In contemporary Holland the reasons given for requests for euthanasia, surprisingly, do not usually include the existence of unbearable physical pain. The most common reasons for such requests are a weariness of life, the feeling of loneliness, a fear of the loss of dignity, but above all a general inability to see in suffering any kind of sense. The problem of euthanasia thus clearly transcends the boundary of the doctor-patient relation, and marks a change in the climate of European society as a whole. While in an earlier religious context the life of a person was understood as meaningful journey from somewhere to somewhere else, in the Darwinian paradigm a person becomes a “piece of matter“ which has evolved amongst other such pieces of matter, and which lives out its time in the middle of a universe in which there is no sense, no God, and where one can scarcely discover any meaning behind suffering. Requests for euthanasia are, therefore, not the individual choice of particular people, but rather a disturbing symptom of the whole of European society.
The situation in the area of ethics is dismal. Not coincidentally the cultivation of ethics has been left in the hands of those who have a special interest in the problem and the people in question are almost invariably associated with theology and religion. It is necessary to develop a discussion of ethics in the field of philosophy that focuses on concrete issues, first and foremost among which is the issue of euthanasia. However, both sides of the discussion should beware of various forms of simplification and dismissal. It is necessary to retain the complexity of the socio-political structures, and also to see the full complexity of pain and suffering. A secular ethics (and indeed ethics in general) dealing with the issue of euthanasia is, and remains, a challenge for the future. The feasibility of euthanasia is an integral part of the possible setting of that ethics.
The text focuses on the need for a straightforward defining of concepts in connection with euthanasia; it concerns itself with medical ethics and the tradition on which it is built (such ethics cannot be left to the tender mercies of the dominant currents of thought in contemporary philosophy); it examines the reflections of certain secular bio-ethicists who ride roughshod over the dignity of man; it demonstrates why it is necessary, particularly today, to remind ourselves of the practice of euthanasia during Nazism; and it emphasises the indispensability of a broad view of the whole question, which cannot be resolved by mere sterile rational reflection. It looks in detail at the history of the Dutch model of euthanasia from its beginning to the present, and it draws attention to the self-evident slippery slope. (Remarks are made here on an article by Dr. Hříbek, cited in the given context.)
CS
Text se věnuje nutnosti jednoznačného vymezení pojmů v souvislosti s eutanazií, zabývá se lékařskou etikou a tradicí, na níž je postavena (tato etika nemůže být vydána zcela na pospas aktuálně panujícím myšlenkovým proudům ve filosofii), rozebírá uvažování některých sekulárních bioetiků, kteří pošlapávají důstojnost člověka. Zdůvodňuje také, proč je třeba právě dnes připomínat akci eutanazie za nacismu, a zdůrazňuje nezbytnost širokého pohledu na celou problematiku, která nemůže být vyřešena pouhým sterilním racionálním uvažováním. Podrobně se zabývá historií holandského modelu eutanazie od jeho počátku až do dnešních dnů a upozorňuje na evidentní kluzký svah. (Jsou zde uvedeny i poznámky k citovanému článku dr. Hříbka v daných souvislostech.)
The research objective of the article is to define European standards for making end-of-life decisions. The study was divided into two analytical parts. In the first part, a broad analysis of the jurisprudence of the European Court of Human Rights was carried out in order to determine the normative boundaries within which European states can move by regulating the issue of making decisions about the end of life. In the second part, a comparative legal analysis of national legal systems was made, distinguishing three main models of regulating this issue: the model legalising euthanasia, the model legalising assisted suicide (PAS), the model penalising euthanasia. These models were assessed in terms of the implementation of the guidelines set out by the ECtHR.
The Hippocratic Oath strictly prohibits the administration of lethal medication and assisting someone in killing him or herself. A significant number of people, however, have felt that this strict prohibition is no longer tenable. They are of the opinion that, in some cases, medicine should help a patient to die peacefully, rather than prolong unbearable and pointless suffering. After discussions of euthanasia had been going on in Europe and the U.S. for more than a century, euthanasia was legalized in two countries, Belgium and the Netherlands, in 2002. At present, there also exist legally sanctioned possibilities for assisted suicide in- besides the Netherlands-Switzerland and Oregon. All these developments have generated an enormous amount of literature on the subject of euthanasia. Given the huge quantity of recent articles on the attitudes of physicians towards euthanasia, a review seemed relevant.
