Dr. Linda Emanuel--one of America's most influential medical ethicists--has assembled leading experts to provide not only a clear account of the arguments for and against physician-assisted suicide and euthanasia but also historical, empirical, and legal perspectives on this complicated issue.
Understanding Assisted Suicide provides both a fresh take on this important topic and the context of intelligent participation in the discussion. Uniquely, John Mitchell frames the issue using his own experience of watching both his parents die, which led him to ask fundamental questions about death, dying, religion, and the role of medicine and technology in alleviating human suffering.
"Over the past hundred years, average life expectancy in America has nearly doubled, due largely to scientific and medical advances, but also as a consequence of safer working conditions, a heightened awareness of the importance of diet and health, and other factors. Yet while longevity is celebrated as an achievement in modern civilization, the longer people live, the more likely they are to succumb to chronic, terminal illnesses. In 1900, the average life expectancy was 47 years, with a majority of American deaths attributed to influenza, tuberculosis, pneumonia, or other diseases. In 2000, the average life expectancy was nearly 80 years, and for too many people, these long lifespans included cancer, heart failure, Lou Gehrig's Disease, AIDS, or other fatal illnesses, and with them, came debilitating pain and the loss of a once-full and often independent lifestyle. In this compelling and provocative book, noted legal scholar Howard Ball poses the pressing question: is it appropriate, legally and ethically, for a competent individual to have the liberty to decide how and when to die when faced with a terminal illness? At Liberty to Die charts how, the right of a competent, terminally ill person to die on his or her own terms with the help of a doctor has come deeply embroiled in debates about the relationship between religion, civil liberties, politics, and law in American life. Exploring both the legal rulings and the media frenzies that accompanied the Terry Schiavo case and others like it, Howard Ball contends that despite raging battles in all the states where right to die legislation has been proposed, the opposition to the right to die is intractable in its stance. Combining constitutional analysis, legal history, and current events, Ball surveys the constitutional arguments that have driven the right to die debate"--Provided by publisher.
This important book includes a compelling selection of original essays on euthanasia and associated legislative and health care issues, together with important background material for understanding and assessing the arguments of these essays. The book explores a central strand in the debate over medically assisted death, the so called "slippery slope" argument. The focus of the book is on one particularly important aspect of the downward slope of this argument: hastening the death of those individuals who appear to be suffering greatly from their medical condition but are unable to request that we do anything about that suffering because of their diminished mental capacities. Slippery slope concerns have been raised in many countries, including Britain, the Netherlands, Canada, and the United States. This book concentrates most of its attention on the latter two countries. Stingl divides the book into four parts. Part I lays out the relevant public policies in the form of legal judgments, making them the philosophical point of departure for readers. Part II discusses the ever-present slippery slope objection to assisted suicide and other forms of euthanasia. Parts III and IV examine the role of social factors and political structures in determining the morality and legalization of voluntary and non-voluntary euthanasia. These sections are especially valuable. The inclusion of a selection of papers on the relationship between the morality and legality of euthanasia and systems of health care delivery is of particular interest, especially to those who want to make statistical, legal and moral comparisons between the USA and Canada.
Advances in medical treatment now enable physicians to prolong life to a previously unknown extent, however in many instances these new techniques mean not the saving of life but prolonging the act of dying. In the eyes of many, medical technology has run out of control and contributes to unnecessary suffering. Hence the demand has arisen that patients should be entitled to choose death when pain and physical and mental deterioration have destroyed the possibility of a dignified and meaningful life and that their doctors should help them to realize this endeavor. At the present time there are seven jurisdictions in the world that, with various restrictions, have legalized the practice of assisted death -- physician-assisted suicide and/or voluntary euthanasia - to wit, the Netherlands, Belgium, Luxembourg, Switzerland in Europe and the states of Oregon, Washington and Montana in the United States. Four of these regimes - in the Netherlands, Belgium, Switzerland and the state of Oregon -- have been functioning for many years, and we have for them a substantial body of data as well as much observational research. This book is based upon this material. The literature dealing with the moral, legal and social aspects of assisted death is voluminous, but there is a paucity of writing that provides a detailed account of the way these four regimes are actually working. Many partisans, on both sides of the issue, cite existing data selectively or, at times, willfully distort the empirical evidence in order to strengthen their case. Based on the documentary record and interviews with officials and scholars, this book seeks to give the specialist as well as the general interested reader a reliable picture of the way assisted death functions and to draw relevant lessons. While accurate factual information cannot settle a moral debate, it nevertheless is a precondition of any well-founded argument. 'The author speaks authoritatively about the issues he addresses. I think this book does make an important contribution to the field. It will be of interest to students and scholars of PAS as a source of information and reference. I definitely recommend publication.' Stuart Youngner, Department of Bioethics, Case Western Reserve University School of Medicine 'The information collected here makes an important contribution to the literature on PAS because it collects a broad array of relevant information into a single volume. It is interesting and enlightening. This will make the book a valuable resource for anyone interested in the subject and an especially useful resource for academics who study or teach about the issues.' Rosamond Rhodes, Director, Bioethics Education, Mt Sinai School of Medicine
Since programmed cell death was first described in insects in 1964 and apoptosis was described in 1972, rapid progress has been made in understanding the basic mechanisms and genes regulating programmed cell death and apoptosis. In addition, defects in various genes regulating programmed cell death have been delineated in several experimental models of human diseases. This volume surveys various aspects of these rapidly developing areas of research in programmed cell death/apoptosis. This volume should be of interest to basic immunologists and molecular biologists. The volume begins with a historical perspective of cell death. The remainder of the volume is divided into four different parts. Part I deals with the signaling pathways in apoptosis, including cell cycle control of apoptosis, role of ceramide in apoptosis, role of antibody signaling, and biochemical regulation of apoptosis. The mechanisms for recognition of apoptotic lymphocytes by macrophages are also reviewed. Part II examines the role of various genes that regulate apoptosis, including the role ofFas, FasL, and other TNF family members in apoptosis and homeostatic regulation of immune response. Recently described splice variants and their influence on apoptosis are also reviewed, and the role of the members of the Bcl-2 family in apoptosis is discussed in detail. Part III reviews various aspects of apoptosis in B lymphocytes, including mechanisms that regulate apoptosis/survival of B lymphocytes and the regulation of Fas-mediated apoptosis in B lymphocytes.
