Atnaujinkite slapukų nuostatas

El. knyga: Assisted Dying and Legal Change [Oxford Scholarship Online E-books]

(Reader in Law, Centre of Medical Law and Ethics, King's College London)
  • Formatas: 252 pages
  • Išleidimo metai: 08-Mar-2007
  • Leidėjas: Oxford University Press
  • ISBN-13: 9780199212873
  • Oxford Scholarship Online E-books
  • Kaina nežinoma
  • Formatas: 252 pages
  • Išleidimo metai: 08-Mar-2007
  • Leidėjas: Oxford University Press
  • ISBN-13: 9780199212873
The question of whether euthanasia and assisted suicide should be legalized is often treated, by judges and commentators alike, as a universal, ethical question, transcending national boundaries and diverse legal systems. By thinking of the issue in this way, the important context in which individual jurisdictions make decisions about assisted dying and the significance of the legal methods chosen to carry out those decisions is often lost.

This book examines the impact of the choice of diverse legal routes towards legalization on the subsequent assisted dying regimes in operation. This examination suggests that greater caution is needed before relying on the experience of one jurisdiction when discussing proposals for regulation of assisted dying in others. The book seeks to demonstrate the need to explore the legal environment in which assisted dying is performed or proposed in order to evaluate the relevance of a particular legal experience to other jurisdictions.

