Recap:Recap:

Describe the UK laws regarding Describe the UK laws regarding voluntary euthanasia 3KUvoluntary euthanasia 3KU

Suggested areas covered in answers: Suggested areas covered in answers: Illegal Illegal England – assisted suicide illegal England – assisted suicide illegal Scotland – no suicide law, it is Scotland – no suicide law, it is

murder/culpable homicide murder/culpable homicide punishable by 14 years in prison. punishable by 14 years in prison.

What are some problems What are some problems and benefits of the UK and benefits of the UK Law?Law?

Some problems of UK LawSome problems of UK Law It is vagueIt is vague. It neither denies nor permits . It neither denies nor permits

euthanasia and allows euthanasia by the back euthanasia and allows euthanasia by the back door. It forces euthanasia underground. door. It forces euthanasia underground.

Each case is taken on its own merits though Each case is taken on its own merits though this causes this causes problems of consistencyproblems of consistency. .

It does not protect the right to life of the dying It does not protect the right to life of the dying and and allows people to take the law and morality allows people to take the law and morality into their own hands.into their own hands.

It prolongs the agony of the dying and It prolongs the agony of the dying and fails to fails to take account of high quality palliative care.take account of high quality palliative care.

Some benefits of UK LawSome benefits of UK Law Each case is dealt with on its own merits. Each case is dealt with on its own merits.

Responsibility lies with the courtsResponsibility lies with the courts not with the not with the individual or medical staff thus it does not place individual or medical staff thus it does not place medical or political organizations in a difficult medical or political organizations in a difficult position.position.

It sets clear precedents and it It sets clear precedents and it does not make it does not make it easy to give euthanasia. easy to give euthanasia.

It works- it is a halfway house between legalization It works- it is a halfway house between legalization and an outright ban.and an outright ban.

UK Law: SummaryUK Law: Summary Illegal

Treatment can be withdrawn or refused

Double effect is legal

Goes on all the time

Benefits and drawbacks of present law

UK Law and Law in UK Law and Law in HollandHolland

EuthanasiaEuthanasia

The Law in HollandThe Law in Holland Since 1973 the Dutch government had been Since 1973 the Dutch government had been

aware that euthanasia was being practiced by aware that euthanasia was being practiced by medical staff. During the following years the medical staff. During the following years the practice became more widespread and more practice became more widespread and more accepted by the public and politicians alike. accepted by the public and politicians alike.

By 2001 the Dutch parliament comfortably By 2001 the Dutch parliament comfortably passed the Termination of Life on Request and passed the Termination of Life on Request and Assisted Suicide (Review Procedures) Act which Assisted Suicide (Review Procedures) Act which became law on April 1, 2002. The law basically became law on April 1, 2002. The law basically made legal what had been common practice for made legal what had been common practice for about 20 years. about 20 years.

Here is the situation…Here is the situation…

The Law in Holland (1)The Law in Holland (1) Euthanasia must be performed in accordance with

careful medical practice, that is, the official guidelines are to be observed.

All cases will be discussed by a regional review committee, made up of a lawyer, a doctor, an ethicist and others.

Euthanasia and assisted suicide will not be a crime if carried out by a doctor who has followed the guidelines, and reported it to a local medical examiner.

The local medical examiner has to satisfy himself that procedures have been carried out properly and then sends a report to the regional committee and the prosecutor.

The Law in Holland (2)The Law in Holland (2) Children between 12 and 16 must normally have

their parents' consent before they may request euthanasia. In exceptional cases a doctor may agree to a child's request even without parental consent.

Requests by children aged 16 -17 do not require parental consent, but parents should be involved in decision making.

Patients who are able may request euthanasia through an advance directive.

The patient's suffering must be unbearable with no prospect of improvement.

The Law in Holland (3)The Law in Holland (3) The patient's request for euthanasia must be

voluntary and persist over time (the request can not be granted when under the influence of others, psychological illness or drugs).

The patient must be fully aware of his/her condition, prospects and options and there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above- the independent doctor must have no previous knowledge of the patient.

The DeathThe Death The death must be carried out in a medically proper

fashion. It is preferred that the patient takes the fatal medication themselves but often this is not possible.

