Why do lawmakers and the courts in the U.S. pretend that there is a meaningful distinction between active euthanasia (e.g., a lethal injection that causes no pain), and passively allowing someone to die by denying her food and water? Death will absolutely occur in both cases.
Who knows. I’ll vote for any party who would legalise voluntary euthanasia.
Because there is a meaningful distinction. If there weren’t, every time you walked past a starving homeless person and didn’t give them any food, then if that person later died of starvation or malnutrition, you’d be just as guilty of their death as if you had given them a lethal injection.
That is not the case, so obviously not going out of your way to help someone is neither the legal nor moral equivalent of going out of your way to harm them.
But the person who doesn’t give the hungry person food isn’t the caretake for that person, and isn’t preventing other people from giving that person food.
Wow. I didn’t know you could MAKE a veil that thin…
Briefly, it’s because a patient (generally) has the right to decline or discontinue a medical treatment even if they know it is going to lead to death. A competent type 1 diabetic has the right to not take his insulin, even though it will eventually lead to his death just as surely as removing Terri Schiavo’s feeding tube will. Similarly, I can’t force a patient to continue to be on a respirator or tube feedings when it is against the patient’s wishes.
However, doctors do not have the right to give treatments that are intended to lead directly to the patient’s death. So while patient autonomy means that the patient has the right to choose from among available medical treatments–including no treatment–active euthanasia is just not among available treatments.
Well, that’s basically what I’m asking — why? I know that medical codes of ethics prohibit this, and that’s all part of my question of — why?
It goes back to the nonmalfeasance principle–“first, do no harm”. It was not that long ago that the medical profession generally considered death to be the greatest harm that could come to a patient, though this was before we had a lot of the ability to keep patients alive indefinitely that we have now. So the idea going back just about as far as doctors themselves is that doing anything to intentionally cause someone’s death is absolutely contrary to what we do.
The tide is turning somewhat in this regard. The modern hospice movement is built on the assumption that when death is inevitable and imminent, there can be greater harm in trying to prevent it than in accepting it and providing comfort. This has not yet led to a widespread push for active euthanasia, though physician-assisted suicide in some cases is permissible in Oregon (though the US Dept. of Justice has promised to prosecute any doctor who provides it). Many doctors feel that it is territory that we don’t want to get into, especially since modern notions of comfort care mean that no one has to die in pain or discomfort. It may be something we see in my lifetime, though.
Walloon, there is a difference.
Even in Switzerland, where foreign nationals are permitted to travel for the purposes of PAS, the patient must SELF administer the Barbiturates. It is physician assisted in the sense that the drugs are provided, suicide in the sense that the person takes the drugs themselves. Most people would have less ethical issues with that, than with a lethal injection administered by a third party.
In the Netherlands, where active euthanasia is legal, palliative care is several years behind the rest of Europe. The reasoning being that it is not necessary to provide good palliative care if someone has the option of PAS or euthanasia.
Everyone deserves to die with dignity and with minimal pain. Personally, I feel that legal euthanasia (as opposed to PAS) is not only a slippery slope where people who do not wish to be euthanised will not receive adequate care, as there would be a general feeling that they’re hanging around needlessly and should just take the “easy” option, but where people who do not wish to be euthanised at all may be pressured into it.
I’m a medical student, I feel very uncomfortable with the idea that I would one day be expected to kill patients as a part of standard care. No matter how much they suffered and how much this was something they wanted, I would still refuse.
I find the idea of giving a person a morphine pump, and telling them exactly how to disable it so as to provide a lethal overdose (should they wish to), less icky. This is because it’s their decision and their action (the GMC disagrees with me, and any doctor who provides the means to a suicidal patient will be struck off and probably prosecuted).
Basically, my feelings are that if a terminally ill person wishes to commit suicide, or refuse medical care, all well and good- if they expect me to kill them, they can think again.
YOu will go down for murder if you fail to feed your ageing parent. So in that sense, the OP’s right. There is no difference.
There we go. As soon as a Christian shows up, the idea of self-inflicted “Guilt” shows its ugly head. Yes, dear, you are a sinner, because in your very righteous Christian ways, you keep on buying and selling property, pushing up the prices of Real Estate, thus depriving increasing number of people from affordable housing. Of course, you feel no “Guilt” about that – that is your “Business” – No guilt, no scruples.
