VSED

This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.

| * Established the independent mental capacity advocates service * Makes it clear who can make decisions for other individuals in different situations, and how they must go about doing so. * Applies whether the decision is about living changing events or every day matters – relevant to adults of any age, regardless of when they lost capacity

The dilemma for ethics committees brought up by the story of Patrick is a question of how much is too much. As technologies in the medical field continue to advance, people can live substantially longer lives, but are they lives worth living? Some people, like Patrick, don’t think being paralyzed is a quality of life worth living. Others, like Armando, refuse to be made DNR and cling to life even if it consists of communicating by blinking of the eye. The questions raised in this book are awful decisions that nobody should ever have to make. Whatever the committees and doctors choose to do can keep patients alive and allow them to have a low quality of live, be in constant pain and be a burden to society, or keep a terminally ill patient comfortable until he or she has said their good-byes and let nature take its course.

The patient is experiencing a major illness or disease within their body. All patients who qualify for this act are terminally ill and have six months or less to live. They have exhausted all treatment options or are opting to forgo treatment in favor of quality and not quantity of life. The medications administered to facilitate dying cause CNS depression which lowers the heart rate and respirations and increases drowsiness causing sedation and then ultimately death.

Quality of life is defined as a person’s wellbeing in terms of health and happiness. With a terminal illness, decline in mental and physical abilities is almost always prevalent. Physician assisted suicide would allow patients to end their life when the “patient’s own ‘value threshold’ for life has been crossed” (Breslow). PAS would allow patients to die while they still feel like their life has meaning and is a life worth living. The Journal of the American Medical Association conducted a study on PAS which concluded that “loss of autonomy and dignity, inability to enjoy life and regular activities and other types of mental distress were the dominant motivation” for seeking PAS (Esposito). If a person can no longer partake in anything that they find enjoyable they do not have a great quality of life. Many people “therefore view it as a means of self-preservation – the opposite of suicide” (Quill). One physician, with a mentally ill brother, stated that if his brother was “bed bound and unable to eat due to his dementia progressing, he would not have any reasonable quality of life, and I would not want to prolong his suffering” (Francis). Quality of life can diminish with illness, but through PAS, patients are able to preserve the quality of life that

It is also clear that while making these decisions, the decisions ought to be made based on informed consent (Werth and Crow 195). Sometime, the patient may be experiencing dementia, clinical depression or delirium for which they may be affecting the patient’s decision making capabilities (Werth and Crow 197, 198). If such a person is allowed to make their right-to-die decision, this may be done without the patient having comprehensive information before consent and thus should not be encouraged (Werth and Crow 198).

It is more important to help a person suffering from mental illness to recover, before they are legally allowed to make such a terminal decision, and after a “thorough and comprehensive attempt to improve their life we have still not made living acceptable to them, we need to allow assistance to die” (Purdy, 2015). The exclusion of mental health as a condition, ties into the safeguard of type of condition. The 2007 British Attitude Survey shows that 84% of respondents agreed that a doctor should “definitely” or “probably” be legally allowed to end a patient’s life at their request” if they are suffering from unbearable pain and terminal illness (p39). However, if assisted dying were to be legalised extending this right to those suffering from painful chronic illnesses or severe disabilities should also be considered, if these individuals make the request, sufferer from terrible quality of life and show no sign of recovery. For example, it seems immoral to allow a cancer patient to request assisted dying, but not allow a paralysed individual, like Tony Nicklinson, to request the same consideration.

Many people believe that the passing of Death With Dignity Laws is a slippery slope that will lead to a variety of unethical medical practices including the use of these laws on mentally ill or Alzheimer’s patients. In all of the states that passed the law there are strict guidelines as to how can access the law and in many cases the laws have not changed since they were passed. The laws come from the idea that terminally ill people should be able to control how they suffer and ultimately how they die without interference from the government, religious organizations, or other external sources of policy. Although a patient may have the lethal dose of prescription provided by their physician under the law in their possession they have absolutely no obligation to use it and in many they don’t. In cases where the medication is taken the patients who choose to take it have self-control and more dignity than they would if they had to suffer through the degenerative processes of a terminal illness.