This study is a critical reflection on Marek Vácha’s article on the ethics of euthanasia. In the first part the author offers a short consideration of the reasons for the moribund state of ethics in Czech philosophy, after which, in the second part, he presents a critique of Vácha’s article. The article in question is, above all, lacking in a philosophical approach to the problem of euthanasia, and we find in it not so much arguments as rhetoric. The only line of argument that is detectable in the article is founded on natural theology, something that Vácha elsewhere repudiates, and it offers the reader a false dilemma between accepting theistic ethics on the one hand or total subjectivism on the other. In reality, of course, there is a wide range of kinds of objective secular ethics. In the third part, one of these forms is summarised a system of everyday morality which is founded on the concept of harm, and which treats conduct as immoral primarily when it causes unjustifiable harm to others. This form of ethics does not presuppose any controversial theory of value, and it constitutes the viewpoint from which the author then defends physician-assisted suicide. A doctor who helps a patient die or who causes the patient’s death on his own request does not cause that individual harm if she has only a period of life filled with pain left. In conclusion the author indentifies certain points of contact between secular and theistic ethics.
The attitude towards death and dying reflects the society’s view on a human being as a subject. Due to the progress in medical science a growing interest has been observed in the problem of death, including the right to dignified dying. One of the issues connected with the phenomenon of dying is the problem of euthanasia seen as one’s right to decide on one’s own death in extreme cases. The question of the legality of euthanasia is becoming a subject of consideration more and more often, which is a result of a celebratory culture of death and the obsolescence of faith and religious practice. The aim of the following report is to show the attitude of major religions of the world towards euthanasia. What arguments of religious nature are against the legality of mercy killing? Both Christian and non-Christian religions rise to speak on the matter. All religions stress their veto over mercy killing, justifying their view in various ways. Christians claim that God is the donor and lord of life; a man cannot decide on ending human life as he or she is only the user, not the owner of it. Judaism assumes that human life has an absolute value, is sacred, untouchable, as God’s gift. Islam, quoting Koran, also preserves life as God’s gift. According to Buddhist ethics, the annihilation of both one’s own and someone else’s life is the worst of evil deeds. Will the arguments of religious nature mean enough to stop the legality of euthanasia?
Defining euthanasia and aggressive treatment is of crucial importance from a researcher’s point of view as any problems concerning the ethical consideration of the two issues stem from their faulty or ambiguous definitions. The Decalogue, with its fifth commandment: "you shall not kill" is the foundation of the Catholic ethics. It prohibits any form of euthanasia as it infringes upon God's power and is an act of usurping God’s right to decide on life and death. The authors present an overview of numerous documents on the value of life by the Catholic Hierarchy to point to the sources of euthanasia prohibition among the followers of this faith and their consent to the use of aggressive treatment.
The article is an answer to prof. Munzarová who criticised my defence of physician‑assisted suicide. The article points to shortcomings in the reply of prof. Munzarová which flow from the author’s underestimation of normative theory. Among these shortcomings are the ignoring of the arguments of her opponent; her calling into question the moral credit of the proponents of the competing theory (utilitarianism) rather than a critical analysis; unclear theoretical principles (a switching between paternalism and autonomy, the presentation of the “principle of double-effect” as the standpoint of common sense); an unconvincing version of the “argument of the slippery slope” (ignoring the diametrical differences between the contemporary demand of some patients for assisted death and the Nazi programme of involuntary euthanasia).
CS
Článek je odpovědí prof. Munzarové, jež kritizovala mou obhajobu sebevraždy za asistence lékaře. Článek upozorňuje na nedostatky v replice prof. Munzarové, jež plynou z autorčina podceňování normativní teorie. Mezi tyto nedostatky patří: přehlížení argumentů oponenta; zpochybňování morálního kreditu nositelů konkurenční teorie (utilitarismu) namísto její kritické analýzy; nevyjasněná vlastní teoretická východiska (lavírování mezi paternalismem a autonomií, vydávání „principu dvojího účinku“ za stanovisko zdravého rozumu); nepřesvědčivá verze „argumentu kluzkého svahu“ (ignorování diametrálních rozdílů mezi současnými požadavky některých pacientů na asistovanou smrt a nacistickým programem nedobrovolné eutanazie).
Our long-time experience in palliative care allowed us to notice changes in ethics of palliative medicine. In the handbook of palliative medicine, its authors R.G.Twycross and D.Frampton in 1995 did formulate the following ethical postulate: respect for life, acceptance of death of a patient as an unavoidable event, respect for a patient as a person, beneficence, nonmaleficence, justice. In addition, they stressed prohibition of euthanasia as a rule. Nine years later, however, in the Oxford handbook of palliative care, its authors: M.S.Watson, C.T.Lukas, M.A.Hoy and J.N.Back described their ethical basis, which were slightly different but quite similar to those of T.L.Beauchamp and J.F.Childers: autonomy of a patient, beneficence, nonmaleficence, justice and the trust. Their set of principles may induce controversy because of unlimited patient's autonomy and absence of physician's autonomy. Further, it may permit euthanasia, which is excluded by palliative medicine.
