Death Anxiety, Immortality Projects and Happiness: A Utilitarian Argument Against the Legalization of Euthanasia

The current, utilitarian debate on the relation between euthanasia and happiness focusses primarily on the subject of dying patients. Where some utilitarians stress how euthanasia may relieve suffering in the process of dying, others emphasize the importance of respecting the autonomy of others to make decisions like these themselves. However, less attention has been paid to how legalizing euthanasia may impact the human decision-making processes of those still in a healthy and mentally sound state. This paper aims to shed light on this relatively underdeveloped subject within utilitarian theory. In particular, I focus on euthanasia’s most contested form: active, voluntary euthanasia. I draw on Ernst Becker, who argues that moderate death anxiety stimulates people to work on ‘immortality projects,’ decisions that help them cope with the concept of death. Subsequently, I draw on several studies to defend the notion that immortality projects are indirectly conducive to happiness because they stimulate healthy decisions and long-term, human progress. Additionally, immortality projects counterbalance decisions that are based on an excessive drive for short-term pleasure. As euthanasia can make dying less painful, I argue it may diminish death anxiety to significant degree, and thereby also an incentive to work on immortality projects. This brings me to the conclusion that legalizing euthanasia is problematic from a utilitarian point of view, considering the observation that immortality projects are indirectly conducive to happiness.

IS THE RIGHT TO DIE WITH DIGNITY CONSTITUTIONALLY GUARANTEED? BAXTER V MONTANA* AND OTHER DEVELOPMENTS IN PATIENT AUTONOMY AND PHYSICIAN ASSISTED SUICIDE

This article examines the question of whether the right to life encompasses the right to die with dignity. It looks at the concepts of autonomy and paternalism as they exist as major themes on either side of the debate. Physician Assisted Suicide (Voluntary Euthanasia) has come under the spotlight in several jurisdictions, not just our own. Most recently in Montana, USA, the issue came before the Supreme Court for deliberation. The states of Washington and Oregon have legislations specific to PAS, legitimizing assisted suicide and removing wrongfulness from the actions of a physician who assists in the prescribed manner. Montana does not have specific legislation, but instead relied on the clauses of its Constitution, and it was held that the right to die with dignity is constitutionally guaranteed in that state. Here, argument is made suggesting that the right to die with dignity, in other words, to seek and easy passing through PAS, is also guaranteed in our Constitution.

Examining the religiosity of nursing caregivers and their attitudes toward voluntary and involuntary euthanasia

Background: Nurses play an important role in taking care of people who have a terminal illness. Aims: To examine nursing caregivers' religiosity as the mediator between voluntary and involuntary euthanasia, and to compare nursing caregiver religiosity groups and the voluntary and involuntary euthanasia attitudes of nurses and nursing students. Methods: A cross sectional design was applied and 298 nursing caregivers voluntarily participated and completed the questionnaire. Findings: Religiosity partially contributes as mediator between voluntary and involuntary euthanasia. All nursing caregiver religiosity groups show more support for voluntary euthanasia. Moreover, nursing students and nurses differ with respect to support for euthanasia in extreme situations, such as patients that are clinically brain-dead. Conclusion: Findings may be attributed to the clash of religious values, due to the common injunction against taking a life especially as regards involuntary euthanasia.

A Parapsychological Naturalist: A Tribute to Mary Rose Barrington (January 31, 1926 – February 20, 2020)

Mary Rose Barrington was born in London; her parents were Americans with Polish-Jewish roots who decided to settle in England. By her own account (she very considerately left a biographical note for her obituary writer), her childhood was idyllic, mostly spent riding her pony and playing tennis, as well as reading her older brother’s science fiction. Later she became interested in classical music (she was an accomplished musician, playing cello in a string quartet and singing alto in a local choir) and in poetry, obtaining a degree in English from Oxford University. She then studied law, qualified as a barrister and a solicitor, and spent most of her professional life as a lawyer; her duties included acting as charity administrator for a large group of almshouses. Having a career in the law helped in pursuing two interests of special significance to her, animal protection and the right to voluntary euthanasia. She was responsible for drafting three parliamentary Bills relating to these subjects; none of them passed, but they produced some useful discussions. However, her main interest was in psychical research. When she was 15 she read Sir Oliver Lodge’s Survival of Man, and at Oxford she joined the Oxford University Society for Psychical Research, at that time headed by the philosopher H.H. Price and ran by Richard Wilson, later physics professor at Harvard. The society was very active and hosted knowledgeable invited speakers such as Robert Thouless, Mollie Goldney, and Harry Price. Eventually Mary Rose herself became the Oxford society’s President.

