ABORTION AND

EUTHANASIA

-1-

LEARNING OBJECTIVE To know and understand the overview of

the course To know and understand some of the

facts about abortion.

KEY QUESTION

WHAT IS A PERSON?

KEY WORDS

ABORTIONPERSONHOODTERMINATION

ABORTION Abortion means the deliberate ending of life

after the fertilisation of the human ovum and before birth.

Today abortion is common for a number of reasons;

Sex is seen as being more for pleasure than procreation

Women have a greater social and legal status

Low child mortality has reduced the need for so many children

Foetal abnormalities can be detected.

QUESTION Why do you think some women

may decide to have an abortion?

ABORTION AND THE LAW - UK Abortion became legal under The Abortion Act 1967. Abortions can only be carried out in a hospital, or in a

specialised licensed clinic. Pregnancies could be terminated up until 28 weeks.

In 1990, the Human Fertilisation and Embryology Act introduced controls over new techniques which had been developed to help infertile couples and to monitor experiments on embryos. Despite attempts to use this law to restrict abortion rights, the 1990 Act lowered the legal time limit from 28 to 24 weeks.

In 2008 a motion failed to changed the law from 24 weeks to 22 or 20 weeks.

In Northern Ireland, abortion is still illegal.

ABORTION AND THE LAW - MALAYSIA

Abortion in Malaysia is legal ifthe woman's life is in dangerthe woman's physical health is in dangerthe woman's mental health is in danger

The woman must consent to an abortion, and she must have a medical professional's authorisation.

The legal period within which an abortion can take place is 120 days (about 17 weeks).

REASONS FOR THESE LAWS UK – 24 weeks

An foetus is viable at 24 weeksThis means it is possible for the foetus

survive unaided outside the womb after 24 weeks.

MALAYSIA The Qur’an doesn’t explicitly condemn abortion. However, it does condemn murder. This has led to disagreement amongst Muslims

regarding abortion laws and whether or not it should be condemned.

Laws differ from one Islamic country to another. In Malaysia the law is up to 120 days based on

the belief that ‘ensoulment’ occurs at 120 days. Nb. not all Islamic schools of thought agree on this.

As it is taught in the Qur’an that to kill one soul is equal to killing the whole of humanity.

This means to kill is intrinsically and objectively wrong.

TYPES OF ABORTION In the UK, providing that two doctors confirm that her

need for an abortion fits the legal criteria, a woman does not need the consent of her own doctor, her partner or her family to have an abortion.

Women under 16 can have an abortion, without parental consent in some circumstances.

There are different types of abortion:

Pill (up to 9 weeks). The effect is similar to an early natural miscarriage.

Vacuum aspiration or suction termination (from 7 to 15 weeks of pregnancy).

Surgical dilation and evacuation (D&E) (from 15 weeks of pregnancy).

FACTS ABOUT ABORTION Abortion is commonplace in many countries

With tens of millions of abortions taking place each year.

According to the department of health data in 2006 there were over 193,700 abortions in England and Wales and 198,499 in 2007

The majority were conducted under 13 weeks gestation.

The proportion of women having abortions in England and Wales is increasing.

TWO CAMPS There are two camps when it comes to

abortion:

PRO-LIFE

Pro-life campaigners argue against abortion. They think that the life of the foetus should come before the choice of the mother.

http://prolife.org.uk

PRO-CHOICE

Pro-choice campaigners argue for abortion. They think that the choice of the mother should come before the life of the foetus.

http://www.prochoice.com

ABORTION ISSUES? A key issue that we have to consider is:

When does a foetus become a person?

This is important because our key question is

Does the definition of human life stop abortion being murder?

The criminal act of murder only applies to a PERSON. When a foetus becomes a PERSON its gets all the legal rights of a human in Britain.

PERSONHOOD A person is a being that deserves

protection under the law.

One of the issues raised by abortion surrounds the definition of a person.

The point at which a life becomes a human is the point at which it is wrong to kill it because it will be protected by the law.

When we talk about LIFE or the START OF LIFE we will be referring to the start of HUMAN LIFE

ABORTION AND

EUTHANASIA

-2-

LEARNING OBJECTIVE To know and understand the definitions

for the start of life.

KEY WORD

KEY PHILOSOPHER

S

GLOVERTHOMPSON

KEY WORDS

CONCEPTIONPOTENTIALVIABILITY

WHAT IS A PERSON?

PERSONHOOD When a foetus is given the legal status of

a person is essential to understanding the debate over abortion.

This is because killing a person would be considered murder.

If the foetus is given the status of a person before birth it means that anybody terminating a baby after that time would be guilty of murder.

The claim: abortion is murder would be justified

DEFINITIONS FOR THE START OF LIFE

There are lots of different definitions for the start of life (personhood) here are the main ideas.

CONSCIOUSNESS

VIABILITY

PRIMITIVE

STREAK

PRE-EXISTEN

CE

CONCEPTION

POTENTIALITY

YOUR VIEW When do you think life begins? Why?

POTENTIALITY Many people believe that a foetus should

be given the status of a person because it is a POTENTIAL person.

