Assisted Dying Plan - Euthanasia essay plan and resources PDF

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Euthanasia essay plan and resources...

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Assisted Dying Plan Reading: CORE Herring Chapter 10 FURTHER McMahan, J The Ethics of Killing OUP: Oxford, 2002 Dworkin, R Life’s Dominion Harper Collins, 1993 Keown, J Euthanasia, Ethics and Public Policy CUP, 2002 Other links https://peachyessay.com/sample-essay/law-on-assisted-suicide-english-legal-system/ https://johnwyatt.com/2019/03/07/essay-euthanasia-and-assisted-suicide-the-ukexperience/

Past Paper Questions 1. Consider to what extent the enactment of the current Assisted Dying Bill would enable doctors to respect autonomy, relieve suffering and treat their patients with humanity, whilst avoiding most of the consequences which are feared by those who oppose the legalisation of euthanasia. 2. Consider whether the Assisted Dying Bill would, if enacted, answer the demands of those who favour legalising euthanasia whilst meeting the concerns of those who oppose it. 3. “It would always be unacceptable for medical professionals to deliberately bring about a patient’s death, but it would be equally unacceptable to strive to prolong a life of pain and disability, where death is the natural outcome.” Discuss. 4. “Objections for proposals to legalise physician assisted dying are based more on practicalities than fundamental principles.” Discuss. 5. “Whereas a general mercy killing defence would undermine the criminal law and put patients and others at risk, there is strong case for legalising physician assisted suicide in limited circumstances.” Discuss 6. ‘In view of the extent to which the current law enables doctors to end suffering and to respect patient’s autonomous decisions to refuse life prolonging treatment, there is no good argument for legalising physician assisted suicide.’ Discuss. 7. Does the doctrine of double effect allow medical professionals to smuggle euthanasia in by the back door? Should the principle be abandoned, or does it serve a useful purpose? 8. Is the current state of the law on assisted suicide satisfactory? If not, how should it be changed? 9. Discuss whether respect for patient autonomy requires legalising euthanasia?

10. ‘Euthanasia does not need to be legalised. The doctrine of double effect provides satisfactory scope for end of life care.’ Do you agree? Give reasons for your answer. 11. ‘There is no need to legalise euthanasia as the current law is perfectly acceptable.’ Do you agree? Give reasons for your answer. REFER to situation in other countries- adopting a comparative perspective

Three-fold clarification between three types of euthanasia  Voluntary euthanasia – causing the patient’s death at the patient’s request  Non-voluntary euthanasia – causing the patient’s death without the consent or objection of the patient  Involuntary euthanasia – causing the patient’s death against her wishes. Typically murder  As we will see, both active voluntary euthanasia and assisted suicide are criminal offences in England  Assisted dying is an umbrella term that refers to euthanasia and assisted suicide  Note that some reformists prefer term assisted dying than euthanasia, because euthanasia can have some negative connotations The Law  Murder – common law. Mens rea and actus reus. Relevant intention to end the life of the patient  Suicide Act 1961, s.2(1) criminalises ‘encouraging or assisting’ suicide  Dr Cox- potassium chloride Defences  Mercy killing – diminished responsibility?  Law Commission Report Partial Defences to Murder (2004) reported that:  In all murder prosecutions in which Diminished Responsibility was pleaded (on mercy killing facts) the plea was accepted. [BUT not for medical staff]  Seems fair, but there are issues:  But not applicable to medical staff? Reformers therefore argue that it does not go far enough in providing protections against various individuals to whom they want to assist in ending the lives of others  Also only a partial defence to a murder charge and it is also merely a defence, whereas reformers of the law would want to argue that people who help others end their lives in acts of legitimate assisted dying should not have to resort to defences to protect themselves under criminal law; these situations should be legal from the beginning Euthanasia Debate in Court  R (Nicklinson) v Ministry of Justice  Precedent in Purdy (2009)

