This document discusses euthanasia, physician-assisted suicide, and the right to die movement. It defines key terms, outlines religious views on the topics, and summarizes several prominent right-to-die cases in the US including Karen Ann Quinlan, Nancy Cruzan, and Terri Schiavo. The document also discusses objections from the medical community to assisted suicide, Dr. Kevorkian's approach, policies on assisted death in the Netherlands and Oregon, and the current status of these issues in the US.

1. Module 5
Euthanasia, Physician Assisted Suicide and The Right to Die
Movement
Key Terms
• Hippocratic Oath – an ancient, optional code of ethical
principles
• Euthanasia – intentional shortening of the life of a person
or animal to spare further suffering
• Active Euthanasia – taking some action to cause
death
• Passive Euthanasia – withholding treatment that
might prolong life (generally tolerated by society)
• Key question: Should actions be introduced,
continued, done, or discontinued?
Key Terms
• Terminal Sedation – relieving dying patients’ distress by

2. keeping them in a deep sedation or coma until death
• An alternative to active euthanasia
• Called “slow euthanasia”
• Liberty Principle – individuals can make their own
decisions
• Informed Consent – patients must be fully informed
before proceeding with treatments
• Competence – the mental ability to understand the
information and make a rational decision
Key Terms
• Nazi “euthanasia” – the false name given to the murder
of innocent people and associated genocide
• Black Stork – The movement in the U.S. in the early
1900s to allow “defective” infants to die
• Eugenics – The movement aimed at sterilizing people
with “defective genes”
• Led to other ideas, such as letting “defective” infants die and
ending the lives of “incurable” patients
• Slippery Slope Argument – Opposing any instance of
assisted death because it could contribute to widespread
abuse in other instances

3. Assisted Suicide and Euthanasia
• In both, at least two individuals are involved.
• In Assisted Suicide, permission and
cooperation is obtained from individual
wishing to end life. Not always the case in
euthanasia.
Euthanasia and Religion
Various Religions have commented on Euthanasia
and other forms of assisted Suicide:
Judaism: God created a person and therefore
owns the body, a person is just the caretaker
Duty to preserve life – Orthodox & Conservative
Jews find euthanasia morally unacceptable
Active Euthanasia is condemned by all Jewish
groups
Euthanasia in Christianity & Islam
Christianity: suffering is part of God’s plan for
all humans

4. Typically oppose any intentional killing of
oneself or others
Islam: Suicide, Euthanasia and Physician
Assisted Suicide is generally disapproved of
“Do not destroy yourselves”
Euthanasia Hinduism & Buddhism
Hinduism: assisted suicide and euthanasia may
interfere with karmic processes and is undesirable,
but is not forbidden
Extending human life through medical interventions
may also interfere with karma
Ahimsa: avoidance of causing pain or killing any life
Gandhi: “Should my child be attacked with rabies and
there was no helpful remedy to relieve his agony, I
should consider ot my duty to end his life”
Buddhism: intentionally ending a life is unacceptable
Easing suffering is inappropriate
Right-To-Die Cases
• Estimated that 10,000 to 35,000 Americans exist in

5. persistent vegetative states
• Estimated that another 150,000 have minimal
consciousness syndrome
• In the news: Karen Ann Quinlan, Debbie, Nancy Cruzan,
Terri Schiavo
• Not in the news: People in similar situations who are not
young, white, attractive females
Right-To-Die Cases:
Karen Ann Quinlan
• Suffered severe, irreversible brain damage as a result of
oxygen deprivation (April 14, 1975)
• Spent months on a ventilator, dropped to 60-pounds,
curled into a fetal position, in a “persistent vegetative
state”
• Parents asked physicians to turn off ventilator; they
refused
• Parents took their request to court; it was denied
• New Jersey Supreme Court ruled that a ventilator could
be turned off if physicians agreed that the patient had no

6. reasonable chance of regaining consciousness
• The ventilator was removed (in 1976)
• She remained alive until she had pneumonia in 1985
Copyright © Allyn & Bacon 2007
Right-To-Die Cases:
Debbie
• Story published in the Journal of the American
Medical Association in 1988 by “Anonymous”
• Debbie, 20 years old, dying of ovarian cancer,
emaciated, hadn’t eaten or slept in two days,
hadn’t responded to chemotherapy, breathing
with great difficulty
• Her only words to the doctor were “Let’s get this
over with.”
• The doctor gave her a lethal injection
Right-To-Die Cases:
Nancy Cruzan

