The issue is whether the doctor must follow the request of the patient and stop treatment and allow her to die.
Michelle_Michy
20201003135042request_to_die_terminal_patients__1_.pptxEuthanasia and Physician-Assisted Dying
Chapter 3
Dr. W Abushahba
Euthanasia come from a Greek antiquity meaning “good death.”
A death free of pain and anxiety brought about by the use of medication
deliberately putting an end to someone's life in order to spare the individual's suffering
What is Euthanasia?
“Active Euthanasia”- taking specific steps to cause the patient's death
“Passive Euthanasia”- usually defined as withdrawing medical treatment with the deliberate intention of causing the patient's death; doctors not killing anyone, but not saving them
Difference? For active, something is done to end the patient’s life. For example, injecting a patient with a lethal substance is a type of Active Euthanasia. In passive, something is not done that would have preserved the patient’s life. A type of Passive Euthanasia would be “Pulling the plug.”
Types: Active vs Passive
Voluntary active euthanasia is when doctors intentionally inject lethal medication or other interventions to cause the patient's death at the patient's request and full consent.
Involuntary active euthanasia is intentionally administering medications or other interventions to cause patient's death when patient was competent but without the patient's explicit request and/or fully informed consent
Voluntary vs Involuntary
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Unbearable Pain
The major argument in favor of Euthanasia is that the person is suffering great pain
They argue that no person should live with the constant fear of dying or the pain associated with a terminal illness
This goes for both physical and mental pain
Right to Commit Suicide
In terms of Euthanasia, the right to commit suicide is associated with persons assisting the suicide
It is a quick solution to a dreadful problem
If they give consent, why is it wrong to assist in suicide?
Reasons for Euthanasia
Arguments For Euthanasia
Provides relief to patients with extreme pain
Provides a way of relief when a person's quality of life is low
Frees up medical funds to help other people
It is another case of freedom of choice
Arguments Against Euthanasia
Devalues human life
Morally incorrect
Physicians and other medical care providers should not be involved in directly causing death
Hippocratic Oath
“I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion”
In 1939, the Nazis created a program to secretly but systematically kill mentally and physically disabled people, including Germans, who were housed in institutions. The code name for this program was Aktion T-4.
Controlled euthanasia for terminally ill, handicapped & psychiatric patients
Handicapped, disabled children (early 1939)
Mentally ill, retarded adults (October 1939)
Criminally insane, epileptics, polio victims, schizophrenics, senile, paralyzed All valueless individuals: Jews, non-Germans
This led to millions being killed
The Nazi’s Slippery Slope into Euthanasia
The Netherlands became the first European country to legalize euthanasia in 2001, permitting it in the case of terminally ill patients who have no hope of recovery, suffer unbearable pain and ask to die.
Belgium has legalized euthanasia under strict conditions
France has passed a right-to-do law that empowers the terminally ill to refuse life-extending treatments but does not legalize euthanasia.
Switzerland allows passive assistance to terminally ill people who have expressed a wish to die, and the practice is common
Other Countries
The Oregon Experience
Oregon legalized physician-assisted suicide in 1997
Physician-assisted suicide: When a physician provides medications or other means to a patient with the understanding that the patient intends to use them to commit suicide
Since 1997 the rule in Oregon has been:
Doctors must agree that patients have less than 6 months to live and are mentally competent to make the decision.
The doctors can only prescribe the dosage not administer it.
ROMAN CATHOLIC : The use of euthanasia consists in putting an end to the lives of handicapped sick or dying persons. It is moral unacceptable.
ISLAMIC: Suicide and euthanasia are explicitly forbidden
"Do not kill (or destroy) yourselves, for verily Allah has been to you most Merciful" (Qur'an 4:29).
JUDAISM:
"...The message of Judaism is that one must struggle until the last breath of life. Until the last moment, one has to live and rejoice and give thanks to the Creator ..." Dr. Rachamim Melamed-Cohen, Jewsweek, March, 2002
Religion’s Perception
Only 1 out of 5 of his patients were terminally ill
Some patients were not ill, only depressed
Proposes doing experiments on people being killed to learn more about death.
He created “suicide centers” in Michigan, but later convicted by the owner.
Dr. Kevorkian
Assisted with one of his patients with death who was suffering from leukemia
In contrast to Dr. Kevorkian, he knew his patient and treated for a long time.
He wrote about her death in a medical journal and was prosecuted by the local district attorney for murder.
Dr. Quill
Dr. Anna Pou
On duty at Memorial Hospital when Hurricane Katrina struck on Aug 29, 2005
July 17 , 2006 Arrested under a judges warrant for four counts of second degree murder in connection of deaths with Life Care Patients
July 24, 2007 A grand jury refused to indict her and was cleared of all charges for second degree murder
Memorial Medical Center
Flooded in the Aftermath of Hurricane Katrina in 2005.
All electrical and plumbing functions failed due to flooding in basement
Temperatures Climbed to 110 degrees without water post Hurricane
2006 Hospital renamed to Oshner Baptist Medical Center
15
Horror at Memorial
Toilets overflowed, spilling feces and filth down the hallways, and there was no running water and scant communication between floors. Backup generators took over for a while, but by early Wednesday morning, the electrical grids in the basement that kept the generators going, also failed. The total blackout meant computers fell silent, cell phones could not be recharged and patients' life-support systems were useless.
Triage and DNR
A nurse wrote “1,” “2” or “3” on a sheet of paper with a Marks-A-Lot pen and taped it to the clothing over a patient’s chest
DNR or Do Not Resuscitate were generally given to patients in category 3.
Interview with Sheri Fink
Interview with Sheri Fink Regarding What happened in Katrina
