Assignment (MPhil)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: This study was undertaken to evaluate whether a mentally competent mature human being, who is suffering an intolerable, irremediable existence resulting from an incurable agonising or devastating paralysing disease; has a moral, personal and civic right to end that life or have it ended by requesting assistance in meeting death in a humane, compassionate and dignified manner. ~ The righteousness of such assistance can only be gauged if it follows the repeated and voluntary request of someone who is presently not suffering from any psychiatric disorder, is presently mentally competent or had made such a written or verbal witnessed advance directive while mentally competent to do so. ~ This study will not deal with assistance in dying either active or passive which is performed on severely mentally and physically handicapped new-born babies with scant prospect of survival; nor with euthanasia for the relief of malignant or paralysing disease in those with life-long [anoxic, congenital, inflammatory or traumatic] mental incompetencies who have never had decision-making capacity. ~ This study will not address issues of aid-in-dying for mentally incompetent persons suffering from senile dementia, Alzheimer's disease, or permanent vegetative states due to brain pathology following anoxic, circulatory, infective, malignant or traumatic events, who have not made advance directives and who had never stated preferences concerning assisted euthanasia. The aim of this study is to outline the moral case advanced by those in favour of legalising Voluntary Assisted Euthanasia [VAE] also called Assisted Euthanasia [AE] and to develop ethically sound and practical proposals for policy and actions contributing towards the resolution of the moral dilemma faced daily by doctors when asked by mentally competent patients suffering from irremediable malignant or paralysing diseases or the agonising symptoms of end-stage Acquired Immune Deficiency Syndrome (AIDS) for assistance to end their lives. }ii> This study will cover and discuss the more important objections of those opposed to the legalising of assisted suicide for mentally-competent terminal patients who are irremediably suffering in their bodies or from dehumanising incurable endstage paralysing diseases and are near to an inevitable death. }ii> The insights of philosophers, theologians, physicians and sociologists on the subject of suicide and aid-in-dying, have been researched in the extensive literature that exists (both in print and in cyberspace) on these subjects and are presented with the study. }ii> The study tries to show that a competent adult in certain grim circumstances should have an inalienable human right, if not a constitutional one, to request assisted euthanasia or aid-in-dying or assistance in ending their lives. }ii> Such assistance must be subject to peer review, after careful assessment by a multidisciplinary team in the healing [both physical and spiritual] professions This paper will try to determine whether the actionalisation of voluntary assisted suicide or assisted euthanasia is murder or an act of compassion and empathy performed out of respect for a fellow human being's autonomy and in deference to their right to self-determination and self-realisation. ~ The relevance of this situation is that aid-in-dying is becoming one of the major, moral, religious, philosophical and bio-medical dilemmas at this time. ~ The author's position is that it is neither just nor ethical to prevent a mentallycompetent human being, who is tormented by agonising, incurable terminal physical or irremediable paralysing disease, from deciding to chose to die when he/she can no longer bear the torment and asking for professional assistance to effect this. This relief should be given not only to those who are able to make an enduring, informed contemporaneous decision, but also to those who [when they still had decision-making capacity] had previously made a considered informed advance directive about the use of ordinary and extraordinary medical methods of sustaining a life that had become merely an existence. / AFRIKAANSE OPSOMMING: Die studie is onderneem om te evalueer of 'n bevoegde, volwasse mens wat 'n onverduurbare en ongeneesbare bestaan het a.g.v. 