Euthanasia: Right to die? Antanas Urbonas, Health Law and Bioethics

1. Euthanasia: Right to die? Antanas Urbonas, Health Law and Bioethics

2. "A gentle and easy death...The means of bringing about a gentle and easy death...” In recent use: The action of inducing a gentle and easy death. Used esp. with reference to a proposal that the law should sanction the putting painlessly to death of those suffering from incurable and extremely painful diseases." The Oxford English Dictionary Online

3. "Euthanasia has many definitions. The Pro-Life Alliance defines it as: 'Any action or omission intended to end the life of a patient on the grounds that his or her life is not worth living.' The Voluntary Euthanasia Society looks to the word's Greek origins - 'eu' and 'thanatos,' which together mean 'a good death' - and say a modern definition is: 'A good death brought about by a doctor providing drugs or an injection to bring a peaceful end to the dying process.' Three classes of euthanasia can be identified -- passive euthanasia, physician-assisted suicide and active euthanasia -- although not all groups would acknowledge them as valid terms.“BBC News stated in its July 1, 1999 special report titled "A Euthanasia Glossary"

4. "Strictly speaking, the term 'euthanasia' refers to actions or omissions that result in the death of a person who is already gravely ill. Techniques of active euthanasia range from gunfire to lethal injection, while passive euthanasia can be achieved by failing to treat a pneumonia or by witholding or withdrawing ventilatory support." Jonathan Moreno, PhD, wrote in his 1995 book Arguing Euthanasia: The Controversy Over Mercy Killing, Assisted Suicide, and the "Right to Die":

5. problem Euthanasia is divided into passive known as ortotanazja and active as murder with compassion. Euthanasia is also misleadingly called the extermination frequented and compared by people with disabilities by Nazis during World War II Admissibility of euthanasia is a difficult issue Ethics. It has both supporters and opponents. The conflict comes because of different value systems, which shall be guided by both sides (Pro life supporters and pro choise supporters). Opponents of euthanasia consider life as sacred gift from God (mainly active opponents of euthanasia), or consider it to be the highest value. Supporters of the claim that it is important to respect the will of the patient, shield him from suffering, and his right to dignity within the meaning of what he accepts.

6. Euthanasia – a new problem for the first time problem of euthanasia is raised as an issue in the Netherlands as part of the public in 1973. The doctor helps his mother to death, society looks favorably. This creates a precedent for active euthanasia in the Netherlands.  In the U.S.  First passive euthanasia case was in 1974.

7. Euthanasia is legalized in Netherlands (2001), Belgium, Luxembourg (including sick children), Albania, Japan and the U.S. states Texas and OregonAnd until recently also in Australia Northern Territory (Australian court has ruled that this issue is only for federal and overturned the legality of euthanasia). Passive Euthanasia is legal in Ireland and in some regions of Mexico. Special form of euthanasia is allowed in SwitzerlandWhere one can prescribe a lethal dose of sleeping pills, but the patient must accept it yourself. It`s private buissiness assisted dying company called ‘Dignitas’ In other countries, euthanasia is not allowed and punishable as murder or simply a milder. Regulations in the world

9. The Dutch law allows euthanasia only if all are met the following conditions: - patient's suffering is unbearable with no prospect of improvement in the status of the patient - request by the patient euthanasia must be voluntary and should be kept to a predetermined time, can not be met if the person is under the influence of drugs, suffering from a mental illness or have been influenced by other people - the patient must be fully aware of their health status, prognosis and asserting their rights Euthanasia in Netherlands (1)

10. - to be consulted with at least one independent doctor, who must confirm the patient's health status and conditions referred to above - Euthanasia must be carried out in a medically appropriate way by the doctor or patient in the presence of a physician - you must be at least 12 years (patients aged 12 to 16 years old must obtain parental consent) - Dutch legislation recognizes the validity of the will of the patient's written statement. Such declaration may be used when the patient will be in a coma or in another state, which makes it impossible to agree to euthanasia. - Only legalized in 2001, but practise is way earlier. Euthanasia in Netherlands (2)

