1. PP produced by Julie Arliss Academy Conferences Euthanasia See the Academy Conferences website for this year’s conference details: http://ethics.academyconferences.com

2. PP produced by Julie Arliss Academy Conferences Key Issue 1.  Is killing somebody, who is in the process of dying, morally the same as allowing them to die?

3. PP produced by Julie Arliss Academy Conferences  An elderly patient in some pain with 2 weeks to live.  Morphine is given to control the pain.  Is there any moral difference between allowing the elderly patient to die, without pain, over a period of two weeks, and giving the patient a lethal injection which will kill them tonight?

4. PP produced by Julie Arliss Academy Conferences Key Issue 2 Rights of Patient or Rights of Medics “WE PREFER NOT TO KILL OUR PATIENTS”

5. PP produced by Julie Arliss Academy Conferences Key Issue 3 HOW ARE THE ‘PREFERENCES’ OF THE INDIVIDUAL TO BE BALANCED AGAINST THE PERCEIVED RISKS TO COMMON GOOD?

6. PP produced by Julie Arliss Academy Conferences Key issue 4  Are humans animals really? If so then, we put animals down, why not humans?

7. PP produced by Julie Arliss Academy Conferences INDIVIDU AL RIGHTS PRIMARY KILLING IS THE SAME AS ALLOWIN G TO DIE HUMANS ARE ANIMALS AND NOTHING MORE EUTHANASIA

8. PP produced by Julie Arliss Academy Conferences INDIVIDU AL RIGHTS CAN BE LIMITED. ALLOWIN G TO DIE IS MORALLY DIFFERE NT FROM KILLING HUMANS ARE FAR MORE THAN ANIMALS NO EUTHANASIA

9. PP produced by Julie Arliss Academy Conferences Active Euthanasia Voluntary Lilian Boyes vs Dr Cox – Potassium choloride1992 Non Voluntary John Pearson a downs child DF118 Involuntary Dr Shipman 1999 Diamorphine (Heroin)

10. PP produced by Julie Arliss Academy Conferences Non-voluntary Active Euthanasia The person is unable to express their wishes. A person in a coma, given a lethal injection. A baby, perhaps with Downs or disabled, given a lethal injection.

11. PP produced by Julie Arliss Academy Conferences Involuntary Active Euthanasia Nellie ‘Mary’ Pickford and 5 others ‘died’ unexpectedly at Parkfields Care home. Rachel and Leigh Baker arrested.  Dr Harold Shipman killed 215 – 250 people The person is able to express their wishes but Is not consulted.

12. PP produced by Julie Arliss Academy Conferences Legislation  Current legislation forbids all forms of active euthanasia.  The Netherlands has the most developed active euthanasia programme in the world.  Only voluntary euthanasia comes under their legislation but, in practise, according to their own reports, all forms of active euthanasia are done.

13. PP produced by Julie Arliss Academy Conferences Passive Euthanasia Voluntary Patient decides to refuse treatment. Non Voluntary – patient cannot be consulted. Intensive care patient has medical support withdrawn. Involuntary – patient not consulted. Medical decision not to offer treatment.

14. PP produced by Julie Arliss Academy Conferences Non-voluntary Passive Euthanasia The person is unable to express their wishes. Tony Bland PVS patient Baby Doe - parents refused Treatment for tracheo esophageal fistula. X

15. PP produced by Julie Arliss Academy Conferences Involuntary Passive Euthanasia  An elderly patient with 2 weeks to live.  Passes out of consciousness.  Medical decision not to resuscitate.

16. PP produced by Julie Arliss Academy Conferences Legislation  Current legislation allows all sorts of ‘passive euthanasia’.  It is not usually called euthanasia, but ‘allowing to die’.  The pro-euthanasia lobby argue that euthanasia goes on all the time.  They are referring to passive euthanasia, whereby a decision is made not to treat, or to withdraw treatment.

17. Utilitarianism and euthanasia

18. PP produced by Julie Arliss Academy Conferences Utilitarianism  Utilitarianism is an ethical theory which claims that the morality of our actions depends on their consequences.  If an elderly person is in the final stages of life and has 2 weeks to live, is there any difference between giving a lethal injection tonight or letting them die slowly?  The Utilitarian argues NO! They are the same, because the consequences are the same. The person dies.

19. PP produced by Julie Arliss Academy Conferences James Rachels 30 May 1941 - 5 Sep 2003  Smith and Jones stand to gain a great deal of money on the death of their 6 year old cousin  Imagine they plan separately to kill their cousin.