Two questions for you:
1- Why did the previous Attorney General of the United States, the “born-again” John Asscrutch took it upon himself to interfere in the laws of the State of Oregon, trying his best to overthrow a popularly voted measure that allows assisted suicide for terminally ill – The only State in the Union that allows that.
2- Why is Dr. Kevorkian still in jail?
Really? I presume we’re talking US law here?
Perhaps there are new treatments available in palliative care that were unavailable just two years ago but my personal experience watching someone die is that at some point no comfort treatment is sufficient to ease a person’s suffering.
My wife’s uncle was dying of cancer…had been fro years and fought it but he was now at the end of his ordeal. I saw him in the hospital just 14 hours before he passed away. He was being heavily medicated to ease his pain. While it doubtless helped a lot he was still in extreme discomfort. He was delirious when he was awake and in apparent distress while sleeping. His family kept asking doctors to give him more medications to ease his pain but the doctors said they were at the limit of what they could do…any more would kill him and what he was on would be enough to kill any normal person (it was explained he had built a tolerance to the pain medications).
I would like to distinguish the case of my uncle (very similar thing also happened to my grandfather) from Terri Schiavo or Physician Assisted Suicide on someone who may be in pain but is conscious and should have weeks (or more) yet to live. My distinction is a person who is absolutely on their deathbed. It may be moments or a few hours to a day or two but it is abundantly clear to everyone that the person will not be leaving the bed alive…ever.
In cases like this I do nto see how “Do no harm” would restrict a doctor from euthanising the patient. In an instance such as I described above the doctor would be doing the patient and the family a favor. Certainly if the patient and/or family said they do not want euthanasia then the doctor should not do it. However, if the patient made his/her wishes clearly known ahead of time and the doctor then sees the patient in the literal final few hours of their life I do not see where the ethical impediment to actively euthanising the patient lies. Indeed, in my world view the unethical thing for the doctor to do is to leave the patient to suffer.
I would absolutely advocate active euthanasia for situations like the Schiavo case. If there is absolute certainty that there will be no recovery it should be a moral imperative to end it quickly. However, I think that there should be oversight so there are no mistakes.
That is, and has been, my only objection to the Schiavo case. Upon recognition that the person will not recover, once the order is given it should be quick, clean, and humane.
Based solely on what you’re saying here, these doctors were wrong. Tolerance to opiates is an unavoidable fact, and it is considered perfectly ethical to give as much morphine as it takes to make the patient comfortable, even if it is likely to hasten his death. In fact, I’d say it is unethical to not do so.
I don’t disagree with you there. I think that a lot of doctors would be comfortable with active euthanasia as long as the patient’s wishes are clear and they are guaranteed that they won’t get in any trouble over it; given Ashcroft’s response to the Oregon law (threatening to prosecute any doc who used it under DEA jurisdiction), that isn’t likely.
Libertarian here. If, being of sound mind, you can’t control when you end your life, what do you control? At least, that’s the way I’ve always seen it.
I certainly cannot fault the doctors not wanting to euthanise a patient if it results in the doctor being thrown in jail and certainly that seems to be the status quo today.
I brought up my example above as a way to see if there are situations that are pretty clear to everyone and where all but the most fervent opponents of euthanasia would agree that it is a situation where euthanasia is the best option. For a patient who is obviously mere hours away from death with literally zero hope of any kind of recovery and in a great deal of discomfort I cannot see how or why anyone would argue against helping the patient along.
When you get into cases of physician assisted suicide with a patient who is in chronic pain but may well live for many months (or longer) but wants to end it all I think the ethical problems multiply greatly. I absolutely feel that an individual should have control over their own death but now you are wandering into what amounts to suicide…just with someone else “pulling the trigger” (so to speak). If someone really was of sound mind and making a rational decision for themselves then having a doctor provide a painless means to end it all makes sense but deciding how rational the decision is and if it is a good decision for that person can get dicey (e.g. are family members who do not want to be bothered with further care a little too encouraging or is the patient in a depression or have all treatment options been exhausted, etc.).