Death Rights is a collection of cutting-edge chapters on assisted dying and euthanasia, written by leading authors in the field. Providing an overview of current regulation on assisted dying and euthanasia, both in the UK and internationally, this book also addresses the associated debates on ethical, moral and rights issues. It considers whether, just as there is a right to life, there should also be a right to death, especially in the context of unbearable human suffering. The unintended consequences of prohibitions on assisted dying and euthanasia are explored, and the argument put forward that knowing one can choose when and how one dies can be life-extending, rather than life-limiting. Key critiques from feminist and disability studies are addressed. The overarching theme of the collection is that death is an embodied right which we should be entitled to exercise, with appropriate safeguards, as and when we choose. Making a novel contribution to the debate on assisted dying, this interdisciplinary book will appeal to those with relevant interests in law, socio-legal studies, applied ethics, medical ethics, politics, philosophy, and sociology.
Margaret Pabst Battin has established a reputation as one of the top philosophers working in bioethics today. This work is a sequel to Battin's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted suicide in Oregon and the Netherlands to furor over proposed restrictions of scheduled drugs used for causing death, and the development of "NuTech" methods of assistance in dying. Battin's new collection covers a remarkably wide range of end-of-life topics, including suicide prevention, AIDS, suicide bombing, serpent-handling and other religious practices that pose a risk of death, genetic prognostication, suicide in old age, global justice and the "duty to die," and suicide, physician-assisted suicide, and euthanasia, in both American and international contexts. As with the earlier volume, these new essays are theoretically adroit but draw richly from historical sources, fictional techniques, and ample factual material.
Analyzing the concepts of intention and causation in euthanasia, this timely new book explores a broad selection of disciplines, including criminal and medical law, medical ethics, philosophy and social policy and suggests an alternative solution to the one currently used by the courts, based on grading different categories of killing into a formalized justificatory defence. This text explores how culpability, blameworthiness and liability are ascribed and how ascertaining mens rea and actus reus are problematic in an end-of-life decision-making scenario. Williams criticizes the way the courts rely so exclusively on the criminal concepts of intention and causation in such medical scenarios and examines and raises awareness of the inadequate and inappropriate legal framework within in which judges have to operate. Topical and compelling, this significant contribution argues for a more open and honest approach which would, in turn, provide the certainty, consistency and equality required by the law. This is a quintessential read for all students studying medical and healthcare law and the legal aspects of health and medicine.
In Western thought, suicide has evolved from sin to sin-and-crime, to crime, to mental illness, and to semilegal act. A legal act is one we are free to think and speak about and plan and perform, without penalty by agents of the state. While dying voluntarily is ostensibly legal, suicide attempts and even suicidal thoughts are routinely punished by incarceration in a psychiatric institution. Although many people believe the prevention of suicide is one of the duties the modern state owes its citizens, Szasz argues that suicide is a basic human right and that the lengths to which the medical industry goes to prevent it represent a deprivation of that right. Drawing on his general theory of the myth of mental illness, Szasz makes a compelling case that the voluntary termination of one’s own life is the result of a decision, not a disease. He presents an in-depth examination and critique of contemporary antisuicide policies, which are based on the notion that voluntary death is a mental health problem, and systematically lays out the dehumanizing consequences of psychiatrizing suicide prevention. If suicide be deemed a problem, it is not a medical problem. Managing it as if it were a disease, or the result of a disease, will succeed only in debasing medicine and corrupting the law. Pretending to be the pride of medicine, psychiatry is its shame.
There is no constitutional right to physician-assisted suicide says the U.S. Supreme Court. Most states have laws against it, but states can also allow it, as Oregon has done; others are considering legalization. Still very little guidance has been offered about its practice. Assisted Suicide: Finding Common Ground fills that void. A diverse group of experts—some for, some against—provide a framework for thinking about what assisted suicide, particularly physician-assisted suicide, is and how its legalized practice might be guided. The book does not take a position on the continuing debate about the morality or wisdom of legalizing assisted suicide. But physician-assisted suicide is now taking place, and the more pressing concerns are those pertaining to its implementation. Editors Lois Snyder and Art Caplan attempt to find common ground on those real-world concerns. Among the questions asked and answered are: What is assisted suicide? Is physician-assisted suicide different from refusal of treatment? Are there alternatives to assisted suicide? How useful are currently available guidelines for physician-assisted suicide? Who should have access to what? Does assisted suicide necessarily mean physician-assisted suicide? Can the practice be effectively and meaningfully regulated? How should physicians respond to requests for assisted suicide? Assisted suicide is one of the most ethically challenging issues in medicine and bioethics, defining who we are and want to be as individuals and as a society. This book takes a hard look at alternatives to the practice, the implications for the patient-physician relationship, who should write guidelines, and how to regulate physician-assisted suicide and establish safeguards so that it is voluntary and an option of last resort.