'n ongeneesbare, folterende of vernietigende siekte, 'n morele, persoonlike of burgerlike reg het om daardie lewe te beeïndig of hulp te vra om dit te laat beeïndig, ten einde die dood op 'n menswaardige wyse tegemoet te gaan. ~ Die regverdigbaarheid van bogenoemde hulp kan slegs bepaal word as dit volg op die herhaalde en vrywillige versoeke van iemand wat nie, wanneer hy/sy dit versoek, ly aan 'n geestessiekte nie, wat bevoeg is of wat so 'n geskrewe of mondelinge versoek, met getuies, gemaak het terwyl die persoon kompetent was. ~ Die studie handel nie oor bystand-in-sterfte, aktief of passief, waar dit uitgevoer word op fisies of psigies ernstig gestremde pasgebore babas met 'n skrale kans op oorlewing nie; ook nie oor genadedood ter verligting van kwaadaardige of verlammende siekte in diegene met lewenslange [anoksiese, kongenitale, inflammatoriese of traumatiese] geestelike ongesteldhede, wat nog nooit besluitnemende kapasiteit gehad het nie. ~ Die studie ondersoek nie gevalle van bystand-met-sterfte waar inkompetente persone wat ly aan seniliteit, Alzheimer se siekte, of permanente vegetatiewe toestande a.g.v. brein patologie n.a.v. anoksiese, sirkulatoriese, infektiewe, kwaadaardige of traumatiese gebeure, nie direk gevra het vir genadedood of nooit die voorkeur vir geassisteerde genadedood uitgespreek het nie. Die doel van hierdie studie is om die morele saak van diegene ten gunste van die wettiging van Vrywillige Geassisteerde Genadedood, ook bekend as Geassisteerde Genadedood, te stel en om praktiese sowel as eties verantwoordbare voorstelle te maak vir beleid en optrede wat kan bydra tot die oplos van die morele dilemma wat dokters daagliks in die gesig staar wanneer hulle deur geestelik bevoegde pasiënte wat ly aan ongeneesbare, kwaadaardige of verlammende siektes, of die folterende simptome van die finale stadium van Verworwe Immuniteits Gebrek Sindroom [VIGS], gevra word vir bystand in die beeïndiging van hulle lewens. ~ Die studie sal die belangriker besware van diegene aanspreek wat teen die wettiging is van geassisteerde genadedood vir geestelik bevoegde terminale pasiënte wat ongeneesbaar ly of van dehumaniserende ongeneesbare finale stadium siektes en wat naby is aan 'n onafwendbare dood. ~ Die insigte van filosowe, teoloë, dokters en sosioloë oor bystand-met-sterfte en selfmoord, is nagevors in die wye literatuur beskikbaar is (beide in druk en kuberruimte) oor hierdie onderwerpe en word saam met die studie angebied. ~ Die studie probeer aantoon dat 'n bevoegde volwassene in sekere erge omstandighede 'n onvervreembare mensereg, indien nie 'n konstitusionele reg nie, behoort te hê om bystand tydens genadedood te versoek. ~ Sulke bystand moet onderworpe wees aan groepsevaluasie, na versigtige ondersoek deur 'n multi-dissiplinêre span in die gesondheidsprofessies [beide fisies en psigies]. Die studie sal probeer bepaal of die uitvoering van vrywillige geassisteerde selfmoord of geassisteerde genadedood moord is, of 'n aksie van empatie, uitgevoer uit respek vir 'n medemens se outonomie, sy/haar reg tot selfdeterminasie en self-realisasie. )lo- Die relevansie van hierdie situasie lê daarin dat bystand-met-sterfte besig is om een van die belangrikste morele, religieuse, filosofiese en biomediese dilemmas van ons tyd te word. )lo- Die outeur se posisie is dat dit nie regverdig of eties is om te verhoed dat 'n geestelik bevoegde mens, wat ly aan folterende, ongeneesbare terminale fisiese of ongeneesbare verlammende siekte, self kies om te sterf wanneer hy/sy nie meer die lyding kan verdra nie en vir professionele bystand vra om dit uit te voer. Die verligting behoort gegee te word, nie net aan diegene wat in staat is om 'n bindende en ingeligte besluit te maak nie, maar ook aan -diegene wat [toe hulle nog besluitnemende kapasitiet gehad het] vroeër 'n oorweegde, ingeligte vroegtydige versoek gemaak het aangaande die gebruik van gewone en buitengewone mediese metodes vir die verlenging van 'n lewe wat bloot 'n bestaan geword het.

