end of life (mini learning)

Question 1

What is gross negligence an example of with regards to killing someone ?

Answer 1

Manslaughter

Question 2

What are the 4 types of euthanasia ?

Answer 2

• Active
• Passive
• Voluntary
• Non-voluntary

Question 3

What is meant by Active Euthanasia ?

Answer 3

A conscious action is taken to bring a life to an end
e.g lethal injection

Question 4

What is meant by Passive Euthanasia ?

Answer 4

Intentionally letting a patient die by withholding life saving treatment/life support
e.g not using ventilation or feeding tube

Question 5

What is meant by Voluntary Euthanasia ?

Answer 5

Ending a patient’s life at their request to relieve suffering

Question 6

What is meant by non-voluntary Euthanasia ?

Answer 6

Ending a patient’s life without consent of the patient and without knowing their wishes (patient lacks capacity to choose)

often referred to as “mercy killing”

Question 7

What is the difference between non-voluntary and involuntary euthanasia ?

Answer 7

involuntary = against patients wishes
non-voluntary = without patient consent but wishes are unknown (patient lacks capacity)

Question 8

What is physician assisted suicide ?

Answer 8

A physician deliberately helping someone commit suicide

Question 9

What is the difference between euthanasia and physician assisted suicide ?

Answer 9

euthanasia = deliberately ending a life to end suffering
physician assisted suicide = deliberately assisting someone in ending their own life

Question 10

List all the non-natural methods of death…

Answer 10

• murder
• man slaughter
• euthanasia
• physician assisted suicide
• suicide

Question 11

What is Gross Negligence Manslaughter (GNM) ?

Answer 11

A failure to meet the appropriate standard of care, resulting in a death through action/omission that is sufficiently negligent to amount to a crime

Question 12

How long is the sentence for Gross Negligence Manslaughter?

Answer 12

10-14 years

maximum sentence is life (18 years followed by parole)

Question 13

What is an example of Active Voluntary euthanasia ?

Answer 13

Assisted suicide (done abroad, illegal in UK)

Question 14

Name a company that partakes in assisted suicide …

Answer 14

Dignitas (in Switzerland)

Question 15

Is Active voluntary euthanasia legal in the UK ?

Answer 15

no, it’s illegal

Question 16

What is an example of Passive voluntary euthanasia?

Answer 16

Elective cessation of treatment from the patient

• Do Not Resuscitate
• Advanced Decision to Refuse Treatment (ADRT)

Question 17

Is Passive voluntary euthanasia legal in the UK?

Answer 17

Yes, you can sign an ADRT or DNR form to refuse treatment/resuscitation

Question 18

Name some examples of Active non-voluntary euthanasia…

Answer 18

Murder
Manslaughter
“Mercy killings”

Question 19

Is Active non-voluntary euthanasia legal in the UK ?

Answer 19

No, it is illegal

Question 20

Give an example of Passive non-voluntary euthanasia…

Answer 20

Any situation where the patient is in a coma/unconscious/lacks capacity with no other indication of wishes/legal documents, and treatment is ceased due to it being unsuccessful

Question 21

Is Passive non-voluntary euthanasia legal in the UK ?

Answer 21

If treatment has no clinical benefit then it may be permissible

The medical staff in charge will be vulnerable to allegations of negligence/manslaughter

Question 22

Is suicide illegal in the UK ?

Answer 22

Suicide is not illegal
Assisted suicide is illegal

Question 23

Give some examples of ‘pro euthanasia’ arguments…

Answer 23

• gives patient autonomy
• patient has a right to die
• could be seen as an act of compassion to avoid suffering
• maintains the patient’s dignity
• suicide isn’t illegal, why not make it equal ?

Question 24

Give some examples of ‘anti euthanasia’ arguments…

Answer 24

• sanctity of life = life is precious and doctors shouldn’t be able to play god and end it
• protection of the vulnerable - avoid coercion for benefit of family members etc
• seen as a slippery slope
• palliative care is an option and can help people go comfortably
• patients may be deterred from certain doctors that perform euthanasia frequently

Question 25

What is the Doctrine of Double Effect

Answer 25

It is **morally indefensible to intend to harm** and innocent person, but it is **morally defensible to perform good intended actions, where harm is foreseen** but an unintended consequence *a non-medical example of this is self defence*

Question 26

What piece of legislation allows doctors to administer potentially lethal medications as long as the primary purpose is therapeutic ?

Answer 26

The Doctrine of Double Effect

Question 27

What are the criteria that, if met, will ALWAYS be prosecuted against in the use of assisted suicide ?

Answer 27

1. victim was **under 18yrs** old 2. victim **didn’t have capacity** to reach informed decision 3. victim **hadn’t reached a voluntary, clear, informed decision** and was pushed into it 16. suspect was acting in anyway within their capacity as a medical professional and the **victim was under their personal care** e.g provide patient their records, knowing that they’ll go to Switzerland etc

Question 28

What are some circumstances that may make prosecution of assisted suicide less likely ?

Answer 28

1. victim had reached a clear, stated, informed decision to commit suicide 2. suspect was wholly motivated by compassion 3. action of suspect were very minor involvement 4. suspect had tried to dissuade victim which resulted in a suicide 5. actions of suspect were reluctant in the face of a determined wish of the victim 6. suspect reports suicide to police and fully assists enquiries

Question 29

Who has authority to dispose of a dead body (via burial/cremation/export etc) ?

Answer 29

- coroner - patient’s beneficiaries stated in the will - local authorities

Question 30

Who is the coroner ?

Answer 30

- an independent judicial officer unrelated to the police, crown or civil court systems - has a legal or bioscience qualification and experience

Question 31

What is the role of the coroner ?

Answer 31

- establish who has died and how - can issue a death certificate if medical staff cannot - can ask for post-mortems - cannot decide who commuted a crime (if murder etc) but their verdict may influence police/courts etc