Euthanasia and

Physician
Assisted Suicide
Martin, Joarth C.
Martin, Mikaela Gabrielle M.
Martinez, Mark T.
Maternal, Charles Justin P.
Matias, Dan Angelo D.
Matic, Renai Eunicia D.
Euthanasia

❖ Greek: euthanatos meaning “good death”

❖ Termination of a very sick person's life in order to relieve them of their
suffering

British House of Lords Select Committee on Medical Ethics

“a deliberate intervention undertaken with the express intention of ending

a life, to relieve intractable suffering”.
I. Active vs. Passive Euthanasia
A. Active Euthanasia

❖ A person (medical professional) directly

and deliberately causes the patient's
death.
- Example: A person is killed by being given an overdose
of pain-killers.
B. Passive Euthanasia
❖ Death is brought about by an omission - i.e.
when someone lets the person die.

Withdrawing treatment:

- Switching off a machine that is keeping a

person alive
- Disconnected feeding tube

Withholding treatment:

- Not carrying out surgery that will extend life for a short time.
- Discontinuation of drugs.
The moral difference between killing and letting die

“ it is acceptable to withhold treatment and allow a patient to die, but that it is never
acceptable to kill a patient by a deliberate act.”

There is no real difference

There is no real difference between passive and active euthanasia, since both
have the same result: the death of the patient on humanitarian grounds
II. Direct vs Indirect Euthanasia
 A.DIRECT EUTHANASIA
When life is ended actively and intentionally as the result of
a specific action

a. Voluntary
b. Non-voluntary
c. Involuntary
A. DIRECT EUTHANASIA
1. VOLUNTARY
● Request of a fully competent person who wishes to die
● Performed with the patient’s consent
● This includes:
○ asking for help with dying
○ refusing burdensome medical treatment
○ asking for medical treatment to be stopped, or life support
machines to be switched off
○ refusing to eat
○ simply deciding to die

http://www.bbc.co.uk/ethics/euthanasia/overview/forms.shtml
A. DIRECT EUTHANASIA
2. NON- VOLUNTARY
● Patient is unable to make a choice at all
● Not competent to give consent
● Someone else takes a patient’s behalf in the eyes of the law.
● Examples:
○ A child, mentally and emotionally able to decide, but is not
regarded by the law as old enough to make a decision
○ Patient in coma
○ Mentally retarded patient
○ Severe brain damage
A. DIRECT EUTHANASIA
3. INVOLUNTARY
● Killing someone for the sake of relieving suffering without consent
when they are capable of giving consent.
B. INDIRECT EUTHANASIA
● Allowing death to occur without a direct link between the action,
intent and result.
● This means providing treatment (usually to reduce pain) that has
the side effect of speeding the patient's death.

PRINCIPLE OF DOUBLE EFFECT

➢ The good result must be achieved independently of the bad one

➢ The action must be proportional to the cause
➢ The action must be appropriate
➢ The patient must be in a terminal condition
EUTHANASIA IN THE PHILIPPINES

Senate Bill No. 1887: Natural Death Act

An act recognizing the fundamental right of adult persons to

decide their own health care, including the decision to have
life-sustaining treatment withheld or withdrawn in instances
of a terminal condition or permanent unconscious condition
ETHICAL APPROACH

The Catechism of the Catholic Church on Euthanasia and

Assisted Suicide

2276 Those whose lives are diminished or weakened deserve

special respect. Sick or handicapped persons should be helped
to lead lives as normal as possible.
ETHICAL APPROACH

The Catechism of the Catholic Church on Euthanasia and

Assisted Suicide

2277 Whatever its motives and means, direct euthanasia consists in

putting an end to the lives of handicapped, sick, or dying persons.
It is morally unacceptable. Thus an act or omission which, of itself
or by intention, causes death in order to eliminate suffering
constitutes a murder gravely contrary to the dignity of the human
person and to the respect due to the living God, his Creator. The
error of judgment into which one can fall in good faith does not
change the nature of this murderous act, which must always be
forbidden and excluded.
ETHICAL APPROACH