Den moderna sjukvårdens avancerade resurser räddar många liv, men kan också leda till ett utdraget och plågsamt döende. I ett fåtal länder i världen är eutanasi och läkarassisterat självmord ett val för den som drabbats av en obotlig sjukdom som leder till döden. Syftet med denna studie är att beskriva obotligt sjuka patienters uppfattningar om dödshjälp. En litteraturstudie genomfördes och relevanta sökord som motsvarade syftet användes vid artikelsökning. Vid bearbetning av data framkom tre olika kategorier med subkategorier som motsvarade de olika uppfattningarna. Resultatet visar att positiva uppfattningar till dödshjälp kan bero på patientens egna syn på värdighet, självbestämmande och hopp, medan negativa uppfattningar till dödshjälp kan bero på rädsla eller religion. Även kommunikation med vårdpersonal kan påverka patienters uppfattningar om dödshjälp. För att möta obotlig sjuka patienters behov den sista tiden i livet behövs det kunskap om alla sorters tankar patienten kan ha, detta gäller även tankar om dödshjälp. Vidare forskning inom området dödshjälp behövs för att möta alla utmaningar som det innebär när patienter önskar hjälp med att dö.

Euthanasia represents one of the most controversial topics around the world. As I mentioned in the first chapter there is no worldwide consistency whether to accept the idea of legalization Active Voluntary Euthanasia ("AVE") or not. The goal of this diploma thesis is not to persuade anybody. In approximately 60 pages of the text I am providing readers with some essential information about euthanasia in the Czech Republic. I am also trying to compare the foreign legal regulation of euthanasia and assisted suicide but theoretical ideas as well. The first chapter is mainly trying to capture the reader's focus and setting the theme of my diploma thesis. The second chapter of my thesis is called ,,The Term Euthanasia". This chapter provides readers with several definitions of euthanasia and Physician Assisted Suicide ("PAS") as well as some historic data. The act of euthanasia has its origin in Greek. First word euthanasia is mentioned in old Greek literature. The term euthanasia is composed from two Greek words. Eu which means good or normal and Thanatos which means death. The word euthanasia can be literally translated as a "good death". It should be mentioned that during the centuries the meaning of euthanasia has changed. Today's understanding of euthanasia is ending ones life in order to relieve...

Euthanasia was and still is one of the most controversial topics. It is a complex problem that involves religious, moral, medical and legal aspects. My thesis is focused on euthanasia in relation to the law. The aim of the thesis is to analyse the issue of euthanasia from the perspective of legislation in the Czech Republic. The thesis consists of five chapters. The first chapter contains introduction to the topic of euthanasia. The second chapter is devoted to the definition of term euthanasia. Euthanasia is a word of Greek origin ("eu"- good and "thanatos"- death). Its meaning is good, beautiful or merciful death. Nowadays the term is used in the sense of intentionally termination of life on request to relieve pain and suffering. This chapter also includes the definition of forms of euthanasia. The third chapter is focused on euthanasia in the sense of killing on request. In this meaning, euthanasia has never been explicitly regulated in the Czech Republic. But it does not mean that the issue of legislation of euthanasia is not actual. This chapter is subdivided into the three parts. The first part is about history of legislation of euthanasia. The second part is concentrated on legal classification of euthanasia according to the Czech Penal Code. The last part contains the ideas de lege ferenda....

The diploma thesis is focused on the society's view of the problems of legalization of euthanasia. The thesis is divided into two main parts, the theoretical and the empirical one. The theoretical part consists of the basic terms related to the given problems, further of historical development of euthanasia, countries where euthanasia is legalized, arguments of proponents and opponents of euthanasia and paliative care. The practical part follows after theoretical information and deals with analysis of data gained by a questionnaire research and interpretation of individual findings relating to respondents' general awareness of euthanasia and differences in the view of euthanasia between lay public and professionals. At the end of the thesis, the concrete recommendations in future discussions about euthanasia are proposed on the basis of gained information.

This paper will provide a far-ranging analysis of the relevant aspects of the filmmaking process as it pertains to the development and production of the thesis project, The Good Killing. This analysis will include both a detailed, biographic overview of the making of the film, as well as an in-depth critique of the creative decision-making and practical methodology that guided the production. In this regard, special attention will be first be given to how the project was initially conceived, and, broadly speaking, what was originally intended. Secondly, proceeding sections will examine key elements of the filmmaker’s technical planning, performance, and working philosophy, specifically citing directing style, cinematography, sound and editing. Through this evaluative process, the film will be judged from the standpoint of both concept and execution in order to determine overall success.

Introduction: Physician assisted suicide (PAS) is the process where the patient terminateshis/her life with the aid of a physician who provides a prescription for lethal medication thatthe patient self-administers in order to commit suicide. PAS is practiced in several countriesand is now gaining support in Sweden. The debate shows some confusion regarding thedefinition of concepts and raises several ethical concerns. Aim: To provide an empirical background and clarify concepts. To analyze the ethical arguments for and against PAS. To investigate relevant ethical differences between PAS, euthanasia and withdrawal oflife-sustaining treatment. Materials and methods: Qualitative literature study based on argumentative- and conceptualanalysis on hermeneutic ground. Materials were gathered through a literature search andconsist of scientific articles, debate articles and official materials. Results: The main ethical arguments supporting PAS are autonomy, beneficence and dignity.PAS is by supporters seen as an act of compassion, which fulfills the physician’s obligation ofnon-abandonment. Opponents emphasize that PAS goes against the duty of beneficence andnonmaleficence and fear that there may be a slippery slope where more and more people willdemand PAS. Conclusion: There is no consensus on whether PAS is considered ethically defendable or not.PAS appears to involve a conflict of interest between the principles of beneficence andautonomy. There seems to be some factual disagreements as well as different positions as tohow the ethical principles should be interpreted, and which ethical principle should be valuedthe highest.

