Death by Assistance: Euthanasia and PAS

By Kumiko Sasa

Euthanasia: Active vs. Passive

Active: “occurs when the medical professionals, or another person, deliberately do something that causes the patient to die” (BBC News,2014)

Passive: “the patient dies because the medical professionals either don’t do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive” (BBC News,2014)

EX:

-Taking someone off life support machine/ feeding tube

-Not carrying out a specific life-extending procedure or

- Giving them life extending drugs

Conflict over definitions! (Boudreau and Somerville, 2014)• Euthanasia’s Origins: meaning of “a good, gentle, and easy death”

(Boudreau & Somerville, 2014, p.2). • Today: ”to euthanize,” which the Oxford Dictionary indicates as the action

of “putting (a living being, especially a dog or cat) to death humanely” (2015). • Boudrea and Somerville’s perspective: USE the Canadian Senate’s Definition

• which states that euthanasia refers to “the deliberate act undertaken by one person with the intention of ending the life of another person in order to relieve that person’s suffering” (Parliament of Canada, 2000).

• OFTEN CONFUSED WITH PHYSICIAN ASSISTED SUICIDE

Physician Assisted Suicide (PAS) 0r Physician Aid-in-Dying (PAD)

• “the practice in which a physician provides a competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient’s request, which the patient intends to use to end his or her own life” (Starks, Dudzinski & White, 2014).

• BOLDED statements get at “The Dying

Person’s Bill of Rights”

be treated as a living human until I die.

maintain a sense of hopefulness, however changing its focus may be.

be cared for by those who can maintain a sense of hopefulness, however changing this may be.

express my feelings and emotions about my approaching death in my own way.

expect continuing medical and nursing attention even though

“cure” goals must be changed to “comfort” goals.

not die alone.

participate in decisions concerning my care.

be free of pain.

have my questions answered honestly.

retain my individuality and not be judged for my decisions, which may be

contrary to the belief of others.

expect that the sanctity of the human body will be respected after

death.

be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and will be able to gain some satisfaction in helping me

face my death.

FROM A SOCIAL WORK PERSPECTIVE Definitions and actions of Euthanasia and PAS = BIOETHICAL CHALLENGES

Each respect individual’s autonomy and self-determination What about Beneficence? Doing what’s best for client but not harming the client or

others?

Section 1.02 in the Code of Ethics of the National Association of Social Workers:

“social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others” (National Association of Social Workers, 2008).

QUIZ QUESTION: Why is PAS and Euthanasia a bioethical challenge for social workers?

Answer: Conflict between the autonomy of the client and it’s the risk of harm to the client

This challenge is presented to the general public as well

Against PAS• The word suicide! The act of

taking one’s life.• STIGMA: Society tends to

associate it with the concept of failure, either in community support, mistreatment of mental health issues, or individual shortcomings.

• It’s a scapegoat for life’s reality!

• “Free choice of PAS is illusory”- (Golden, 2014).• Driving forces: feelings of

being a burden on family, elder abuse

• Overall problems in managed care.

For PAS• Respecting autonomy, justice,

compassion, honesty and transparency (Starks, Dudzinski, & White, 2014)

• Relief of anguish for patient and family• Predictability in death, preparation for

death and saying goodbye

• allows patients the opportunity to “die with dignity rather than have the illness reduce them to a shell of their former selves” (Balancedpolitics.org, 2014)

• reduce health care costs, “which would save estates and lower insurance premiums,” along with freeing up nurses and doctors “to work on savable patients” (Balancedpolitics.org, 2014)

CONCLUSION

https://www.youtube.com/watch?v=kk0_X7Yb7jA