Guenter Lewy
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199746415
- eISBN:
- 9780199866151
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746415.001.0001
- Subject:
- Philosophy, General
This book provides a detailed account of four regimes of assisted death for which there is a substantial body of data as well as observational research: The Netherlands and Belgium have legalized ...
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This book provides a detailed account of four regimes of assisted death for which there is a substantial body of data as well as observational research: The Netherlands and Belgium have legalized both voluntary euthanasia as well as physician-assisted suicide; the state of Oregon allows physician-assisted suicide; and in Switzerland assisted suicide can be provided by non-physicians. For each regime the book describes the unique cultural, political, and legal context in which the legalization of assisted death has taken place. It analyzes problem areas that have developed, such as the issue of assisted death for patients with mental suffering or the termination of life in pediatric cases, and the effectiveness of each system of regulation is assessed. While accurate factual information cannot settle the moral debate over assisted death, it nevertheless is a precondition of any well-founded argument. The conclusion discusses the lessons that can be learned from the experience of these four regimes, and analyzes a model statute for physician-assisted suicide that has been proposed for the United States.Less
This book provides a detailed account of four regimes of assisted death for which there is a substantial body of data as well as observational research: The Netherlands and Belgium have legalized both voluntary euthanasia as well as physician-assisted suicide; the state of Oregon allows physician-assisted suicide; and in Switzerland assisted suicide can be provided by non-physicians. For each regime the book describes the unique cultural, political, and legal context in which the legalization of assisted death has taken place. It analyzes problem areas that have developed, such as the issue of assisted death for patients with mental suffering or the termination of life in pediatric cases, and the effectiveness of each system of regulation is assessed. While accurate factual information cannot settle the moral debate over assisted death, it nevertheless is a precondition of any well-founded argument. The conclusion discusses the lessons that can be learned from the experience of these four regimes, and analyzes a model statute for physician-assisted suicide that has been proposed for the United States.
Bernard Gert, Charles M. Culver, and K. Danner Clouser
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195159066
- eISBN:
- 9780199786466
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195159063.003.0012
- Subject:
- Philosophy, Moral Philosophy
This chapter discusses why euthanasia presents a moral dilemma for physicians. It shows that trying to distinguish between active and passive euthanasia in any of the following four ways: (1) acts ...
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This chapter discusses why euthanasia presents a moral dilemma for physicians. It shows that trying to distinguish between active and passive euthanasia in any of the following four ways: (1) acts versus omissions, (2) withholding versus withdrawing, (3) ordinary care versus extraordinary care, or (4) whether death is due to natural causes, does not work. It then shows that using the distinction between patient requests and patient refusals does provide an adequate way to make this distinction. It provides an analysis of killing and discusses the Supreme Court decision concerning assisted suicide.Less
This chapter discusses why euthanasia presents a moral dilemma for physicians. It shows that trying to distinguish between active and passive euthanasia in any of the following four ways: (1) acts versus omissions, (2) withholding versus withdrawing, (3) ordinary care versus extraordinary care, or (4) whether death is due to natural causes, does not work. It then shows that using the distinction between patient requests and patient refusals does provide an adequate way to make this distinction. It provides an analysis of killing and discusses the Supreme Court decision concerning assisted suicide.
Guenter Lewy
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199746415
- eISBN:
- 9780199866151
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746415.003.0004
- Subject:
- Philosophy, General
According to the Swiss Criminal Code, assisted suicide is illegal only if done “for selfish motives.” While in other jurisdictions only physicians are allowed to engage in the practice of assisted ...
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According to the Swiss Criminal Code, assisted suicide is illegal only if done “for selfish motives.” While in other jurisdictions only physicians are allowed to engage in the practice of assisted death, in Switzerland the actual assistance in suicide can and usually is performed by non-physicians. This chapter examines the role of several right-to-die organizations that offer the service of assisted death. Among these, Exit-German Switzerland stands out as operating in a fairly responsible manner, while the organization Dignitas caters to suicide tourism from other countries and often is charged as operating for profit. While the law requires a doctor's prescription for the lethal medication that is used by patients committing suicide, medical scrutiny appears to be slight. For the year 1996, for example, Exit reported an acceptance rate of 86%, which contrasts with 37% of granted applications by doctors in the Netherlands. While the Swiss public is broadly supportive of the practice of assisted death, there has developed concern about the lax rules that govern the practice of assisted death by Swiss right-to-die organizations. The Swiss Academy of Medical Sciences and a National Advisory Commission on Biomedical Ethics have proposed guidelines that seek a more restrictive regulation. In 2009, the federal government finally proposed legislation that would circumscribe the practice of assisted death, but it is not clear whether the Swiss parliament will adopt such a law.Less
According to the Swiss Criminal Code, assisted suicide is illegal only if done “for selfish motives.” While in other jurisdictions only physicians are allowed to engage in the practice of assisted death, in Switzerland the actual assistance in suicide can and usually is performed by non-physicians. This chapter examines the role of several right-to-die organizations that offer the service of assisted death. Among these, Exit-German Switzerland stands out as operating in a fairly responsible manner, while the organization Dignitas caters to suicide tourism from other countries and often is charged as operating for profit. While the law requires a doctor's prescription for the lethal medication that is used by patients committing suicide, medical scrutiny appears to be slight. For the year 1996, for example, Exit reported an acceptance rate of 86%, which contrasts with 37% of granted applications by doctors in the Netherlands. While the Swiss public is broadly supportive of the practice of assisted death, there has developed concern about the lax rules that govern the practice of assisted death by Swiss right-to-die organizations. The Swiss Academy of Medical Sciences and a National Advisory Commission on Biomedical Ethics have proposed guidelines that seek a more restrictive regulation. In 2009, the federal government finally proposed legislation that would circumscribe the practice of assisted death, but it is not clear whether the Swiss parliament will adopt such a law.
