Debating Euthanasia

In this new addition to the 'Debating Law' series, Emily Jackson and John Keown re-examine the legal and ethical aspects of the euthanasia debate. Emily Jackson argues that we owe it to everyone in society to do all that we can to ensure that they experience a 'good death'. For a small minority of patients who experience intolerable and unrelievable suffering, this may mean helping them to have an assisted death. In a liberal society, where people's moral views differ, we should not force individuals to experience deaths they find intolerable. This is not an argument in favour of dying. On the contrary, Jackson argues that legalisation could extend and enhance the lives of people whose present fear of the dying process causes them overwhelming distress. John Keown argues that voluntary euthanasia and physician-assisted suicide are gravely unethical and he defends their continued prohibition by law. He analyses the main arguments for relaxation of the law - including those which invoke the experience of jurisdictions which permit these practices - and finds them wanting. Relaxing the law would, he concludes, be both wrong in principle and dangerous in practice, not least for the dying, the disabled and the disadvantaged.

The proliferation of life-prolonging technology in recent years has made the controversy over the "right to die" and physician-assisted suicide one of the most explosive medical and ethical issues of our day. Dr. Jack Kevorkian's "suicide machine" has commanded front-page coverage for several years, while in 1994 Oregon passed a measure allowing the terminally ill to obtain lethal prescriptions for suicide, and other states have placed similar proposals on their ballots.

After assessing the strengths and weaknesses of arguments for assisted suicide and euthanasia, Gorsuch builds a nuanced, novel, and powerful moral and legal argument against legalization, one based on a principle that, surprisingly, has largely been overlooked in the debate; the idea that human life is intrinsically valuable and that intentional killing is always wrong. At the same time, the argument Gorsuch develops leaves wide latitude for individual patient autonomy and the refusal of unwanted medical treatment and life-sustaining care, permitting intervention only in cases where an intention to kill is present.

Sensitive and high-profile public policy issues often benefit from being considered in comparative perspective. Here, euthanasia and the right to die are examined in the context of the social, legal, and religious settings of a wide range of countries. The authors employ public opinion data, where available, to illustrate the great disparity between approval of physician-assisted suicide and the general illegality of the practice. Ultimately, making and implementing laws to ensure a responsible right to die_as the U.S. has been struggling with in Oregon, Michigan, and elsewhere_will be informed by experiences in such places as the Netherlands, Australia, and the only country in the world where euthanasia is a clear-cut medical option: Colombia.

"Argues that people who promote the legalization of euthanasia ignore the vast ethical, legal and social differences between euthanasia and natural death. Permitting euthanasia, Somerville demonstrates, would cause irreparable harm to respect for human life and society." --Cover.

This open access book has been written by ten Belgian health care professionals, nurses, university professors and doctors specializing in palliative care and ethicists who, together, raise questions concerning the practice of euthanasia. They share their experiences and reflections born out of their confrontation with requests for euthanasia and end-of-life support in a country where euthanasia has been decriminalized since 2002 and is now becoming a trivial topic.Far from evoking any militancy, these stories of life and death present the other side of a reality needs to be evaluated more rigorously.Featuring multidisciplinary perspectives, this though-provoking and original book is intended not only for caregivers but also for anyone who questions the meaning of death and suffering, as well as the impact of a law passed in 2002. Presenting real-world cases and experiences, it highlights the complexity of situations and the consequences of the euthanasia law.This book appeals to palliative care providers, hematologists, oncologists, psychiatrists, nurses and health professionals as well as researchers, academics, policy-makers, and social scientists working in health care. It is also a unique resource for those in countries where the decriminalization of euthanasia is being considered. Sometimes shocking, it focuses on facts and lived experiences to challenge readers and offer insights into euthanasia in Belgium.

claim was that he had faced a conflict of duties pitting his legal duty not to kill against his duty as a physician to relieve his patient’s unbearable suffering. He was acquitted on the important grounds of conflict of duty. These grounds are based on a concept in Dutch law called "force majeure" 4 which recognizes extenuating circumstances such as conflicts of duty. The acquittal was upheld by the Lower Court of Alkmaar, but revoked by an Amsterdam court of appeal. The case went on to the Supreme Court, but before the Supreme Court's decision was issued, the Royal Dutch Medical Association (RDMA) attempted to clarify the criteria for euthanasia that many within the profession already accepted. The RDMA proposed that physicians be permitted to perform euthanasia provided that a set of procedures had been met. Variously stated, the guidelines contain the following central provisions: Voluntary, competent, explicit, and persistent requests on the part of the • patient; Requests based on full information; • The patient is in a situation of intolerable and hopeless suffering (either • physical or mental); No further acceptable alternatives to euthanasia. All alternatives • acceptable to the patient for relief of suffering having been tried; Consultation with at least one other physician whose judgment can be • 5 expected to be independent. Indirectly, these guidelines became the criteria prosecutors used to decide whether or not to bring charges.

In this book, a global panel of experts considers the international implications of legalised euthanasia based on experiences from Belgium.