What portions of the cited decisions are you referring to?
I’m not aware of any law against asking people to kill you. You can ask people to kill you all day long. No one’s obligated to do it.
The portions which refer to double effect being acceptable.
Post #6 assumes values inherent to religiously motivated beliefs on human life that I do not subscribe to
Intentional kill is bad if its non-consensual but rewarding if its consensual. Human life need not be preserved, it has no value except to those it belongs to
Death is not a “public health” problem, dying is. By definition, death removes the problem.
Integrity and ethics are poor beliefs to fall back into when there is suffering. Death eliminates suffering. One should not be forced to live so that another can be psychologically appeased.
I don’t think there is enough pressure on vulnerable groups to kill themselves. Even if there is, so what?
Slippery slope is not an argument, and misses the point that death is not a negative. If many people die, so what?
By the way Bricker, you probably shouldn’t say a post “refutes” anything. Rather it debates it and presents a different viewpoint. Saying “refute” sounds like its the only correct belief
So the answer to my original request was “no”, then, because you were talking out of your arse.
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Perhaps you could point us to SCOTUS’ support for this practice.
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They are the two cites to SCOTUS’ acceptance of the common law concept of double effect given by the standard text on Medical Ethics. The rule of double effect is based on intentionality and is deeply rooted in English Common law and Catholic ethics.
I can give you a reference online to the Wikipedia article on the latter judgement which was based on the first.
“In cases of terminally ill patients who would hasten their deaths because of unbearable pain, or whose caregivers would do so for them (euthanasia, physician-assisted suicide, etc.), a principle of “double effect death” could be applied to justify the deliberate administration of a pain-killer in potentially unsafe doses — not in an attempt to end life, but with a conscious disregard of the possibility. The U.S. Supreme Court has voiced support for this principle in its deliberations over the constitutionality of physician-assisted suicide.”
AND
https://www.law.cornell.edu/supct/html/95-1858.ZO.html
Respondents also argue that the State irrationally distinguishes between physician assisted suicide and “terminal sedation,” a process respondents characterize as “induc[ing] barbiturate coma and then starv[ing] the person to death.” Brief for Respondents 48-50; see 80 F. 3d, at 729. Petitioners insist, however, that " `[a]lthough proponents of physician assisted suicide and euthanasia contend that terminal sedation is covert physician assisted suicide or euthanasia, the concept of sedating pharmacotherapy is based on informed consent and the principle of double effect.’ " Reply Brief for Petitioners 12 (quoting P. Rousseau, Terminal Sedation in the Care of Dying Patients, 156 Archives Internal Med. 1785, 1785-1786 (1996)). Just as a State may prohibit assisting suicide while permitting patients to refuse unwanted lifesaving treatment, it may permit palliative care related to that refusal, which may have the foreseen but unintended “double effect” of hastening the patient’s death. See New York Task Force, When Death is Sought, supra, n. 6, at 163 (“It is widely recognized that the provision of pain medication is ethically and professionally acceptable even when the treatment may hasten the patient’s death, if the medication is intended to alleviate pain and severe discomfort, not to cause death”).
These religious people man…
I think it should absolutely be legal. I mean if it’s consensual and he or she is going to die soon anyway and is in so much pain, it’s much more humane to listen to him or her and take him or her out of her misery.
The whole point of the double effect distinction is that the patient’s death is not intentional.
But it is killing. If the drugs were more carefully titrated, palliative care could continue pain free life for a considerably greater length of time. Skilfully done, carefully administered diamorphine results in long term survival of a pain free but unconscious patient and only delays inevitable death. The law of double affect absolves doctors from the requirement to avoid causing death by respiratory depression, even though this is possible, and avoids wards full of virtual cadavers.
The technique is to agree among all concerned including next of kin that death is probable in the short term, but that sufficient drugs should be given with two understood effects, first to remove pain and secondly as a consequence to cause an early death. Careful titration would result in life lasting longer, but instead a sufficient dose is prescribed to both relieve all pain and consciousness and also to cause rapid death by respiratory depression.
Double effect is a typical Jesuit casuistry still in use today. Medics everywhere use it to legally cause an early and painless death, where death could have been delayed much longer either without or with additional pain.
For Right Wing Gun Lovers it is worth pointing out that the Stand-your-ground and Castle defences also rely on the principle of double effect. You are permitted to use lethal force if your intent is to protect yourself, your property or your family even if you were incorrect in your assessment.
Only if you believe there’s a difference between “intent” and “willful disregard.” I certainly don’t–they’re effectively synonyms as far as I’m concerned.
If a doctor attempted to cure cancer by blowing out the tumor with a stick of dynamite, would you say that the death was unintentional?
Hardly. The death is a certain consequence there.
First, you still haven’t pointed to anything where SCOTUS “supported” the practice. You cited a footnote where they distinguished it from activities that were prohibited by the New York law under review, which is nothing of the sort.
Second, the reason they distinguished it is because it is not euthanasia, which is why they were able to distinguish it.
A sane albeit severely depressed person doesn’t need a Dr.'s help; if he has the guts he can do it by his own hand.
