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Right to Die. Right to Die. Choices for dying patients and their families due to technology What constitutes a “good death” Most people die in hospitals with staff trying to keep patient alive until no chance of recovery Most people want total effort to fight off death. - PowerPoint PPT Presentation
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Right to DieRight to Die
Right to DieRight to Die
Choices for dying patients and Choices for dying patients and their families due to technologytheir families due to technology
What constitutes a “good death”What constitutes a “good death” Most people die in hospitals Most people die in hospitals
with staff trying to keep patient with staff trying to keep patient alive until no chance of recoveryalive until no chance of recovery
Most people want total effort to Most people want total effort to fight off deathfight off death
Some are facing a terminal illnessSome are facing a terminal illness There may come a point when the There may come a point when the
fight no longer seems worth itfight no longer seems worth it Those patients may find their Those patients may find their
wishes and those of their families wishes and those of their families overlooked as physicians juggle overlooked as physicians juggle medical, legal and moral medical, legal and moral considerationsconsiderations
Patients undergoing minor Patients undergoing minor surgical procedures are surgical procedures are routinely asked if they would routinely asked if they would like to fill out a document, like to fill out a document, known as an “advance known as an “advance directive” or “living will”directive” or “living will”
Living WillLiving Will
Every state now allows people Every state now allows people to issue form of directiveto issue form of directive
Specifies what course of action Specifies what course of action they want if they are unable to they want if they are unable to communicatecommunicate
Only 40% of people have living Only 40% of people have living willswills
Not always bindingNot always binding
Court rulings have firmly Court rulings have firmly established a patient’s legal right established a patient’s legal right to discontinue life sustaining to discontinue life sustaining treatment, such as respirators or treatment, such as respirators or artificial nutritionartificial nutrition
Debate over these decisions is Debate over these decisions is far from settled- Terri Schiavo’s far from settled- Terri Schiavo’s case went on for 12 yearscase went on for 12 years
Another issue is whether Another issue is whether individuals should be able to individuals should be able to ask physicians to hasten their ask physicians to hasten their deaths- in effect, help them deaths- in effect, help them end their lives- and whether end their lives- and whether it is morally acceptable for it is morally acceptable for physicians to do sophysicians to do so
Right to DieRight to Die
Should individuals be able to Should individuals be able to ask doctors to hasten their ask doctors to hasten their deaths?deaths?
Who decides whether life is Who decides whether life is worth living or not?worth living or not?
Should others (families, Should others (families, doctors, government) be able doctors, government) be able to decide for them?to decide for them?
Many people say they would Many people say they would rather die than suffer in rather die than suffer in great pain or endure life great pain or endure life trapped in a vegetative statetrapped in a vegetative state
Should individuals have the Should individuals have the right to decide when and how right to decide when and how they will die?they will die?
What is considered What is considered unbearable?unbearable?
Terminal illness?Terminal illness? Chronic physical pain?Chronic physical pain? Debilitating, although not Debilitating, although not
fatal, illness?fatal, illness?
Right to DieRight to Die
Euthanasia: hastening the Euthanasia: hastening the death of a terminally ill death of a terminally ill patient- patient-
Is it mercy and respect?Is it mercy and respect? Or is it murder?Or is it murder?
Right to DieRight to Die
Euthanasia: Euthanasia: Is it a measure of control Is it a measure of control
over timing, or is it a slippery over timing, or is it a slippery slope of neglect of old, poor, slope of neglect of old, poor, disabled, emotionally disabled, emotionally distraught, seriously ill?distraught, seriously ill?
Right to DieRight to Die
Religious and moral Religious and moral questions:questions:
Life and death should be left Life and death should be left for God, not human beingsfor God, not human beings
Life is to be cherished, not Life is to be cherished, not abandonedabandoned
Right to DieRight to Die Netherlands, Belgium, Netherlands, Belgium,
Switzerland, Luxembourg- Switzerland, Luxembourg- physician assisted suicide is legalphysician assisted suicide is legal
United States: Oregon and United States: Oregon and Washington permit physician Washington permit physician assisted suicide- Montana and assisted suicide- Montana and Massachusetts have tried to make Massachusetts have tried to make it legal but so far it has failedit legal but so far it has failed
““Death with Dignity Act”Death with Dignity Act”
19941994 OregonOregon Doctors can prescribe lethal Doctors can prescribe lethal
dose but not give itdose but not give it Ensure patients seeking this Ensure patients seeking this
to be mentally competent, in to be mentally competent, in great pain, intent on ending great pain, intent on ending their lifetheir life
60% say doctor assisted 60% say doctor assisted suicide not murdersuicide not murder
Dr. Jack KevorkianDr. Jack Kevorkian
MichiganMichigan Helped 130 people commit Helped 130 people commit
suicidesuicide Sentenced to prison for 10-25 Sentenced to prison for 10-25
yearsyears Served 8 years in a Michigan Served 8 years in a Michigan
prison for administering a fatal prison for administering a fatal injection to a terminally ill maninjection to a terminally ill man
Should Kevorkian have Should Kevorkian have been convicted of murder?been convicted of murder?