Penney Lewis
- Published in print:
- 2007
- Published Online:
- January 2009
- ISBN:
- 9780199212873
- eISBN:
- 9780191707063
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199212873.001.0001
- Subject:
- Law, Criminal Law and Criminology, Medical Law
The question whether assisted dying (euthanasia and assisted suicide) should be legalized is often treated, by judges and commentators alike, as a question which transcends national boundaries and ...
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The question whether assisted dying (euthanasia and assisted suicide) should be legalized is often treated, by judges and commentators alike, as a question which transcends national boundaries and diverse legal systems. One obvious example is the use made of the ‘Dutch experience’ in other jurisdictions. By treating the issue as a transcendent, global ethical question, the important context in which individual jurisdictions make decisions about assisted dying and the significance of the legal methods chosen to carry out those decisions is often lost. This book concentrates not on the issue of whether assisted dying should be legalized, but rather on the impact of the choice of a particular legal route towards legalization. Legal change on assisted dying may be achieved in a variety of ways: challenges to criminal prohibitions using constitutionally entrenched rights; the use of defences available to defendants who are prosecuted for assisting a death; legislative change; or referenda or ballot measures proposed by individual citizens or interest groups. The examination in this book of the impact of these different alternatives suggests that greater caution is needed before relying on the experience of one jurisdiction when discussing proposals for regulation of assisted dying in others, and the possible consequences of such regulation. The book seeks to demonstrate the need to explore the legal environment in which assisted dying is performed or proposed in order to evaluate the relevance of a particular legal experience to other jurisdictions.Less
The question whether assisted dying (euthanasia and assisted suicide) should be legalized is often treated, by judges and commentators alike, as a question which transcends national boundaries and diverse legal systems. One obvious example is the use made of the ‘Dutch experience’ in other jurisdictions. By treating the issue as a transcendent, global ethical question, the important context in which individual jurisdictions make decisions about assisted dying and the significance of the legal methods chosen to carry out those decisions is often lost. This book concentrates not on the issue of whether assisted dying should be legalized, but rather on the impact of the choice of a particular legal route towards legalization. Legal change on assisted dying may be achieved in a variety of ways: challenges to criminal prohibitions using constitutionally entrenched rights; the use of defences available to defendants who are prosecuted for assisting a death; legislative change; or referenda or ballot measures proposed by individual citizens or interest groups. The examination in this book of the impact of these different alternatives suggests that greater caution is needed before relying on the experience of one jurisdiction when discussing proposals for regulation of assisted dying in others, and the possible consequences of such regulation. The book seeks to demonstrate the need to explore the legal environment in which assisted dying is performed or proposed in order to evaluate the relevance of a particular legal experience to other jurisdictions.
Penney Lewis
- Published in print:
- 2007
- Published Online:
- January 2009
- ISBN:
- 9780199212873
- eISBN:
- 9780191707063
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199212873.003.2
- Subject:
- Law, Criminal Law and Criminology, Medical Law
There have been unsuccessful attempts to use constitutionally entrenched rights claims to challenge criminal prohibitions on assisted suicide in Canada, the United States, and the United Kingdom. ...
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There have been unsuccessful attempts to use constitutionally entrenched rights claims to challenge criminal prohibitions on assisted suicide in Canada, the United States, and the United Kingdom. These challenges, brought by patients, reached the highest courts in Canada, the United States, and Europe. Their failure makes unlikely — in any major common law or European jurisdiction — the legalization of assisted suicide or euthanasia using challenges based on constitutionally entrenched rights. To determine what we can learn about the use of rights as a mechanism for legal change on assisted dying from the debate which surrounded these cases requires an examination of the use of rights in litigation and debate over the legalization of assisted suicide, including the rights to liberty, autonomy, privacy, dignity, equality, freedom of conscience and religion, life, and property.Less
There have been unsuccessful attempts to use constitutionally entrenched rights claims to challenge criminal prohibitions on assisted suicide in Canada, the United States, and the United Kingdom. These challenges, brought by patients, reached the highest courts in Canada, the United States, and Europe. Their failure makes unlikely — in any major common law or European jurisdiction — the legalization of assisted suicide or euthanasia using challenges based on constitutionally entrenched rights. To determine what we can learn about the use of rights as a mechanism for legal change on assisted dying from the debate which surrounded these cases requires an examination of the use of rights in litigation and debate over the legalization of assisted suicide, including the rights to liberty, autonomy, privacy, dignity, equality, freedom of conscience and religion, life, and property.