Those who don’t have the guts can do it via another agency i.e. “suicide by cop.”
Dr.'s only come in when it’s a terminal illness situation. Many Dr’s have secretly admitted they practice covert euthanasia via palliative sedation, which actually hastens death by a few days-week.
If I have a terminal illness like ALS (Gehrig’s Disease) I wouldn’t have the guts to stick it out. When swallowing became difficult I’d ask to be put into palliative sedation and kept there until I passed even if it shorted my life by weeks/months. Some people travel to Switzerland where euthanasia is legal and do it there.
So will a sufficient dose of morphine.
Perhaps you say that there is still at least some probability of the patient surviving with morphine. If I size my stick of dynamite such that it is not guaranteed to kill the patient, at least not immediately, does it make a difference?
You are arguing against the leading medical ethics text Quill and Battin in which Kathryn Tucker gives the legal background to the law of double effect. She quotes the deliberations in those two cases cited above, not the judgements. SCOTUS based its judgement on the basis of separating physician assisted death as a main intent from PAD as a consequence of another intention- palliative care. SCOTUS accepted that even where the death was hastened and caused by medical intervention, it was legal so long as the intention of the physician was palliative care. This is interpreted in practice as allowing the administration of major analgesics known to increase the likelihood of death to the point of certainty so long as death is predicted in the short term and the medicine is given with the intention of pain relief. Large doses of diamorphine or other analgesia known to cause respiratory depression are given to intentionally reduce pain but actually hasten death.
Tucker, Kathryn E., “Legal Advocacy to Improved Care and Expand Options at the End of Life,” in Physician-Assisted Dying: The Case for Palliative Care & Patient Choice, edited by T.E. Quill and M.P. Battin (Johns Hopkins University Press, 2004
It is not available on line but is referenced by several sources such as
“Finally, in 1997, the US Supreme Court, in Vacco v. Quill and Washington v. Glucksberg, reversed the appeals courts, declining to find a federal constitutional right to assisted dying, although reserving the possibility that it might do so in the future and making it clear that death hastened by palliative measures was permissible. Crucially, the Court held that for the moment the question of allowing assisted dying should be left to the states.8”
No.
One is based on reasonable risk- prescribing any effective medicine carries a risk of death, even aspirin and acetaminophen. Morphine may be given in such doses to relieve pain such that the patient survives indefinitely without pain. In cases that are not terminal such treatment is normal and great care is taken to titrated the dose to avoid life threatening side effects. The use of diamorphine at the end of life is different in that it is known that the dosage is almost certain to cause early death but the claimed intention is merely analgesia.
People may find this uncomfortable but it has been ethically and legally accepted for generations and SCOTUS has recognised it as being acceptable.
I can’t quite tell if you’re agreeing with me or not. Since the morphine is known to cause early (and possibly immediate) death, there is no functional difference between that and intending to kill the person. Sufficiently willful disregard is functionally identical to intent.
I’m aware that the idea of double effect comes from Catholic philosophy, but I am doubtful that there is anything ethical about it. There is certainly nothing resembling the idea in my professional career as an engineer. Even the tiniest lapse in attention to side effects is a serious breach of ethics.
Bodily autonomy is the necessary and sufficient argument for assisted euthanasia. If our society really believed in such, there would be no argument at all.
Heroin derivatives such as morphine and diamorphine, contrary to public opinion, are relatively free of side effects when prescribed normally. The worst usually expected is constipation. Even dependence is quite rare! It is one of the safer drugs around. One of the measures of danger is what is called the therapeutic ratio- the closeness between the normal and lethal dose. Acetaminophen Tylenol) is amongst the most dangerous and opiates are much less so.
Physicians can control opiate regimes with little chance of death but with full pain relief. The principle of double effect however absolves physicians from blame should they administer higher levels of pain relief than necessary with the consequence of early death, so long as they can state that the INTENTION was pain relief.
It is weasel words but it is very widely accepted by legal, moral and medical authorities.
Like all explanations and excuses for undesired actions, the borders are not clear, but it is necessary to free medics from the fear of prosecution to the point where they fail to give sufficient pain relief.
That’s not a million miles away from some of the treatments for more advanced cancer, which do in fact damage the whole body, with the hope that the cancer will be eradicated or sufficiently slowed before the patient dies.
To answer the OP, there’s always the problem of conflict of interest - are we certain that the person asking to die actually wants to, hasn’t been pressured into it, and so forth. Due to the final nature of death, an extremely high standard of certainty would be needed before allowing it, even if you accept assisted suicide in principle.
We’re not talking about medical ethics. We’re talking about the law. The section you quoted is an incorrect statement of the court’s decision.
The supreme court did not “make it clear that death hastened by palliative measures was permissible”. It merely quoted the parties’ positions on an issue that was not before it in a footnote - the one you quoted from Vacco (no. 11). The the court makes none of its own pronouncements on the matter. Its job was to determine if New York could ban physician-assisted suicide, not whether it could ban prescribing potentially fatal doses for therapeutic reasons.
The court was only discussing whether it was permissible to draw a line between refusing medical treatment and assisted suicide.