This is called POTENTIALITY

Anything that has POTENTIAL to be a human is a human.

What do you think about this?

Does that mean we should include

Sperm and eggs?

PRE-EXISTENCE Hindus and Buddhists believe in

reincarnation.

Reincarnation contains the idea of pre-existence.

This is the belief that the soul or existence of the new life has lived before.

It is a returning life and is not a newly created existence.

Life therefore has INTRINSIC worth.

CONCEPTION Conception is the point at which the unique

selection of genetic information is present

It is the moment the sperm and the egg have combined to create a fertilized ovum.

if allowed to continue and be successful in development it will go on to be a unique human being.

1869 Pope Pius declared that a foetus is a human person from the moment of conception.

This has been the basis for Roman Catholic teaching on abortion that to kill a foetus is to murder a human person.

CRITICS The fertilized egg is too different from anything

that we normally recognize as a person to be called the same thing.

THOMSON- accepts that there is continuous development in foetal growth but suggests that there is a point at which it is not a human being.

“There is continuous growth from acorn to oak true but an acorn is not an oat tree; just as a fertilized ovum – is not a person.”

GLOVER – to call a foetus a human at the point of conception stretches the term beyond normal boundaries.

PRIMITIVE STREAK Others have identified the presence of the

primitive streak on the fourteenth day after fertilization, as the point at which a unique human being can be said to exist, albeit in potential form.

The primitive streak provides the structure around which embryonic structures organise and align themselves.

Up until that point it is not clear whether one individual or more than one individual will form, and at this point it becomes clear which cells will go on to form the placenta and which go on to form the embryo.

PRIMITIVE STREAK The ‘primitive streak’ is evidence of the

start of the nervous system at 2 weeks. At this point it is thought that the young embryo can experience pain and has primitive sensations.

14 days is the limit for embryo research. After this point it cannot be used.

This demonstrates that the law is recognising the change in the foetus at this point.

CRITICISMS Thomson and Glover’s observations could

still be made about the foetus at this time.

THOMSON- there is a point at which the foetus is not a human being.

“There is continuous growth from acorn to oak true but an acorn is not an oak tree; just as a fertilized ovum – is not a person.”

GLOVER – to call a foetus a human at the point of primitive streak stretches the term beyond normal boundaries. It is completely unrecognisable.

CONSCIOUSNESS Consciousness may be suggested as a

definition of personhood.

Consciousness cannot be applied to all living tissue, as it implies sensory experiences, the ability to feel pleasure and pain. However, consciousness would include many animals, and most would argue that animals are not persons in the same sense as humans are.

The presence of rationality, and our ability to develop complex language and make complex tools, are distinctive features of personhood

VIABILITY Viability is the point at which human

personhood should be recognised.

Viability means when the foetus can survive a birth and exist independent of the mother.

This used to be referred to as quickening when the mother first felt the foetus move although now first-movement feeling and viability are not connected. 20-24

WEEKS

CRITICISMS TO VIABILITY The age which the foetus can survive outside

the womb is reducing as medical technology progresses.

The moral judgement is made on the basis of technical ability rather than anything inherent to the foetus.

Second there are many people who are dependent on continual medical assistance such as dialysis in order to survive. We consider them to be persons despite their medical conditions.

Also even healthy born human babies would not survive without adult aid.

WHAT DO YOU THINK? Review your view – have you changed

your mind? Write an explanation of what you think

is the start of life on the slide below and next.

Abortion is the termination of a foetus before it goes full term.

There are 5 definitions for the start of personhood these all use different justifications for the potential of human life.

Pre-existence

Conception

Primitive streak

Consciousness

Viability

Birth

REVIEW

WHAT HAVE WE

LEARNT?

EXAM QUESTION d) ‘A foetus is not a person.’

Do you agree? Give reasons for your opinion,

showing that you have considered another point of view. In your answer, you should refer to at least one named religion.

(5)

HOW TO ANSWER THIS QUESTION Worth 5 marks You need to show awareness of different

points of view and argue your own opinion in light of these views.

Structure:Some people may argue….. because….Others may argue…. because….However, I would disagree because……

(argue against the above points) I think that….. because…..

ABORTION AND

EUTHANASIA

-3-

LEARNING OBJECTIVE To consider whose life is more important

the mother or the foetus. To consider the self defence argument

as a justification for abortion.

KEY QUESTION

WHOSE LIFE IS MORE

IMPORTANT?

KEY WORDS

SELF DEFENCEECTOPIC

PREGNANCYDOUBLE EFFECT

OVERVIEW1. This lesson introduces one of the key

issues in debate over abortion.

2. It discusses whose life is more important

3. The mother or the child

4. This presents one of the arguments for the justification of abortion.

5. Main philosophers: Thomson

TIMES WHEN A PERSON WOULD WANT AN ABORTION

What about when a woman’s life is in danger?

GETTING PREGNANT A pregnancy and a growing foetus have

an enormous impact on the mother.

Not only does it cause physiological and emotional changes it places the mother’s body under enormous pressure and has significant health risks attached.

