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Medical Euthanasia

An HSP3M6 ISP Research Presentation

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on 25 January 2010

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Transcript of Medical Euthanasia

Medical Euthanasia Background Info Broad Topic Where does it all fit? Known Unknowns, M.D. A Good Death? Dr. Shemirani??? Why did I choose this topic?

Interest in medicine

Inspired by the House episode 'Known Unknowns'

Death is something every human being will have to face TERMINOLOGY
Physician Assisted Suicide (PAS) THEMES
Philosophy (Life & Death)
Autonomy and Dignity
"Euthanasia is a practice that if legalized allows for the alleviation of family trauma, easing of physical pain, and conservation of valuable medical resources."
Could not finalize my position until the last minute
Each side has logical and rational arguments
Stayed on the pro side Bibliography 1.Niemeyer, Darcy. "Eigth Annual Report on Oregon's Death with Dignity Act." Oregon.gov. 09 Mar. 2006. Oregon Department of Human Services, Web. 10 Jan 2010. <http://www.oregon.gov/DHS/ph/pas/docs/year8.pdf>.
2. "Euthanasia: The Key Points of the FMSQ Survey ." Federation des Medecins Specialistes du Quebec. 13 Oct. 2009. Federation des Medecins Specialistes du Quebec, Web. 18 Jan 2010. <http://www.fmsq.org/e/centredepresse/communiques/coms/20091013.html>.
3.Barnes, Stephen. "Baby Boomer Update: Baby Boomer Health Challenges." 2009. San Diego State University Interwork Institute, Web. 18 Jan 2010. <http://calbooming.sdsu.edu/documents/BabyBoomerHealthChallenges.pdf >.
4.Wister, Andrew. "Discussion paper: The aging of the baby boomer generation." Health Innovation Forum. Simon Frasier University, Web. 18 Jan 2010. <http://www.healthinnovationforum.org/2009/aug/01/aging-baby-boomer-generation/>.
5."Historical Timeline History of Euthanasia and Physician-Assisted Suicide." Euthanasia.ProCon.org. 04 Jan 2010. ProCon.org, Web. 23 Jan 2010. <http://euthanasia.procon.org/viewresource.asp?resourceID=000130#2000-present>.
6.Glasser, William. Positive Addiction. Oxford, England: Harper & Row, 1976. 8. Print.
7.Keown, John. Euthanasia examined: ethical, clinical, and legal perspectives. Cambridge, United Kingdom: Cambridge Univ Pr, 1997. 141-164. Print.
8."Voluntary Euthanasia ." Stanford Encyclopedia of Philosophy. 27 08 2008. Stanford University, Web. 3 Jan 2010. <http://plato.stanford.edu/entries/euthanasia-voluntary/>.
9.Wasmuth, Carl E. "Euthanasia." Encyclopedia Americana. 2010. Grolier Online. 3 Jan. 2010 <http://ea.grolier.com/article?id=0148430-00>.
10.Swarte, Nikki, Marije van der Lee, Johanna van der Bom, Jan van den Bout, and Peter Heintz. "Effects of euthanasia on the bereaved family and friends: a cross sectional study." British Medical Journal 327. (2003): n. pag. Web. 17 Jan 2010. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC166123/>.
11.Clark, Jocalyn. "Freedom from unpleasant symptoms is essential for a good death." British Medical Journal 327. (2003): n. pag. Web. 18 Jan 2010. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126569/>.
12.White, Katherine, Susi Wise, Ross Young, and Melissa Hyde. "Exploring the Beliefs Underlying Attitudes to Active Voluntary Euthanasia in a Sample of Australian Medical Practitioners and Nurses: A Qualitative Analysis." Omega: Journal of Death & Dying 58.1 (2009): 19-39. Web. 3 Jan 2010. <http://web.ebscohost.com/ehost/detail?vid=1&hid=111&sid=e374a9bd-f4f9-4c2c-b6c8-be702d37b1ff%40sessionmgr113&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=ehh&AN=35042000#db=ehh&AN=35042000>.
13.van den Block, Lieve, Reginald Deschepper, Johan Bilsen, Viviane van Casteren, Nathalie Bossuyt, and Luc Deliens. "Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium." British Medical Journal 339. (2009): n. pag. Web. 18 Jan 2010. <http://www.bmj.com/cgi/content/abstract/339/jul30_2/b2772>.
14.Lewis, Charles. "Canadians still have reservations regarding euthanasia: poll." National Post 02 Nov. 2009, Web. <http://network.nationalpost.com/np/blogs/holy-post/archive/2009/11/02/canadians-still-have-reservations-regarding-euthanasia-poll.aspx>.
15.“Diane Pretty dies.” BBC News 12 May 2009, Web. <http://news.bbc.co.uk/2/hi/health/1983457.stm>
16.“Debate call after euthanasia poll.” BBC News. 9 Sep. 2004, Web. <http://news.bbc.co.uk/2/hi/uk_news/scotland/3640438.stm>
17.“Most support voluntary euthanasia.” BBC News. 24 Jan. 2007, Web. <http://news.bbc.co.uk/2/hi/health/6293695.stm>
18."Ageing Population Fuels Debate." BBC News. 28 Nov. 2000, Web. <http://news.bbc.co.uk/2/hi/health/background_briefings/euthanasia/331125.stm>
19.“Dr. Moor: Landmark Verdict.” BBC News. 28 Nov. 2000, Web. <http://news.bbc.co.uk/2/hi/health/background_briefings/euthanasia/331263.stm>
Psychology Sociology The Voice of the Public Alleviation or Aggravation? The Bleak Future To Assist or not to Assist Legislative Framework and Palliative Care The Slippery Slope to what? Ancient Greeks , Stoics, and Spartans all supported euthanasia

