Voluntary assisted dying and patient autonomy

Authors

Keywords:

Voluntary assisted dying, Assisted suicide, Voluntary euthanasia, Autonomy, Political liberalism, Patient self-determination principle

Abstract

In this paper, I defend medical assistance in dying, both in the form of physician-assisted suicide and in that of active, direct, voluntary euthanasia. At the beginning, I clarify the notions to be used in the discussion and the legal and clinic conditions that patients should ideally fulfill to request aid in dying. After underlying the bioethical and philosophical dimension involved in the question of voluntary death, I examine the major arguments for and against this practice. Once the four main counterarguments are rebutted (based on the sanctity of life, the mission of medicine, the slippery slope, and the palliative medicine), I conclude by stressing that there are good reasons to support the legalization of voluntary death, since it represents an extension of patients’ rights and of the principle of autonomy.

Author Biography

  • Marcos G. Breuer, Universidad Abierta de Grecia, Universidad de Ática Occidental, / Instituto Cervantes en Atenas, Atenas, Grecia

    Marcos G. Breuer es docente de la Universidad Abierta de Grecia, la Universidad de Ática Occidental y el Instituto Cervantes en Atenas. Obtuvo su Licenciatura en Filosofía por la Universidad Nacional de Córdoba (2000) con una tesis sobre la teoría de los procesos sociales de Norbert Elias, y su Doctorado en Filosofía por la Universidad de Düsseldorf (2006), con un trabajo sobre los supuestos antropológicos subyacentes a la ética normativa de Peter Singer, Richard Hare y John Rawls. Autor de obras sobre ética, sociología y bioética. Actualmente está investigando sobre los fundamentos teóricos de la bioética, como un aporte al debate actual en torno al concepto de persona y sujeto de derecho. Más información en https://marcos-breuer.com/.

References

Agassi, J. (2016). Toward a fictionless liberalism. Philosophy of the Social Sciences, 46 (1). https://doi.org/10.1177/0048393115612035

Baron, C. H. y otros (1996). A model State act to authorize and regulate physician-assisted suicide. Harvard Journal of Legislation, 33 (1), 1 – 34.

Beauchamp, T. L. y J. F. Childress (1979). Principles of biomedical ethics. New York: Oxford University Press.

Battistella, G. (2021). Il reato di auto al suicidio al vaglio della Corte costituzionale austriaca. Rivista di BioDiritto, 2, 319-348. https://doi.org/10.15168/2284-4503-824

Benzenhöfer, U. (1999). Der gute Tod? Euthanasie und Sterbehilfe in Geschichte und Gegenwart. Múnich: C. H. Beck.

Birnbacher, D. (2020). Doing and allowing in the context of physician-assisted suicide. Erkenntnis, 85, 575–588.

Birnbacher, D. (2021). Warum kein Anspruch auf Suizidassistenz?. Ethik in der Medizin, 34, 161–176.

Black, A. y otros (2020). Palliative care skills and new resources for oncology practices: meeting the palliative care needs of patients with cancer and their families. ASCO Educational Book, 40, 14–22.

Blake, R. R. y C. Blake (2021). Why people think they might hasten their death when faced with irremediable health conditions compared to why the actually do so. Omega: Journal of Death and Dying, 0(0). https://doi.org/10.1177/00302228211033368

Breuer, M. G. (2019). Eutanasia y autonomía: conceptos, argumentos, reflexiones. Villa María - Río Cuarto: Eduvim/UniRío.

Bundesverfassungsgericht. Urteil des Zweiten Senats vom 26. Februar 2020, 2 BvR 2347/15, Rn. 1-343. 2020

Byock, I. y otros (2001). Improving end-of-life experience and care in the community: a conceptual framework. Journal of Pain and Symptom Management, 22 (3), 759-772.

Camps, V. (2005). La voluntad de vivir. Las preguntas de la bioética. Barcelona: Ariel.

Carobene, G. (2015). Sul dibattito scientifico e religioso in tema di ‘fine vita’: accanimento terapeutico, stato vegetativo ed eutanasia. Stato, Chiese e Pluralismo Confessionale, 9.

Cassell, E. J. y B. A. Rich (2010). Intractable end-of-life suffering and the ethics of palliative sedation. Pain Medicine, 11 (3), 435–438. doi.org/10.1111/j.1526-4637.2009.00786.x

Congregazione per la Dottrina della Fede (1980, 5 de mayo). Dichiarazione sull’eutanasia. Disp en https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19800505_eutanasia_it.html.

Della Croce, Y. (2022). Assisted suicide for prisoners. An ethical and legal analysis from the Swiss context. Bioethics, 36 (4), 381-387.

Den Hartogh, G. (2009). The slippery slope argument. En H. Kuhse y P. Singer, A companion to bioethics (2da ed.) (pp. 321-332). Wiley-Blackwell.