In the past before developed health care childbirth was a principal cause of women’s death and it remains so in less economically developed countries. LDEC’s

THE ISSUE There is a complex question about the

conflicting interests between mother and child.

At one end of the spectrum are the severe danger of death examples:

An ectopic pregnancy will kill both the mother and the child if left uninterrupted.

There are also increased chances of pregnancy aggravating existing health problems.

Mothers with heart complaints or high blood pressure are under increased risk of serious problems.

ECTOPIC PREGNANC

Y

A pregnancy in which

the foetus develops outside

the uterus.

THE LIFE OF THE MOTHER

In some situations it is hard to determine whose life is more important:

Mother childVS.

A DEFENCE OF ABORTION - THOMSON Thomson sees abortion as an issue of

self-defence and uses this to justify it in some cases.

If the foetus threatens the health of the mother abortion is a defensive measure against unacceptable dangers.

Thomson uses the example of a cardiac condition which should the pregnancy be allowed to continue would place the mother in real danger.

Judith Jarvis Thomson

QUESTIONS1. How should a decision be made about

the two rights to life; that of the mother or the baby?

2. Who should decide which life should be preserved over and above the other?

3. While we might kill in self-defence, it is unclear whether we should kill an innocent in self defence.

4. Perhaps the foetus has the right of self defence against the mother?

DOUBLE EFFECT One position which takes account of

the threat to the mothers life is that which argues for a double effect way of thinking.

It may be that a medical procedure is necessary to protect the life of the mother which inadvertently and indirectly leads to the termination of the pregnancy.

In this way of thinking the action is not deliberately to kill but deliberately to save life.

The death of an innocent is an unfortunate side-effect.

DOUBLE EFFECT: this is a doctrine devised to deal with moral conflicts in natural law theory.

It says that it is always wrong to do a bad act intentionally in order to bring about good consequences.

It is sometimes permissible to do a good act while at the same time knowing that it will bring about bad consequences.

In rough terms, this is sometimes translated as ‘provided your intention is to follow the rule, you can “benefit” from any unintended consequences.

REVIEW

WHAT HAVE WE

LEARNT?

People who disagree/agree with abortion have their view complicated by the problem raised when a child has a negative effect on the life of the mother.

Is it self defence?

Can you use double effect?

Whose life is more important, the mother or the child?

ABORTION AND

EUTHANASIA

-4-

LEARNING OBJECTIVE To understand the question of rights. To understand the feminist view of

abortion.

KEY PHILOSOPHER

S

WARREN AND FEMINISM

KEY WORDS

OPPRESSIONPATRIARCHY

RIGHTS

THE LAW ON ABORTION Induced abortion in the UK became a

statutory offense in 1803.

However in the 1960’s there was a period of extensive and rapid social and cultural change leading to the passing of the abortion act in 1967.

The passing of the act reflected the ‘sexual revolution’ of the 1960’s.

The law gave women more rights as humans. The right to control their own lives. This had previously not existed.

THE FEMINIST POSITION Some have argued that there are other

compelling reasons to permit abortion in all, or almost all, cases, not just when there is certain risk to the mother.

The feminist position begins from the historical experience of female suppression and a patriarchal society, and the role of religion in that history.

PATRIARCHAL: male dominated

FEMINIST POSITION Women were subordinated within the

family and had their freedom limited by the constraints of motherhood and the unreliability of contraception.

Women's roles have primarily been defined in terms of motherhood and it was only towards the latter end of the 20th century that women in large numbers began to have equal legal rights and equal opportunities in employment.

THE FEMINIST POSITION MARY ANNE WARREN believes

women should have the RIGHT to abort unwanted pregnancies at any time.

It should become part of their RIGHT TO LIFE given to them by the HUMAN RIGHTS ACT

If not undesirable consequences would follow, such as dangerous illegal ‘backstreet’ abortions and even women self harming.

THE FEMINIST POSITION Before the legalisation of abortion

women have paid a terrible price.

Life in the family and without the option of contraception and abortion they are forced to bear many children at short intervals and become debilitated and died young

This is also a situation that aggravates poverty and places stress on families and whole societies.

WARREN The world health organisation (WHO) says that

unsafe abortions kill 200,000 women every year.

In Romania during a period of abortions being illegal there was an increase in birth rate but also an increase in the mortality rate of women through backstreet abortions.

Therefore, to be forced to bear a child is to be forced to undergo a risky process that may lead to the possibility of giving up work, education and consequent harm.

Prohibition of abortion thus infringes on a woman's basic human rights of SELF-DETERMINATION and LIBERTY.

KEY QUESTION

What is the most important set of rights?

If the foetus is a person then it has its own right to life that might be more important that the mothers

VS. RIGHT TO LIFE

RIGHTS OF LIFE

WARREN SELF DETERMINATION in this context

means the ability to control your own life.

Most people should have the right to control their own FREEDOM from the infliction of bodily harm.

Warren argues that in most cases killing is wrong to prohibit abortion on demand would deny a woman’s basic human rights.

She would be forced to suffer the risk of death – this is wrong.

