CAS3701 CASE STUDY 02/ ASSIGNMENT 15
1). The case of dr. morris
Ans: Euthanasia is a complicated topic that has been debated for over decades and
even to this day. It is impossible to come upon an agreement because everyone has
different views and morals and every person has different opinions and beliefs about
euthanasia, whether it is moral or immoral and ethical or not. The case of Paul Mills and
Dr. Nancy Morrison creates a very complex situation that still is spoken about today; she
is accused of performing active euthanasia. The nurse and Dr. Morrison believed that the
patient was in visible and excruciating pain and therefore came to the decision of
terminating the patient's life. Alternatives were done in attempts to make the patient feel
at ease, but it was obvious that the patient's quality of life was over. The case had gotten
reported and resulted in Dr. Morrison being charged with first-degree murder. What should
be taken into account are the conditions that the patient was going through and her
intentions for proceeding with her decision. The decision to live or not is a fundamental
freedom; doctors and governments should not have the power to take that freedom away
from an individual, therefore, euthanasia should not be illegal; on the contrary, euthanasia
should be assessed on a case by case basis upon evaluation of the unique situation and
circumstances. Nonetheless, it is critical to consider if euthanasia is ethical or not. Was it
ethical for Dr. Morrison to proceed with active euthanasia because passive euthanasia did
not work? There are many factors to reflect on about this topic when investigating a
complicated situation such as this.
Part of our society believes it is unethical and immoral to terminate an innocent life of an
individual, but it is more inhumane to let the individual continue living and suffering deeply
while losing their dignity without interference. The quality of life is an important aspect in
an individual's existence, in Paul Mills case, his life support had already been removed to
allow him to die naturally, unfortunately, it resulted in the patient experiencing pain that
could not be relieved by the doctor. Paul Mills was a living and breathing human being
who was suffering with an incurable cancer and being unable to relieve his discomfort is
cruel and inconsiderate. A situationist believes that the patient should die; what is the
purpose of sustaining someone's life that is suffering from a problem that is terminal?
Those who surround the patient are affected and may feel hurt, but they should accept
their loved ones decision to die. The doctor applied euthanasia as a motive only to
alleviate the patients suffering in an unselfish perspective and also came to a conclusion
that it was the right thing to do (Downie, 2004). Dr. Morrison did not have the intention of
purposely killing the patient because she wanted to have one less patient to deal with or
because she ran out of alternatives, she wanted to end the painful suffering of the patient.
According to a study, pain is the most common symptom to end one's life as a patient,
and 40% of patients have pain from moderation to severe in their last days of life (Zahed,
Larijani, Bazzaz, 2007). It should be considered that euthanasia should be illegal in terms
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, of the situation.
In utilitarianism, the main concept is to act in a way that it achieves goodness for a great
amount of people. There are two ways a utilitarian can approach the topic of euthanasia,
which are act-utilitarianism and ruleutilitarianism "[they both] base their judgments on
whether changing the law will have better consequences than not changing it" (Singer,
2003). Some may see as letting the person die as a good option as it puts them out of
their pain and misery, however, some may see that the amount of people that will be
affected is greater than the amount of pleasure the patient gets from dying. Dr. Morrison
performs euthanasia on patient Paul Mills because of wanting to put him out of pain and
misery; he had already gone through many surgeries and ended up with post-surgery
infections and was found depressed and wished to die. As Paul Mills suffering came to an
end, the nurse, doctor and loved one's distress were relieved. Euthanasia may be the
simplest answer to allow the person to end their pain, but some situations happen to be
ambiguous, therefore, it should be illegal.