life by physician-assisted suicide or euthanasia. One of the reasons why states have concerns and interests in these two forms of suicide is because, “the state has an interest in the preservation of human life, and that far too many lives are lost prematurely” (Wellman, 2003). A great number of people that are elderly and dying will go to hospice. Hospice is where people go to die. It involves not giving food, fluids, or medicine to their patients. However, if their patients are starving and dehydrated then that is a form of suicide by not giving them the proper nutrition. Individuals would have closure with families, friends, and be able to make proper arrangements for their assets, if physician-assisted suicide and voluntary euthanasia were

There are limited choices the terminally ill have, and physician assisted suicide is one of them. Physician-assisted suicide gives these individuals that are suffering some control. In today’s society physician-assisted suicide is a very controversial subject of social interest; this should be a socially acceptable way for the terminally ill to choose to die.

For many years, medical assisted death has been disagreed upon with the Canadian Quebec legislation, Bill 52, An Act respecting end-of-life care. Terminal ill patients have been fighting rights with their incurable conditions which caused them unbearable suffering. In many situations, death is always unacceptable since life was given for a reason. We all must pass away one day, although for some individuals, death can be measured by time due to tragic news that they have been informed about. In means of measuring time, we would all like to know when and how our death would be given. “Living is not good, but living is well. The wise man, therefore, lives as well as he should, not as long as he can...He will always think of life in terms of quality not quantity…Dying early or late is of no relevance, dying well or ill is…life is not to be bought at any cost. – The Stoic philosopher Seneca (4 B.C.- 69 A.D).” (Shneidman, 2001, p. 5). Sue Rodriguez, who was an advocate for medical assisted death, fought for legal rights in 1993. She was diagnosed with Amyotrophic lateral sclerosis (ALS) in 1991. In a video to the Parliament, she poured her heart out. “If I cannot give consent to my own death, whose body is this? Who owns my life?” (CBC Radio-Canada, 1993). She lost the battle against Supreme Court Canada to legalize assisted death under the Criminal Code of Canada. In 1994, Rodriguez was given a “constitutional exemption” which allowed assisted death under many conditions. In

In the Netherlands, 2.1% of those who requested assisted dying were those who were between 65-74 years old. The elderly who experienced Alzheimer’s, chronic illness and physical handicaps did not have a heightened risk of PAS. The vast majority of PAS were requested by 18-64 year old. Therefore, there is no current evidence to support the so-called slippery slope concern about the risk of abuse towards the elderly in physician-assisted suicides. Other slippery-slope claims are that the legalization of voluntary PAS will result in non-voluntary PAS and many PAS request are due to mental illness and depression (Boer 2007). Neither of these claims is supported by evidence and is false (Boer 2007, Battin 2007). 20% of PAS requests came from depressed patients; 0% progressed to PAS (Battin). Overall, the mere possibility of abuse towards the elderly is a extremely weak argument. The legal system is built upon placing restriction in order to avoid a slippery slope (Rubin 2010).

Speker and Scully (2008) stated that the Act sets out decision specific standards that define the assessment of capacity and best interest principles to improve the decision making for patients that is believed to lack capacity. The Act put out the justification that patient undergoing serious treatment must have an independent mental capacity benefactor in the absence of any appropriate person to consult in determining the client’s interests, underpinning the legal significance bestowed on the patient’s rights, autonomy, liberty, and empowerment. If there is no independent

The new topic that we discussed in class was about assisted suicide and death hastening. This new source that I found talks about if someone can hasten their death as they wished if they have dementia and I found this article to be really interesting. The article starts out by saying how it can be simple to hasten your own death. All you have to do is not eat or drink for a week. The article mentions the case of Margaret Bentley. Bentley had decided years ago that she wanted to stop eating if she became disabled. Her dementia had gotten a lot worse and she needed other people to help her. Her family would allow her to die and they respected her wishes, but the administrators of her nursing home did not. She even wrote and signed a living will

Active euthanasia should be permitted as a medical treatment to allow people the right to die with dignity without pain and in peace. Euthanasia, also known as assisted suicide or mercy killing, takes on many different forms. When most Americans think of euthanasia, they think of a specific form that is referred to as “active euthanasia” which means to actively do something that will end a patient’s life with or without that individual’s consent. When euthanasia is performed in an involuntary manner it is usually because the patient is comatose, unconscious, or otherwise unable to communicate whether or not they want to have their life prolonged through artificial means. In such cases, the physician makes an