Deck 10: Euthanasia

Question 1

Respirator Removal. Jim is an active person. He is a lawyer by profession. When he was forty-four years old, a routine physical revealed that he had a tumor on his right lung. After surgery to remove that lung, he returned to a normal life. However, four years later, a cancerous tumor is found in his other lung. He knows he has only months to live. Then comes the last hospitalization. He is on a respirator. It is extremely uncomfortable for him, and he is frustrated by not being able to talk because of the tubes. After some thought, he decides that he does not want to live out his last few weeks like this and asks to have the respirator removed. Because he is no longer able to breathe on his own, he knows this means he will die shortly after it is removed. Do Jim or the doctors who remove the respirator and then watch Jim die as a result do anything wrong? Why or why not? Would there be any difference between this case and that of a person such as Terri Schiavo, who was in a persistent vegetative state, was not able to express her current wishes, and had left no written request? Would there be a difference in cases such as hers between removing a respirator (which she was not using) and removing a feeding tube? How would you tell whether a respirator or a feeding tube would be considered an ordinary or extraordinary means of life support? What would be the significance of these labels in each case?

Answer 1

Euthanasia means killing a person to free them from suffering and pain according to the wish of that person. It is also called mercy killing. There are two types of euthanasia, which are as follows:
• Active euthanasia
• Passive euthanasia
If the doctors stop the treatment and let a patient die cannot be considered as wrong due to the following reasons:
• J wishes to remove the respirator to avoid the pain and discomfort in final days
• No one forced J to make express the wish to remove the respirator. It is free consent
• People are considered to be autonomous, meaning that they have the power to decide when and how to end their lives
Non-voluntary euthanasia is different from voluntary euthanasia since the patient would not be able to communicate their wishes to the doctor or physician. Hence, doctors should do anything possible to keep a patient alive if the patient does not have the ability to express their desire to die.
Removing a respirator or a feeding tube are both examples of passive euthanasia, meaning that a physician stops the treatment that would keep the patient alive. Both would be considered ordinary means of life support because they are standard measures that a doctor or physician is morally obligated to perform. Moreover, they are treatments that have a good chance of being successfully in helping the patient to get better.

Question 2

What is the difference between "whole brain death" and "persistent vegetative state?"

Answer 2

The difference between whole brain death and persistent vegetative state is that whole brain death indicates a person who has lost all brain functions. This is the criteria used to define a person legally dead. On the other hand, a person in a persistent vegetative state is unconscious but he or she still has some basic brain function that allows him or her to remain awake.

Question 3

Pill Overdose. Mary Jones has a severe case of cerebral palsy. She has spent twenty-eight years of life trying to cope with the varying disabilities it caused. She can get around somewhat in her motorized wheelchair. An aide feeds her and takes care of her small apartment. She went to junior college and earned a degree in sociology. She also has a mechanism whereby she can type on a computer. However, she has lately become weary with life. She sees no improvement ahead and wants to die. She has been receiving pain pills from her doctor. Now she asks for several weeks' worth of prescriptions so that she will not have to return for more so often. Her doctor suspects that she might be suicidal.
Should Mary Jones's doctor continue giving her the pills? Why or why not? Would she be assisting in Mary's suicide if she did? Should Mary have a right to end her life if she chooses? Why or why not? Should her physician actually be able to administer some death-causing drug and not just provide the pills? Why or why not?

Answer 3

Euthanasia means killing a person to free them from suffering and pain according to the wish of that person. It is also called mercy killing. The following are the types of euthanasia:
• Active euthanasia
• Passive euthanasia
• Voluntary euthanasia
• Involuntary euthanasia
• Non voluntary euthanasia
• Physician assisted suicide
In this case, the doctor should continue to give the medication to MJ, the patient until the patient tells the doctor otherwise due to the following reasons:
• It is the doctor's moral duty to provide treatment to patients that would make them suffer less and keep them alive
• If the doctor would stop providing the medication, then it would be passive euthanasia, which implies that the doctor would be assisting the patient in suicide
• People are autonomous, meaning that they have the power to decide when and how to end their lives. MJ wants to die through the physician assisted suicide
• Therefore, the patient has the right to end her life if she believes it is the right thing to do. The physician should give to the patient drugs that would make her die if that is the patient's intention

Question 4

If a person has whole brain death, then what kind of euthanasia is possible? Explain.