Devos, T. (Ed.) (2021). Euthanasia: searching for the full story: Experiences and insights of Belgian doctors and nurses. Springer Nature

Downar, J. y otros (2020). Early experience with medical assistance in dying in Ontario, Canada: a cohort study. CMAJ, 192 (8), E173-E181. https://doi.org/10.1503/cmaj.200016

Downie, J. y U. Schuklenk (2021). Social determinants of health and slippery slope in assisted dying debates: lessons from Canada. Journal of Medical Ethics, 47 (10), 662-669. http://dx.doi.org/10.1136/medethics-2021-107493

Dworkin, R. (1998). Fritz B. Burns Lecture: Euthanasia, Morality and the Law-Transcript. Loyola Los Angeles Law Review, 31(4),1147- 1159. Disp. en https://digitalcommons.lmu.edu/llr/vol31/iss4/3.

Galletti, M. (2012). Scelte di fine vita, identità, autonomia. Alcune riflessioni sul rifiuto di cure e testamento biológico. Rivista di BioDiritto, 1, 29-51.

Hohendorf, G. y otros (2002). Die Opfer der nationalsozialistischen Euthanasie-Aktion T4. Nervenarzt, 73, 1065–1074.

Horn, R. (2018). The ‘French exception’: the right to continuous deep sedation at the end of life. Journal of Medical Ethics, 44, 204 – 205. http://dx.doi.org/10.1136/medethics-2017-104484

Jordan, J. R. (2001). Is suicide bereavement different? A reassessment of the literature. Suicide and Life-Threatening Behavior, 31 (1), 91 – 102.

Küng, H. y otros (2010). Menschenwürdig sterben. Ein Plädoyer für Selbstverantwortung. Múnich: Piper.

Leven, D. C. (2022). Refuting arguments against the medical aid in dying act. NYSBA Health Law Journal, 27 (1), 61 – 64. Disp. en https://endoflifechoicesny.org/wp-content/uploads/2022/03/NYSBA-Health-Law-Journal-22-Refuting-Arguments-v.-MAID.pdf

Maessen, M. y otros (2010). Requests for euthanasia: origin of suffering in ALS, heart failure, and cancer patients. Journal of Neurology, 257, 1192–1198. https://doi.org/10.1007/s00415-010-5474-y

Mill, J. S. (1867). On Liberty. Londres: Longmans, Green & Co.

Morita, T. y otros (2017). Continuous deep sedation: a proposal for performing more rigorous empirical research. Journal of Pain and Symptom Management, 53 (1), 146–152.

Orentlicher, D., T. M. Pope y B. Rich, B. (2016). Clinical Criteria for Physician Aid-in-Dying. Journal of Palliative Medicine, 19 (3), 259-262.

Perrett, R. W. (1996). Buddhism, euthanasia and the sanctity of life. Journal of Medical Ethics, 22 (5), 309-313.

Platón (1999). Fedón. Fedro (Trad. Luis Gil Fernández). Madrid: Alianza

Quill, T. y otros (2021). Voluntary stopping eating and drinking. A compassionate, widely available option for hastening death, Oxford University Press.

Raus, K. (2011). Is continuous sedation at the end of life an ethically preferable alternative to physician-assisted suicide?. The American Journal of Bioethics, 11 (6), 32-40.

Rochas, B. (2018). Recommandations pour la pratique de la sédation en situation palliative. Revue JALMALV, 4 (135), 79-84.

Schmuhl, H. W. (2007). Der Mord an psychisch kranken und behinderten Menschen. Eine Forschungsbilanz. En M. Gerhardt y otros (Comps.), Medizin und Gewissen. Im Streit zwischen Markt und Solidarität. Dokumentation des Internationalen IPPNW-Kongresses, 20.-22. Oktober 2006 in Nürnberg (pp. 21 – 42). Frankfurt am Main: Mabuse Verlag.

Selby, D. y S. Bean (2019). Oncologists communicating with patients about assisted dying. Current Opinion in Supportive and Palliative Care, 13 (1), 59-63. DOI: 10.1097/SPC.0000000000000411

Spence, R. A. y otros (2017). Responding to patient requests for hastened death: physician aid in dying and the clinical oncologist. Journal of Oncology Practice, 13 (10), 693-699. DOI: 10.1200/JOP.2016.019299

Van Oorschot, B. y A. Simon (2008). Aktive, passive oder indirekte Sterbehilfe? Über subjektive Definitionen und Klassifikationen von Ärzten und Richtern in Entscheidungssituationen am Lebensende. Psychologie und Gesellschaftskritik, 32 (2/3), 39-53. Disp. en https://nbn-resolving.org/urn:nbn:de:0168-ssoar-325704.

Downloads

Published

2022-09-26

How to Cite

Voluntary assisted dying and patient autonomy. (2022). Erasmus. Revista Para El diálogo Intercultural, 24(1). https://mail.qellqasqa.com.ar/ojs/index.php/erasmus/article/view/600