The Catechism of the Catholic Church on Euthanasia and

Assisted Suicide

2278 Discontinuing medical procedures that are burdensome,

dangerous, extraordinary, or disproportionate to the expected
outcome can be legitimate; it is the refusal of "over-zealous"
treatment. Here one does not will to cause death; one's inability to
impede it is merely accepted. The decisions should be made by the
patient if he is competent and able or, if not, by those legally
entitled to act for the patient, whose reasonable will and
legitimate interests must always be respected.
ETHICAL APPROACH

The Catechism of the Catholic Church on Euthanasia and

Assisted Suicide

2279 Even if death is thought imminent, the ordinary care owed to a

sick person cannot be legitimately interrupted. The use of
painkillers to alleviate the sufferings of the dying, even at the
risk of shortening their days, can be morally in conformity with
human dignity if death is not willed as either an end or a means,
but only foreseen and tolerated as inevitable. Palliative care is a
special form of disinterested charity. As such it should be
encouraged.
ETHICAL APPROACH

The Catechism of the Catholic Church on Euthanasia and

Assisted Suicide

2280 Everyone is responsible for his life before God who has
given it to him. It is God who remains the sovereign Master
of life. We are obliged to accept life gratefully and
preserve it for his honor and the salvation of our souls. We
are stewards, not owners, of the life God has entrusted to
us. It is not ours to dispose of.
ETHICAL APPROACH

Pope John Paul II, Evangelium Vitae, 1995

Euthanasia is a grave violation of the law of God, since it

is the deliberate and morally unacceptable killing of a human
person
III. Physician Assisted Suicide
A. Physician Assisted Suicide vs. Euthanasia
PHYSICIAN ASSISTED SUICIDE
● Physician prescribes the
treatment
● Patients administer the
treatment
Example: patient ingesting
a lethal dose of medication
prescribed by the physician
EUTHANASIA
● Physician prescribes the
treatment
● Physician directly
administer the treatment
to the patient.
Example: A lethal injection
performed by the physician
B. Legalizing Physician Assisted Suicide

Proponents Opponents

● Principle of Autonomy ● Physicians should not

● Physician’s duty to participate in intentionally
relieve the patient’s ending a patient’s life.
suffering ● Principle of autonomy must
be balance with other
ethical principles such as
beneficence and
nonmaleficence.
C. Principle of Stewardship

● Our stewardship over life presupposes that we

preserve our life and not destroy it
● With suicide, this is a rejection of God’s gift of
life
● Suicide therefore is intrinsically and always
wrong.
IV. Hospice Care
A. Hospice Care Overview
● Provided for a person with a terminal illness; has
6 months or less to live if the illness runs its
natural course
● Objective is pain and symptom relief.
● Addresses the patient’s physical, emotional, and
spiritual needs
● Treats the whole patient and the family, offering
psychosocial and spiritual counseling
 “Hospice care focuses on you
and your family, instead of the
disease. It’s about providing
the best possible quality of
life for whatever time remains”
B. Palliative and hospice care do not mean giving up

● Palliative and hospice patient have more control

over their care including decision about what
treatments to accept or reject.

● Palliative and hospice care help patient shift goals

and achieve new priorities.
B. Palliative and hospice care do not mean giving up

● So instead of giving up, patients receiving palliative

and hospice care are focusing on what’s most important
to them- and making every moment count.
C. Discontinuation of Hospice Care

● “Please, I want to go home”-ethical issues raised →

Hospice Care
● Reasons for discharge
○ Upon patient/family request;
○ When competent staff are not available to give care;
○ If there are requests or issues that compromise the
ethical or professional integrity of the caregivers.
C. Discontinuation of Hospice Care

● Respect for autonomy:

○ healthcare professionals abide by the
voluntary and rational choices of a patient
● Beneficence:
○ healthcare professionals promote the welfare
of their patients
● Nonmaleficence:
○ avoid harming them