CONCLUSION If the foetus is given equal rights then,

in principle, a court could force a woman to go through with a dangerous birth rather than abort, because her life would be considered to be no more valuable than that of the foetus.

The foetus’ life should be subordinate to the woman’s life, if not, it is another example of the oppression of women by the patriarchal society we live in.

ABORTION AND

EUTHANASIA

-5-

LEARNING OBJECTIVE To know and understand the religious

perspective on abortion.

KEY QUESTION

KEY WORDS

THE SANCTITY OF LIFE

PASTORALLYHIPPOCRATIC

OATH

STARTER What is the feminist perspective?

Genesis 4:1Adam lay with his wife Eve, and she became pregnant and gave birth to Cain. She said, "With the help of the LORD I have brought forth a man.

Job 31:15 Did not God make him as well as me? did he not give us life in our mothers' bodies?

Isaiah 44:24The Lord, who has taken up your cause, and who gave you life in your mother's body, says, I am the Lord who makes all things; stretching out the heavens by myself, and giving the earth its limits; who was with me?

Isaiah 48:1,5

Give ear to this, O family of Jacob, you who are named by the name of Israel, and have come out of the body of Judah; who take oaths by the name of the Lord, and make use of the name of the God of Israel, but not truly and not in good faith.

For this reason I made it clear to you in the past, before it came I gave you word of it: for fear that you might say, My god did these things, and my pictured and metal images made them come about.

Jeremiah 1:5Before you were formed in the body of your mother I had knowledge of you, and before your birth I made you holy; I have given you the work of being a prophet to the nations

Matthew 1:18Now the birth of Jesus Christ was in this way: when his mother Mary was going to be married to Joseph, before they came together the discovery was made that she was with child by the Holy Spirit.

THE SANCTITY OF LIFE The religious perspective revolves around

the sanctity of life. This view states that all life is created by God and therefore, only God has the right to take life.

Life is therefore SACRED.

To say that life is sacred implies reverence and respect.

This is a core belief of Christianity. For that reason murder is wrong.

TEN COMMANDMENTS

THE SANCTITY OF LIFE Christianity generally prohibits abortion

due to the sanctity of life.

However, despite the ‘sanctity of life’ there are some justifications for killing in the Bible; such as self-defence and war.

Death is ok as long as it is to prevent undesirable consequences such as the deaths of innocents.

Acceptance of these seems to be at odds with an attitude against abortion based on the idea of the sanctity of life.

RELIGIOUS PERSPECTIVES As we said ‘life as sacred’ for Christianity

but there are differences when applying this to abortion.

Viewpoints vary:

1. Some are completed opposed in all circumstances with virtually no exceptions.

2. Others opposed in principles but pastorally sensitive.

3. Supportive of abortion in some specified cases

4. Believe the mother some have complete choice.

RELIGIOUS PERSPECTIVES

Conservative religious traditions are deontological or absolutist and find statements to support a complete ban on abortion.

Some give more authority to the individual religious leaders are advisory on moral issues but not binding on all believers.

Other are more proportional and are willing to allow it in certain situations.

REMEMBER FOR YOUR ESSAYS There is always a difference between what

the religious teaching is and what a believer actually does.

Some Churches like Catholics expect all believers to follow their teachings. Some protestant Churches let followers follow their own conscience.

When you evaluate religious views you should show understanding of the diversity within religions and difference between official teaching and actual actions!

OVERVIEW - CHRISTIANITY Historically abortion is sinful

It is prohibited in many Christian writings

Christian writers have disputed:

the point at which the soul infused with the body (ensoulment)

If early abortions are as bad as late ones

But essentially it has always been viewed as murder.

CATHOLIC VIEW Catholic – Abortion is intrinsically

evil

Abortion goes against the natural law and the word of God and there are no exceptions or scenarios that make it right.

the foetus deserves the same status as a born human being.

Having an abortion leaves you open to excommunication

EXCOMUNICATIONThe act or banishing a member of a church from the communion of believers and the privileges of the Church; cutting someone off from the religious community.

ENSOULMENTThe process in Christian belief, by which a body is endowed with a soul.

HINDUISM Abortion can lead to a serious karmic setback

for the individual as it can hinder the soul’s progress.

Ahimsa – total nonviolence. It is wrong to kill.

Many Hindus believe the soul is present at the moment of conception.

However, due to the cultural preference for sons, abortion of girls does happen in Hindu societies.

ISLAM Abortion is haram However, it may be permitted if the life

of the mother is in serious danger as this would be the lesser of two evils

Some may allow abortion if the foetus is found to have a serious defect which will be untreatable and will cause serious suffering to the child. However, the foetus must be less than 120 days old.

Some Muslims are more liberal but the general consensus is that abortion is not permissible after 120 days.

BUDDHISM Life starts at conception. It is wrong to kill. The foetus and mother will suffer bad

karma. The decision to abort is up to the

individual. They must take a mindful approach, carefully weighing up the issues involved and coming to an informed decision.

It is up to the individual to choose the most ethical path, be it to save the life of the mother or prevent future suffering of mother or child.