Medication usually involves a drug that makes the patient unconscious followed by a drug that stops the heart. The drugs are taken intravenously or orally and the doctor must be present throughout the procedure.

If these conditions are not met then the doctor will be subject to prosecution.

It is possible for non-Dutch nationals to receive euthanasia. It is strongly discouraged but euthanasia tourism remains an issue.

In practice…In practice… In 2003 just over 1% of deaths in Holland were through

requests for euthanasia. The bulk of them were for cancer patients and the most of the patients opted to die at home.

It is very likely that these figures are artificially low because many deaths from euthanasia will not have been recorded or reported. The Dutch government is very self-conscious of the need to be clear on its euthanasia legislation and have an excellent guide on the web at: http://www.minbuza.nl/default.asp?CMS_ITEM=MBZ413077

Interestingly enough the Dutch government has palliative

care as an entitlement in their National Health Service unlike the UK where there is a dependence on charitable organisations to provide palliative care.

Euthanasia debate flares up in Europe

What are some criticisms What are some criticisms and positive reactions of and positive reactions of the Law in Holland?the Law in Holland?

Some criticisms of Dutch Some criticisms of Dutch LawLaw

It does not prevent illegal euthanasia and euthanasia can go unreported. It permits involuntary euthanasia in some cases. This violates the principle that government’s duty is to protect lives of innocent.

It goes against the fundamental purpose of a doctor as a healer and changes the patient-doctor relationship.

It increases pressure on doctors from families and patients and also on patients to request euthanasia. Furthermore Doctors against euthanasia are under pressure to go against their conscience.

It may overestimate maturity in minors and an Advance Directive risks uninformed changes of mind. 66% of requests are turned down thus patient doesn’t really have the right to choose, it is up to others.

Positive reactions to Dutch LawPositive reactions to Dutch Law It reduces incidences of underground euthanasia and it

has safeguards against abuse through its procedures. Better to have laws about euthanasia than none at all. Euthanasia laws allow it to be regulated.

It is compassionate and it allows people to die with dignity at a time of their choosing. The policy seeks to ensure that those thinking about euthanasia are fully informed and it gives people a choice.

Palliative care is given equal importance in the law.

Doctors and nurses can never be disciplined or prosecuted for not carrying out euthanasia and it takes moral burden off doctors.

Summary: Dutch LawSummary: Dutch Law Legal since 2002

Available for 12+ only

Referred to committee

Referred to medical examiner

Preferred that patients do it themselves

Most requests are refused

Small percentage officially recorded

Benefits and drawbacks

Describe the Netherlands‟ law on Describe the Netherlands‟ law on voluntary euthanasia. 3KUvoluntary euthanasia. 3KU

Suggested areas covered in answers: Suggested areas covered in answers: Legal but only if strict criteria are met Legal but only if strict criteria are met Still a criminal offence if strict criteria are not met Still a criminal offence if strict criteria are not met Age limit Age limit Medical procedure Medical procedure Unbearable suffering Unbearable suffering Persistent request Persistent request Legal, social and medical check ups Legal, social and medical check ups Alternatives explained. Alternatives explained.

““Euthanasia laws provide Euthanasia laws provide adequate protection for adequate protection for everyone involved in it.” Explain everyone involved in it.” Explain two reasons why some people two reasons why some people disagree with this statement. disagree with this statement.

Suggested areas covered in answers: Suggested areas covered in answers: UK laws don’t protect from pain UK laws don’t protect from pain Euthanasia goes on in many forms so there is no Euthanasia goes on in many forms so there is no

protection protection

Inadequate end of life care Inadequate end of life care Euthanasia cases regularly appear in court – stressful for Euthanasia cases regularly appear in court – stressful for

all. all.

Should the UK adopt Laws Should the UK adopt Laws similar to those in Holland similar to those in Holland concerning euthanasia?concerning euthanasia?

18/04/23

H/W for Thursday -Research the H/W for Thursday -Research the following names in relation to following names in relation to

euthanasiaeuthanasia Micheal Caine

Charlotte Wyatt Tony Bland Reginald Crewe Dignitas Dr. Ann Turner Terry Prachett

Organise you ideas in a suitable way. Who shares ideas? Who would disagree?

ExTN: What are your opinions on these case studies?