Carla Staton and Heather Mutchie
Questions?
 How old is old?
 When have you lived a full life?
 What is bioethics and why has it become so important?
 What is the difference between active and passive
euthanasia?
 How does having the option of euthanasia effect people?
 How hard should we work to keep an old person alive?

Vs. keeping a young adult or child alive?
Bioethics
 Because of increased medical technology, Bioethics
has become more prominent
 Bioethics is the study of the interface between human
values and technological advances in health and life
sciences
 Which means, balancing between respecting a person’s
freedoms and wishes and recognizing that it is
impossible to to establish one solid version of the moral
decision
 Example: the decision to turn off life support for a family
member.
Euthanasia
 Euthanasia is the practice of ending life based on
mercy
 Euthanasia is arguably the most important issue in
bioethics today and very controversial
 The considerations that must be made when
considering euthanasia are the value and quality of a
human life
 Most common situations where this arises are terminal
illnesses and when life is sustained only by a medical
machine
Euthanasia
Active vs. Passive Euthanasia
 Euthanasia can be practiced either actively or passively
 Active euthanasia is deliberately and intentionally
ending a person’s life
 If the patient is unresponsive the wishes of their proxy or
 surrogate are considered in this matter.
 Passive euthanasia is the type of euthanasia that
involves letting someone die
 Example: not preforming a surgical procedure
Active Euthanasia
 Active Euthanasia is also commonly referred to as
assisted suicide
 Examples are administering a drug overdose or
disconnecting life support
 Though most Americans support actions like
disconnecting life support, there is still strong moral
opposition for many reasons, commonly religion
 Many studies have been conducted in European
countries as well on this issue and found that mixed
feelings are widespread
Cont.
 A Swedish study (Valverius, Nilstun, & Nilsson, 2000)
showed that increasing the education on pain relief
methods decreased the amount of requests for assisted
suicide
Cultural Influences
 A person’s culture has a tremendous effect on how they
view suicide
 Catholics view suicide as the ultimate sin
 Japanese believe that suicide is an honorable way to die
 Asian Americans have the highest rate of suicide in
America and generally feel that being a burden on their
families is justification
 Less than a third of Americans in most Ethnic groups
oppose physician-assisted suicide
Cultural Influences
Criteria
 Many people accept physician-assisted suicide if a certain
number of criteria are met
 The Oregon law makes it legal to request a lethal dose of
medicine, however there are strict guidelines
 The Dutch Supreme Court ruled that physicians cannot be
prosecuted for assisted suicide if criteria are met
 Oregon law is more restrictive but fundamentally similar.
 It requires that patient be informed that they terminally ill
and of all the alternatives, the patient must be mentally
competent and make a total of 2 oral requests and a written
request with 15 days in between each request
Impacts of Oregon Law
 341 deaths in the first 10 years
 Psychological benefits for the patients
 Knowing the option is available for them to use is
comforting
Passive Euthanasia
 Withholding treatment from an already dying person is
generally accepted
 Treating cancer in a dementia patient
 The moral justification is that treatment would only prolong
death and extend the pain of the patient
 Withholding nourishment, such as food, is generally
opposed by most people, even when the patient is
terminally ill.
 U.S. Supreme Court ruled in the Nancy Cruzan case that a
living will or health care power of attorney must indicate the
desire to stop nourishment and that no third party has the
right to do so.
Passive Euthanasia
 Terri Schiavo Case also dealt with the form of passive
euthanasia that ended nourishment through forced
feeding.
 This case illuminated all of the moral, medical, and legal
issues surrounding the topic of passive euthanasia
 The argument between her parents and husband
showed how emotional passive euthanasia and the belief
in “death with dignity” can be.
End-of-Life Intentions
 Some of the controversy and argument around euthanasia
can be avoided by making one’s intentions clearly known
 End-of-life intentions are generally made known through a
living will. In the living will, feelings about certain
treatments, diseases and life support are written down and
a durable power of attorney for health care is appointed.
 Living wills come into importance when the person is not
competent or unconscious.
 Living wills bring up issues that many people do not want
to think about or deal with so many people avoid taking
this step, making the ethics surrounding euthanasia more
and more complex
Passive Euthanasia
 Passive Euthanasia has become a controversy in more
ways that one
 Euthanasia itself is highly debated but passive
euthanasia seems to be contradictory
 The argument is any form of euthanasia still ends a life,
which is an active process
 Passive Euthanasia can be accomplished two ways:
withholding treatment and withholding nourishment;
However, these two methods are met with differing
levels of approval
How old is old?
 Life Expectancy: age at which 50% of the population
dies

as of this Century: 85 years old
 Lifespan: maximum potential; longest lived of a
population

As of this Century: 120 years old
All of these are great for caring for
sweet old ladies BUT…
 Callahan’s “On Setting Limits” 1968
 What is the social role of the old that we are keeping
around?


Being used for the effects that come with aging rather than for
the unique quality of being aged
Social responsibilities
 Theories of Aging: Disengagement and Active
THEREFORE: Is it right to use public funds to prolong their
lives?
Arking, R, Biology of Aging
Public funding for the Aged
 ACTIVE - The Advanced Cognitive Training for Independent and Vital Elderly
 REACH-Resources for Enhancing Alzheimer’s Caregiver Health
 Medicare – gov’t funding for medical expenses
 Hospice – end of life care (not exclusive to elderly)
Cont’d
Resource
Allocation
-Society as a
Cell
Graph from Dr. Rodney Guttmann
When have you lived a ‘full’ life?
 Measurements of quality of life



How to quantify?
How could we declare a cut-off point?
When can we say a life is ‘worth’ living?