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Ethical decision making & Assisted suicide: No easy answers. Jo Fernandes: Practice Development Nurse Hospice of St Francis June 2012. Aims. The law Helpful guidelines / theory Public influences Case studies. Current UK law 1961 Suicide Act remains unchanged ↡
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Ethical decision making &Assisted suicide: No easy answers Jo Fernandes: Practice Development Nurse Hospice of St Francis June 2012
Aims • The law • Helpful guidelines / theory • Public influences • Case studies
Current UK law • 1961 Suicide Act remains unchanged • ↡ • Assisting in someone’s suicide = ILLEGAL
Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide February 2010
“Let me make it clear; only parliament can change the criminal law…. So the critical question I have considered is; what are the circumstances in which it is or is not in the public interest to prosecute a person who assists in another’s suicide” www.telegraph.co.uk 23/09/09
“We are proud of the way we temper justice with mercy” Starmer 09
“An act by which the Doctor’s primary intention is to bring about a patient’s death would be unlawful”
Conclusion • “The commission has concluded that it is possible to devise a legal framework that would set out strictly defined circumstances in which terminally ill people could be assisted to die, while providing upfront safeguards to protect potentially vulnerable people. It must be a matter for parliament to decide on behalf of our society as a whole whether to implement such a framework
“Submission to the commission on Assisted dying” April 2011
Reinforces ethos of hospice and palliative care : “intends to neither hasten nor postpone death”
Nurses bullied nurses and some bullied patients. Other exhausted nurses would be in tears because they could not give basic care “The Killing Wards” Sunday 26.06.11
Ethical theory Burden Benefit
Beneficence Non- maleficence Autonomy Justice Beauchamp and childress
The Four Principles • Do NOT provide a method for choosing • Do provide a common moral language and a common set of moral issues…
Case study 1 “If my symptoms get worse I’d rather be dead, so I’m going to take an overdose with those pain killers you’ve prescribed me”
Intense level of distress conveyed to HCP Exploration of despair/ vulnerability Time Desire for Death Desire for death changes Breaking confidentiality Protocols blunt instruments