7. • 26 y.o., auto accident, brain trauma, oxygen deprivation
• Maintained with feeding tube; no communication
• Parents decided to stop tube feeding; hospital refused
without court order
• U.S. Supreme Court ruling: a competent person had the
right to refuse medical treatment, and if the person
wasn’t competent the State could decide what
constituted clear evidence of the person’s wishes
• Nancy’s physician withdrew his opposition after 6 years
• Nancy died after the tubes were removed
Copyright © Allyn & Bacon 2007
Right-To-Die Cases:
Terri Schiavo
• Suffered a heart attack (2-25-90)
• On life support; showed only reflexive movements,
random eye opening, and no communication ability
• Terri’s husband and parents had intense conflict
• 1994 Terri developed a urinary tract infection; husband
and physician agreed not to treat it; also DNR posted
• 1997 husband petitions to discontinue life support; many

8. court battles between husband and parents
• Much rested on testimony that Terri said she wouldn’t
want life support
Right-To-Die Cases:
Terri Schiavo
• On several occasions courts ruled in favor of removing
life support, but each time it was blocked
• Media got involved; Florida Governor Jeb Bush passed
“Terri’s Law” to return feeding tube; the U.S. House and
Senate agreed to a federal bill to return feeding tube
• Terri died (3-31-05) of dehydration
• Autopsy showed that her brain had shrunk to half its
size; she had severe and irreversible damage
Objections of the Medical Community
to Assisted Death
• Taking a life is inconsistent with the responsibilities and
values of a physician
• Religious convictions forbid taking a person’s life under

9. any circumstances, with the possible exception of self-
defense
• The life might be mis-taken
• Serious legal consequences might be expected to befall
any physician who engaged in assisted death
• The dying person accuses the physician of being a
failure (actually the physician’s self-accusations)
Assisted Suicide
• Assistance can include: means used to cause
death such as drugs or a gun, place,
emotional support.
• Physician-assisted suicide: assistance ending
one’s life with the help of a physician.
• Usually sought out by the terminally ill or
chronically ill.
Evaluating Dr. Kevorkian’s Approach:
Summary of 93 Cases
• Most of the people were not terminally ill
• Gender bias - encouraged and increased suicidality
among women
• Clients fit the profile of suicide attempters rather than

10. terminally ill
• He functioned without adequate medical information and
consultation
• Death is much too extreme a solution for the relief of
suffering
• Despite his disclaimers, it appears that he has rushed
people into assisted death without adequate safeguards
and consideration
• He uses “silencing” techniques to defend his actions
Assisted Death in
The Netherlands
• Requirements for a physician to assist in ending
a patient’s life:
• The patient is terminally ill
• The patient has made an explicit request for life-
termination
• The physician informs the coroner of his actions and
provides a detailed check list regarding the patient’s
situation and the physician’s own actions

11. • First nation to make it legal
• Belgium now has similar laws
• Australia had such a law, but later overturned
Current Status of
Assisted Death in the U.S.
• Merging of The Hemlock Society and Compassion in
Dying in 2005 to form Compassion and Choices
• Has many requirements and safeguards
• Will help clients arrange for assisted death
• Oregon Death with Dignity Act
• Has many requirements and safeguards
• Physicians write prescriptions for lethal doses of
medication after an adequate waiting period
• Patient must be 18 or older with an incurable,
irreversible terminal illness and life expectancy of less
than 6 months
Copyright © Allyn & Bacon 2007
Module 5Key TermsKey TermsKey TermsAssisted Suicide and
EuthanasiaEuthanasia and ReligionEuthanasia in Christianity &
IslamEuthanasia Hinduism & BuddhismRight-To-Die

12. CasesRight-To-Die Cases: �Karen Ann QuinlanSlide Number
11Right-To-Die Cases: �DebbieRight-To-Die Cases: �Nancy
CruzanSlide Number 14Right-To-Die Cases: �Terri
SchiavoRight-To-Die Cases: �Terri SchiavoSlide Number
17Objections of the Medical Community to Assisted
DeathAssisted SuicideEvaluating Dr. Kevorkian’s Approach:
Summary of 93 CasesSlide Number 21Assisted Death in �The
NetherlandsCurrent Status of�Assisted Death in the U.S.Slide
Number 24