REVIEW Lots of different Christian views on

abortion. Official teaching is not always

represented in the action of the believer. Centred around the sanctity of life

principle.BRANCH OF CHURCH AGAINST FOR

CATHOLIC CHURCH SANCTITY OF LIFE USE DOUBLE EFFECT

C of E SANCTITY OF LIFEUSE OWN

CONSCIENCE

ORTHODOX AND EVANGELICAL

SANCTITY OF LIFEDO NO MURDERGOD AUTHOR OF

LIFE

LIBERAL SANCTITY OF LIFEIF MOTHERS LIFE IS

THREATENED

EXAM QUESTION (b) Choose one religion. Outline

its teachings about the sanctity of life.

(5)

Nb you are being asked to outline. You therefore are not required to explain reasons for these teachings or discuss them in any way. You simply state what the teachings are.

EXAM QUESTION Explain why some people believe it is

the woman’s choice to have an abortion.

(8)

You should refer to pro-choice, religious teachings and feminism.

ABORTION AND

EUTHANASIA

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LEARNING OBJECTIVE To know and understand the key terms

for euthanasia To know and understand what

euthanasia is

KEY PHILOSOPHER

S R. H. Crook

KEY WORDSActive

euthanasiapassive

euthanasiaLiving will

KEY QUESTIONS1. Is there any moral justification for taking your

own life?

2. Is it wrong to assist in killing those who don’t want to live?

3. Is there a difference between withdrawing life-sustaining treatment and delivering a lethal injection?

4. Should comatose patients who have no hope of recovery be kept alive for as long as technology permits?

5. Is human dignity better defined or sustained by having freedom to choose to end life or not having that freedom?

EUTHANASIA Euthanasia is the termination of a

person’s life, either with their consent or without, as a way of alleviating pain or removing unnecessary suffering.

The word comes from two Greek words

EU meaning good

And THANOS meaning death.

It literally translates as good death

WHO MIGHT WANT TO HAVE EUTHANASIA?

CASESAnnie Lindsell – suffering with Motor Neurone disease in December 1997 was worried she would die in pain. She requested the High Court to allow a doctor to administer her with diamorphine.

Tony Bland – victim of the Hilsbourgh disaster was allowed to die by the courts through withdrawal of food.

Dianne Pretty – wanted the courts to allow her husband to help her commit suicide because she feared the choking and asphyxia often caused by her disease. This went to the ECHR and was declined because the right to die was not part of her right to life.

WHAT IS THE ROLE OF A DOCTOR?

THE ROLE OF A DOCTOR The job of a doctor is to heal.

The hippocratic oath that a doctor must take entails the requirement that they do not willing harm another person.

But many people argue a doctors job is to preserve the quality of a persons life by healing.

If this is the case surely if a person feels they have no quality of life a doctor should preserve that by helping them to die?

QUOTES

I will not prescribe a deadly drug to please someone, nor give advice that may cause his death.’

Hippocrates

EUTHANASIA Some doctors maintain that killing a

patient should not fit in with what a doctor should do.

A doctor should heal, prevent diseases and assist people in living a healthy life.

Some doctors today feel that the need to preserve the patient’s quality of life extends to a duty to help that patient end his or her life in the way that he or she sees fit.

What do you think?

EUTHANASIA In thinking about what sort of death a

person should have, one can say that a peaceful death is one in which pain and suffering are minimised, where the patient is never neglected and whose needs are always taken account of.

However, in all countries, the peaceful death is not thought in legal terms to include euthanasia.

KEY TERMS

Voluntary euthanasia:

helping a person who wishes to die to do so.

Passive euthanasia: not carrying out the actions which would prolong

life.

Active (direct) Euthanasia: carrying out

some action to help someone to

die.

Euthanasia: is inducing a painless

death, by agreement and

with compassion, to ease suffering. From the Greek meaning ‘Good

Death’.

Involuntary Euthanasia:

helping a person to die when they

are unable to request this for themselves.

Living Will: a document that specifies an individual’s wishes

regarding care and treatment if he or she

becomes incapacitated, such as limiting life-

support that would only prolong life

THE UK LAW ACTIVE / DIRECT EUTHANASIA:

anything that involves the administering of a treatment or drug in order to shorten or end a persons life is illegal. This is true even if they have given their consent to the death.

PASSIVE/ INDIRECT EUTHANASIA: withdrawing treatment from a person in order to bring about their death is legal and widely practised in Britain.

BRITISH LAW AND MURDER Murder, is defined as the unlawful killing

of another human being with intent (or malice aforethought).

To murder somebody you must intend to kill them.

Euthanasia is the intentional killing of a person.

It is clearly murder under the current definition.

In order to legalise it we would have to define euthanasia so that it was considered legal killing, along with war.

EUTHANASIA Euthanasia is a criminal offence in virtually all

countries, and it is strongly opposed by most governments and religious organisations.

In Holland, about a thousand assisted deaths take place each year, and organisations such as the Voluntary Euthanasia Society (VES) campaign for a similar practice to be available in the UK.

It is worth noting that the VES, along with most other pro-euthanasia groups, would never support ending someone’s life against that person’s will.

FINALLY... there are active and passive dimensions

to the ethical debate.