Currently there is a stand-off- currently law remains the same and no reform. Assisted Dying Bill failed and has not passed into law. So currently a stand-off with some judicial opinions suggesting the law may be incompatible with the convention rights but parliament has not taken that forward and legislated on the issue and courts have not yet issued a declaration of incompatibility. Closest courts have come to ruling that the law on assisted dying is inconsistent with convention rights Two principles (deontological thinking)  Doctrine of double effect  Act/omissions distinction  Relevant to criminal law and medical law  Also, widely discussed by moral philosophers who are interested in the ethics of harming and liability to defensive harm. So application in cases of self-defence, war and criminal law cases beyond medical context Doctrine of Double Effect  Traced to St. Thomas Aquinas  In law, Bodkin Adams (1957) quote  So the doctrine of double effect says it is objectionable for the doctor to give pain killing medication knowing it may result in patient’s death, as long as they do not intend it to cause patient’s death, they merely foresee it as a side effect  Primary intention is to relieve pain of patient  Airedale NHS v Bland (1993) - Lord Goff “.[It is] the established rule that a doctor may, when caring for a patient, who is, for example, dying of cancer, lawfully administer painkilling drugs despite the fact that he knows that an incidental effect of that application will be to abbreviate the patient’s life …Such decisions may properly be made as part of the care of the living patient, in his best interest; and, on this basis, the treatment will be lawful.” - Also re-establishes the legality of the doctrine of double effect and emphasises in addition that the treatment has to be in patient’s best interests  But double effect permits doctors to be confident they will not face charge. - Double effect allows doctors to make difficult end of life decisions without worrying about potential criminal prosecution - Double effect provides a legal shield against doctors and other medical professionals to practice end of life care in the best interests of their patients Problems with Double Effect  Conflicts with notion of intent laid down in Wooliin case  Smuggles euthanasia in by the back door- difficult to establish intention of the doctor. By referring to Dr Cox case by way of comparison where it was easily proven that intention was to bring about patient’s death since PC had no medical benefits. Other drugs can be more ambiguous  Does not depend upon request  May lead to a culture of managing patients with a view to their death Summary of Double Effect

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Seems to be many pros and cons to the doctrine of double effect On one level it seems entirely necessary because without it, it would be difficult to administer palliative care to patients But also worries that it smuggles euthanasia in by the back door Encourages doctors not to do what is directly in patient’s best interests but rather to manage patients with a view to facilitating their death

Act/Omission Distinction  NHS Airedale Trust v Bland (1993)  Browne-Wilkinson said that removal of feeding tube counted as an omission not an act  Lord Goff said discontinuance of life support counted as an omission  Criticism of distinction – J. Glover Causing deaths and saving lives (1997) 92-4.  so sometimes the distinctions between acts and omissions can be complex  and this is important because it can make the difference between a case of active euthanasia and passive euthanasia Assisted Dying (No. 2) Bill 2015 Importance of safeguards to prevent slippery slope and abuse of the system This act was not passed into law so we are in a situation at present where assisted dying is a criminal offence, assisted suicide is a criminal offence in this country subject to the principles of double effect and the acts/omission distinction So unlikely there will be legal reform, Bill would only apply to those with terminal illnesses, so would not have provided recourse for Nicklinson and others who have challenged the law Broader Debate on Assisted Dying The Arguments for and against the legalisation of assisted dying Further reading and further perspectives feminist perspective – women more likely to be pushed forward so this could be an issue with legalising euthanasia perspective from Wolf from Herring textbook Herring’s point that by focusing on euthanasia we are potentially diverting resources away from other areas such as mental health Allocation of resources perspective Australia – recent example of reform Lots of checks and balances Safeguards are so critical for reform of the system Nuances – problems with lack of clarity, exceptions which makes the position unclear, there is no positive right but lots of different legal ramifications. Letting it in through the back door Incoherence, amorphous

Creative ideas – wider interests at play...