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.001.0001
- Subject:
- Philosophy, Moral Philosophy
This work is a sequel to the author's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted ...
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This work is a sequel to the author's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted suicide in Oregon and the Netherlands to the furor over proposed restrictions of scheduled drugs used for causing death, and the development of “NuTech” methods of assistance in dying. This new collection covers a remarkably wide range of end-of-life topics, including suicide prevention, AIDS, suicide bombing, serpent-handling and other religious practices that pose a risk of death, as well as genetic prognostication, suicide in old age, global justice and the “duty to die”, suicide, physician-assisted suicide, and euthanasia, in both American and international contexts. As with the earlier volume, these new essays are theoretically adroit, but draw richly from historical sources, fictional techniques, and ample factual material.Less
This work is a sequel to the author's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted suicide in Oregon and the Netherlands to the furor over proposed restrictions of scheduled drugs used for causing death, and the development of “NuTech” methods of assistance in dying. This new collection covers a remarkably wide range of end-of-life topics, including suicide prevention, AIDS, suicide bombing, serpent-handling and other religious practices that pose a risk of death, as well as genetic prognostication, suicide in old age, global justice and the “duty to die”, suicide, physician-assisted suicide, and euthanasia, in both American and international contexts. As with the earlier volume, these new essays are theoretically adroit, but draw richly from historical sources, fictional techniques, and ample factual material.
Margaret Otlowski
- Published in print:
- 2000
- Published Online:
- March 2012
- ISBN:
- 9780198298687
- eISBN:
- 9780191685507
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198298687.003.0003
- Subject:
- Law, Medical Law
This chapter examines the law in relation to assisted suicide and the circumstances in which a doctor may be subject to criminal liability for this offence. It considers relevant analogies between ...
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This chapter examines the law in relation to assisted suicide and the circumstances in which a doctor may be subject to criminal liability for this offence. It considers relevant analogies between the legal response to active and passive euthanasia on the one hand, and assisted suicide on the other. Historically, at the common law level, a person who has committed suicide is regarded as a self- murderer or felo de se (felon against himself). Consequently, anyone who has instigated or aided another to commit suicide is guilty of murder as an accomplice. In England, the Suicide Act of 1961 abrogated the crime of committing suicide and created a new offence of ‘aiding, abetting, counselling or procuring the suicide of another’. In Scotland, assisting suicide may be treated as culpable homicide. In the United States, suicide is no longer a crime, but in most states, assisting suicide has been made a specific statutory offence. In Canada, Australia, and New Zealand, suicide and attempted suicide are no longer unlawful, but a statutory offence of assisting suicide has been established.Less
This chapter examines the law in relation to assisted suicide and the circumstances in which a doctor may be subject to criminal liability for this offence. It considers relevant analogies between the legal response to active and passive euthanasia on the one hand, and assisted suicide on the other. Historically, at the common law level, a person who has committed suicide is regarded as a self- murderer or felo de se (felon against himself). Consequently, anyone who has instigated or aided another to commit suicide is guilty of murder as an accomplice. In England, the Suicide Act of 1961 abrogated the crime of committing suicide and created a new offence of ‘aiding, abetting, counselling or procuring the suicide of another’. In Scotland, assisting suicide may be treated as culpable homicide. In the United States, suicide is no longer a crime, but in most states, assisting suicide has been made a specific statutory offence. In Canada, Australia, and New Zealand, suicide and attempted suicide are no longer unlawful, but a statutory offence of assisting suicide has been established.
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.003.0002
- Subject:
- Philosophy, Moral Philosophy
Something is amiss with the debate over euthanasia and physician-assisted suicide. On the one side were liberals, who thought physician-assisted suicide and perhaps voluntary active euthanasia were ...
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Something is amiss with the debate over euthanasia and physician-assisted suicide. On the one side were liberals, who thought physician-assisted suicide and perhaps voluntary active euthanasia were ethically acceptable and should be legal; on the other side were conservatives, who believed assisted dying was immoral and/or dangerous to legalize as a matter of public policy. This chapter explores the richness of this debate by showing something of the terrain of the debate and the figures that have inhabited it, both the public figures and the academic ones partly behind the scenes. It examines the principal arguments for assisted dying, namely, the argument from autonomy and the argument from relief of pain and suffering, as well as the principal arguments against it, namely, the argument from the intrinsic wrongness of killing, the argument from the integrity of the profession, and the argument from potential abuse (known as the slippery-slope argument).Less
Something is amiss with the debate over euthanasia and physician-assisted suicide. On the one side were liberals, who thought physician-assisted suicide and perhaps voluntary active euthanasia were ethically acceptable and should be legal; on the other side were conservatives, who believed assisted dying was immoral and/or dangerous to legalize as a matter of public policy. This chapter explores the richness of this debate by showing something of the terrain of the debate and the figures that have inhabited it, both the public figures and the academic ones partly behind the scenes. It examines the principal arguments for assisted dying, namely, the argument from autonomy and the argument from relief of pain and suffering, as well as the principal arguments against it, namely, the argument from the intrinsic wrongness of killing, the argument from the integrity of the profession, and the argument from potential abuse (known as the slippery-slope argument).
