Archive for Beginning and end of life issues

New Guidelines on Assisted Suicide September 2009

In response to the Law Lords’ ruling in the Debbie Purdy case. The Director of Public Prosecutions has now clarified the law on assisted dying.
Since 1961 it has not been agaisnt the law to commit suicide, but it has been against the law to assist a person to commit suicide. This has affected not only the actions of doctors and carers but also those who accompanied friends or relatives to the Dignitas Clinic in Zurich. To date over 100 people have travelled to the Dignitas clinic from the UK in order to end their lives. Invariably those who accompanied them on the journey have been questioned by Police on their return to this country. Despite this no one has yet been prosecuted for assisting in the death of a friend or relative.
In July of this year Debbie Purdy asked for a clarification of the existing law. She fears that one day she will have to travel to Switzerland to end her life and does not want her husband, jazz musician, Omar, to be questioned or arrested by the British Police for assisting her.

Keir Starmer, the Dirctor of Public Prosecutions has now published guideline for England and Wales. Key considerations spelled out in the guidelines include deciding whether someone is acting “on compassionate grounds”, whether the friend or relative assisting stands to financially benefit from the death and whether the person was in a fit enough state to make the decision to die.
Writing in a letter to The Telegraph ahead of the publication of the guidelines today, Mr Starmer said: “It is not easy and there are lots of factors that have to be taken into account.

“The basic approach we have taken is to try to bring some clarity, but at the same time to protect the vulnerable.”

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Debbie Purdy

Debbie Purdy was born in 1963. She is married to Omar Puente a Cuban Jazz musician. Origianlly from Bradford, Debbie Purdy has lived and worked in Singapore, Japan, Hong Kong, Norway and the US, writing music, selling jewellery and working as a waitress and dancer. In 1995 she was diagnosed with multiple sclerosis.

As the illness progresses Debbie Purdy admits that she is finding life more difficult. She wants to be able to choose the moment when she can end her life, but admits that she will not be able to do so without assistance. her intention is to one day go, accompanied by her husband to the Swiss suicide clinic Dignitas. However she is afraid that on Omar’s return to Britain he could be arrested and sent to jail for up to 14 years for assisting a person to commit suicide.

On 30th July 2009 Debbie Purdy won a landmark ruling. The Law Lords agreed that the Director of Public Prosecutions should draw up a policy that would spell out when prosecutions would and would not be pursued.

“I am eagerly awaiting the DPP’s policy publication so that we can make an informed decision to make sure what we do does not risk prosecution. I feel like I have my life back,” she said. “I want to live my life to the full, but I don’t want to suffer unnecessarily at the end of my life. This decision means that I can make an informed choice, with Omar, about whether he travels abroad with me to end my life because we will know exactly where we stand.”
Guardian Newspaper
Debbie Purdy profile
Situation on assisted suicide

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Sir Edward & Lady Joan Downes

Sir Edward Downes, a former conductor of the BBC Philharmonic orchestra and his wife Lady Joan Downes ended their lives together at the Dignitas clinic in Switzerland.
Sir Edward, who was 85, had become virtually blind and was deaf. His wife. Lady Joan, was suffering from cancer. She had been a ballet dancer and a choreographer.
Their deaths were announced by their children Caractacus and Boudicca “After 54 happy years together they decided to end their own lives rather than struggle with serious health problems.”
Police are investigating their deaths.
It is claimed that over 800 people in the UK are members of Dignitas and at least 115 have travelled to Switzerland to die.
Telegraph
Times
Sunday Observer

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Craig Ewert & Sky Television

 

Wednesday December 17th 2008

The case of Craig Ewert has pushed the debate about Assisted Suicide to new levels. He allowed his visit to the Dignitas Clinic in Switzerland, where he was helped to end his life, to be filmed. The film was shown on Sky Television on Wednesday 10th December 2008.
Television watchdogs expressed concern that the programme, Right to Die, shown on Sky Real Lives, would promote euthanasia.
Mr Ewert, who suffered from motor neurone disease (MND), was filmed as he passed away, comforted by Mary, his wife of 37 years, at the Dignitas clinic in Zurich in September 2006.
The screening of the documentary caused a great deal of controversy among the usual groups but on this occasion repercussions were felt even in the House of Commons.
At Prime Minister’s Question Time Gordon Brown made clear his own opposition to assisted suicide, saying: “I believe that it is necessary to ensure that there is never a case in this country where a sick or elderly person feels under pressure to agree to an assisted death or somehow feels it is the expected thing to do. That is why I have always opposed legislation for assisted deaths.’”
Information about the programme Telegraph

Ewert’s wife explains his hopes about the film. Telegraph

Comment on the programme Telegraph

Legacy Margo MacDonald a Scottish MP on the “right to die”. Telegraph.