Purpose: To assess attitudes towards euthanasia among medical staff (hospice workers and nurses not working in hospice), nursing students and family members of patients in hospice. Materials and methods: The study group included 565 persons: 175 nursing students, 183 professio-nally-active nurses not working in hospice, 103 hospice workers and 104 family members of patients in hospice. We used the original questionnaire survey. Results: Nearly half of the nurses, 49.6% of the students, 71.8% of the hospice workers and 45.2% of the family members were opposed to active euthanasia, whereas, 24.6% of the nurses, 32.4% of the students, 19% of the family members and 9% of the hospice workers supported euthanasia. Nurses supported the following forms of euthanasia: stopping resuscitation (47.5%), discontinuing life-support equipment (24%), and lethal injection (12%). In the student group, 43.6% supported stopping resuscitation, 34.4% supported the withdrawal of life-support equipment, and 12.6% supported lethal injection. Almost 46% of family members of patients in hospice accepted discontinuing life-support equipment and 21.2% supported stopping resuscitation. Nearly 37% of hospice workers accepted stopping resuscitation and 28.6% supported the withdrawal of life-support equipment. Most hospice workers were opposed to active euthanasia while most of the nursing students supported it. Conslusion: The legalization of euthanasia was favored by most of the students; however, in contrast, it was rarely favored by the hospice workers
This article undertakes to show the way that has led to the statutory decriminalization of euthanasia-related murder and assisted suicide in the Kingdom of the Netherlands. It presents the evolution of the views held by Dutch society on the euthanasia related practice, in the consequence of which death on demand has become legal after less than thirty years. Due attention is paid to the role of organs of public authority in these changes, with a particular emphasis put on the role of the Dutch Parliament – the States General. Because of scarcity of space and limited length of the article, the change in the attitudes toward euthanasia, which has taken place in the Netherlands, is presented in a synthetic way – from the first discussions on admissibility of a euthanasia-related murder carried out in the 1970s, through the practice of killing patients at their request, which was against the law at that time, but with years began more and more acceptable, up to the statutory decriminalization of euthanasia by the Dutch Parliament, made with the support of the majority of society.
The principal hypothesis of our inquiry states that the mechanisms of power and controlling human life, practiced by the Nazis during WW 2, reflected the modern approach to the human defined in the categories of life unworthy of life. The studies conducted hitherto in the context of the above hypothesis focus on the sites which in the wake of commemorating the extermination are treated as symbols of the genocide industry, such as the Auschwitz-Birkenau death camp. In turn, this article aims to investigate the validity of the hypothesis with regards to a site which so far has not been considered in cultural studies – (for example the Hospital for the Mentally Ill “Dziekanka” in Gniezno – in addition, we treat this hospital as the exemplification of the wider ideological, political, economic phenomenon). I wish to show that the phenomena of reducing and destroying human life, which held no value for the authority, was virtually identical regardless of the place where the extermination took place. Thus, we will establish a new point on the map of memory of the victims of Nazi policies, a site where the annihilation was carried out, at the same time demonstrating the particular features associated with that particular space. The “might” of the German authority during World War 2 was founded on tremendous attention to detail; consequently, that which took place in the sites of mass extermination proceeded in much the same way in those places which are now hardly remembered.
The present article is part of a dense literature – result of a perennial debate – that has polarized societies for a long time and has evident reverberations in the present. It deals with “the right to death”, trying to offer some answers referring to its existence in fact and the way in which it is perceived by different states and diverse entities with juridical nature. In the first part of the paper, it is insisted upon the right to life, so that subsequently, to speak in detail about a “right to death” and the moral and juridical implications of using such phrases. There are analyzed different states of the world found on one part or the other of the barricade in what concerns the legality of euthanasia and assisted suicide – considered the two hypostasis of the right in question. It is offered, as well, an analysis of the Convention for the Protection of Human Rights and Fundamental Freedoms, mentioning that, paradoxically, while it cannot be modified so that it allows the appearance of some new rights, it can tacitly accept the creation by some states that have adhered to it of some rights antagonistic with those presented in its text. The conclusion, is that not any liberalization movement of a social action – quantified through the request of a right – has as a direct result a progress of the respective society, especially when the action creates something diametrically opposed to some fundamental functioning norms, such as, by excellence, the granting of the protection of life of all individuals.
Fundamental aspects of human existence such as birth and death are at the core of our values and profoundly sensitive to our religious beliefs, our ideals as a society, and our opinions on the extent to which individuals may interfere in these basic life issues. This article analyses the factors that explain people's attitudes towards key beginning- and end-of-life issues. To do this, we first tracked variations across two points in time, and then looked at the effects of value orientations and socio-demographic factors in comparative perspective across countries. Based on previous literature, we consider justification for euthanasia, abortion, and in vitro fertilisation as a latent variable using European Value Study data from the 2008 and 2017 waves. Five European societies were analysed: Spain, Germany, the Netherlands, the Czech Republic, and Russia. All the countries observed showed growing levels of justification for these practices, although significant differences were found in the value orientation effects and respondents´ background variables on attitudes towards life and death issues. In order to properly address comparability, multi-group confirmatory factor analyses across countries and across waves were conducted, and measurement invariance tested. From our analyses, we can conclude that age and religiosity, alongside other sociodemographic variables, are important explanatory factors in the justification of life and death issues in all the countries examined; however, value orientations show less conclusive effects on such attitudes.