The book begins with an examination of the unsuccessful attempts to use constitutionally entrenched human rights claims to challenge criminal prohibitions on assisted suicide which reached the highest courts in the United States, Canada and Europe. Their failure makes legalization through a rights-based claim unlikely in any major common law or European jurisdiction. Alternative routes towards legalization are then discussed, including the defence of necessity, by which euthanasia was effectively legalized in the Netherlands and an approach based on compassion which has been proposed in France, as well as the legislative approaches which have been taken in Oregon, Belgium and the Northern Territory of Australia. All of these approaches are compared in detail, with particular attention paid to the effectiveness and transferability of the ubiquitous slippery slope arguments
Table of Cases xvii
Table of Statutory Material xxii
List of Abbreviations xxix
1. Introduction 1
I. The Background to the Legalization Debate
3
II. Definitions
4
A. Euthanasia
4
B. Assisted suicide
5
C. Assisted dying
6
D. Other medical behaviour that (potentially) shortens life
6
III. Criminal Prohibitions
6
A. Euthanasia
6
1. Murder
6
2. Consensual homicide
7
3. Compassionate homicide
8
B. Assisted suicide
8
1. Complete prohibitions
8
2. Limited prohibitions
9
3. Absence of prohibition
9
2. Rights to Assisted Dying 12
I. Introduction
12
A. Individual cases
12
B. Constitutional challenges to criminal prohibitions on assisted suicide
14
C. The rights debate over assisted suicide
15
II. Rights in the Assisted Suicide Debate
16
A. Right to suicide or right to assisted suicide?
16
B. Different types of rights to suicide or assisted suicide
17
C. Rights-based arguments in favour of assisted suicide
20
1. Right to liberty
20
2. Right to autonomy or self-determination
22
3. Right to privacy
26
4. Right to dignity
27
5. Right to equality
29
a. Using the legality of suicide
29
b. Using the right to refuse life-saving or life-sustaining treatment
30
6. Right to freedom of conscience and religion
31
7. Right to property
34
D. Rights-based arguments against assisted suicide
35
1. Right to life
35
2. Right to equality or equal protection
37
a. The impact of legalization on marginalized groups
37
b. The form of legalization
39
3. Right to property
40
4. Right to autonomy
41
3. The Effects of Rights 43
I. Introduction
43
II. Failure to Provide Solutions to Complex Social Problems
45
A. Problems with rights discourse generally
45
1. The indeterminacy critique
45
a. Conflicts between competing rights
46
b. Conflicts between rights and their limiting features
47
c. Levels of generality
47
d. Definitional vagueness
49
2. The critique of suppression and distortion
51
a. Focus on the self
52
b. Equality rights
52
c. Transformation of duties
53
3. The critique of rights discourse as simplistic and conclusory
55
4. The absolutist critique
56
a. Absolutist claims on both sides of the debate
57
b. The difficulty of limiting rights
57
5. The critique of rights discourse as uncompromising
60
a. The right to equality
61
b. Devaluation of opposing rights or interests
61
B. Problems with rights discourse associated with personal rights
62
1. Lack of articulation of basis of personal rights
63
2. The problem of the slippery slope
65
III. Questioning the Underlying Assumptions
65
A. The individualist critique
66
B. Applying the individualist critique to assisted suicide
68
1. Focus on community
68
2. The problem of isolation
70
3. Compromise between individual and community
73
IV. Conclusion
74
4. Duties and Necessity 76
I. The Dutch Defence of Necessity
76
A. The Criminal Code provisions
77
B. The conflict of duties
78
C. Codification
81
II. Necessity at Common Law
83
A. England: cannibals and conjoined twins
84
B. Canada: non-voluntary euthanasia of a disabled child
88
C. The elements of the defence of necessity explore
91
1. Proportionality
91
a. Justification or excuse?
91
b. Classification of necessity in the presence of a proportionality requirement
91
2. Reasonableness
92
a. No reasonable alternative
93
b. Imminent peril or inevitable evil
93
c. Personal limitation
94
III. Explaining the Different Roads Taken
94
A. Why has the common law defence of necessity excluded euthanasia?
95
1. Alternatives to the use of necessity at common law
95
2. The role of consensus
97
a. An example of the importance of consensus: existential suffering
99
b. The democracy problem
101
B. Why did the Dutch not use constitutionally entrenched rights as the mechanism of legalization?
102
1. Legal and strategic arguments
103
2. Cultural arguments
105
3. The role of other arguments in the Dutch debate
105
a. Autonomy
106
b. Respect for life
107
IV. Conclusion
108
5. Compassion 109
I. Introduction
109
II. CCNE Opinion Number 63
109
A. Incorporating the CCNE's proposal into the criminal law
110
B. The basis of the CCNE's proposal
111
C. Future developments
113
III. The Unavailability of Other Mechanisms of Legal Change
114
A. A right to assisted dying in France?
114
B. The defence of necessity in France
116
IV. Conclusion
117
6. Comparing the Mechanisms of Legal Change 118
I. Introduction
118
II. Rights as the Mechanism of Legal Change
118
A. The dissenting reasons of McEachern C.J.B.C. in Rodriguez
119
B. The dissenting reasons of Lamer C.J.C. in Rodriguez
121
C. The Second Circuit Decision in Quill v. Vacco 122
D. The En Banc Ninth Circuit Decision in Compassion in Dying v. Washington
124
III. Necessity as the Mechanism of Legal Change
124
A. (Active voluntary) euthanasia or termination of life on request
124
1. The patient's request
125
2. Unbearable and hopeless suffering
126
3. No reasonable alternative
126
4. The doctor—patient relationship
127
B. Non-voluntary euthanasia or termination of life without request
127
1. The neonate cases
129
2. Proxy consent
132
3. Incompetent persons generally
133
4. No reasonable alternative
135
C. Conclusion
136
IV. Compassion as the Mechanism of Legal Change
137
V. Summarizing the Boundaries
138
A. Request
139
1. Jurisdictions which accept proxy exercise of the incompetent person's rights
143
2. Jurisdictions which do not accept proxy exercise of the incompetent person's rights
144
3. Concerns about proxy decision-making
144
B. Terminal illness
145
1. If necessity or compassion are the mechanisms of legal change
145
2. If rights are the mechanism of legal change
146
C. Suffering and the 'no reasonable alternative' requirement
146
D. Assisted suicide or assisted dying?
147
E. Prospective approval
147
F. Restriction to doctors
148
G. Moving forward
149
VI. Legislative Change
149
A. Oregon
150
1. A brief history
150
2. An examination of the Oregon provisions
152
B. Belgium
153
1. A brief history
153
2. An examination of the Belgian provisions
154
C. The Northern Territory of Australia
157
VII. Conclusion
158
7. The Slippery Slope 159
I. Introduction
159
A. The legal significance of the slippery slope argument
161
B. Terminology
163
II. The Logical Slippery Slope Argument
164
A. Two versions
164
1. An argument from consistency
164
2. A sorites-type argument
165
B. The legal context
166
1. Necessity and compassion as mechanisms of legal change
167
2. Rights as the mechanism of legal change
167
3. Conclusion on the logical arguments in a legal context
167
III. The Empirical Slippery Slope Argument
169
A. The causal argument
171
1. A post-legalization increase in non-voluntary euthanasia
172
2. An increase caused by legalization
173
B. The comparative argument
175
1. Comparative evidence
175
a. Survey prevalence evidence
176
b. Beyond non-voluntary euthanasia prevalence rates
177
2. Difficulties associated with the comparative evidence
180
a. Lack of reliable data
180
b. Effect of the topic
180
3. Drawing inferences from the comparative data
182
a. The problem of the baseline
182
b. Comparing jurisdictions which have legalized with those which have not
183
4. Beyond the rates of non-voluntary euthanasia
185
IV. Conclusion
186
Select Bibliography 189
Individual Jurisdictions
189
Australia
189
Belgium
189
Canada
191
England and Wales
191
Europe
192
France
193
Germany
195
Netherlands
195
Law
195
Practice
198
Critics
200
Proponents
202
Ethics
202
New Zealand
202
Oregon
202
Switzerland
203
U.S.A.
203
Compassion
205
Common Law Defence of Necessity
205
Comparative Works
206
Ethics and Sociology
207
Palliative Care
208
Rights
209
Slippery Slopes
210
Index 213


Penney Lewis is Reader in Law at the Centre of Medical Law and Ethics and the School Law, King's College London where she teaches medical law and criminal evidence. From September 2007 she will be Professor of Law.