Sunday Times on Assisted Suicide

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No Prosecution for Daniel James’ parents over Assisted Suicide

 Wednesday December 17th 2008

At the same time as the Craig Ewert incident was being reported, news was released that the parents of Daniel James would not be prosecuted by the Crown Prosecution Service for accompanying their son to the Dignitas Clinic in September 2008. This was something of a landmark decision. Daniel was the only person from the UK who had chosen to end his life in this way even though his condition was not terminal.
Telegraph
Guardian
Mirror

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Daniel James

Sunday October 26th 2008

 A rugby injury in March 2007 left a young man, Daniel James, paralysed for life. The student was left paralysed from the chest down after his spine was dislocated when a scrum collapsed during training with Nuneaton Rugby Club. Despite several operations and a period of convalescence at a private health clinic, Daniel’s condition failed to improve. He made several attempt to end his own life, but these failed. In accordance with his wishes he was taken by his parents to the Dignitas Clinic in Zurich, Switzerland, where his life was ended.
Daniel had been an enthusiastic rugby player. He had played for England Schoolboys and was not able to adapt to what he described as “a second-class existence”.
This incident seems to be unprecedented. It is the first time that a person from the UK has travelled to the Dignitas Clinic with a condition that was not essentially terminal.
Daniel’s story Times Newspapers
Sunday Times Comment
Guardian Mary Warnock
BBC BBC report on the Police enquiry.

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Dr Anne Turner

Thursday, January 26, 2006

Dr Anne Turner ends her own life 

Dr Anne Turner aged 66 had been suffering from an incurable terminal brain disease called “progressive supranuclear palsy” (PSP).
She was a widow with three grown up children. Some years ago she watched her husband Jack die from a degenerative illness and was determined that she would not suffer the same fate.
She decided therefore to end her life in her own time. “Everyone” she said “has the right to die with dignity.”
Sadly for her the government, most doctors and leading churchmen in the UK do not agree and “Assisted Suicide” is illegal.
Dr Turner began discussions with an organization called Dignitas. In Switzerland assisted suicide is not illegal. Last Wednesday Dr Turner and her family made her final journey to Zurich.
In Zurich she was joined by a representative from Dignitas. The party went to an apartment where Dr Turner, still surrounded by her family, received a lethal dose of barbiturates. Within five minutes she was asleep and a few moments later she died.
On her final journey to Zurich Dr Turner was accompanied by members of the press who had been invited. She wished to publicize the plight of suffers of PSP and she hoped to influence those who have the power to alter the law on euthanasia.
Dignitas is an organization founded by a Swiss lawyer, Ludwig Minelli in 1998. Its aim is to help people with chronic terminal illnesses to die a quick and painless death.

British Press Links News Telegraph
Guardian Unlimited
The Independent
Times

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Applied ethics – Euthanasia

Euthanasia - translated “a good death”

Definition “Euthanasia is the intentional killing by act or omission of a person whose life is not thought to be worth living. It is done for the patient’s own sake.

Make sure you are familiar with the following terms

Voluntary Euthanasia- when a terminally ill person requests death

Involuntary Euthanasia – when a person is killed or allowed to die to save them from more pain, even if they don’t request it.

Non-Voluntary Euthanasia – when a person is unable to make the request for himself or herself.

Active Euthanasia- to do – illegal in the UK. The killing of a person. In the UK the 1961 Suicide Act permits suicide but forbids it being assisted.

Passive Euthanasia – not to do- legal in the UK. Allow a person to die e.g. not feeding.

Where the Christians stand on this issue?
Christians emphasise that life is sacred and a gift from God. Remember your Old Testament ideas from the creation narratives of Genesis, Psalm 139:13-16, Job 1:20-21 and in the New Testament Paul in 1 Corinthians 3:16-18. The body is the temple of the Holy Spirit.
Roman Catholics and Orthodox Christians think that to end life prematurely is a mortal sin. (See Natural Law.)
Anglicans pay lip-service to Natural Law but in reality tend more towards Situation Ethics.
Non-Conformist Christians also defend the sanctity of life but in practical terms defend active euthanasia, arguing that in attempting to keep a patient alive rather than letting nature run its course, is to interfere with the will of God.