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.003.0005
- Subject:
- Philosophy, Moral Philosophy
Is a physician ever obligated to help a patient die? If physician-assisted suicide were to become legal or legally tolerated, would the patient have a right to assistance, a right held against the ...
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Is a physician ever obligated to help a patient die? If physician-assisted suicide were to become legal or legally tolerated, would the patient have a right to assistance, a right held against the physician for performance of this duty? In voter initiatives in Washington, California, and Oregon, in state legislative initiatives, in model statutes such as that of the Boston Working Group, and so on, all proposals have opt-out provisions, or “conscience clauses”, that permit physicians to refuse to participate in a suicide. But the basis of opt-out clauses — the ubiquitous assumption that a physician's scruples provide adequate justification, legally and morally, for excusing him or her from assisting in suicide — is rarely challenged. This chapter reviews the principal arguments for and against physician-assisted suicide in terminal illness. Two kinds of a dying patient's rights to assistance in suicide are considered: the “negative” right and the “positive” right. The moral argument in favor of permitting physician assistance in suicide is grounded in the conjunction of two principles: self-determination (or autonomy) and mercy (or the avoidance of suffering).Less
Is a physician ever obligated to help a patient die? If physician-assisted suicide were to become legal or legally tolerated, would the patient have a right to assistance, a right held against the physician for performance of this duty? In voter initiatives in Washington, California, and Oregon, in state legislative initiatives, in model statutes such as that of the Boston Working Group, and so on, all proposals have opt-out provisions, or “conscience clauses”, that permit physicians to refuse to participate in a suicide. But the basis of opt-out clauses — the ubiquitous assumption that a physician's scruples provide adequate justification, legally and morally, for excusing him or her from assisting in suicide — is rarely challenged. This chapter reviews the principal arguments for and against physician-assisted suicide in terminal illness. Two kinds of a dying patient's rights to assistance in suicide are considered: the “negative” right and the “positive” right. The moral argument in favor of permitting physician assistance in suicide is grounded in the conjunction of two principles: self-determination (or autonomy) and mercy (or the avoidance of suffering).
David E. Guinn (ed.)
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195178739
- eISBN:
- 9780199784943
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195178734.001.0001
- Subject:
- Religion, Philosophy of Religion
This book discusses the role of religion in a religiously pluralistic liberal society, namely the United States. Nowhere else in the public realm do the fundamental religious questions about the ...
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This book discusses the role of religion in a religiously pluralistic liberal society, namely the United States. Nowhere else in the public realm do the fundamental religious questions about the meaning and nature of life arise in a context where resort to a political answer is the norm. Many people continue to insist that the US Constitution precludes religious participation in the political process, while others insist that by denying a role to religion we fundamentally discriminate against people of faith. As the chapters in this book demonstrate, the issues are complex and multifaceted. The book address such specific and highly contested issues as assisted suicide, stem cell research, cloning, reproductive health, and alternative medicine as well as general questions concerning as who legitimately speaks for religion in public bioethics, what religion can add to our understanding of justice, and the value of faith-based contributions to healthcare. The book begins with overview chapters about the role of religion in bioethics since the inception of the field. It then explores that role in the formation of public policy in terms of sociology, critical studies, philosophy, and religious studies. The book questions the distinction between public policy bioethics and clinical care, recognizing the close interconnection between the two. It offers insight on how religion shapes questions of justice in patient care and the ethical tools provided by Islam, Buddhism, and Evangelical Christianity that can be used both in advocating for public policy and in making individual care decisions. Over the last five to ten years, researchers have begun to explore the efficacy of religion as a mode of treatment.Less
This book discusses the role of religion in a religiously pluralistic liberal society, namely the United States. Nowhere else in the public realm do the fundamental religious questions about the meaning and nature of life arise in a context where resort to a political answer is the norm. Many people continue to insist that the US Constitution precludes religious participation in the political process, while others insist that by denying a role to religion we fundamentally discriminate against people of faith. As the chapters in this book demonstrate, the issues are complex and multifaceted. The book address such specific and highly contested issues as assisted suicide, stem cell research, cloning, reproductive health, and alternative medicine as well as general questions concerning as who legitimately speaks for religion in public bioethics, what religion can add to our understanding of justice, and the value of faith-based contributions to healthcare. The book begins with overview chapters about the role of religion in bioethics since the inception of the field. It then explores that role in the formation of public policy in terms of sociology, critical studies, philosophy, and religious studies. The book questions the distinction between public policy bioethics and clinical care, recognizing the close interconnection between the two. It offers insight on how religion shapes questions of justice in patient care and the ethical tools provided by Islam, Buddhism, and Evangelical Christianity that can be used both in advocating for public policy and in making individual care decisions. Over the last five to ten years, researchers have begun to explore the efficacy of religion as a mode of treatment.
