Euthanasia, Ethics, and Public Policy: An Argument against Legalisation

By John Keown | Go to book overview

3
'Physician-assisted suicide'

Whereas in VAE it is the doctor who terminates the patient's life, in PAS he assists the patient to take his or her own life. Assistance may take the form of giving the patient the means to commit suicide, such as supplying a lethal pill to be swallowed or a plastic bag to be put over the head. Or it may take the form of advice about methods, such as which are the most effective. Laws against assisted suicide tend to prohibit not only facilitating suicide ('Here's a plastic bag to put over your head') but also encouraging suicide ('Go on – put the plastic bag over your head and breathe deeply').

A contemporary and striking example of PAS is provided by the bizarre activities of Dr Jack Kevorkian (or 'Dr Death' as the media have dubbed him) in the USA. Dr Kevorkian, a retired pathologist, assisted over forty people to commit suicide in recent years in circumstances which were somewhat removed from regular medical practice. These people travelled to Kevorkian from all over the USA to seek his assistance in suicide. He assisted them, sometimes by attaching them, in the back of his rusting Volkswagen van, to his 'suicide machine', which injected them with lethal drugs when they activated it. Despite being prosecuted for assisted suicide on several occasions, Kevorkian escaped conviction and continued his personal campaign for relaxation of the law in his peculiar way. It was only when he moved from assistance in suicide to euthanasia that he was finally convicted. He filmed himself administering a lethal injection, and the film helped secure his conviction for murder.

The focus of Kevorkian's activities, and the debate he has helped fuel in the USA, is PAS rather than VAE. In recent years campaigners for relaxation of the law in the USA have shifted their focus from VAE to PAS. For example, in the early 1990s, proposals to decriminalise PAS were put to voters in the states of Washington and California, but were narrowly defeated. In 1994, however, such a proposal was passed by voters in the

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Euthanasia, Ethics, and Public Policy: An Argument against Legalisation
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Preface xi
  • Foreword xiii
  • Acknowledgments xv
  • Table of Cases xvi
  • Abbreviations xviii
  • Introduction 1
  • Part I - Definitions 7
  • 1 - 'Voluntary Euthanasia' 9
  • 2 - Intended V. Foreseen Life-Shortening 18
  • 3 - 'Physician-Assisted Suicide' 31
  • Part II - The Ethical Debate: Human Life, Autonomy, Legal Hypocrisy, and the Slippery Slope 37
  • 4 - The Value of Human Life 39
  • 5 - The Value of Autonomy 52
  • 6 - Legal Hypocrisy? 58
  • 7 - The Slippery Slope Arguments 70
  • Part III - The Dutch Experience: Controlling Vae? Condoning Nvae? 81
  • 8 - The Guidelines 83
  • 9 - The First Survey: the Incidence of 'Euthanasia' 91
  • 10 - Breach of the Guidelines 103
  • 11 - The Slide Towards Nvae 115
  • 12 - The Second Survey 125
  • 13 - The Dutch in Denial? 136
  • Part IV - Australia and the United States 151
  • 14 - The Northern Territory: Rotti 153
  • 15 - Oregon: the Death with Dignity Act 167
  • Part V - Expert Opinion 181
  • 16 - Expert Committees 183
  • 17 - Supreme Courts 191
  • 18 - Medical Associations 208
  • Part VI - Passive Euthanasia: Withholding/withdrawing Treatment and Tube-Feeding with Intent to Kill 215
  • 19 - The Tony Bland Case 217
  • 20 - Beyond Bland: the Bma Guidance on Withholding/withdrawing Medical Treatment 239
  • 21 - The Winterton Bill 260
  • Conclusions 273
  • Afterword: the Diane Pretty Case 282
  • Bibliography 292
  • Index 303
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