Video on assisted dying from Ollie Burton

Hello everyone my name is Ollie I'm a second year medical student at the University of Warwick on the gradual entry medical program. So they're difficult topics, but something that I feel reasonably could come up in a med school interview are assisted dying and the euthanasia things can become very charged.

Difficult topic of assisted dying

But as with all of these difficult ethical problems, I hold the opinion that any competent thinker who understands the arguments should be able to argue convincingly for either side, that can be difficult, but I think we should really make our best effort to be able to do that. And I need to note that most of the information that I'm gonna go through here is actually taken directly from the NHS website.

And I'll leave a link to that in the description below as usual, we need to begin by defining our terms. So euthanasia is the killing of a person. In order to prevent suffering. There are two categories that we can put this into the first of which is voluntary euthanasia in which the person asks for help in dying.

Whereas non-voluntary euthanasia takes place. When euthanasia is performed, but the person is unable to consent to it. They don't have capacity. So an example for that might be when they're in a coma. And the decision for that to happen is made by a third party. This most commonly happens when a person has expressed a particular wish to die, should a particular set of circumstances come to pass.

Active and passive euthanasia

We also need to understand the difference between active and passive euthanasia. In active euthanasia as the name suggests, that's when the clinician involved makes a direct intervention in order to end the life of the person. So you might do something like a lethal injection, active euthanasia is different because that's more about withholding treatment that that patient would need in order to survive.

And you're basically allowing them to sort of die on their own. As an onlooker. You are not directly intervening the NHS. Site also specifically points out that passive euthanasia is not the same thing as withdrawing treatment that would be given as part of a normal palliative care process. The specific example is that taking someone's life support away by turning the switch off, as the example is.

Um, that can actually be part of good palliative care. So that's not the same thing as passive euthanasia. Now that that's dealt with, we need to talk about the ideas of assisted suicide or assisted dying, which are slightly different. Assisted suicide is either encouraging or providing the means for someone to kill themselves.

Someone with a wish

So an example of that might be that if you know, someone has a wish, um, to die, if you provide them with say a lethal dose of medications, With the knowledge that they would use them to kill themselves that might be considered assisted suicide because you have provided the means in order to allow them to do that in the knowledge that that's what they were gonna do.

What's different?

So then bringing it back to the beginning, why are euthanasia and physician assisted suicide different? In euthanasia, the assistant has to directly act. So in the case that we gave before of a lethal injection or something like that in assisted suicide, the assistant provides the means to allow that debt to happen, but they won't do it themselves.

Laws and legal trouble

The next key thing to know is that no matter how passionately you feel about anything involved. Both euthanasia and physician assisted suicide are completely illegal under UK law. Um, with assisted suicide, you face up to 14 years imprisonment under the suicide act euthanasia depending on the particulars of the circumstances.

Is either seen as manslaughter or murder and you can face up to a life sentence for being involved in that. What we're gonna do next is we're gonna talk through some arguments in favor of allowing euthanasia under the law, and then talk about some reasons why we might not want to allow it under the law, but just to start, let's have a purely autonomy based argument.

I think therefore I am, my life belongs to me and no one. I therefore have an absolute right to die if I so choose, and I should have the means to be able to do that. You can also make a libertarian argument. Um, you know, if I want to die and I'm okay with it. And my friends and family are okay with helping me do that.

We are individual entities

We are individual entities. The state, the government should have absolutely no right to intervene with that process and stop me doing what I want. You could argue that euthanasia does provide some small amount of dignity and control to a patient that might have had those things taken away from them by a terminal illness, as well as simply preventing the suffering that comes as part of a long drawn out dying process that has the added benefit of not only preventing the patient's suffer.

Friends and family

But it means their friends and family don't have to effectively watch them die as well. That's the kind of argument we would make. If we had a pet put down, for example, um, I had a dog that had cancer. Um, we chose because we thought it was the best thing to do. He was very clearly in a lot of pain and distress.

Preventing suffering

We had him put down to prevent his suffering. That argument is made very commonly and pets are put to sleep a lot. So I'd simply extend that same argument to humans. It's also technically possible to regulate euthanasia and assisted suicide. However, I think you have to acknowledge that that's gonna be incredibly difficult when you try and do that, just because of the complexities involved.

A utilitarian stance

You can also take it from a more utilitarian or consequentialist stance. People are going to either assist others in committing suicide or commit suicide themselves anyway. So it's better off that that process is made legal and safe instead of placing people more at risk by creating black markets. And that will ultimately keep more people safe in the process.

You might also say that terminally ill patients consume a huge amount of resources within the NHS. If that person simply doesn't want to be alive. There's no sense. Arguably, in using up all those resources on someone, you know, is not gonna get better. So, if they wish to die, it may as well free up the resources for another group of patients.

Abusing laws

Lastly, one of the huge objections to euthanasia is the idea that if you create laws, people are gonna start abusing them to either pressure or push people into taking assisted suicide pathways or euthanasia pathways when maybe assisted dying is not the best thing for that patient. They might be pressured by family or friends.

That have something to gain from that situation. My objection to this. However, so I'm still putting it under the pro euthanasia set of arguments is that we have laws for lots of things that are broken or twisted all the time. People steal things, despite theft being very strictly illegal. To me putting laws in place doesn't increase or decrease the likelihood of those same things happening.

Against allowing euthanasia

So now we're gonna talk about some arguments against allowing euthanasia under law in the UK. And. Like I have to give my personal perspective here. I am pro allowing it, um, on the NHS in the UK. But what that means for me is that I have to make more effort to engage with these arguments. On the other side, I think the opposing arguments that are presented are very legitimate.

And I know that a great many doctors hold these positions that are contrary to the ones that I hold. So particularly young people, I know we reflexively tend to be more. Allowing euthanasia to happen, but we really have to be clear and engage properly with these other arguments. I think we have the moral and ethical duty to do that.

Libertarian argument

So to start with we'll do another libertarian argument. You might feel that giving doctors the power or whatever healthcare professional you give the power to end life, too. That creates a huge power imbalance. Way greater than any ones that already exist. That simply puts too much power in the hands of the state because doctors are state controlled for the most part in the UK, which in turn may damage the trust between doctors and their patients.

And we know that damage to that relationship results in worse health outcomes for most people. My understanding is that it's felt by a great many people, including lots of palliative care expert doctors, that the palliative care process actually already allows people to die with dignity. We've already discussed that withdrawing that treatment can be part of the normal palliative care process and therefore extending it to include euthanasia, maybe isn't necessary.

A slippery slope

And there is also the very big slippery slope argument. If we put laws in. The government conceivably could, or not even the government, but even just individual doctors could start kind of bumping off, uh, members of certain groups from society, people who are seen as too complex or problematic to deal with, or people who are seen as undesirable there's then kind of a legitimate way of getting rid of them.

Cultural and religious arguments

And the last thing is that I think it's important to take cultural and religious arguments very seriously. I know personally, that's not something I'm particularly good at. I tend to get very worked up when dealing with patients who, who come in with these kind of views that alters their healthcare in some way, but public policy, you know, the NHS should where possible and where appropriate bead.

Kind of driven by the public. The patient's concerns and ideas are the most valuable thing whenever you're talking to them. So if they've got cultural or religious objections to allowing euthanasia and assisted suicide under the law, they do have to be listened to. So that's where I'm gonna wrap this video.