PHL 223 Week 4 Notes
PHL 223 Week 4 Notes PHL 223
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This 3 page Class Notes was uploaded by Paola Araque on Saturday February 13, 2016. The Class Notes belongs to PHL 223 at University of Alabama - Tuscaloosa taught by Stuart Rachels in Summer 2015. Since its upload, it has received 32 views. For similar materials see Medical Ethics in PHIL-Philosophy at University of Alabama - Tuscaloosa.
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Date Created: 02/13/16
Medical Ethics Notes: Week 4 Lecture ● What Causes Death? ○ Active Euthanasia→ someone other than the patient ○ Passive Euthanasia→ the disease or some natural process ○ Permanent Sedation→supposedly the disease as well. ■ alleviates the pain. ultimately the disease kills the patient, not the medicine. ○ Physician Assisted Suicide (PAS): the patient. ■ the doctor does NOT do the killing ■ assisting in suicide is illegal in 45 states ■ insurance policies may vary ● The Netherlands: ○ Active Euthanasia is legal if: ■ a voluntary request is made by a competent patient It has to be multiple requests, the patient can’t go back and forth between the decision, and the decision cannot be made out of pressure. ■ the patient’s suffering is intolerable ■ all analgesics have been tried ■ the patient is fully informed ■ a second opinion from another doctor is needed to agree with the patient undergoing active euthanasia ○ 90% of Dutch citizens support the law ○ PVS patients cannot be killed, because they are not competent to make the decision about ending their life. ○ Patient does not need to be dying ○ Almost all the patients that end their lives are terminally ill ● The Case of Elizabeth Bouvia ○ a disabled person requested help in dying ○ in the end, she changed her mind about having the feeding tube and allowed nurses to continue feeding her. ○ she was unable to use her arms or legs ○ killing yourself when you are so disabled is not easy ● doctors are aware of drugs that can cause a lot of harm to a patient if too much is given, but they don’t really know HOW to kill a patient ● Suicide: ○ 3x more common than homicide, and about 38,000 suicides occur in the U.S. each year. ■ about 13,000 murders occur each year ○ only 4% of attempts at suicide succeed ○ men are 4x more likely to commit suicide than women ○ why? men are more likely to use a gun vs. a woman who may use medications. ■ hence, most suicides being gun related ○ when guns are used, it is twice as likely used for suicide than a homicide ○ many people who attempt/commit suicide have temporary problems and it’s just a decision made in a spur of the moment. ○ In the 1950s, 50% of England’s suicides were oven related. ○ When they switched to natural gas the percentage went down A LOT, and it never went back up. ○ the most popular place to commit suicide is the Golden Gate Bridge. ■ 1600 suicides in the last 80 years ○ 76 million dollars are being invested for a stainless steel safety net at the Golden Gate Bridge. ○ the most depressed people commit suicideuring recovery. ○ if more than one doctor can make the call that you are a harm yourself, you can be involuntarily institutionalized ● Physician Assisted Suicide ○ Jack Kevorkian helped over 100 people die in the 90s ■ took place in MIchigan, and what he did was not illegal at the time. ■ he was arrested and put on trial, even though he was not breaking the law. ■ his medical license was taken away ■ known as theercy trials ■ he wanted to represent hiimself in court, and fired his lawyer. ■ 1999: convicted of 2nd degree murder (manslaughter, responsible for death but you didn’t want it) after triggering the lethal dose himself. ■ under the law, he was guity of 1st degree murder ■ died in 2011 ■ took patients to public park where they could commit suicide, and then took their bodies to the morgue. ○ Kevorkian: ■ did not always know his patients well ■ was a pathologist, not a pain specialist or an oncologist (someone who deals with patients undergoing cancer treatment) ● Pathologists look at autopsys and cell tissue ● they also deal with corpses, and never see live patients. ■ Kevorkian usually didn’t have access to medical records and talk to specialists, but the medical community wouldn’t work with Kevorkian. ■ But maybe what he did was better than letting these patients suffer. ● Timothy Quill: ○ knew Diana for 8 years ○ had access to medical records ○ had access to the advice of specialists, including pain specialists. (unlike Kevorkian) ○ Quill, like Kevorkian, was charge with murder but the grand jury didn’t indict him. ● Physician Assisted Suicide: The Law ○ In Quill vs. Vacco (1997) the Supreme Court said States can ban PAS if they want. ○ In 1994, the Oregon Death with Dignity Act passed 51% to 49%, and it made PAS suicide legal in the state of Oregon ○ In 2006: the Supreme Court upheld Oregon’s law 63 ○ Washington (state) legalized PAS in 2008 ○ Vermont did the same in 2013 ● To qualify for PAS, the patients must: ○ be clearly competent (patient can express their values) ○ be dying (according to the law, the patient must be within 6 months of deat and another doctor can concur) ○ wait 15 days after initial request ● In 2014, 105 people died resulting from PAS ● Mostly cancer patients kill themselves, because they are aware of how weak they are. ● In 2012 1 case out of 425 were physician assissted suicide deaths. ● What are the patient’s reasons? ○ loss of autonomy/ control 91%. Patient has no control of his/her body and they are VERY sick. Patient wants to take control of their own death. ○ unable to enjoy things 87% ○ loss of dignity 71% ○ pain 28%
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