In situation of Paul Mills, it was evident that he was suffering; he was diagnosed with
terminal esophageal cancer. First, Paul Mills had to remove his esophagus, experienced
nine extra operations that lead to post-surgical infections that were impossible to heal,
and chest and stomach tubes attached to his bodies; it was clear that there was no hope
for his recovery (Fisher, 2013). Even though there were visible signs that he was suffering
and wanted to die, not all cases like Paul Mills are visible and easy to determine by
applying euthanasia, if it was legalized. Another reason to why euthanasia should be
illegal is because of the concerns of exploitation. The main reason for maintaining legal
distinctions between end-of-life practices and physician-assisted suicide is that any
safeguards would be unable to protect 'vulnerable' persons and their autonomy; basically,
the purpose of this is to protect individuals by maintaining the illegal status of assisted
suicide (Barbuzzi, 2014). There is no evidence that ulterior motives were present, even
though his family agreed to end his life, but what if Dr. Morrison felt pressured to
terminate his life the moment he became sick? Or perhaps maybe she did just want to
have one less patient to deal with. These are possibilities that may appear in other cases,
but are highly unlikely in this case. In addition, a doctor who practices medicine must take
an oath as known as the famous Hippocratic oath.
The Hippocratic oath that doctors must swear on is "a preamble section calling upon a
pantheon of Greek gods as witness of the physician's sincerity, a second section defining
relations between physicians, and a third section describing the physician's responsibility
to patients as a primary duty" (Koch, 2013). In sum, if a physician respects the oath they
will be surrounded with respect and as well happiness, and that a physician must heal and
not harm the patient. No matter the circumstances, whether Dr. Morrison was unselfish
with her act and attempted to relieve Paul Mills suffering, she was not authorized to
proceed. The purpose of her career as a doctor is not to simply end lives because it is the
best and easy answer, but find alternatives to extend the patient's life and minimize the
patient's suffering
The case if Dr. Morrison and Paul Mills is a case that I believe the doctor did the right
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, thing. All the surgeries he had gone through along with the 10 different IV tubes
throughout his body, infections from the surgeries, and that there was absolutely no hope
for him to survive. Dr. Morrison performed passive euthanasia at first in attempt to lower
his blood pressure and removing his life support, as it was unsuccessful, it was beyond
doubt that he was in noticeable pain. Downie (2004) argues that an individual, who is
competent, has a terminal illness, unbearable suffering and demands any voluntary
request for assisted death should be respected. Paul Mills realized that he was in so
much pain and that there was no way of him gaining back his quality of life that he was
found depressed and as a conscious person, wished to die. Dr. Morrison, the nurses and
loved ones had physical evidence of his suffering and pain, therefore continuing, this is
why I believe in this specific case the doctor did the right thing.
In conclusion, euthanasia should be illegal in terms of assessing the circumstances and
situation of each case. Not all cases are like Paul Mills where it was noticeable that he
was in agonizing pain and wished to die because he realized that there was no way that
he could gain back his quality of life. Despite that in this specific case, it appeared to be
the best thing to do. If euthanasia was to be legal, there should be a general policy that
can be applied to all types of cases, but unfortunately, it is clearly impossible to find a
main principle for all practitioners to follow and agree upon because each case is always
different.
2). Case study: euthanasia, merciful killing or murder?
Ans: As medicine evolves, many technologies and advancements are created to
improve the quantity and quality of our lives. But, when does quality override quantity?