Human Rights, Secularism and Religion

The focus of this chapter is a comparative study between Läcité (secularism) and religious beliefs in the domain of human rights. These issues are discussed in this chapter: axes of the challenges of religions and human rights, the secular approach to human rights, the religious approach to human rights, categorisation of the orders of the public sphere as compared with religious and secular values, and particulars of the challenges of religion and secularism. Among the most important examples of the challenges between Läcité (secularism) and religiosity in the public sphere, one can cite elementary education not only in public schools but also in compulsory public education, as well as media, free sexual relations outside marriage, homosexuality and mercy killings (euthanasia). In these cases, it is not wise to deny shared religious values as a source of reference. Involuntary euthanasia is absolutely prohibited. Non-voluntary euthanasia (regardless of whether it is passive or active) is permitted by decision of a committee. The challenge is voluntary euthanasia. Religious believers reject voluntary euthanasia, especially its active variants.

Assessment of patient decision-making capacity in the context of voluntary euthanasia for psychic suffering caused by psychiatric disorders: a qualitative study of approaches among Belgian physicians

ObjectiveIn Belgium, people with an incurable psychiatric disorder can file a request for euthanasia claiming unbearable psychic suffering. For the request to be accepted, it has to meet stringent legal criteria. One of the requirements is that the patient possesses decision-making capacity. The patient’s decision-making capacity is assessed by physicians.The objective of our study is to provide insight in the assessment of decision-making capacity in the context of euthanasia for patients with psychic suffering caused by a psychiatric disorder.MethodTwenty-two semistructured interviews with psychiatrists and neurologists were analysed with NVivo, a qualitative analysis software to code and organise transcribed data.ResultsDifferent views and approaches regarding decision-making capacity in the context of euthanasia emerged from the data.Most of the physicians have some knowledge of the cognitive ability approach on decision-making capacity. According to this approach, four abilities constitute decision-making capacity: communication, understanding, appreciation and reasoning. We observed differences in the way these abilities are valued in relation to competence. Some physicians take additional elements into consideration when assessing decision-making capacity.Physicians acquired their knowledge on the subject in many different ways. Most of the physicians reported that decision-making capacity was not part of their training.ConclusionWe conclude that physicians assess decision-making capacity in different ways and that personal values and beliefs influence their approach. As such, a common approach in assessing the decision-making capacity of a patient among the interviewed physicians is lacking. Less arbitrariness could be obtained by consistently implementing the cognitive ability approach.

Assisted dying and voluntary euthanasia: awareness and perception among health care professionals in a tertiary care centre, South India

Background: On March 2018, the supreme court of India adjudicated passive euthanasia legal which was termed as obsolete by Indian Council of Medical Research. There are varied opinions because of difference in terminologies used in the country. As per the current Indian legislations, the procedure of voluntary euthanasia and assisted dying is illegal. Hence, this study aims in understanding the awareness and perception towards the same. Methods: A descriptive cross-sectional study was conducted among all the 369 health care professionals employed in the selected departments of a tertiary care institute during the study period. The questionnaire used was content validated and pre-tested before administering it to the participants. It consisted of five domains (in a five-point Likert scale) and were summarized as proportions.Results: Most of the doctors (64%) and nurses (59.3%) said that euthanasia is illegal in India. About one fourth of the responders encountered a situation where the patient asked for assisted dying or voluntary euthanasia. A total of 65.3% of the participants agreed that it is helping the patient to die and not killing them.Conclusions: The study demonstrated that the health care professionals had favourable responses for half of the statements. Re-looking into the verdict by the supreme court of India, standardising the terminologies and advocating for ‘advance medical directive’ would be welcoming steps in deciding the future of assisted dying/voluntary euthanasia in the country.