If someone is terminally ill they may ask you not to intervene medically to help them and allow them to die sooner

(passive voluntary euthanasia)

or you may wish to do so after they have lost consciousness and basic brain functions

(passive involuntary euthanasia)

FINALLY... The person may ask you to give them

medicines which will bring about their death

(active voluntary euthanasia)

or you may wish to do so once they have lost consciousness and basic brain functions

(active involuntary euthanasia)

REVIEW The debate on euthanasia covers:1. What is the responsibility of a doctor?2. To kill or to preserve life?3. Does a doctors responsibility of preservation

of life extend to preserving quality of life?4. Should a person have a right to self-

determination and autonomy?5. Is part of the ‘right to life’ the ‘right to die’?6. Is there a similar ethical concern over

involuntary euthanasia?7. What is the religious view on euthanasia?

ABORTION AND

EUTHANASIA

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LEARNING OBJECTIVE To know and understand the arguments

for voluntary euthanasia.

KEY PHILOSOPHERS

Gregory E. PenceThomas More

JS. Mill

KEY WORDS

MERCIFUL AUTONOMYPALLIATIVE

CARE

THIS LESSON:1. Euthanasia is not murder

2. Euthanasia is merciful

3. Euthanasia gives people autonomy

4. Jack Kevorkian

5. Euthanasia goes on anyway

WHY WOULD SOMEONE WANT EUTHANASIA?

VOLUNTARY EUTHANASIA There may be situations where people

are in terrible pain or have such a profound sense of indignity because of their mental deterioration that they wish while they still have the chance to express a choice, to bring about death more quickly.

There are several arguments in favour of legal voluntary euthanasia.

FOR – VOLUNTARY EUTHANASIA IS NOT MURDER In his article “why physicians should aid

the dying” Gregory E. Pence argues that killing humans who don't want to live is not wrong.

It isn't wrong to help the dying to die, because they are actually dying.

You are simply speeding up the process. This is therefore, not murder.

FOR – VOLUNTARY EUTHANASIA IS MERCIFUL Voluntary euthanasia shows mercy for

those suffering with intolerable pain from an incurable disease.

The English humanist Thomas More argued in his famous 1516 book Utopia that when a patient suffers a ‘torturing and lingering pain, so that there is no hope, either of recovery or ease, (they may) choose rather to die, since they cannot live but in much misery’.

Voluntary euthanasia is a merciful opportunity to end needless suffering – one which we offer to animals and should offer to humans as well.

FOR – VOLUNTARY EUTHANASIA GIVES PEOPLE AUTONOMY

Mill argues that if it doesn’t affect someone else’s, individuals should have full autonomy. (complete freedom)

We expect to have control over our bodies in matters of life, and it should be the same in matters of death.

FOR – VOLUNTARY EUTHANASIA GIVES PEOPLE AUTONOMY

The VES (voluntary euthanasia society) argues that every human being deserves respect and has the right to choose his or her own destiny, including how he or she lives and dies.

JACK KEVORKIAN

Kevorkian aka 'Dr Death' because he photographed the eyes of dying patients. Later in his career (starting in 1987) he advertised his services as a physician offering 'death counselling'. When terminally ill patients learned that he was helping people to die, more and more people came to him. Despite several failed court cases, Kevorkian helped over 130 people to die.Kevorkian believed that helping people was not enough, and actually killed Thomas Youk, filmed himself doing so and recieving consent by the man. He was sentenced to 10-25 years in prison.

FOR –EUTHANASIA GOES ON ANYWAY In 1994 the British Medical Journal

published a survey that showed some doctors already help patients to die.

Doctors can legally give pain relieving treatment in doses that will bring about people’s deaths more quickly and, in certain circumstances, such as in the case of the braindead or comatose, they may also withdraw or withhold treatment even though a person will die if they do so.

What is this type of euthanasia called?

FOR –EUTHANASIA GOES ON ANYWAY They cannot however, help someone to

die at that person's request.

The VES holds that it would be more honest and much safer if voluntary euthanasia was legal and regulated.

They argue that there is no ethical difference between withdrawing treatment and delivery a lethal injection.

Is this true?

FOR – VOLUNTARY EUTHANASIA MAINTAINS THE QUALITY OF LIFE Human beings should be able to maintain their

dignity up until the ends of their lives.

This is not simply a matter of pain, but of self-respect.

If someone’s standard of living is such that they no longer want to live, then they should be able to end their life and, if necessary, be assisted in doing so.

What is more, the quality of life worth living is one that only they can define.

Having control over their life is a way of enhancing their human dignity.

REVIEW1. Euthanasia is not murder

2. Euthanasia is merciful

3. Euthanasia gives people autonomy

4. Jack Kevorkian

5. Euthanasia goes on anyway

ABORTION AND

EUTHANASIA

-9-

LEARNING OBJECTIVE To know and understand the arguments

against voluntary euthanasia.

KEY PHILOSOPHER

S

GloverHelga Kuhse

KEY WORDSMotiveMistake

Informed consent

EXAM QUESTION(c) Explain why some people believe a person has the right to a good death.