Elizabeth Wicks
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780199547395
- eISBN:
- 9780191594373
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199547395.003.0007
- Subject:
- Law, Human Rights and Immigration, Medical Law
This chapter focuses on the interest and right of autonomy which may conflict with the right to life in the context of suicide and other life-threatening autonomous actions. The positive obligations ...
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This chapter focuses on the interest and right of autonomy which may conflict with the right to life in the context of suicide and other life-threatening autonomous actions. The positive obligations imposed upon states under the right to life in this context are identified, including any special duties imposed in relation to individuals under the control of the state, such as prisoners and mental patients. It is argued that, in respect of a clear suicide attempt by a mentally competent adult, the state’s negative duty not to infringe an individual’s autonomy will outweigh its positive obligation to take reasonable steps to preserve life under the right to life. Suicide should not, therefore, be criminalized but the state is also not required to provide assistance in committing suicide.Less
This chapter focuses on the interest and right of autonomy which may conflict with the right to life in the context of suicide and other life-threatening autonomous actions. The positive obligations imposed upon states under the right to life in this context are identified, including any special duties imposed in relation to individuals under the control of the state, such as prisoners and mental patients. It is argued that, in respect of a clear suicide attempt by a mentally competent adult, the state’s negative duty not to infringe an individual’s autonomy will outweigh its positive obligation to take reasonable steps to preserve life under the right to life. Suicide should not, therefore, be criminalized but the state is also not required to provide assistance in committing suicide.
Guenter Lewy
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199746415
- eISBN:
- 9780199866151
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746415.003.0002
- Subject:
- Philosophy, General
Despite provisions in Dutch law criminalizing all forms of assisted death, a series of court cases since the 1970s made both voluntary euthanasia and physician-assisted suicide, when carried out with ...
More
Despite provisions in Dutch law criminalizing all forms of assisted death, a series of court cases since the 1970s made both voluntary euthanasia and physician-assisted suicide, when carried out with what the courts called “due care,” a practice that carried little risk of prosecution. Legalization, when it came in 2002, for the most part merely changed the law to conform to what long had become accepted by the public, the medical profession, and the courts. This chapter describes the path to legalization and the provision of the 2002 law. It presents demographic and other relevant data concerning end-of-life care. It analyzes problem areas in the practice of euthanasia and physician-assisted suicide, including failure to report cases of assisted death, ending life without explicit request of the patient, termination of life in pediatric cases, and assisted death for patients with mental suffering. Great improvements in palliative care during the last decade mean that most of those who choose assisted death do so for valid personal reasons and not because of the inadequacy of their terminal care. The chapter ends with an assessment of the Dutch regime. It concludes that the real difference between the Netherlands and countries that criminalize assisted death is that in the Netherlands this practice is out in the open and subject to legal control. While this system of control, like the enforcement of laws everywhere, is imperfect, it is probably better than no legal control at all.Less
Despite provisions in Dutch law criminalizing all forms of assisted death, a series of court cases since the 1970s made both voluntary euthanasia and physician-assisted suicide, when carried out with what the courts called “due care,” a practice that carried little risk of prosecution. Legalization, when it came in 2002, for the most part merely changed the law to conform to what long had become accepted by the public, the medical profession, and the courts. This chapter describes the path to legalization and the provision of the 2002 law. It presents demographic and other relevant data concerning end-of-life care. It analyzes problem areas in the practice of euthanasia and physician-assisted suicide, including failure to report cases of assisted death, ending life without explicit request of the patient, termination of life in pediatric cases, and assisted death for patients with mental suffering. Great improvements in palliative care during the last decade mean that most of those who choose assisted death do so for valid personal reasons and not because of the inadequacy of their terminal care. The chapter ends with an assessment of the Dutch regime. It concludes that the real difference between the Netherlands and countries that criminalize assisted death is that in the Netherlands this practice is out in the open and subject to legal control. While this system of control, like the enforcement of laws everywhere, is imperfect, it is probably better than no legal control at all.
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.003.0003
- Subject:
- Philosophy, Moral Philosophy
Because we tend to be rather myopic in our discussions of death and dying, especially about the issues of active euthanasia and assisted suicide, it is valuable to place the question of how we go ...
