RS1/2 CS – Introduction to Religion in Contemporary Society (AS)
Topic One: Medical & Environmental Issues
Aim
At the end of this topic you should be able to:
· explain the difference between active and passive euthanasia
· understand a range of different religious viewpoints on euthanasia
· explain the moral and religious arguments surrounding euthanasia
· evaluate the arguments for and against legalising euthanasia
· evaluate arguments surrounding the use of animals for entertainment and medical experimentation
· understand issues of hunting, blood sports and culling in the UK.
EUTHANASIA
Euthanasia is a medical procedure by which a person who may be suffering from a very painful or terminal illness or may be seriously brain damaged and beyond assistance is helped, perhaps by a doctor to die. ‘Euthanasia’ comes from the Greek words ‘eu’ meaning ‘well’ or ‘good’ and ‘thanatos’ meaning death. It literally means ‘good death.’
‘Euthanasia is the intentional killing by act or omission, of one whose life is deemed not worth living.’ – New Dictionary of Christian Ethics.
Assisted suicide is a form of euthanasia where a terminally ill person asks a friend or family member to help them to commit suicide – for example by getting them drugs, poisons or by taking them to a clinic abroad where they will be assisted to die.
There are two important differences concerning the way that euthanasia is performed:
· Active euthanasia occurs where a person asks a doctor or other person to take an action deliberately designed to end their life, for instance, to give them a lethal injection. It is illegal to agree to do this in the UK.
· Passive euthanasia occurs where a person is allowed to die by withdrawing medical treatment – for example, by turning off the life-support machine of someone in a coma. This is legal in the UK.
For reflection
Do you think that active and passive euthanasia should be treated the same? Why / why not?
Euthanasia – the present legal position:
In the UK, euthanasia is illegal, apart from passive euthanasia.
• It is a crime to deliberately or recklessly bring about the death of another person without just cause – Homicide Act 1957, and assisted suicide is made illegal under the Suicide Act 1971.
• The offence is murder or manslaughter and the offender is liable to be imprisoned.
• In 1993, the House of Lords rejected a proposal to legalise euthanasia, saying: ‘It would be next to impossible to ensure that all acts of euthanasia were truly voluntary’.
A number of people have signed a legal document called a ‘living will’ or ‘advance directive’ which says that, if they ever suffer serious brain damage, they should be allowed to die and do not want to receive medical treatment. Such documents are not valid in the UK.
However, recently there have been some amendments to the law:
Mental Capacity Act 2007:
· The patient may appoint a representative with power of attorney to instruct doctors to stop giving treatment.
February 2010 Government guidelines:
Those who help loved ones to die (‘assisted suicide’) may not be prosecuted if:
· the victim is in their right mind and asks for help to die
· the person helping is a close relative or friend acting out of love and compassion. This does not include the victim’s doctor.
· they report it to police immediately.
In some European countries, notably Belgium and the Netherlands, active euthanasia is permitted for the terminally ill who have expressed a desire to die and where the consent of two doctors and a panel of experts have agreed. In the UK meanwhile, the Brunel University Survey disclosed that in 2003, 936 people died by voluntary euthanasia and 1,930 by involuntary euthanasia.
For reflection
Do you agree with the rules concerning euthanasia in the Netherlands? Why / why not?
Voluntary Euthanasia
This is where the patient has expressed their desire to die. Though illegal in the UK, many groups have campaigned to have the law changed to allow euthanasia to be carried out if it is the specific request of the dying person. One group, ‘Dignity in Dying’ offers this vision:
‘For everyone to be guaranteed choice and dignity at the end of their life… a legal right to effective pain relief and help to ease suffering… We want a full range of choices to be available to terminally ill people including medically assisted dying within strict legal safeguards.’ – (www.dignityindying.org.uk)
Case Study – Diane Pretty
Diane Pretty had incurable Motor Neurone disease. Her mind was sharp but her muscles were fading away, leaving her in a wheelchair and fed artificially. She did not want to die from choking, so went to court to argue that it was her human right to die and that she wanted her husband to help her to commit suicide. The Court said that this was illegal and that she had no right to die. In the end, she died without euthanasia in 2002.
Because such euthanasia is illegal in the UK, a number of British people have visited a very controversial Swiss organisation called ‘Dignitas’ that has a clinic which enables those with terminal illnesses to undergo assisted suicide. A person who wishes to die has to meet the doctors first and they must consent to the assisted suicide procedure. Assisted suicides are carried out by lethal injection or drink and the person dies peacefully.
Seminar Topic
Should voluntary euthanasia be legalised? Examine the reasons for and against.
Is ‘Dignitas’ the answer or is there a better alternative?
Case Study – Daniel James
Daniel James, aged 23, suffered a terrible accident whilst playing rugby and was paralysed. He was in constant pain, could not move and needed 24 hour care. Daniel hated this and tried on three occasions to commit suicide, but was unable to do so. Finally, he asked his parents to take him to the Dignitas Clinic in Switzerland, where he would be able to die. They reluctantly agreed and he died peacefully there by euthanasia. Many people criticized Daniel’s parents for letting him die when he was so young and in his right mind. His mother said that it was a decision made out of love and compassion.
For Reflection
Were Daniel’s parents right to act as they did?
