rae, moral choices: euthanasia 3

8/4/2019 Rae, Moral Choices: Euthanasia 3

1/15

Ethics and the terminationof life support (TLS)

The courts have in the USA ruled such action islegal - this does not mean there are not moral

issues involved - not every decision to turn off

life support is morally acceptable.

If a person needs help from a ventilator to aid

recovery, or if CPR will restart a persons heart,

surely these should not be withheld?

And, what of the cost of treatments which helpcancer patients etc. - some of these drugs might

only give a little extra time and are very

expensive

Wednesday 21 September 2011


2/15

Withdrawing andwithholding

treatments - if it is ethically acceptable to

withdraw a treatment then it is to

withhold it - there appears no significant

moral difference. But to withdraw

treatment can be far more emotional for

the family concerned - it can feel like the

family are then causing the death by

taking away the treatment.

In removing treatment the doctor doesnot cause death - they simply allow a

disease etc. To take its natural course

(result = death).



3/15

Removal of such support does not mean

the family cause death - the disease does

this, whether it is slowly or quickly. People

who want no more treatment might not

want to die, they just want to live out

their life without medical technology

interfering.

Does this mean we are playing God by

TLS - this could only apply if TLS is

killing the person (which it is not)- so forexample removal of a feeding tube is not

starving a person, the disease is

preventing them from feeding.



4/15

Does it violate the idea of the sanctity of

human life-

life is sacred so as long as theperson has breath we (medical science)

should do all we can to keep them alive?

Here a family could not make any

decisions which would remove treatmentskeeping people alive - but is medical

science obliged to keep people alive at all

times and regardless of cost? Is it

acceptable to humbly accept death is

coming, but it is not the end, and so chose

not to employ life support systems?



5/15

In fact this view of the sanctity of life

might suggest earthly life is the highest

good. When we know eternal life withGod is the greatest good - if this is

accepted there has to be a time when it is

ok to say it is ok to end life support and

let death take its course.Some say we continue as long as possible

hoping for a miracle to occur. Is this a

failure to let go? If a miracle is desired

should all support be removed anyway?Rae suggests the greatest miracle is the

ulhealingas we enter into eternity

with the Lord.



6/15

Refusing treatments with time to live

What if someone declines

treatment, such as kidney dialysis,

which would give them longer life?

Some say suffering has redemptive

value-James 1:2

-5

-but this isusually about suffering for your

faith or suffering that is

unavoidable, and it will add to your

character (which will be perfect ineternity)-1 Pet 2:20-25- if all

suffering is redemptive you should

never go to a doctor or dentist!



7/15

But we cannot terminate lifesupport in every case - we

should consider:1. Does an adult suffererrequest it in writing or orally?

2. Is the treatment of no

benefit to the patient?3. Does the burden to thepatient outweigh the benefit?

Usually TLS takes place when

support is futile orburdensome. In the US it islegal and a patient has theright to refuse any treatmentthey do not want.



8/15

Doctors can say no!

The US has seen a legal battle fought overthe right of a doctor to say no to patients,

or more their families, who demandtreatment thought to be of no benefit tothe patient. (Doctors have to try to findanother doctor who will do what the

family ask).Doctors can refuse to give futiletreatment - e.g. an antibiotic for a virus,or those which will not reverse an

imminent downward spiral towards death.Also if the burden of treatment exceedsbenefit then this is now examined - notjust for the patient, but family(e.g. costs)

and even of societ as a whole.Wednesday 21 September 2011


9/15

Withdrawal of nutrition and hydration

Not giving food and water to a patient ina permanent vegetative state or with low

brain function from Alzheimers - brainfunction is lost apart from the brain stem

which controls lower involuntary actions(breathing, digestion etc.). If food/water

provided the person might live to arelatively advanced age - added to whichthe person might not have a terminalillness.

Medically provided food/water aremedical treatment- as it is medicallyprovided some say it is like a ventilatorperforming a function that the body

cannot do any longer.Wednesday 21 September 2011


10/15

Some say food and water are needed even

in dying, they are a base level of care for

the dying symbolising our care for them.

It can then be asked if the person is held

captive by medical technology? They are

exiled from the human community but

denied death. And, if they have no higher

brain function, can a person experience

pain?

Most bioethicists, according to Rae, saywithdrawal of food/water to people in a

vegetative state is acceptable as it is a

medical treatment



11/15

Physician assisted suicideand euthanasia(PAS/E)

These issues are increasinglybringing life and death choices andsituations into normal peopleslives.

Rae says that the bible teaches thatthe taking of life is a prerogativethat belongs to God alone - henceno suicide or murder. Should this

apply to these issues-

many(in theworld) think no, but religious

believers tend to think this violatesmoral ground protecting the life anddignity of the seriously ill.



12/15

In the USA there are many state

laws prohibiting PAS/E - but still

increasing demand for it to be

allowed - and in some parts of

Europe it is already legal. Although

PAS/E are different the same

arguments are often applied to

both .

Rae suggests we have an

imaginary conversation with JackKevorkian who tells us why he is so

committed to the leagalisation of

physician assisted suicide.



13/15

Arguing for Mercy- the most

merciful thing to do for aterminally ill person who is

suffering and wants to die is to

offer PAS/E. Medicine aims to

relieve suffering- we readily do

this for animals. The Golden Rule

might be cited - who would want

to suffer needlessly at the end oflife? So we should do to them

what we would have done to us.



14/15

Raes response: the number of people this

would affect (with severe suffering prior to

death) is very low(there are some though)-for most the pain can be controlled so there

is no need for PAS/E. Also there are other

options such as a does of painkiller which

means the patient will sleep before theydie - this is not killing as the disease still

takes its course. It is also possible that the

pain relief might affect the heart rate of the

patient and hasten death - the law of doubleeffect - this is acceptable as the intent is

what is important and if intent was to

relieve pain (not permanently) then it is ok.



15/15

Arguing for utility[useful, profitable,

beneficial]- if PAS/E is done at a patients

request it is win-win - there is no downside- patients suffering is ended

- high costs are removed

- family can grieve and get on with life

- medical staffdo not have to deal with theanguish of a long drawn out death process

Rae counters saying: what of the long and

short term impact on the public at large - are

the effects good for peoplein society in general,esp. those thinking of PAS/E - should any

utilitarian approach be countered by sanctity of

life/prohibition of killing?

W d d 21 S t b 2011

rae, moral choices: euthanasia 3

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