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Biomedical - Session 9

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Kelin Emmett

Biomedical - Session 9  physician-assisted suicides  provide the means for the patient  at the patient‟s request  involves a choice  patient is necessary  euthanasia  mercy killing  physician brings about death of patient  passive  withdrawing or withholding of life sustaining treatment  legal in Canada  thought to be grounded in a patient‟s right to refuse treatment  active  physician actively and directly kills the patient  often by means of lethal injections  legal in Switzerland, but not Canada  withholding life sustaining treatment  not starting a potentially life-sustaining treatment  withdrawing life sustaining treatment  stopping treatment that is potentially sustaining the life of the patient  Health Law Institute quote on page 142  voluntary passive euthanasia  Do refusals always constitute cases of euthanasia?  note: euthanasia involves the physician‟s intent  physician can agree or disagree with the patient  unsure  Sopinka ruling on the 1993 Rodriguez case  recognized in the Canadian law  explicit in case law  if the patient can consent to treatment, vice versa applies  patient can refuse treatment  course argue that the common law recognizes  if the patient is competent, the patient is autonomous  bodily integrity must be respected  (in order to respect the autonomy of the patient)  doctrine of informed consent is crucial for protection  previously competent with advanced directives  advanced directives should be followed according to common law  no longer competent without advanced directives or never competent  identify substitute decision-maker  substitute decision maker  prior wishes known  act in accordance with wishes  unknown prior wishes  act in best interests of patient  involuntary euthanasia  grounded in right to refuse  paper by multiple writers  argue that it‟s thought that physician assisted suicide and  Why not more than passive euthanasia?  morally controversial  more active role that the physician is thought to play  distinction lies in between action and omission  providing means and taking means  controversies seem to overlook  requests  refusals  Voluntary passive and active difference?  voluntary passive euthanasia  pain and suffering is to be endured for longer compared to active  legal, but not necessarily accessible to all of us  legal because it‟s grounded in right to refuse treatment  note: physician is legally bound to respect the refusal of a patient  legal requirement  patient competence  capacity to make the decision  requirements for informed consent  patient competence, freedom from coercion, etc.  rational decisions  do not produce harm to the patient  in terms of whether or not benefits outweigh harms  benefits outweigh harms  irrational decision  great harm without sufficient gain at a sufficient point  benefits do not outweigh harms  note that the authors say that physicians ought to respect patients rational decision  (rather than competent patients)  rational refusal” (page 144)  depends on interpretation  capacity or an in fact, rational decision  respect for rational decision or a decision of a competent patient  confusion surrounding terminology  requests  refusals  acts  omissions by physicians  natural  other causes of death  VAE and VPE  refusals are often reinterpreted as requests  rational refuses  grounded in notion of autonomy  physician is morally required to honor  patient requests  do not need to be honored  physician is not morally required  distinction between actions and omissions  source of confusion  (for thinking, no moral difference between passive and active euthanasia)  creates “false moral distinction” because it focuses on the physician  (the actions executed by the physician)  lead to the conclusion that there are no relevant moral differences  (between passive and active euthanasia)  undermines reasons for „allowing to die‟ and
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