(8)

VOLUNTARY EUTHANASIA Voluntary euthanasia or

assisted euthanasia is when a person asks to be helped to die.

Should we have the ability to control our own destinies, by being offered assistance to take our own lives when we judge that the quality of our lives has deteriorated to the point at which they are no longer worth living?

HOW CAN YOU BE SURE OF MOTIVES? When a person asks for death, can we

be sure that the person isn't crying out in despair, rather than making a definitive decision?

In desperate moments, someone may feel that they want their life to end – that the pain is too great and life too agonising – but perhaps those moments will pass and they will be glad that no-one acted on their pleas.

MOTIVES Can doctors be sure that they know and

understand all the facts? Is it possible that they may fear a future

which will not be realised? Any euthanasia process would have to be

able to establish, beyond any doubt, the true intentions of the patient who is requesting euthanasia and that the patient is fully aware of the situation.

The risk of misinformation or a failure to comprehend the situation leaves the patient vulnerable to a decision that he or she might not truly want to make.

MOTIVES You can never be 100% sure of

a persons motives They may be depressed or

struggling and may not really be able to give the informed consent necessary to make the difficult decision about the end of their life.

WHAT ABOUT MISTAKES? Suppose that someone chooses death

because they have been diagnosed with a fatal, incurable and painful illness.

Then after the person has died, it becomes apparent the diagnosis, but can there always be medical certainty about what the conditions will entail and how long it will take to develop?

There is an area of doubt here that could lead to terrible mistakes.

Refusing to allow voluntary euthanasia safeguards us against this.

Is this fair? Should we

not just safeguard

against mistakes?

ABUSE OF THE SYSTEM Would elderly relatives who think

they are burdens to their families ask for voluntary euthanasia out of a sense of duty to the family?

Jonathan Glover 1977 notes that people who feel they are burdens on their families sometimes commit suicide.

On the other hand, could they be pressured into asking for assisted death by scheming relatives?

GLOVER Glover’s anti-euthanasia stance concentrates on the value of life. Glover uses the example in which there are two planets; on one a single vegetable grows and on the other there is no sign of life and no form of life can ever be achieved. We must destroy one planet. Those who chose to save the planet with the vegetable recognise that life has intrinsic value.

ABUSE OF THE SYSTEM The conviction of Harold

Shipman for multiple murders – where he, as a GP, murdered dozens of elderly patients over a period of many years – highlights the power of doctors, especially over the elderly.

A voluntary euthanasia system could allow such people even more scope for murder, by manipulating patients and documentation.

JACK KEVORKIAN

Kevorkian aka 'Dr Death' because he photographed the eyes of dying patients. Later in his career (starting in 1987) he advertised his services as a physician offering 'death counselling'. When terminally ill patients learned that he was helping people to die, more and more people came to him. Despite several failed court cases, Kevorkian helped over 130 people to die.Kevorkian believed that helping people was not enough, and actually killed Thomas Youk, filmed himself doing so and recieving consent by the man. He was sentenced to 10-25 years in prison.

IMPACT ON THE COMMUNITY

What cultural effect might voluntary euthanasia have on society?

Might it lead to other forms of euthanasia being supported – ultimately concluding with the kinds of involuntary euthanasia carried out by the Nazis on the sick, the elderly and the disabled?

REVIEW1. How can you be sure of a persons

motives?

2. What about mistakes?

3. How can you prevent abuse of the system?

4. Impact on the community?

ABORTION AND

EUTHANASIA-

10-

LEARNING OBJECTIVE To know the issues of involuntary

euthanasia.

KEY PEOPLE TONY BLAND

KEY WORDSComatosePersistent vegetative state (PVS)

INVOLUNTARY EUTHANASIA Voluntary euthanasia refers to situations where

a person is able to make wishes known, perhaps at time or possibly by an advance directive.

However, there are other cases where a patient cannot let their wishes be known, such as when they are in a coma.

The withdrawal of treatment (passive) or the application of certain medicines (active) may bring about involuntary euthanasia.

Involuntary euthanasia means that it is compulsory and without the consent of the patient.

TONY BLAND Tony bland was the victim of the 1989

Hillsborough disaster in which many football fans were crushed to death.

He survived but was left in a persistent vegetative state (PVS) in which it was thought he would never recover.

In this state the body can breathe and main organs function properly.

In Bland’s case he could open his eyes but did not respond to anything around him.

TONY BLAND He could not feed but could digest food

so needed to have food and water provided through a feeding tube.

There was no cure for Tony’s condition but he was not dying.

The question, which eventually ended up in court, was whether or not it was right to remove artificial feeding and lead to death through starvation and dehydration.

This seems like a painful and cruel way if he was able to sense the pain although it was thought he would not.

INVOLUNTARY EUTHANASIA The 2005 mental capacity Act makes it clear that

assisted food and fluids is a medical treatment which can be withdrawn.

This seems to take a step towards active involuntary euthanasia or even non-voluntary euthanasia.

The ethical challenge here is that there are instances where doctors are convinced that a person will never wake up from a coma, or has no capacity for higher life function, and yet can be sustained indefinitely.

