En kritisk granskning av Oregonmodellen

The so-called Oregon model has been described as a more attractive and safer alternative for assisted dying than the controversial euthanasia laws in the Benelux countries. Many advocates of assisted dying believe that the Oregon model, which implies physician-assisted suicide, is better adapted to Swedish (Nordic) conditions. In order to be able to offer assisted dying according to the Oregon model, seven criteria must be met. In this chapter, we will analyse the criteria and examine whether the practices of the Oregon model meet them. Is it a safe model to help severely ill people from suffering during their very last stage of life? To what extent can the model guarantee security and justice for those involved? Finally, we want to investigate whether it can be a suitable model for the Nordic countries.

Autonomi er noget vi giver hinanden

The concept of autonomy is essential in the discussion of assisted dying. In this chapter I will endeavour to nuance the concept of autonomy towards also encompassing an essential element of mutual commitment. Thus, the chapter will emphasise the importance of strengthening a nuanced concept of autonomy that I consider to be essential. Therefore, I will try to take the argument about the individual’s right to decide over his or her own life as a starting point to investigate autonomy and assisted dying. In the common understanding of autonomy, the mutual obligation towards the community seems to be reduced in favour of the individual’s right to decide for himself/herself. I will illustrate this aspect with an example from the world of cinema, Bille August’s Stille hjerte (Silent Heart).

Er det mulig å lage en entydig, rettferdig og forsvarlig dødshjelpslov?

The public debate about assisted dying follows several tracks. The most important political question is whether euthanasia should be legalised, and if so how it should be delimited, regulated and controlled. Is it even possible to create a law that delineates when assisted dying should be allowed and when it should be prohibited, in a clear, fair and safe way? This chapter proposes criteria that can be used to design an assisted dying law, and discusses how existing laws can be evaluated based on the criteria. Particular emphasis is placed on the recent Canadian assisted dying legislation, which, in the author’s view, has failed in all three areas.

Er det at blive gammel tilstrækkelig årsag til dødshjælp?

A proposal put forth in the Dutch Parliament suggests that anyone over the age of 75 should have a legally guaranteed right to physician-assisted suicide if they wish to die, unless the wish is the result of a mental illness. This chapter discusses three questions about the relationship between age and entitlement to assisted dying: 1) are there good reasons to introduce a purely age-determined criterion for a right to assisted dying; 2) would such an age criterion lead to problematic discrimination against the elderly, or alternatively to discrimination against people who are too young to meet the criterion; and 3) what is the relationship between an age criterion and a postulated duty to choose assisted dying in specific situations. The discussion of these three issues shows that there are no good reasons for introducing an age criterion for the right to die, that an age criterion is potentially discriminatory to both the elderly and the young, and that introducing an age criterion could lead to problematic pressure against vulnerable elderly people.

Fem spor i dødshjelpsdebatten

The assisted dying debate in the public square often involves talking past one another. Participants talk about what is important to themselves, without necessarily considering the other party’s arguments. Why is this so? We believe it is partly because the assisted dying debate actually consists of several more or less distinct “tracks”, all of which are important, but where not all are equally important to all participants. In this chapter, we outline the five main tracks of the assisted dying debate and show what characterises them and how they are expressed in the public debate.

Språk og virkelighet i dødshjelpsdebatten

Language describes reality. It also creates reality and perceptions. This is particularly evident in the assisted dying debate; there is a “battle for concepts” where both sides have their preferred words. But fruitful ethical debates require concepts and definitions that the debaters can agree on. This chapter therefore proposes a set of concepts and definitions for the Nordic assisted dying debate. Good concepts are concrete and precise, with simple and unambiguous language free from unnecessary use of imported terms; they have concise and normatively neutral definitions, and they are preferably already familiar to and in use by the public. The last part of the chapter asks whether the way we have linguistically drawn the most important distinction in the field of assisted dying – between euthanasia on the one hand and treatment-limiting decisions on the other – points to a real difference that is also ethically relevant. It is argued that the answer is yes, and that the healthcare provider’s intention is an ethically relevant difference: In euthanasia, the patient’s death is intended, while in treatment-limiting decisions the intentions are typically of quite another nature.

Fortellinger om død, verdsetting av liv

Assisted dying is, almost by definition, a dramatic topic. Thus it can also be dramatised, both in fiction and in media coverage. Stories, whether they are bestseller books like Jojo Moyes’ Me Before You or newspaper articles that spread virally, can reach a large audience. Stories also serve as indirect arguments. By depicting how assisted dying might or ought to work, they also express a normative stance on reality. This chapter investigates the patterns of some culturally central narratives of assisted dying, and questions the value judgments expressed in them. It also raises the question of which premises for further debate are brought about by such stories – premises about the assessment and valuation of human life.

En leges nei til dødshjelp

While there is broad support for assisted dying in the general public, many doctors say no – no to performing it, no to legalising it. What explains this resistance? This chapter deals with the counterarguments against assisted dying, from a professional ethics standpoint and a doctor’s outlook. I will present the eight main reasons why I as a doctor say no to euthanasia. The same reasons can be found in declarations on assisted dying from medical and specialist associations worldwide. A recurring feature is that they do not necessarily presuppose a categorical rejection of assisted dying as an isolated phenomenon, or a morally grounded rejection of the euthanasia act. The most important concern is how the doctor will be able to cope with the extremely difficult question of whether another person should be helped to die. At the same time the doctor must preserve the care of vulnerable individuals, as well as the doctor’s own role and values.

De to veiene til dødshjelp

This chapter’s claim is that arguments for legalising assisted dying essentially follow one of two paths. We can either justify it in the person’s self-determination (the “autonomy path”), or in the person having rational, good reasons for his death wish (the “rationality path”). Both these lines of argument have radical consequences when their logical implications are fully pursued, and an attempt to balance these principles will be under constant pressure. This presents a challenge to those who think it is fairly straightforward to design our preferred assisted dying law, and should make us think through carefully what any legalisation will entail and what principles underlie it. If we take the principle of self-determination seriously, it leads to a very liberal assisted dying law that few Nordic advocates of legalisation would want. On the other hand, choosing the path of rationality requires that we, as a society, define criteria for when life is “not worth living”, based on characteristics that large groups of fellow human beings possess, including those who do not share a desire to die.

Dödshjälpsdebatten i Finland

The citizens’ initiative to legalise euthanasia was addressed in the Finnish Parliament in 2017. The Parliament rejected the initiative and appointed an expert group to investigate the need for legislation regarding end-of-life care and the need for euthanasia. Thus, the debate continues. This chapter provides an overview of the public debate and the political process associated with the citizens’ initiative. The initiative is critically examined on the basis of expert opinions requested by the Parliament’s Social and Health Committee. In a vote, the MPs rejected the initiative. One of the central arguments has been that it is not appropriate to legalise euthanasia when end-of-life care is not sufficiently developed in Finland. From many quarters, opinions were raised against the legalisation of euthanasia, promoting support for legislation on end-of-life care instead.