Legalising Assisted Suicide? - Medical Ethics and Law

2018-01-17 · Long video (solo, talking head or whiteboard) · Ali, Charlotte, Molly Hunt, a guest · recording, 26:48 · watch on YouTube

Topic: Medicine and his doctor years · mode: Explanation and tutorial · tags: Aimed at students

In the fourth video of his medical ethics series for medicine interviews, Ali explains the UK law on assisted suicide through the cases of Diane Pretty, Debbie Purdy and Daniel James and Lord Falconer's failed bill, predicts the law will change, and his friends Charlotte and Molly debate the ethics of legalising it.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Ali introduces the fourth medical ethics video and suggests watching the euthanasia video first

★ Ali, a final-year Cambridge medical student, presents the fourth video of his medical ethics mini-series for medicine interviews, on legalising assisted suicide. — 00:00:00 · Medical ethics, Assisted suicide, Medicine interview, University of Cambridge
★★ Ali suggests watching the third video of his medical ethics series, on euthanasia, before this one on assisted suicide. — 00:00:00 · Euthanasia, Assisted suicide, Medical ethics

00:00:58 — How to watch the video: the law is less useful for interviews than the ethics

★★★ Ali says the law on assisted suicide is not very high-yield for medicine interviews: applicants revising should focus on the ethics of euthanasia and physician-assisted suicide, which interviewers are very likely to ask about. — 00:00:58 · Assisted suicide, Euthanasia, Medicine interview

00:02:26 — Content note on suicide and euthanasia

★★ Ali says the candid discussion of suicide and euthanasia in his assisted suicide video is not required knowledge for getting into medical school. — 00:02:26 · Assisted suicide, Euthanasia

00:03:33 — Family-assisted suicide and the Suicide Act 1961

★★★ Ali says the Suicide Act 1961 makes it illegal in the UK to assist anyone's suicide, whether by giving them a pill or by helping them fly to the Dignitas Clinic in Switzerland. — 00:03:33 · United Kingdom
★★ Ali says many argue the ban on assisted suicide discriminates against physically disabled people: an able-bodied person may legally end their life, while someone disabled by terminal illness cannot without help. — 00:04:20 · Assisted suicide
★★ Ali says family-assisted suicide is still technically illegal in the UK, but high-profile cases over the last 25 to 30 years have made the law less draconian. — 00:04:55 · United Kingdom, Assisted suicide

00:05:25 — Case 1: Diane Pretty

★★ Ali says Diane Pretty had motor neurone disease, which left her unable to take her own life, and in 2002 she wanted her husband to help her commit suicide. — 00:05:25
★★ Diane Pretty took her case to the European Court of Human Rights, arguing under the European Convention on Human Rights that she had a right to be free from torture or inhuman or degrading treatment. — 00:05:55
★★ Diane Pretty lost: the European Court of Human Rights said her terminal illness was the fault of the disease, not of the state. — 00:06:48

00:07:16 — Case 2: Debbie Purdy and the guidelines of the Director of Public Prosecutions

