Many bioethicists have recently shifted from using “physician-assisted suicide” (PAS) to “medical aid-in-dying” (MAID) to refer to the act of voluntarily hastening one’s death with the assistance of a medical provider. This shift was made to obscure the practice’s connection to “suicide.” However, as the charge of “suicide” is fundamental to arguments against the practice, “MAID” can only be used by its proponents. The result has been the fragmentation of the bioethical debate. By highlighting the role of human agency—as opposed (...) to natural processes—in causing death, the term “PAS” makes it easier both to perceive potential risks to vulnerable populations and to affirm suicide as a potentially autonomous choice. As such, “PAS” thus more transparently expresses the arguments of both supporters and opponents of the “right to die,” while avoiding the unnecessary stigmatization of suicide and suicidal people which is a result of the usage of “MAID.”. (shrink)

The judgment handed down in the case of Ms B confirms the right of the competent patient to refuse medical treatment even if the result is death. The case does, however, raise some interesting legal points. The facility for conscientious objection by doctors has not previously been explicitly recognised in case law. More importantly perhaps is that the detailed inquiry by the court into Ms B’s reasons for refusing treatment, apparently as a precondition for finding her competent, seems to contradict (...) earlier case law where it has been asserted that competent patients can refuse treatment for no reason at all. (shrink)

The moral significance of the distinction between killing and allowing to die has played a key role in debates about euthanasia and physician assisted suicide. Since the withdrawal of life-sustaining treatment is held as morally permissible in the medical community, it follows that if there is no morally significant difference between killing and allowing to die, then there is no morally significant difference between withdrawing life-sustaining treatment or administering a lethal injection to end a patient’s life. Consistency then requires that (...) voluntary active euthanasia is also morally permissible. The debates over whether the distinction is morally significant have carried on for decades with little hope of consensus. We begin by surveying the literature to identify common argumentative strategies used in defending or rejecting the distinction’s significance. We observe, based on our review, that many of these strategies operate in ways that are conceptually removed from the concrete clinical situation of physicians involved in practices that lead to patient death. We conclude by arguing for a novel way of moving the debate forward indicated by our reading of the literature, namely, by paying careful attention to the moral experience of physicians involved in end-of-life interventions to understand how they experience these practices. Exploring physician experience can reveal how the distinction may or may not be useful for moral deliberation and can provide the needed context to theorize about the distinction in a more empirically informed and practically useful way. (shrink)

Objectives: To clarify how lay people and health professionals judge the acceptability of ending the life of a terminally ill patient.Design: Participants judged this acceptability in a set of 16 scenarios that combined four factors: the identity of the actor , the patient’s statement or not of a desire to have his life ended, the nature of the action as relatively active or passive , and the type of suffering .Participants: 115 lay people and 72 health professionals in Toulouse, France.Main (...) measurements: Mean acceptability ratings for each scenario for each group.Results: Life ending interventions are more acceptable to lay people than to the health professionals. For both, acceptability is highest for intractable physical suffering; is higher when patients end their own lives than when physicians do so; and, when physicians are the actors, is higher when patients have expressed a desire to die than when they have not . In contrast, when patients perform the action, acceptability for the lay people and nurse’s aides does not depend on whether the patient has expressed a desire to die, while for the nurses and physicians unassisted suicide is more acceptable than physician assisted suicide.Conclusions: Lay participants judge the acceptability of life ending actions in largely the same way as do healthcare professionals. (shrink)