Karen Ann QuinlanKaren Ann Quinlan
21 yrs old21 yrs old April 15, 1975, took alcohol April 15, 1975, took alcohol
and drugsand drugs Full blown comaFull blown coma Doctors pronounced her Doctors pronounced her
condition a “persistent condition a “persistent vegetative state”vegetative state”
Karen Ann QuinlanKaren Ann Quinlan
Doctors said most basic life Doctors said most basic life processes could be kept going, but processes could be kept going, but she had ceased to be a human beingshe had ceased to be a human being
Or had she?Or had she? EEG detected traces of electrical EEG detected traces of electrical
activity in her brainactivity in her brain Machine said she was not “brain Machine said she was not “brain
dead”dead”
Karen Ann QuinlanKaren Ann Quinlan
Her parents were deeply religiousHer parents were deeply religious Felt that she had the right to “die Felt that she had the right to “die
with dignity”with dignity” Tried to get respirator turned offTried to get respirator turned off New Jersey Superior Court New Jersey Superior Court
rejected plea after 7 months on rejected plea after 7 months on respiratorrespirator
Karen Ann QuinlanKaren Ann Quinlan
““This is not a court of love, of This is not a court of love, of compassion, but a court of law. compassion, but a court of law. You can’t just extinguish life You can’t just extinguish life because it is an eyesore.” said because it is an eyesore.” said her court appointed guardianher court appointed guardian
New Jersey Supreme Court New Jersey Supreme Court overturned decision March 31, overturned decision March 31, 19761976
Karen Ann QuinlanKaren Ann Quinlan
Everyone thought she would Everyone thought she would die very soon from brain die very soon from brain deathdeath
She lived for 10 years She lived for 10 years without a respiratorwithout a respirator
Died in 1986 from pneumoniaDied in 1986 from pneumonia
60% say spouse should 60% say spouse should make decision for coma-make decision for coma-
like patientlike patient
Terry SchiavoTerry Schiavo
Brain damaged patientBrain damaged patient No living willNo living will Family was dividedFamily was divided Years of litigationYears of litigation Husband eventually won to Husband eventually won to
have feeding tube removedhave feeding tube removed
Terry SchiavoTerry Schiavo
Increased public interest in Increased public interest in living willsliving wills
20 states have issued bills to 20 states have issued bills to clarify laws about living willsclarify laws about living wills
Right to DieRight to Die Perspective 1Perspective 1
Recognize the right to die with Recognize the right to die with dignity, with a physicians dignity, with a physicians assistanceassistance
Permit people to have a “humane” Permit people to have a “humane” deathdeath
Individuals have the right to Individuals have the right to determine the time and determine the time and circumstances of their deathcircumstances of their death
Right to DieRight to Die
Perspective 2Perspective 2 Focus on giving comfort and Focus on giving comfort and
recognizing the patient’s recognizing the patient’s preferencespreferences
Recognize patient’s right to control Recognize patient’s right to control the treatment they receive- relieve the treatment they receive- relieve pain and ease the depression the pain and ease the depression the patient is experiencingpatient is experiencing
Improve the quality of life for the Improve the quality of life for the patientpatient
Allow patient to issue directives, Allow patient to issue directives, not just preferences, about end of not just preferences, about end of life care and treatmentlife care and treatment
Expand hospice careExpand hospice care Remove barriers to effective pain Remove barriers to effective pain
management- such as overly management- such as overly restrictive regulation of narcoticsrestrictive regulation of narcotics
Right to DieRight to Die
Perspective 3Perspective 3 Reaffirm the commitment to Reaffirm the commitment to
preserve lifepreserve life Condemn practice of physician Condemn practice of physician
assisted suicideassisted suicide It should be illegalIt should be illegal Unconditional value of human Unconditional value of human
lifelife
Except when patients explicitly Except when patients explicitly decline further treatment, decline further treatment, physicians must make every effort to physicians must make every effort to sustain lifesustain life
Any compromise in the commitment Any compromise in the commitment of medical professionals to protect of medical professionals to protect and extend life would undermine the and extend life would undermine the public’s faith in the medical public’s faith in the medical professionprofession
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