Question 5

Teen Euthanasia. Thirteen-year-old Samantha is in the last stages of cancer. She says she doesn't want any further treatment because she thinks that it is not going to make her well. Her parents want the doctors to try a new experimental therapy for which there is some hope. If they cannot convince Samantha to undergo this experimental procedure, should the doctors sedate Samantha and go ahead with it anyway, or should they do what she asks and let her die? Do you think that the doctors should be allowed to end her life with a fatal dose of a drug if that is what she wishes, even though her parents object and they are still her legal guardians?

Question 6

What is the difference between active and passive euthanasia? Is physician-assisted suicide more like active or passive euthanasia? How so?

Question 7

Baby John Doe. Sarah and Mike's baby boy was born with a defect called spina bifida, which involves an opening in the spine. In his case, it is of the more severe kind in which the spinal cord also protrudes through the hole. The opening is moderately high in the spine, and thus they are told that his neurological control below that level will be affected. He will have no bowel and bladder control and will not be able to walk unassisted. The cerebral spinal fluid has already started to back up into the cavity surrounding his brain, and his head is swelling. Doctors advise that they could have a shunt put in place to drain this fluid and prevent pressure on the brain. They could also have the spinal opening repaired. If they do not do so, however, the baby will probably die from an infection. Sarah and Mike are afraid of raising such a child and worry that he would have an extremely difficult life. In a few cases, however, children with this anomaly who do not have the surgery do not die, and then they are worse off than if the operation were performed. What should Sarah and Mike do? Why?

Question 8

Where do advance directives such as living wills and durable powers of attorney fit into the distinction between voluntary and non-voluntary euthanasia?

Question 9

What is the difference between ordinary and extraordinary measures of life support? If some measure of life support were common and inexpensive, would this necessarily make it an ordinary means of life support? Explain.

Question 10

Label the following as examples of voluntary or non-voluntary and active or passive euthanasia; if passive, are the measures described more likely to be considered ordinary or extraordinary measures of life support?
a. A person who is dying asks to be given a fatal drug dose to bring about his death.
b. A dying patient asks that no more chemotherapy be administered because it is doing nothing but prolonging her time until death, which is inevitable in a short time anyway.
c. Parents of a newborn whose condition involves moderate retardation refuse permission for a simple surgery that would repair a physical anomaly inconsistent with continued life, and they let the infant die. d. A husband gives his wife a lethal overdose of her pain medicine because he does not want to see her suffer anymore.
e. Doctors decide not to try to start an artificial feeding mechanism for their patient because they believe that it will be futile, that is, ineffective given the condition of their patient.

Question 11

List the consequentialist concerns that could be given in arguing about whether the actions proposed in three of the scenarios in Question 6 are justified.
Reference: Question 6:
Label the following as examples of voluntary or non-voluntary and active or passive euthanasia; if passive, are the measures described more likely to be considered ordinary or extraordinary measures of life support?
a. A person who is dying asks to be given a fatal drug dose to bring about his death.
b. A dying patient asks that no more chemotherapy be administered because it is doing nothing but prolonging her time until death, which is inevitable in a short time anyway.
c. Parents of a newborn whose condition involves moderate retardation refuse permission for a simple surgery that would repair a physical anomaly inconsistent with continued life, and they let the infant die. d. A husband gives his wife a lethal overdose of her pain medicine because he does not want to see her suffer anymore.
e. Doctors decide not to try to start an artificial feeding mechanism for their patient because they believe that it will be futile, that is, ineffective given the condition of their patient.

Question 12

What non consequentialist concerns could be given in arguing about these same three scenarios?