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Because we tend to be rather myopic in our discussions of death and dying, especially about the issues of active euthanasia and assisted suicide, it is valuable to place the question of how we go about dying in an international context. This chapter explores the three rather different approaches to end-of-life dilemmas prevalent in the United States, the Netherlands, and Germany — developments mirrored in Australia, Belgium, Switzerland, and elsewhere in the developed world — and consider how a society might think about which model of approach to dying is most appropriate for it. The United States, with the sole exception of Oregon, legally permits only withholding and withdrawal of treatment, “double effect” uses of high doses of opiates, and terminal sedation, all conceived of as “allowing to die”. The Netherlands permits these but also permits voluntary active euthanasia and physician-assisted suicide. Germany rejects physician-performed euthanasia but, at least until recent legal threats, permits assisted suicide not assisted by a physician.Less
Because we tend to be rather myopic in our discussions of death and dying, especially about the issues of active euthanasia and assisted suicide, it is valuable to place the question of how we go about dying in an international context. This chapter explores the three rather different approaches to end-of-life dilemmas prevalent in the United States, the Netherlands, and Germany — developments mirrored in Australia, Belgium, Switzerland, and elsewhere in the developed world — and consider how a society might think about which model of approach to dying is most appropriate for it. The United States, with the sole exception of Oregon, legally permits only withholding and withdrawal of treatment, “double effect” uses of high doses of opiates, and terminal sedation, all conceived of as “allowing to die”. The Netherlands permits these but also permits voluntary active euthanasia and physician-assisted suicide. Germany rejects physician-performed euthanasia but, at least until recent legal threats, permits assisted suicide not assisted by a physician.
Guenter Lewy
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199746415
- eISBN:
- 9780199866151
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746415.003.0001
- Subject:
- Philosophy, General
This introductory chapter reviews the US Supreme Court's decisions regarding the refusal of unwanted medical treatment and the states' right to legalize assisted death. As of the time of writing, ...
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This introductory chapter reviews the US Supreme Court's decisions regarding the refusal of unwanted medical treatment and the states' right to legalize assisted death. As of the time of writing, Oregon, Washington, and Montana allow physician-assisted suicide. The fact that until 1997 physician-assisted suicide was illegal in all states of the union explains the suicide practice of Dr. Jack Krevorkian—a pathologist with no special expertise in end-of-life care—whose conduct, until ended by his imprisonment, probably represented the worst case scenario of a maverick doctor on his own. Equally unsettling is the fact that despite its illegality in most jurisdictions, the deliberate ending of life by physicians occurs rather often. This euthanasia underground, an entirely unregulated aspect of medicine, reveals a pattern that not only is secretive and deceptive but also has great potential for abuse. The question therefore is probably not whether to permit physician-assisted suicide. The real choice we face is whether we seek to regulate and control the practice of assisted death, or whether it is left unregulated and unchecked, which creates great risks for both doctors and patients.Less
This introductory chapter reviews the US Supreme Court's decisions regarding the refusal of unwanted medical treatment and the states' right to legalize assisted death. As of the time of writing, Oregon, Washington, and Montana allow physician-assisted suicide. The fact that until 1997 physician-assisted suicide was illegal in all states of the union explains the suicide practice of Dr. Jack Krevorkian—a pathologist with no special expertise in end-of-life care—whose conduct, until ended by his imprisonment, probably represented the worst case scenario of a maverick doctor on his own. Equally unsettling is the fact that despite its illegality in most jurisdictions, the deliberate ending of life by physicians occurs rather often. This euthanasia underground, an entirely unregulated aspect of medicine, reveals a pattern that not only is secretive and deceptive but also has great potential for abuse. The question therefore is probably not whether to permit physician-assisted suicide. The real choice we face is whether we seek to regulate and control the practice of assisted death, or whether it is left unregulated and unchecked, which creates great risks for both doctors and patients.
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.003.0016
- Subject:
- Philosophy, Moral Philosophy
In the years since Dr. Jack Kevorkian went to jail, public involvement with the issues of physician-assisted suicide and voluntary active euthanasia may seem to have subsided in the United States. ...
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In the years since Dr. Jack Kevorkian went to jail, public involvement with the issues of physician-assisted suicide and voluntary active euthanasia may seem to have subsided in the United States. Many other countries have been concerned with end-of-life issues, including Canada, the Netherlands, Britain, Australia, Switzerland, Belgium, and the Scandinavian countries, but the change is most evident in the United States. This chapter looks at the ways in which new strategies of political and legal activism by both proponents and opponents of legalization are tending to escalate the debate. It examines the controversy surrounding an Oregon legislation that would prohibit the dispensing or distribution of scheduled drugs for the purpose of causing, or assisting in causing, the suicide or euthanasia of any individual. It discusses a series of methods of producing death that can be employed without the assistance of a physician and without prescription-controlled drugs, though they will still assure a gentle, easy death. These techniques are generally referred to as “self-deliverance new technologies,” or “NuTech”.Less
In the years since Dr. Jack Kevorkian went to jail, public involvement with the issues of physician-assisted suicide and voluntary active euthanasia may seem to have subsided in the United States. Many other countries have been concerned with end-of-life issues, including Canada, the Netherlands, Britain, Australia, Switzerland, Belgium, and the Scandinavian countries, but the change is most evident in the United States. This chapter looks at the ways in which new strategies of political and legal activism by both proponents and opponents of legalization are tending to escalate the debate. It examines the controversy surrounding an Oregon legislation that would prohibit the dispensing or distribution of scheduled drugs for the purpose of causing, or assisting in causing, the suicide or euthanasia of any individual. It discusses a series of methods of producing death that can be employed without the assistance of a physician and without prescription-controlled drugs, though they will still assure a gentle, easy death. These techniques are generally referred to as “self-deliverance new technologies,” or “NuTech”.