11. In Luxembourg February 202008Luxembourg, the Parliament adopted by a majority of 30 of the 59 votes in a law legalizing shortening life seriously ill persons upon request. It entered into force after the second ballot in March 2009 . The bill was strongly criticized by the Catholic Church (which have a large impact on society Luxembourg), most of the medical and the ruling Christian Social Party. According to the draft decision on euthanasia can only be taken provided that the patient is seriously and terminally ill. Decide on euthanasia can be taken include writing down a will Euthanasia in Luxembourg

12. The Belgian parliament Belgium passed a law legalizing euthanasia in September 2002 year. Euthanasia in Belgium

13. Albania was the first country Europe that legalized euthanasia - has been the case in 1999 year under amendments to the Law on the Rights of the terminally ill. It legalizes any form of active euthanasia, with the consent of the patient. Passive euthanasia is permissible with the consent of three members of the family of the sick person. Albanian legislation on euthanasia, is criticized by Catholic Church and some environments Pro-life. Euthanasia in Albania

14. Euthanasia in Australia Euthanasia is now illegal in Australia. It was once legal in the Northern Territory, by the Rights of the Terminally Ill Act 1995. In 1997, the Australian Federal Government overrode the Northern Territory legislation through the introduction of the Euthanasia Laws Act 1997.

15. Euthanasia in Ireland it is illegal for a doctor (or anyone) to actively contribute to someone's death. It is not, however, illegal to remove life support and other treatment (the "right to die") should a person (or their next of kin) request it - in other words, passive euthanasia is legal. A September 2010 Irish Times poll showed that a majority, 57% of adults, believed that doctor-assisted suicide should be legal for terminally ill patients who request it

16. Cases (1) Karen Ann Quinlan collapsed on April 15th, 1975. She was twenty-one years old. Within hours, she entered a coma from which she could never recover. Her parents, staunch Roman Catholics, knew their daughter would not want to be kept alive by extraordinary means. A year later, as Karen lay in a "persistent vegetative state," the courts finally allowed her treatment to be stopped; but artificial feeding was continued and she was maintained as a living corpse until June 1985, when she eventually died of pneumonia. Her case spurred thousands of letters of sympathy and fuelled the "right to die" movement.

17. Karen before the accident

18. Cases (2) Nancy Cruzan lost control of her car one day in January 1983 in Missouri. When the paramedics arrived, they were able to restore her breathing and heartbeat and she was transported, unconscious, to hospital. She continued to be fed through a surgically- implanted tube. After several years, a court found that, although her respiration and circulation continued unaided, she was oblivious to her surroundings except for reflexive responses to sound; her brain had degenerated, irreversibly; she suffered irreversible muscle and tendon damage; and had no cognitive or reflex ability to swallow food or water or to maintain her essential daily needs nor would she ever recover such an ability. She lay in persistent vegetative state even though she had told her housemate that, if sick or injured, she would not wish to continue her life unless she could live "at least halfway normal." This was the first time the U.S. Supreme Court had been faced with what we call the "right to die." She had not made a living will, and the court case paved the way for a uniform, national Patient Self- Determination Act that regulated living wills and made them more widely available.

19. Book about Nancy Cruzan case

20. Situation for society approval For example, Export model  of euthanasia of the Netherlands without the imposition  would be a big mistake. One of the reasons why it works so well in Netherlands is the high standard of medical care and trust in doctors. A large proportion of primary medical care is done by family physicians in the Netherlands. Many people visit the same doctor for many years, and between doctors and patients develop strong long term relationships of trust. Therefore, even before the consolidation of euthanasia this has been popular for a while and now is also not always officially done.

21. Ethical and legal issues of euthanasia 1. Especially difficult situation - seriously ill teenagers will to die. In society teenager is treated as  ’nether a child nor an adult’, so no one knows he or she  reasonably able to decide.  Should teenagers decide or parents? 2. Legalizing euthanasia in the Netherlands raised the debate on this issue. It was originally intended to make a decision to allow 12 years of age for decide for themselfs , regardless of parents' opinions. The "too low public support" raised this age to 16 years. 3. How about people, who was unconscious always during the treatment? Comatose state located? (the most common passive euthanasia cases in the U.S.) 4. How about Alzheimer's disease or other disabling mental illness sufferers?

22. The End Thanks for attention