By Usman Nasir
Before this article, check out the previous one called “Everything about ethics at interviews” to read about how to approach ethical scenarios and questions.
Alongside abortion, this is one of the most common ethical scenarios that students research before an interview. There are many different avenues that an interviewer can follow with their questioning, so it is important to build a solid understanding of euthanasia. You need to understand the following definitions, before exploring the ethical issues.
Euthanasia can be active or passive:
Active euthanasia – a deliberate action by a medical professional or a member of the public to cause a person’s death. It can be voluntary or non-voluntary.
Passive euthanasia - cessation of treatment at the end of a person’s life, by either withdrawing or withholding treatment that would extend a person’s life.
4 main types of euthanasia:
1. Voluntary active euthanasia - this is assisted suicide and is illegal in the UK, but legal in countries such as Colombia, Belgium and Switzerland.
Example: A physician injecting a patient with a lethal dose of drug at their request, to end that patient’s life.
(NB: you may have heard of the famous euthanasia clinic in Switzerland called Dignitas, where some people from the UK have controversially travelled to end their life)
2. Non- voluntary euthanasia – this is effectively murder or manslaughter and is very much illegal.
Example: murdering someone against their will.
3. Voluntary passive euthanasia - stopping treatment that would extend a patient’s life at a patient’s request or WITH THEIR CONSENT. This is legal and can be outlined in a patient’s records, via an Advanced Directive to Refuse Treatment (ADRT). An ADRT is a legally binding document that can be made at any time by a competent patient, so they can express their wishes for refusing a certain type of treatment in the future.
Example: Withdrawing life-support at the end of a patient’s life WITH CONSENT.
4. Non-voluntary passive euthanasia - stopping treatment that would extend a patient’s life WITHOUT THEIR CONSENT. This may be allowed , if it the treatment offers no clinical benefit, but this type of euthanasia is very open to allegations of negligence or manslaughter.
Example: Withdrawing life-support at the end of a patient’s life WITHOUT CONSENT.
Other key definitions
1. Indirect euthanasia
A healthcare professional gives the patient the tools and means to end their own life by themselves. In this case, the healthcare professional is not directly acting to end that patient’s life, but they are giving that patient access to do it themselves. This is again illegal.
Example: A physician gives their patient a lethal number of pills so the patient can take them at home to end their life.
2. Assisted suicide
When any person (medical professional or not) helps another person die.
3. Physician-assisted suicide
An example of voluntary active euthanasia, where the physician injects a lethal dosage of a medication into a patient at the patient’s request.
TIP: Make sure you become familiar with all of these definitions, as misunderstanding them is one of the most common pitfalls at an interview.
UK Legal Facts
· Active euthanasia and assisted suicide of any kind is illegal in the UK, under the 1961 Suicide Act This states that it is a criminal offence to help or assist a person in taking their own life.
· Voluntary passive euthanasia in the best interests of a patient is legal in the UK.
· Court cases of patients fighting for their right to end their own life and assisted dying bills have changed the landscape of euthanasia in UK law, but it remains illegal.
Some Ethics Arguments to start you off
· A patient deserves the right to make a decision about their own life and if they want to die to end their suffering, then this should be respected. AUTONOMY
· Euthanasia would be in that patient’s best interests, as they can take back control of their life. It also allows the patient to die with dignity and respect. BENEFICENCE.
· A physician took the Hippocratic oath to “DO NO HARM”. Therefore, euthanasia is an act of MALEFICENCE.
· Where do you draw the line when deciding which patients are eligible for euthanasia and which patients are not? A patient who has just gone blind may be just as distressed, as a patient with a terminal illness. They might be going through just as much suffering, so does that mean they would be allowed euthanasia.
· How do you build a criterion and regulate it so that the vulnerable are not exploited? Many believe that the elderly will feel like they are a burden and be pressurised by society or family members to accept euthanasia, if it became legal. JUSTICE
What is the difference between active and passive euthanasia?
What are the current UK laws regarding euthanasia? Which countries have made euthanasia legal?
Discuss some ethical issues surrounding euthanasia? Give arguments for and against.
Do you think euthanasia should be legalised in the UK (Very popular question and a much more likely format for an interview)
Scrubbed up Tips
· Make sure you understand the definitions of euthanasia.
· Be aware of the legal status of euthanasia in UK and other countries.
· Use the 4 pillars of ethics throughout your students.
· Presenting a balanced argument in your discussion.
· Show empathy and understanding for a patient that wants to end their suffering through euthanasia in your discussion.
· Give your own opinion but do not be too forceful and keep it as part of a balanced argument.
· Become familiar with any court cases of people fighting for their right to end their own life.
There have been several controversial cases in the news, and it will take your answer to the next level if you use them in your answer.
Definitions for active and passive euthanasia - http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_1.shtml / BBC Ethics Guide: Active and passive euthanasia.
Definitions for the voluntary and non-voluntary forms of each –
http://www.bbc.co.uk/ethics/euthanasia/overview/volinvol.shtml BBC Ethics Guide: Voluntary and involuntary euthanasia
For the countries that voluntary active euthanasia is legal –
https://www.mydeath-mydecision.org.uk/info/assisted-dying-in-other-countries/ My Death My Decision: Assisted Dying In Other Countries
Definitions for indirect euthanasia and physician assisted suicide –
http://www.bbc.co.uk/ethics/euthanasia/overview/forms.shtml BBC Ethics Guide: Forms of Euthanasia
UK Legal facts –
https://www.nhs.uk/conditions/euthanasia-and-assisted-suicide/ NHS: Euthanasia and assisted suicide