★ Ali says Diane Pretty died of motor neurone disease, from natural causes, in 2002. — 00:07:16
★★ Ali says Debbie Purdy, whose case shaped UK law, had multiple sclerosis and would be physically unable to take her own life in the end stages of the disease. — 00:07:16 · United Kingdom
★★ Debbie Purdy argued that the Suicide Act pushes people to end their lives sooner than they would want, so that their family members are not prosecuted. — 00:08:23
★★★ In response to Debbie Purdy's case, the Director of Public Prosecutions agreed with her and issued guidelines on when people would not be prosecuted for assisting suicide. — 00:08:23 · Assisted suicide
★★ Ali says assisting someone's suicide is still illegal under the Suicide Act 1961, despite the prosecution guidelines. — 00:08:23 · United Kingdom
★★ Ali says the Director of Public Prosecutions' guidelines on assisted suicide have about 16 criteria, which most of the cases discussed would meet, and use the term "grudging acquiescence". — 00:09:37 · Assisted suicide
★★ Ali says a family member who has tried to talk the person out of it and has had to make this difficult choice can be pretty confident of not being prosecuted for assisting suicide. — 00:10:01 · Assisted suicide
★★ Under the prosecution guidelines, people may be prosecuted for assisting suicide if they gain financially, do not know the person, or have helped more than one person. — 00:10:01 · Assisted suicide
★★ Ali says the prosecution guidelines have made the discrimination against physically disabled people who want to end their lives less severe than before. — 00:10:30
★★★ Being a healthcare professional is one of the guideline criteria in favour of prosecution for assisting suicide, which makes physician-assisted suicide very illegal. — 00:10:57 · Assisted suicide
★★ At a lecture a few months earlier, Ali's class was told that a doctor helping his own wife commit suicide, not in his role as a doctor, would still probably be prosecuted. (hedged) — 00:11:33
★★ Ali calls the rules on assisted suicide a grey area, as they are guidelines rather than legislation, but says helping someone commit suicide is very dangerous for a healthcare professional. — 00:11:58 · Assisted suicide

00:12:27 — Case 3: Daniel James

★★ Ali says Daniel James was a young rugby player, in his 20s, when he was paralysed from the neck down. (hedged) — 00:12:27
★★ Daniel James's parents helped him go to Switzerland to end his life and were not prosecuted, as the case fell precisely within the prosecution guidelines. — 00:13:00

00:13:52 — Physician-assisted suicide: the law and Ali's forecast

★★★ Ali says physician-assisted suicide, euthanasia and "passive euthanasia" are all completely illegal in the UK, and a physician who helped a patient commit suicide would be prosecuted. — 00:13:52 · Assisted suicide, Euthanasia, United Kingdom
★★ Ali says physician-assisted suicide is legal in quite a lot of countries, including the Netherlands, Switzerland and some US states. — 00:13:52 · Assisted suicide
★ Ali thinks Oregon was the first US state to allow physician-assisted suicide. (hedged) — 00:13:52 · Assisted suicide
★★★ Ali predicts UK law will probably change at some point to allow physician-assisted suicide in some form, as the world becomes more libertarian about the right to choose when one's life ends. (hedged) — 00:14:21 · Assisted suicide, United Kingdom
★★ Ali says Lord Falconer tried to put an assisted suicide bill through Parliament in 2015 and failed. — 00:14:44 · Assisted suicide
- a number in question (doubtful): "2015" — check against the recording

00:15:11 — Lord Falconer's Assisted Dying Bill

★★ a guest: Charlotte and Molly say Lord Falconer's bill was thrown out of the House of Commons, where MPs voted overwhelmingly against it. — 00:15:37 · Charlotte, Molly Hunt
★★ a guest: Charlotte and Molly say legalising assisted suicide will keep being brought up again and again because it is a really emotive subject. — 00:15:37 · Assisted suicide, Charlotte, Molly Hunt
★★ Ali says that since Lord Falconer's bill was thrown out by such a majority, another bill is unlikely in the near future, but public perception may change in about ten years. (hedged) — 00:16:06

00:16:52 — The ethics are what interviews ask about

00:17:24 — Charlotte and Molly debate the arguments for and against legalising assisted suicide