Penney Lewis
- Published in print:
- 2007
- Published Online:
- January 2009
- ISBN:
- 9780199212873
- eISBN:
- 9780191707063
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199212873.003.0001
- Subject:
- Law, Criminal Law and Criminology, Medical Law
The upsurge in interest in assisted dying has occurred against a backdrop of growing concern over the modern reality of dying. Important terms must be defined including euthanasia (voluntary, ...
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The upsurge in interest in assisted dying has occurred against a backdrop of growing concern over the modern reality of dying. Important terms must be defined including euthanasia (voluntary, non-voluntary, and involuntary); assisted suicide; assisted dying; and other medical behaviour that (potentially) shortens life. The current legal position in most major Western jurisdictions is relatively consistent. Most common law and some civil law jurisdictions treat termination of life on request or voluntary active euthanasia as murder. Some civil law jurisdictions have a separate, lesser offence of consensual homicide or termination of life on request, and others have a separate offence of compassionate homicide. Most jurisdictions have criminal prohibitions on assisted suicide, although a minority restrict the scope of criminalization of assistance in suicide based on the assister's motive. In jurisdicitions without a prohibition on assisting suicide, other offences may be used to effectively criminalize such behaviour.Less
The upsurge in interest in assisted dying has occurred against a backdrop of growing concern over the modern reality of dying. Important terms must be defined including euthanasia (voluntary, non-voluntary, and involuntary); assisted suicide; assisted dying; and other medical behaviour that (potentially) shortens life. The current legal position in most major Western jurisdictions is relatively consistent. Most common law and some civil law jurisdictions treat termination of life on request or voluntary active euthanasia as murder. Some civil law jurisdictions have a separate, lesser offence of consensual homicide or termination of life on request, and others have a separate offence of compassionate homicide. Most jurisdictions have criminal prohibitions on assisted suicide, although a minority restrict the scope of criminalization of assistance in suicide based on the assister's motive. In jurisdicitions without a prohibition on assisting suicide, other offences may be used to effectively criminalize such behaviour.
Joshua A. Green and Matthew G. Jarvis
- Published in print:
- 2008
- Published Online:
- October 2011
- ISBN:
- 9780195329414
- eISBN:
- 9780199851720
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195329414.003.0012
- Subject:
- Political Science, American Politics
This chapter examines both the structure of public opinion on the right to die and how different framings of the issue affect that structure. In general, respondents are much more likely to support ...
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This chapter examines both the structure of public opinion on the right to die and how different framings of the issue affect that structure. In general, respondents are much more likely to support the right to die or assisted suicide when asked about a hypothetical case that involves a terminal illness or extreme pain, a painless method of “exit,” and consultation with family. Support for the right to die is considerably weaker among opponents of abortion, opponents of the death penalty, blacks, women, Republicans, and people scoring high on measures of religiosity. Rulings by the Supreme Court do not seem to have had any effect on Americans' attitudes toward end-of-life issues. Court cases at both the state and federal levels regarding right-to-die issues have contributed to impressive spikes in media attention that bring the controversy to the forefront of national debate.Less
This chapter examines both the structure of public opinion on the right to die and how different framings of the issue affect that structure. In general, respondents are much more likely to support the right to die or assisted suicide when asked about a hypothetical case that involves a terminal illness or extreme pain, a painless method of “exit,” and consultation with family. Support for the right to die is considerably weaker among opponents of abortion, opponents of the death penalty, blacks, women, Republicans, and people scoring high on measures of religiosity. Rulings by the Supreme Court do not seem to have had any effect on Americans' attitudes toward end-of-life issues. Court cases at both the state and federal levels regarding right-to-die issues have contributed to impressive spikes in media attention that bring the controversy to the forefront of national debate.
Margaret Pabst Battin
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195140279
- eISBN:
- 9780199850280
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195140279.003.0004
- Subject:
- Philosophy, Moral Philosophy
Vigorous, often vitriolic debate over active euthanasia and physician-assisted suicide in terminal illness has occupied both the public and the medical profession in many countries in recent years. ...
