This chapter discusses ethical and legal aspects of euthanasia and assisted dying. It first examines the non-voluntary termination of life, covering the relationship between medical treatment and assistance in dying as a matter of failure to treat, and the philosophical concept of ‘double effect’. The chapter then discusses activity and passivity in assisted dying; dying as an expression of patient autonomy; suicide and assisted suicide; physician-assisted suicide; and assisted dying in practice.
Chapter
19. Medical Assistance in Dying
G. T. Laurie, S. H. E. Harmon, and E. S. Dove
Chapter
18. Euthanasia and Assisted Suicide
A. M. Farrell and E. S. Dove
As with treatment withdrawal and withholding, both law and ethics are engaged in the debates on euthanasia and assisted suicide. While the law is immovable on the proscription of the former as murder, assisted suicide is becoming increasingly permissible in various jurisdictions, subject to a range of conditions, or ‘safeguards’. These range from residency in the jurisdiction for a period of time, to capacity and a terminal diagnosis. In this chapter, we begin by discussing the question of euthanasia, before turning to assisted suicide as an expression of a person’s autonomy. We consider the ways in which the UK jurisdictions could reverse the current position in which assisting a suicide amounts to a criminal offence, including both a jurisprudential and a legislative route to reform. We conclude that while this is an essentially constitutional issue, there is no need for legislative reform, save in respect of that narrow class of patient with a degenerative and incapacitating neuromuscular disease.
Chapter
17. Assisted Dying
This chapter examines assisted dying. It looks at the current law, and arguments for and against its reform. It covers attempts to change the law in parliament and through human rights challenges in the courts. There is also brief coverage of other jurisdictions’ experience with legalization.
Chapter
11. Dying and Death
This chapter examines the legal and ethical aspects of death. It begins with a discussion of the difficulty of the choosing a definition of ‘death’. It then sets out the law on a range of ‘end-of-life issues’, including euthanasia, assisted suicide, and refusal of medical treatment. It considers some particularly complex cases in which the law is not always easy to apply. These include the administration of pain-relieving drugs, the treatment of severely disabled newborn children, and the position of patients suffering from PVS. Next, the chapter considers the ethical debates surrounding euthanasia, assisted suicide, and terminating treatment. This is followed by a discussion of palliative care and hospices.
Chapter
9. The end of life
This chapter deals with key legal and ethical issues surrounding end-of-life decisions, with particular reference to physician-assisted death, such as euthanasia. Suicide and assisted suicide, administration of pain relief, and futility are considered. Relevant legislation such as the Suicide Act 1961 (as amended by the Coroners and Justice Act 2009), the Human Rights Act 1998, and the Mental Capacity Act 2005 are discussed. The chapter examines several bioethical principles, including sanctity-of-life and quality-of-life debates; autonomy, beneficence, and medical paternalism; personhood, palliative care, and the double effect doctrine. Finally, it considers human rights issues, treatment requests, incompetent patients, prolonged disorders of consciousness, and locked-in syndrome. Recent cases are considered.