★★ Charlotte: Arguing against legalisation, Charlotte says palliative care focuses entirely on relieving symptoms, so with good palliative care ending someone's life to relieve their symptoms should not be necessary. — 00:18:03 · Assisted suicide, Euthanasia, Charlotte
★★ Charlotte says palliative patients who months earlier wanted to die say that, given good palliative care, they are really happy to still be alive. — 00:18:03 · Charlotte
★★ Molly Hunt: Arguing for legalisation, Molly says that under the principle of beneficence some would argue a doctor causes more harm by letting a suffering patient live longer. — 00:19:43 · Four principles of medical ethics, Molly Hunt
★★ Molly Hunt: Molly argues that not allowing someone to commit suicide infringes their autonomy, one of the pillars of medical practice. — 00:20:11 · Four principles of medical ethics, Molly Hunt
★★★ Charlotte gives the argument that legal euthanasia and assisted suicide could pressure vulnerable and elderly people to end their lives because they feel a burden to their families and the NHS. — 00:20:11 · NHS, Euthanasia, Assisted suicide, Charlotte
★★★ Molly Hunt: Molly counters that denying access to physician-assisted suicide discriminates against vulnerable people who cannot end their lives without help. — 00:20:55 · Assisted suicide, Molly Hunt
★★ Molly Hunt: Molly argues from consequentialism that stopping suffering and enabling someone to do what they cannot do alone could outweigh the act of helping end a life. — 00:22:45 · Consequentialism, Molly Hunt
★★ Molly Hunt: Molly asks why withdrawing treatment, such as a ventilator or life-sustaining medication, is legal while euthanasia is not, when both have the same consequence. — 00:22:45 · Euthanasia, Molly Hunt
★★★ Charlotte argues against legalisation that the aim of medicine is to preserve life, and legalising one form of intentional killing is a slippery slope. — 00:23:15 · Assisted suicide, Euthanasia, Charlotte
★★ Charlotte adds personal beliefs against legalising euthanasia: that life is sacred and death should be a natural process, with no one playing a deity. — 00:24:05 · Charlotte

00:25:13 — Closing remarks and the next videos

★★ Ali again urges applicants never to use the phrase "passive euthanasia", because it is confusing. — 00:25:42
★★ Ali says end-of-life ethics is a difficult area, but it is what doctors deal with day to day. — 00:25:42 · Medical ethics
★ Ali says a few more videos of his medical ethics series and a few more about interviews are coming, before the channel moves into more uncharted territory. — 00:26:11 · Medical ethics, Medicine interview

Threads in this video

kept · Ali says part two of his euthanasia videos, which should be out at some point the following week, will cover assisted suicide, attempts to change the law on it, and its ethics. — Ali, a final-year Cambridge medical student, presents the fourth video of his medical ethics mini-series for medicine interviews, on legalising assisted suicide. (00:00:00) → refers to Euthanasia - Medical Ethics and Law at the end of life
kept · Ali promises more videos on the BMAT, interviews and personal statements (2017) — Ali, a final-year Cambridge medical student, presents the fourth video of his medical ethics mini-series for medicine interviews, on legalising assisted suicide. (00:00:00)
progress update · Ali promises more videos on the BMAT, interviews and personal statements (2017) — Ali says a few more videos of his medical ethics series and a few more about interviews are coming, before the channel moves into more uncharted territory. (00:26:11)
refine · How do you answer medical ethics questions in interviews? — Ali says the law on assisted suicide is not very high-yield for medicine interviews: applicants revising should focus on the ethics of euthanasia and physician-assisted suicide, which interviewers are very likely to ask about. (00:00:58)
restate · How do you answer medical ethics questions in interviews? — Ali again urges applicants never to use the phrase "passive euthanasia", because it is confusing. (00:25:42)
predicted · Ali predicts UK law will probably change at some point to allow physician-assisted suicide in some form, as the world becomes more libertarian about the right to choose when one's life ends. — Ali predicts UK law will probably change at some point to allow physician-assisted suicide in some form, as the world becomes more libertarian about the right to choose when one's life ends. (00:14:21)

Where the stories that moved here went next

Mentioned

Central: Assisted suicide · Medical ethics

Also: People: Charlotte · Molly Hunt

Organizations: NHS · University of Cambridge

Concepts: Consequentialism · Euthanasia · Four principles of medical ethics · Medicine interview

Places: United Kingdom

Replies to

continues · How to answer Medical Ethics interview questions
continues · Euthanasia - Medical Ethics and Law at the end of life

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