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PHL 302
Glen Hoffmann

1 November 13, 2009 NURSING ETHICS – LECTURE 9 I – Introduction • The last several weeks we have been using theoretical frameworks to analyze particular concepts and issues that arise in healthcare. • We have thus far looked at the concepts of veracity, informed consent, confidentiality, and justice. • We have also looked at the issues of public health, distributive justice, and genetic testing. • This week we’ll look at another important ethical issue that arises in the provision of healthcare: euthanasia. 2 II – Euthanasia: The Issue • Euthanasia is traditionally defined as a ‘mercy killing’. • It involves scenarios whereby one person takes the life of another for some beneficent reason. • Euthanasia: the killing of one person by another for beneficent reasons, or for reasons which will promote the good of the person being killed or some other set of persons. 3 • Euthanasia is obviously an important ethical issue that arises in the provision of healthcare. -Are they any situations in which a doctor, nurse, or other healthcare practitioner should be allowed to perform euthanasia on a patient? -Are physician-assisted or nurse-assisted suicides ever ethically justified? • As we will see, a wide variety of practical, rational, and other considerations are relevant to answering these kinds of questions. 4 III – Different Types of Euthanasia • Broadly speaking, euthanasia involves the killing of one person by another for beneficent reasons. • There are two distinctions we need draw with respect to different kinds of euthanasia. (1) Voluntary and involuntary euthanasia. (2) Active and passive killing. 5 (1) Voluntary euthanasia and involuntary euthanasia. • The killing of another person for beneficent reasons may be done voluntarily on involuntarily. -Voluntary euthanasia: killing another person beneficently with that person’s permission, consent, or agreement. -Involuntary euthanasia: killing another person beneficently without that person’s permission, consent, or agreement. • This is an important distinction because it is thought by many that if euthanasia is morally justified in any situation it must be in situations where the person being killed has given consent. • If one has given consent, and they are suffering irremediably of chronic or fatal illness, perhaps it is morally justified for a healthcare practitioner to kill them. 6 • But is it ever morally justified to kill someone without their permission? • Perhaps not. • Certainly not when they are mentally competent and have patently refused to be euthanized. • But perhaps there might be certain situations in which it is permissible. E.G.: someone is comatosed, brain-dead, with little to no chance for recovery. -Perhaps euthanasia might be morally justified for this person (even if they haven’t given consent and are unable to) on beneficent grounds: e.g., to relieve the suffering of the patient’s family, to save money, etc. -This is a tricky case. 7 (2) Active and passive killing. • Active killing: performing a specific action which brings about a person’s death. • Passive killing: failing to perform a certain action which is needed to keep a person alive. E.G.: a doctor might refuse to continue to use extraordinary measures such as large doses of medication to keep a patient alive. • This distinction is also described by some bioethicists as that between ‘killing’ and ‘letting die’. 8 • The distinction between passive and active killing i
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