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Vigorous, often vitriolic debate over active euthanasia and physician-assisted suicide in terminal illness has occupied both the public and the medical profession in many countries in recent years. Comparatively little public and professional discussion, however, has focused on AIDS. Social and legal conditions relevant in decision-making vary widely among illnesses: in some places — the Netherlands, Switzerland, and Oregon, for example — assisted or physician-assisted suicide is legal, so that patients can openly discuss their choices with their physicians and also in the presence of family and friends, something much riskier in other places. If assistance in suicide is provided, it should protect as much as possible the rationality of the patient's choice. This chapter provides an analysis of what is called the “rational structure” of the choice faced by a person contemplating the possibility of suicide — what components it has, in what order they occur, and what types of problems can be addressed. It shows that it is possible to explore the rationality of end-of-life choices.Less
Vigorous, often vitriolic debate over active euthanasia and physician-assisted suicide in terminal illness has occupied both the public and the medical profession in many countries in recent years. Comparatively little public and professional discussion, however, has focused on AIDS. Social and legal conditions relevant in decision-making vary widely among illnesses: in some places — the Netherlands, Switzerland, and Oregon, for example — assisted or physician-assisted suicide is legal, so that patients can openly discuss their choices with their physicians and also in the presence of family and friends, something much riskier in other places. If assistance in suicide is provided, it should protect as much as possible the rationality of the patient's choice. This chapter provides an analysis of what is called the “rational structure” of the choice faced by a person contemplating the possibility of suicide — what components it has, in what order they occur, and what types of problems can be addressed. It shows that it is possible to explore the rationality of end-of-life choices.
Russell K. Portenoy and Eduardo Bruera
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195130652
- eISBN:
- 9780199999842
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195130652.003.0019
- Subject:
- Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
With the growing public, political, and medical interest in physician-assisted suicide, euthanasia, and other end-of-life issues, the importance of empirical research related to end-of-life care has ...
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With the growing public, political, and medical interest in physician-assisted suicide, euthanasia, and other end-of-life issues, the importance of empirical research related to end-of-life care has become increasingly apparent. The need for such research has resulted in a rapidly growing empirical literature addressing many end-of-life issues. This chapter examines a number of the primary methodological issues that accompany such complex areas as physician-assisted suicide and the desire for death. The primary issues covered here involve difficulties selecting and operationalizing dependent variables, sampling issues, and confounding influences on the measurement of relevant variables. Legalization offers unique opportunities for researchers to study individuals who actually seek assisted suicide instead of the hypothetical preferences frequently studied, and this research promises to yield important data to guide future policy debates.Less
With the growing public, political, and medical interest in physician-assisted suicide, euthanasia, and other end-of-life issues, the importance of empirical research related to end-of-life care has become increasingly apparent. The need for such research has resulted in a rapidly growing empirical literature addressing many end-of-life issues. This chapter examines a number of the primary methodological issues that accompany such complex areas as physician-assisted suicide and the desire for death. The primary issues covered here involve difficulties selecting and operationalizing dependent variables, sampling issues, and confounding influences on the measurement of relevant variables. Legalization offers unique opportunities for researchers to study individuals who actually seek assisted suicide instead of the hypothetical preferences frequently studied, and this research promises to yield important data to guide future policy debates.
Louise Campbell
- Published in print:
- 2016
- Published Online:
- May 2016
- ISBN:
- 9780719099465
- eISBN:
- 9781526104410
- Item type:
- chapter
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719099465.003.0005
- Subject:
- Sociology, Culture
This chapter provides an analysis of the main ethical issues which arise in the debate about assisted suicide, with particular attention to the role played by the concept of autonomy in the ...
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This chapter provides an analysis of the main ethical issues which arise in the debate about assisted suicide, with particular attention to the role played by the concept of autonomy in the discussion. The concept of autonomy plays a prominent role in justifying claims that a terminally-ill person should have a right to determine the point at which his or her life should end. However, opponents of assisted suicide argue both that such claims distort the meaning of autonomy and that autonomy should not be prioritised when its exercise threatens the rights or interests of healthcare professionals, family members or others. The chapter attempts to determine whether the concept of autonomy is capable of supporting the arguments on both sides of the discussion which rely on it. It examines briefly the evolution of the concept of autonomy in healthcare generally and analyses the role played by arguments from autonomy in support of, and against, the permissibility of assisted dying/suicide. It provides a critique of the use of the concept of autonomy on both sides of the debate and examine the implications of this critique for the validity of the concept of autonomy in healthcare more generally.Less
This chapter provides an analysis of the main ethical issues which arise in the debate about assisted suicide, with particular attention to the role played by the concept of autonomy in the discussion. The concept of autonomy plays a prominent role in justifying claims that a terminally-ill person should have a right to determine the point at which his or her life should end. However, opponents of assisted suicide argue both that such claims distort the meaning of autonomy and that autonomy should not be prioritised when its exercise threatens the rights or interests of healthcare professionals, family members or others. The chapter attempts to determine whether the concept of autonomy is capable of supporting the arguments on both sides of the discussion which rely on it. It examines briefly the evolution of the concept of autonomy in healthcare generally and analyses the role played by arguments from autonomy in support of, and against, the permissibility of assisted dying/suicide. It provides a critique of the use of the concept of autonomy on both sides of the debate and examine the implications of this critique for the validity of the concept of autonomy in healthcare more generally.