Does it show more or less respect for the value of the human person to withdraw life-sustaining measures?

QUESTION Is there a moral difference between

voluntary and involuntary euthanasia?

Analogy: is there a moral difference between pushing someone in a lake or watching someone drown and not helping them?

ABORTION AND

EUTHANASIA-

11-

LEARNING OBJECTIVE To know the Catholic perspectives on

euthanasia.

KEY QUESTIONS

IS SUFFERING CHARACTER BUILDING?

KEY WORDS

SUFFERINGCHOICE

FREEDOM

JOSEPH FLETCHER – SITUATION ETHICS1. The quality of life is to be valued over

biological life

2. Death is a friend to someone with a debilitating illness.

3. All medical interventions place human will against nature and extraordinary means.

4. Special equipment and unnecessary surgery are not morally required for a person who is terminally ill.

RELIGIOUS PERSPECTIVES There are similarities between the

religious approaches to euthanasia and abortion.

Many religious perspectives work from interpretation of sources and applying them to the issues at stake.

The most important thing to remember is that there is diversity both within and between religious traditions.

CHRISTIAN PERSPECTIVES Roger Crook captures the Christian

perspective on euthanasia by posing the question of how we care for the dying.

What do we do for the person who is comatose with no hope of recovery?

How do we care for the terminally ill person whose remaining days are increasingly, agonisingly painful?

The human being is not simply a biological entity but a person, in the image of God and Christ. Death marks the end of personhood in this life.

CHRISTIAN PERSPECTIVES - GENERAL1. Biblical teachings prohibit killing

2. The sixth commandment “you shall not murder” (exodus 20:13)

3. Jesus ministry was about healing. Providing care for the sick, needy and the weakest members of society.

4. Christians have traditionally considering taking one’s own life to be wrong.

CATHOLIC – LIFE IS SACRED

At the Second Vatican Ecumenical Council, the Roman Catholic Church condemned crimes against life such as;

Murder, genocide, abortion, euthanasia, or wilful suicide

“life is sacred and a gift from God”

To take a life opposes God’s love for that person, and rejects the duty of a person to live life according to God’s plan.

CATHOLIC – LIFE IS SACRED

In the same declaration they made it clear that it was wrong to ask someone for an assisted death.

And that an individual cannot consent to such as death: ‘For it is a question of the violation of the divine law, an offence against the dignity of the human person, a crime against life and an attack on humanity.’

The kind of autonomy that is argued for by JS Mill is rejected here.

We simply don’t have that freedom, because we are made by God for the purpose of loving God. God has created us for a purpose, and it is our duty to live and pursue that purpose.

CATHOLIC – THE IMPORTANCE OF SUFFERING A distinct argument is made about

suffering and its role in Christian theology.

Jesus died in pain on the cross, and human suffering at the end of life connects us to the suffering that Jesus felt.

This does not mean that Christians should refuse to take painkillers or should actively seek pain, but it does grant suffering the possibility of having a positive effect on the individual.

OTHER CHRISTIAN VIEWS Liberal protestants

argue that euthanasia can be an act of love as the quality matters as much as quantity, death is not the end and can be a friend to those suffering terribly.

Conservative protestants

Argue that while withdrawing treatment could be an act of kindness when death is inevitable and life is intolerable, it should only take place in exceptional cases and cannot include actively taking life

ISLAM Life is sacred and God-given. Humans

cannot intervene and play God. Do not take life, which Allah made

sacred, other than in the course of justice.

Qur'an 17:33 Destroy not yourselves. Surely Allah is

ever merciful to you.Qur'an 4:29

However, many Muslims agree that a patient should not be kept alive when in a vegetative state if there is no hope of recovery.

BUDDHISM Voluntary euthanasia is the result of a

negative state of mind which needs to be addressed. This can be so by meditation and medication.

Some Buddhists argue Euthanasia should be forbidden as it is killing and so will negatively alter the karmic balance.

The taking of one’s own life is permitted in some cases, e.g. the suicide of monks. However, monks are believed to have a different state of mind to other people and therefore this may only apply to them.

HINDUISM

Euthanasia will result in negative karma for the individual as the body and atman, soul, are being separated at an unnatural time.

The karma of the doctor will also be damaged. Hindus believe in ahimsa and are against killing However, euthanasia to end the suffering of an

individual could be viewed as a morally permissible, even good, deed.

A form of passive euthanasia is known as prayopavesa in Hindu law.

this is when an individual has a terminal disease and makes the decision to not eat food thus slowly dying from starvation.

This is allowed since the person is dying anyway and it is a non-violent, natural method.

REVIEW The human person is the image of God.

Bible teachings prohibit killing and promote healing although there are some exceptions in terms of self-sacrifice for others.

Catholic teaching opposes all euthanasia as it interferes with

1. God’s plan2. The gospel is a gospel for life3. Killing is an offense against the dignity of the

human person4. Sometimes suffering is for a purpose

EXAM QUESTIONS

(b) Choose one religion. Outline teachings on euthanasia.

(5)

(c) Explain why some people argue that the legalisation of euthanasia is dangerous.