Philosophers like Plato, Aristotle, Pythagoras, and Cicero advertised its use

7th century A.D., St. Augustine forbids euthanasia under Christian law

1500s, Thomas More creates an imaginary utopia that supports euthanasia

1943/8, Pope Pius the 7th condemns euthanasia after news of Nazi euthanasia clinics

1990s marked the legalization of voluntary euthanasia in Australia’s Northern Territory

1994 Death with Dignity Act is passed in Oregon

1996-7 Northern Territory faces legal opposition and the law is overturned

1997 a repeal to the Oregonian law is rejected

2000 a Death with Dignity Act in Maine is defeated

2001, John Ashcroft prohibits controlled substance use in euthanasia, but his motion and further appeals were denied by the U.S. District Court

2001, full legalization of euthanasia in Netherlands

2008, Luxembourg legalizes euthanasia

2008, Washington also legalizes the Death with Dignity Act

2008-9, Montana legalizes the Death with Dignity Act
affects societal views of life and death

paradigm shift in medicine and social institutions like hospitals
physical and psychological suffering

depression and its effects on the human mind

psychiatric assessments to measure competence in decisions
"Voluntary euthanasia is a deep rooted medical practice that alleviates trauma for those who wish to be freed, has an overwhelming support community in society and medicine, and allows for a solution of to the looming medical resource dearth." severe pain is a symptom of terminal illness

Diane Pretty case and Motor Neurone Disease

a study in Utrecht, Netherlands, showed family and friends of cancer patients felt better after euthanasia than a natural death

British Medical Journal - relief of unpleasant symptoms, place of death, time of death, and lack of heroic medical intervention were top characteristics of good death

support for euthanasia is growing

3 U.S. states have legalized PAS in the past 10 years

Netherlands, Luxembourg, and Belgium all support euthanasia as well

a poll conducted by Pedrum Shemirani showed support is strong in younger generations =D

61% of Canadians, and 75% of Quebecers support voluntary euthanasia

British survey showed 80% would support doctor's
administering lethal drugs if requested but only 60%
show support if the doctor did not inject it him/herself

the number of elderly is increasing

by 2031 there will be 36 000 people aged over 100 in the U.K.

by 2030 the number of people aged over 65 in the U.K. will be 13.5 million

in China the elderly population is expected to double between 2000 and 2027

chronic illnesses are expected to increase

hospital wait times and taxes will increase

euthanasia allows for those who wish to die to fulfill their wish and relieve the health sector
no legislation foces doctors to perform euthanasia

many doctors perform euthanasia illegally like Dr. Moor and Dr. Kevorkian

some medical associations like the Fédération des Médecins Spécialistes du Québec and the Quebec College of Physicians and Surgeons supports legalizing euthanasia

76% of members said they would openly support euthanasia if the House of Commons passed such a bill
pallative care will never replace euthanasia and vice-versa
opioids only make pain bearable or side effects will result
the process requires trial and error and is only received near the end of life
psychological suffering is difficult to relieve
in Oregon patients must be told of options and receive proper care before euthanasia
multiple requests, signatures, witnesses, and external prognosis must be made opponents argue voluntary legalization will lead to involuntary acceptance

no such cases have been reported in Oregon

since 2002 only 38 deaths occur every year

12 of every 10 000 deaths is PAS related
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