Let's consider a case where a person is suffering from a serious disease that doesn't let
her enjoy life. At what time does a person decide that she doesn't want to live anymore
because of her disease? Does she even have the right to make that choice and seek help
from a physician? Currently in Canada, any form of assisted suicide and euthanasia is
illegal, therefore these actions are murder. "Suicide occurs when the patient acts to end
his own life, either on his own or with the help of another, such as a relative, friend, or
medical professional" (Fisher, page 189, introduction: Chapter 5) For a suicide to occur,
the patient has to be the one making the action of ending his own life. Physician-assisted
suicide is when a patient seeks assistance from a physician who "provides the means to
end the patient's life, such as a prescription for a lethal dosage of medicine." (Page 190)
Euthanasia takes place when an HCP is the one who undertakes the procedure necessary
to end a patient's life or when he refuses or withdrawals the treatment necessary to
sustain the patient's life. (P191) Euthanasia can be divided in two categories: Passive
euthanasia or Active euthanasia. Active euthanasia is when the HCP makes a direct
action to provoke the patient's death, like administrating a lethal dose. Passive euthanasia
is when "life-sustaining treatment is either withdrawn or withheld from the patient",
leading the patient to die from natural causes. (p191) Euthanasia (passive and active) can
be subdivided in three categories: nonvoluntary, voluntary and involuntary. Voluntary
euthanasia is when a fully competent and autonomous patient makes the request of
either getting a lethal dose or to withhold/withdraw treatment in order to end his or her
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, life. Involuntary euthanasia is when a fully competent and autonomous patient who did
not express his will to die, gets killed or his treatment gets withdrawn/withheld without his
consent. Nonvoluntary euthanasia is when the patient is not autonomous (therefore
cannot take any decision) and a surrogate decides to ask the for the lethal dose or that
his or her treatments are withheld/withdrawn. (p 191) In the case of Tracy Latimer, it was
nonvoluntary euthanasia. Tracy suffered from an oxygen deprivation when she was born
which caused "an extreme form of cerebral palsy, an incurable, permanent brain injury
typically affecting muscle control and movement." (chapt 5, case 3, page 263) She wasn't
able to do anything by herself, not even walk nor eat. Her brain injury left her at a mental
age of four to five-month-old child. As time went on, her situation deteriorated her
surgeries could only help with her pain for a short amount of time, "additional surgeries
would be required to mitigate the pain [...]. Tracy would have to endure all of this with
inadequate pain management. The Latimers felt that further surgery would be futile and
would, in fact, constitute a mutilation of their daughter." (Chapt 5, case 3, page 264) On
Sunday 24 October 1993, Tracy's dad decided to end her pain and killed her by carbon
monoxide poisoning. (Chapt 5, case 3, page 264) Many people think that considering this
case as merciful killing would be wrong because it was nothing but murder. I'd like to
disagree, considering the facts of this case, I do not think that the action Mr. Latimer
carried out was murder, I think it was merciful killing. Proponents of euthanasia argue that
it should be legalized because of two values: selfdetermination and individual well-being.
Self-determination is what lets patients decide what they want to do with their life and
how do they wish to value their life. In the essay "Voluntary Active Euthanasia", Dan W.
Brock argues that "[i]n exercising selfdetermination people take responsibility for their
lives and for the kinds of persons they become. A central aspect of human dignity lies in
people's capacity to direct their lives in this way." (chap 5 page 205) By respecting
someone's self-determination, their dignity is also respected. Patients are allowed to have
full control of their last moments on earth. In a case of child suffering from a disease that
is incurable, a disease that makes him suffer, and if the child doesn't have the mental
capacity to take a decision of his own, a parent might lean towards euthanasia to keep the
child's dignity and to stop his endless suffering. This leads to the second value which is
individual well-being. It seems wrong to allow and extend someone's suffering, when they
are no options left for the patient to help him with the pain. The opponents will argue that
self-determination is a wrong argument to use, because the decision is made with the
help of the HCP. In the essay "When Self-Determination Runs Amok", Daniel Callahan
argues that "[e]uthanasia is not a private matter of selfdetermination. It is an act that
requires two people to make it possible, and a complicit society to make it acceptable."
(p224) According to him, since it is a mutual decision, the doctor would have to share the
same values as the patient but also agree on the same level that defines what is "too
unbearable to live". It is important to remember, that if euthanasia would be legalized, the
case would be thoroughly examined, and it would have to be the only option left for the
patient to help him with his disorder. The decision of ending someone's life is not one that
can be easily made without considering every aspect of the situation. A relevant argument
made by the opposite side is the slippery slope argument. Making euthanasia legal will
lead to abuse. In the essay mentioned before, Daniel Callahan states that "[the abuse]
happens because not everyone will agree with the law as written and will bend it, or ignore
it, if they can get away with it." (225) Some people might even take advantage of the
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