<p>There is no stronger or more enduring prohibition in medicine than the rule against the killing of patients by doctors. This prohibition is rooted in some medical codes and principles. Out standing among the principles surrounding these prohibitions are the principles of beneficence and non-maleficience. The contents of these principles in a way mark the professional integrity of the physician. But the modern approach to health care services pulls a demand for the respect of the individual right of self-determination. This demand is now glaring in almost all the practices pertaining to health care services. In end of life decisions, this modern demand is found much in practices like physician- assisted suicide and euthanasia. It demands that the physician ought to respect the wish and choice of the patient, and so, must assist the patient in bringing about his or her death when requested. In such manner, this views the principle of autonomy as absolute and should not be overridden in any circumstance.</p><p>However, the physician on his part is part of the medical profession that has integrity to protect. This integrity in medical profession which demands that the physician works only towards the health care of the patient and to what reduces diseases and deaths often go contrary to this respect for individual autonomy. Thus faced with such requests by patients, the physician always sees his integrity in conflict with his demand to respect the autonomous choice of the patient and so has a dilemma in responding to such requests. This is the focus of this work,"Professional Integrity and the Dilemma in Physician- Assisted Suicide"</p><p>However, the centre of my argument in this work is not merely though necessary to develop general arguments for or against the general justification of PAS, but to critically view the role played by the physicians in assisting the death of their patients as it comes in conflict with the medical obligation and integrity. Is it morally right, out rightly wrong or in certain situation permissible that physicians respond positively to the request of the patients for PAS? This is the overarching moral problem in the morality of physician- assisted suicide, and this work will consider this in line with the main problem in the work “the dilemma of professional physicians in the assistance of suicide.</p>

<p>The two most controversial ends of life decisions are those in which physicians help patients take their lives and when the physician deliberately and directly intervenes to end the patients’ life upon his request. These are often referred to as voluntary euthanasia and physician assisted suicide. Voluntary euthanasia and physician assisted suicide have continued to be controversial public issues. This controversy has agitated the minds of great thinkers including ethicians, physicians, psychologists, moralists, philosophers even the patient himself. Hence the physician, patient, the public and policy makers have recently had to face several difficult questions.</p><p>Is it morally right to end the life of the patients? Is there any moral difference at all between Voluntary euthanasia and physician assisted suicide? Should a terminally ill patient be allowed to take his life and should the medical profession have the option of helping the patient die. Should voluntary euthanasia and physician assisted suicide be legalised at all? And what actually will be the legal and moral implications if they are allowed.</p><p>In a bid to find a lasting solution to these moral problems and questions has led to two different strong positions viz opponents and proponents of voluntary euthanasia and physician assisted suicide. The centre of my argument in this work is not to develop new general arguments for or against voluntary euthanasia and physician assisted suicide but to make a critical ethical comparative analysis of voluntary euthanasia and physician assisted suicide. This is the focus of my work. The sole aim of this work is neither to solely condemn nor to support voluntary euthanasia and physician assisted suicide but to critically analyze the two since we live in a world of pluralism.</p>

<p>Suffering from a terminal illness, or being chronically sick or severely disabled is not pleasant, which most of us will never experience life like this. However, there are people who are living in precisely that kind of constant, excruciating pain, agony and misery, 24 hours of the day, 365 days a year, stuck in a “living Hell” with no way of ending their enforced but unwanted torment – other than the highly controversial ‘therapy’ of euthanasia.</p><p>Those of us who are relatively healthy have a choice in how and when we end our lives. We can decide to wait until our life ends naturally, or we can speed up the process by committing suicide in whatever manner we choose. But, because of their illness or disability, the patients discussed in this thesis are being denied that same choice – because they must ask for help to die, they have had their right to decide matters such as when, where and how to go, for themselves taken away from them by people who believe that they know better than the patient what is best for them.</p><p>In Chapter 1, I will clarify some of the many, often contradicting, definitions and ideas associated with euthanasia.</p><p>In Chapter 2, because death is a very personal subject and everyone has different reasons why they want to die, I have used extracts from two very personal letters explaining why they sought euthanasia.</p><p>In Chapter 3, I will show how a patient considering euthanasia can use two Ends and Means arguments (Utilitarianism and Deontology) to decide if killing themselves would be the moral course of action to end their suffering. I will also discuss the morality of euthanasia eastern and western society.</p><p>In Chapter 4, the discussion turns to who would be the best person to help the patient die. I will examine how euthanasia can comply with various professional and personal codes of conduct and discuss the ideal character of the would-be euthaniser.</p><p>In Chapter 5 (the final chapter) I will conclude by using the information from the previous chapters to answer two important questions:</p><p>1. Whether it is ethical for a patient to even be thinking about euthanasia in the first place.</p><p>2. Who is (ethically) the best person to ask to kill the patient</p><p>This thesis is not about whether or not euthanasia should be legalised (as I will explain – euthanasia is already going on, albeit illegally) but to discuss the morality of asking someone else to go against all matter of strictly enforced and deeply ingrained legal, moral and professional rules imposed by society in order to help the patient die.</p>