20. PP produced by Julie Arliss Academy Conferences Smith goes up and drowns their cousin in the bath. (Active euthanasia – the doctor takes positive action to kill.)

21. PP produced by Julie Arliss Academy Conferences Jones goes up with the intention of drowning his cousin, but finds the boy has banged his head, fallen and is unconscious drowning in the bath. Jones does nothing and the boy dies. Passive euthanasia – the doctor omits treatment and allows to die.

22. PP produced by Julie Arliss Academy Conferences James Rachels  Rachels uses this example to show that it would be ridiculous to say that Smith is a murderer and Jones not.  The consequences of their acting/not acting makes them morally the same because the result is the same.  IF consequences are the only morally relevant factor he is right.  Once you say this there is no difference between active and passive euthanasia. 

23. PP produced by Julie Arliss Academy Conferences ACTIVE / PASSIVE No Moral Significance  “Stripped of all other differences, what remains is…a difference that has no moral significance. In active euthanasia the doctor initiates a course of events that will lead to the patients death. In letting die (or passive euthanasia) the agent stands back and lets nature take her sometimes cruel course. Is letting die morally better than active euthanasia? I think not. Very often it is much worse.”  Helga Kuhse; Case for Active Vol. Euth. 87  Passive euthanasia, or allowing to die, happens all the time so why not active euthanasia? Peter Singer also argues for this.

24. PP produced by Julie Arliss Academy Conferences Utilitarianism  For utilitarian's the good action is that which brings about the greatest good for the greatest number.

25. PP produced by Julie Arliss Academy Conferences Greatest good for greatest number?  John Pearson was born with Down’s on 28.7.1980. His mother remarked “I don’t want it, duck”  Down’s apart there were no clinically detectable abnormalities  Dr Arthur recorded: “Parents do not wish baby to survive. Nursing care only.”  Dr Arthur prescribed DF118,the infant was given  water but no nourishment and antibiotics were withheld when broncho-pneumonia developed  John Pearson died three days after birth  Dr Arthur charged with murder, changed to attempted murder, as DF118 may not have caused death.

26. PP produced by Julie Arliss Academy Conferences Retarded or ‘unfit to breed’. Homosexuals. Disabled. Gypsies. Jews. Greatest Good for Greatest number?

27. PP produced by Julie Arliss Academy Conferences Utilitarian contribution § Consequences are vital. § For the Utilitarian human life is not sacred – we put animals out of their misery. § Consider how best to reduce pain and create pleasure. § Stress on pleasure over pain may mean helping to die rather than prolonging suffering. § Creating the greatest good for the greatest number may mean carefully evaluating the use of medical resources, and helping to die.

28. PP produced by Julie Arliss Academy Conferences  There are already some utilitarian voices suggesting that treatment for the elderly be restricted.

29. PP produced by Julie Arliss Academy Conferences Rule Utilitarianism - Mill  Euthanasia IS against the LAW and the rule utilitarian will not break the law but work to change it if needed.  Any higher pleasures which can be experienced by the sick person must be weighed into a decision.  The long term consequences of allowing euthanasia would also be put into a decision.  The German experience and the Dutch experience might well persuade a utilitarian not to opt for the legalisation of active euthanasia.

30. Holland ‘Abuse is the norm.’

31. PP produced by Julie Arliss Academy Conferences "LEBENSUNWERTES LEBEN" – Life Unworthy of Life. HELNWEIN'S OPEN LETTER TO EUTHANASIA DOCTOR HEINRICH GROSS Once active euthanasia is accepted the question is then one of quality of life. Which life is sufficiently worthy of being lived? Which life is not? Austria's number one forensic psychiatrist admitted putting poison in children’s food.

32. PP produced by Julie Arliss Academy Conferences The Missing Link in Utilitarian Case.  Smith and Jones intended to murder and inherit from their cousin.  WHAT IF we change the story.

33. PP produced by Julie Arliss Academy Conferences Winston Nesbitt What if Jones did not want to inherit from his cousin, and had no intention of killing his cousin in the bath. He went up and found him unconscious in the water and did nothing, because he thought there was nothing to be done. Is he still a murderer?

34. PP produced by Julie Arliss Academy Conferences Jones is now far more representative of our doctors.

35. PP produced by Julie Arliss Academy Conferences The Missing Link in Utilitarian Case.  The consequences of Jones’ actions are the same as before – the cousin dies.  Jones’ different motive means he is not a murderer.  This means that morality is not to be judged solely on the basis of consequences as James Rachels, and Utilitarianism claims.  Motive is a vital indicator.