Non-Voluntary Euthanasia
This is the killing of a person who is unable to express their own desire as to whether they want to live or die – for example, someone in a long-term coma or a Permanent Vegetative State. Here, the issue is ‘at what point does someone cease to be a person?’ This is very difficult, because if they are not a person, then killing them is not murder.
This is controversial, because with advances in medical science, the notion of personhood and death has changed – we know now, for example, that just because a heart stops, it doesn’t mean a person is already dead. Even ‘brain death’ is problematic – does it mean the death of the whole brain, the higher functions only (thoughts and feelings) or brainstem death?
Case example – Tony Bland
Tony was severely injured in the Hillsborough football tragedy of 1989, when supporters were crushed against barriers. Tony was diagnosed as being in a Persistent Vegetative State. He had to be fed artificially and his family wanted his treatment to stop and for Tony to be allowed to die. However, this was not agreed to because some believed that not feeding Tony would amount to murder. It took a four year battle in the courts before it was agreed that the artificial feeding could be stopped because there was no real chance of Tony ever recovering. Tony died in 1993. Many critics expressed the view that legalised euthanasia in this situation would have been a kinder option.
Writing Task:
‘Euthanasia should never be carried out on young people.’ Assess this view.
Arguments for legalising euthanasia
· Personal Autonomy – A person should be allowed to make important decisions concerning their own lives. The General Medical Council’s ‘Good Medical Practice’ Guide (2006) states that doctors should respond to patients’ concerns and respect their rights when making decisions about their medical treatment and care.
· ‘Quality of Life’ – People are entitled to a reasonable quality of life, which includes physical, intellectual and emotional well-being. If, through severe illness, a person no longer has a real quality of life, perhaps because they are bed-ridden and totally dependent upon others, then they should be allowed to have their lives ended in a dignified manner, if that is what they wish.
· Ending Suffering – If a person is in severe pain with no hope of a cure, then being allowed to die will end their suffering. Some say that this may be the most loving thing to do.
· Pressures on Society – Many elderly and terminally sick people have no family to care for them and there are not enough places in hospices. Also, the continued medical treatment of such people is very costly in terms of money and hospital care. Death may be preferable – and many people often say they would prefer to die than have dementia or Alzheimer’s disease.
· Patient’s Family – If a person is dying very slowly, this can put great pressure on their families and can affect the family emotionally and psychologically. Allowing a patient to die would reduce such suffering.
· Regulation – The ‘Principle of Double Effect’ means that a doctor may legally administer a pain-killing drug such as morphine, even though it may have the secondary effect of hastening the patient’s death. The doctor is not held responsible for the patient’s death in such circumstances. However, this is confusing, and legalising euthanasia would enable patients to be treated more consistently.
· Is there a difference? – Some argue that if passive euthanasia (withdrawing medical treatment) is legal, then why is active euthanasia, through say a lethal injection, illegal? Is there a difference?
· Other Countries – Euthanasia is legal in a number of other countries and many UK citizens are forced to go abroad, perhaps to the Dignitas Clinic, to die. This is very distressing and expensive. It would be better to allow people to die with dignity in their own homes.
· NHS Budget – It would be a better use of limited NHS resources to spend money on treating younger patients who are more likely to recover.
Seminar Topic
Which of these reasons do you think is the most convincing and why?
Are there any other more convincing reasons?
Arguments against legalising euthanasia
· Sanctity of Life – A religious argument that euthanasia is against God’s will. All life is created by God and therefore sacred. A person has no right to commit suicide or take the life of another. Life is created by God for a purpose and can only be ended by God.
· Vulnerability – People who are suffering should not have pressure put upon them to choose whether or not to die.
· Doctors – If doctors had the right to end life, then people would feel less confident about them being able to treat and save lives.
· Mistakes – Doctors may wrongly diagnose that someone is terminally ill – for example, people with severe brain injuries can recover.
· Motive – Can we be really sure that a person asking for euthanasia really means it? Maybe it is just a cry for help? It can be difficult to be certain of a person’s real intentions.
· ‘Slippery Slope’ – If we allow euthanasia, then other controversial issues will follow – infanticide, killing of the handicapped etc. Also, euthanasia could become compulsory.
· Respects for Life – Will euthanasia make people view life as less important? What kind of society do we want – one that kills or cares for?
· Medical Duty – The medical ethic guidelines for doctors and the famous Hippocratic Oath, state that doctors have a duty never to harm a patient and to treat them to the best of their ability.
For reflection
Is there such a thing as the sanctity of life?
Seminar Topic
Which of these arguments is the most convincing and which is the least convincing? Why?
The Hospice Movement
A hospice is a place where terminally ill patients are cared for. There are over a hundred in the UK. In recent years, palliative care has developed greatly – this is care which takes away the extremes of suffering and allows people to live out their days in peace and dignity.
The hospice movement exists to:
· control pain and give patients the best possible quality of life
· care for the terminally ill
· show the public and the medical profession an alternative to euthanasia
· offer people in the final days of life the chance to end their days with peace and dignity.
Patients are sometimes able to go home or to nursing homes and be cared for by McMillan Nurses employed by the hospices.
Seminar Topic
Here are some views from people who either support or are against euthanasia. Which are the most convincing and why?
‘It allows the patient a gentle, pain-free death.’