unit, but the next day was taken off life support because of the severity of his brain injury.

Decisions like the one made by Gary Coleman’s doctors are common in intensive care. Many deaths follow decisions to stop intensive treatment because it is believed to have no chance of succeeding or because of the burden of illness even if the treatment does work. One question raised about cases like these is about the importance (or risks) of living wills. A separate question (and one that was raised during the critical care grand round earlier today) is about the difference between stopping treatment and failing to start treatment.

Critical Care ethics grand round

by Practical Ethics
June 17, 2010

by Dominic Wilkinson

Today I gave a talk at the John Radcliffe Medical Grand Round on Advance Directives and treatment withdrawal decisions in intensive care – based on a case I was involved in last year.

A middle-aged patient presents with acute respiratory failure, and is intubated and transferred to the intensive care unit. After admission he improves, but it transpires that he has a progressive neurodegenerative disorder and has previously expressed a wish not to have intensive life support measures provided.

Whether to die, or when to die? The distinction between assisted suicide and ‘aid in dying’

by Tom Douglas
June 14, 2010

Assisted suicide is illegal in the state of Connecticut. But two doctors have sought to circumvent the law by requesting that the administration of lethal agents to terminally ill patients be classed as “aid in dying” rather than assisted suicide. The doctors’ lawyers reportedly drew the distinction as follows:

"Suicide is a choice of whether to die or not. Aid in dying involves not whether a person will die, but when, and how much pain and suffering the patient must endure first."

The judge, Julia Aurigemma, rejected the request, arguing that the cases in question are precisely the sort of case to which the assisted suicide prohibition was intended to apply. But the question remains whether there is a meaningful distinction between assisted suicide and aid in dying, and if so, whether it is morally significant.

The distinction, as formulated by the lawyers, does seem clearly bogus. No-one yet faces choices about whether to die. All actions that might plausibly be classed as suicide are really decisions about the timing of death. But there does seem to be a genuine distinction lurking here somewhere.

Organ Donation Euthanasia

by Dominic Wilkinson
May 10, 2010

by Dominic Wilkinson and Julian Savulescu

There are 8000 patients on transplant waiting lists in the UK. Every year 400 patients die while waiting for an organ to come available.
We are all far more likely to be in need of an organ transplant than to be a donor. Most of us expect that if we needed a transplant that someone would donate one. On the basis of the ethical golden rule – do unto others as you would want them to do for you, we should all think seriously about whether and how we could donate our organs if we no longer need them.

Ending It, in Paternia

by Simon Rippon
February 18, 2010January 19, 2011

In the Republic of Paternia there has, of late, been a vigorous debate on the question of whether the law should change to permit marital separation in some circumstances. Some desperate Paternian couples have been illegally travelling abroad to engage in marital separations in Switterland (where they are permitted for now, though the Switts are becoming uncomfortable with their country’s renown for so-called “separation tourism”). Some of these couples have been dragged through the Paternian courts on their return. Sympathetic juries have often chosen to acquit, recognizing that their situations had become unbearable, that they had separated consensually, and that legal enforcement of their cohabiting marital relationship would only have prolonged their suffering. Moreover, prosecutors in Paternia have for a long time only selectively prosecuted cases of marital separation that illegally took place abroad.