The main aim of the article is to present some aspects of euthanasia in the perspective of Robert Spaemann—one of the most significant contemporary German thinkers. First of all, the paradox of the right to euthanasia derived from one’s own decision is pointed out. It is illustrated by the practice of legalising these acts in the Netherlands, Belgium and Luxembourg. On the one hand, such acts are to be motivated by our personal right to self-determination, but on the other, relevant decisions are taken by a doctor. Ultimately, the law protects the doctor, not the patient. Next, the nature of two main types of euthanasia is discussed and defined: active euthanasia and passive euthanasia. Also, an attempt is made to show the inevitable consequences of the right to kill oneself by answering the question whether the right to euthanasia breeds a sense of duty. Finally, a polemic between Robert Spaemann and Peter Singer is presented, which gives us an opportunity to see the three fundamental differences between these philosophers in their views on the problem of the so-called good death. The author of the article emphasizes that the patient’s living will, introduced in Germany in 2009 (Patientenverfugung), may indirectly imply consent to passive euthanasia, which is omitted in specialist literature. He then indicates the specificity of the philosophical argumentation of the eminent thinker against euthanasia. He also highlights two aspects of Spaemann’s discussion with Singer: one concerns the downward spiral argument which undermines the legitimacy of euthanasia legalisation, and the other distinguishes two ways of abandoning the treatment if a person faces death.
The aim of this research was to investigate the views on euthanasia expressed by followers of various religions. Material and methods: It was a qualitative, comparative study conducted in the period between February and March 2016. The respondents were representatives of three religions – Catholicism, Judaism and Islam. The method used was a categorised interview. Results: Generally, the respondents express the opinion that euthanasia is not a good solution and negate it. They consider euthanasia to be a form of murder, manslaughter or suicide. They refuse people the right to decide about the time of their own death, as well as that of their relatives. Nevertheless, the respondents following Islam and Judaism accept euthanasia in some specific circumstances. Those attitudes correspond to the assumptions of their religions. Conclusions: The respondents representing different religions express general opposition to the idea of euthanasia. Thus, one can conclude that the respondents’ values stem not only from their faiths but also from other ideas of humanitarianism. Euthanasia and death constitute issues that will probably never be fully grasped by the human mind, but nursing staff should be prepared for different questions asked by patients staying in terminal care, palliative care and end-of-life care units.
PL
Celem badań było poznanie opinii respondentów będących wyznawcami różnych religii na temat eutanazji. Materiał i metody: Były to badania jakościowe, porównawcze prowadzone w lutym – marcu 2016 roku. Respondentami byli przedstawiciele trzech religii – katolicyzmu, judaizmu i islamu. Badanie przeprowadzone zostało za pomocą wywiadu skategoryzowanego Wyniki: Wypowiedzi respondentów wskazują, że eutanazja nie jest zjawiskiem dobrym, negują ją. Podkreślają, że eutanazja to morderstwo, zabójstwo i rodzaj samobójstwa. Nie dają prawa decydowania o wyborze czasu śmierci własnej i najbliższych choć u respondentów będących wyznawcami Islamu i Judaizmu występują kwestie dopuszczenia do wykonania eutanazji w określonych okolicznościach. Postawy te są zbieżne z ich religiami. Wnioski: Badani przedstawicieli różnych religii wyrażają ogólny sprzeciw w zakresie zgody na eutanazję. Można więc przyjąć ostrożną sugestię, iż respondenci wyznawane wartości wywodzą nie tylko ze źródeł swojej wiary, ale także innych, np. idei humanitaryzmu. Eutanazja, śmierć są tematami, których pewnie nigdy człowiek nie zgłębi, ale personel pielęgniarski powinien być przygotowany na różnorodne pytania, które padają w opiece terminalnej, opiece paliatywnej, opiece u schyłku życia, po to, aby lepiej sprawować opiekę nad tą grupą pacjentów.
In the context with scientific knowledge and technical possibilities of modern medicine are rising many ethical, legal, social, psychological, economic, and specifically medical problems, also problems in therapeutic and nursing care for terminally ill and dying patients. Process of dying is moved from intimate family environment into professional institutions - clinics, departments and other health and social facilities. People are for years divided into two camps - some are strongly opposed to euthanasia and others on the other hand believe that in some conditions when the pain is unbearable even after a strong dose of morphine, suffering person becomes only a helpless „victim of medicine“.
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