The perfect person 2. Worthwhileness of life in the face of progressive disease

and disability. Euthanasia- including assisted suicide

David Carpenter14th October 2015

Portsmouth Cathedral

Choice Chance

Treating for living

Treating for dying

A Rough Framework

Choice Chance

Treating for living

Treating for dying

Historical Position

Choice Chance

Treating for living

Treating for dying

Historical Position

Strangely Comfortable• Much greater sense of

the spiritual• Appeal of scepticism• Limited professional

power• Virtue and compassion

above professional knowledge and skill

Choice Chance

Treating for living

Treating for dying

Today

Strangely Disturbing• Displacement of the

spiritual• Impossible demands

• Limitations of knowledge and skills• Compassion

displaced by helplessness

Treating for living

Treating for dying

Moral questions related to intention / motive / duty

Choice Chance

Moral questions related to autonomy and liberty

What would you do if?

• you were told that you had a terminal illness

• there was no cure

• you will gradually deteriorate and will eventually become completely helpless

• you have time to consider a range of alternatives

What are the options?

Which one would you choose?

Why?

Voluntary

Non –voluntary / Involuntary

Active Passive

Suicide

Physician Assisted suicide

Treatment refusal

Treatment withdrawal

Treatment withholding

Killing

‘Euthanasia’

? Suicide

Murder / manslaughter

EugenicsDouble effect

Respects autonomy

Respects autonomy

Dangerous paternalism

Dangerous paternalism

http://www.bbc.co.uk/news/health-27887292

Dignitas – ‘Suicide Tourism’

Terry Pratchett: my case for a euthanasia tribunalShould those with incurable illnesses be allowed to choose how and when they die? In his Richard Dimbleby lecture, author Terry Pratchett, who has Alzheimer's disease, makes a plea for a common-sense solutionThe Guardian, Tuesday 2 February 2010

The public interest factors in favour of prosecution identified in the interim policy include that:A prosecution is more likely if the person committing suicide was under 18, if they did not have mental capacity or had not made a voluntary decision. A prosecution is also more likely if the assister has a history of violence or abuse towards the assisted person, if they assisted or encouraged several people's suicide, or are paid for their assistance.

The public interest factors against a prosecution include that:

A prosecution is less likely if the assisted person made a voluntary, well informed decision to commit suicide, and if the assister was wholly motivated by compassion and if they had sought to dissuade the person from committing suicide.

http://www.youtube.com/watch?v=mzNnA3ISOlo

Under the amendments to the country’s 2002 euthanasia law, a child of any age can be helped to die, but only under strict conditions. He or she must be terminally ill, close to death, and deemed to be suffering beyond any medical help. The child must be able to request euthanasia themselves and demonstrate they fully understand their choice. The request will then be assessed by teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents.

Dr. Stefaan Van Gool, a pediatrician at the University of Leuven, says the doctors were concerned that procedures for assessing a child’s mental capacity to make life-and-death decisions were not sufficiently clear in the bill. They were also worried a child might be pressured into making a decision by parents, and that were are too many possibilities for misuse of the law.“We are suffering together with these children to get through the most difficult moments of life, but at such time what we deliver to these children is care,” he says, adding that his experiences show children want to live as full a life as possible right until the very end. “We have children who do exams up to two days before they die. They are children that always dream about a future, although this future may only be a few hours.

She has come across children as young as eight who have articulated an understanding of their situation, but doctors expect the most likely cases would involve adolescents.While assisted suicide is permitted under certain conditions in Switzerland, Germany and parts of the United States, only Belgium, Luxembourg and The Netherlands allow doctors to take steps to actively end a patient’s life, usually by administering an overdose of sedatives. In Luxembourg, that patient must be over 18, while in The Netherlands children can request euthanasia from the age of 12.