In some ways that is an oversimplification because there are many refinements of those opinions found in all branches of Christianity.

Natural Law
This follows the ideas of Aquinas. Fundamental to this approach is the concept that life is sacred and should be preserved. To take a human life or to terminate a human life is against a fundamental principle of Natural Law. Remember thought the doctrine of double effect – the doctor’s duty is to cure or alleviate pain. If in doing so the high dose of the pain killer ends the patient’s life then no wrong has been committed. The doctor has been performing a good act but it has a secondary consequence. In practice a doctor may use ordinary means to keep a patient alive, but not extraordinary means. The problem these days for followers of Natural Law is the definition of ordinary and extraordinary.

Situation Ethics
Situationists will ask the question “What is the most loving thing to do in this situation”. They may argue that in some circumstances to help someone to die is a more loving solution than to keep them alive and in great pain. This invokes the concept of Christian compassion but runs foul of the scriptures which talk about the will of God taking a backseat to the precepts of men! Small wonder that the Roman Catholic church condemned the philosophy from the outset. Even so Situation Ethics can appeal to the anti-nomian attitude of Jesus who spoke out against the law. Many feel it is a Christian common sense solution.

Kant
Kant did not write about euthanasia, but he regarded suicide as wrong. Have a look at the first and second formulations of the categorical imperative. The willing that this should become a universal rule? Suicide is treating oneself as a means and not as an in one’s self.

Utilitarianism
As always Utilitarianism is a complex appoach and you must make sure that you examine all parties involved. The solution will of course consider the needs of the patient, but possibly the needs of others, friends, family and the hospital authorities. Make sure you look at the problem from all sides.

Bentham’s approach. Quantitative Utilitarianism may well agree to euthanasia in a particular instance. Consequentialist in its appraoch and it looks at all the consequences of (i) keeping a patient alive and (ii) allowing his or her life to be ended. You must not simply look for happiness here – and there isn’t a great deal of that – but the avoidance of pain. The Hedonic Calculus looks at the maximising of happiness and the avoidance of pain. It is the second part that might allow euthanasia to happen.

Mill – higher and lower pleasures don’t at first seem to yield a solution, but Mill would probably argue that the right to die with dignity and for an individual to retain a measure of autonomy over his own life and death, might be regarded as a higher pleasure.

Utilitarianism does not provide a one sided answer. Some utilitarian principles are in favour of euthanasia, while others would count against it. That is why this is a favourite choice for examiners. If you know your stuff there is plenty for you to get your teeth into.

Utilitarian pro euthanasia arguments

  1. If the patient is in pain then the Hedonic Calculus might find there is no pleasure to balance against the pain. As might seem likely the patient’s condition deteriorates, then there will be more pain. In this case qualitative euthanasia might be justified.
  2. If equipment used in a hospital to keep a patient alive could be used elsewhere to save lives, the hospital authorities may wish to rationalise use of their equipment. Similar arguments may surface over costs and hospital budgets.
  3. Mill would argue that the right to die with dignity is a higher ideal if not actually a higher pleasure.
  4. If the health and well-being of next of kin to the terminally ill person is being compromised eg those who visit a patient in pvs – see notes on Tony Bland.

Utilitarianism and arguments against euthanasia

  1. When a patient is unable to communicate with family or medical staff, many utilitarians support anti-euthanasia legislation which safeguards human rights.
  2. There is a fear that vulnerable elderly people might be co-erced into asking for euthanasia by family pressure.
  3. Utilitarianism looks closely at the consequences of any decision. However there is a possibility that the diagnosis of a doctor could be wrong. A wrong decision could cause maximum pain and no happiness for the family.
  4. There is a sense in which even utilitarians accept that one can only push these principles so far. Suppose one allowed euthanasia on demand. That might lead to an increase in calls for involuntary euthanasia of the terminally ill, the chronically sick, social outcasts, homosexuals, gypsies – is this starting to ring any bells?

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Applied Ethics – Abortion

This PowerPoint may serve as an introduction.

click on the image

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