Euthanasia - Medical Ethics and Law at the end of life
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- Опубліковано 9 січ 2018
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In this video, we discuss the legal side of euthanasia/physician assisted suicide. To summarise - euthanasia is illegal in the UK. 'Passive euthanasia' is a confusing term which we should avoid. 'Withdrawing medical treatment' is good medical practice when done appropriately, and is NOT the same thing as 'euthanasia'.
Throughout the video we talk through the case of Dr Cox and Lillian Boyes which illustrates a lot of these points and is pretty seminal as far as legal cases go.
CORRECTIONS:
In Re T (Jehovah’s witness case) it was the refusal that was deemed invalid, not the original consent (Molly said that the consent was found invalid).
And in the case of Nigel Cox, he was found guilty of attempted murder, not of manslaughter as we say (at 12.48).
Profound apologies for the inaccuracies, and many thanks to Dr Fistein from the Cambridge Clinical School faculty for pointing out the errors.
TIMESTAMPS:
01:04 - Introducing the Dr Cox + Lillian Boyes case
02:27 - More information about the case
04:31 - Active Euthanasia vs Passive Euthanasia
05:49 - Physician Assisted Suicide
06:43 - Don't use the phrase 'passive euthanasia'
08:36 - Doctrine of Double Effect
12:25 - Dr Cox - The verdict
14:03 - Ali's closing remarks
15:55 - Possible MMI scenario
17:00 - Sneak preview of the next video
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Who am I:
I'm Ali, a junior doctor working in Cambridge, UK. I make videos about medicine, technology, productivity and lifestyle design. I also have a weekly podcast with my brother ( / notoverthinking , and I write a weekly email newsletter that contains some quick thoughts + links to interesting things (aliabdaal.com/newsletter/).
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This soundtrack really set the mood
How can i get it?
The soundtrack was aweful, but gave me a reason to end it all
You all prolly dont care but does anybody know of a way to get back into an instagram account??
I stupidly lost my login password. I love any tips you can give me.
Me in an interview:
Don’t say it
Don’t say it
Don’t say it
PASSIVE EUTHANASIA
I actually said that in a medical interview and the interviewer reemed me for it and I lot all of my confidence and absolutely flopped that question, hence why I’m watching this vid to avoid that from happening again 😔
Uzma N sorry to hear, hopefully you hear back from them with good news. I’m also stressing about interviews this year
Speedrunning these videos an hour before my Liverpool interview… I know that I’m not alone when I say you’re an absolute legend and godsend for every aspiring medic
How did the interview go??!!
One of the best discussions of end-of-life ethics I have ever seen.
Vets always recommend euthanasia to our pets when they see that they're suffering. If we have this much respect for animals then why shouldn't it be the same for humans
Each of us has the right to live or die. Humans have been slaughtering each other via wars since time began. We should have the right to kill ourselves when, for whatever reason, we feel it is our time to go.
ali we r rly so BLESSED for you to be providing us with all these crucial info. It rly sets the groundwork for us n makes it so much easier preparing for the interview. Deeply appreciated 🙏
This video reminds me of the movie "Me Before You". Interesting and informative
Very Helpful, Many Thanks , My Mother 96 yrs is in a similar position to the case in Question. Has very much helped considerations.
Great work you guys really help me a lot just coming to do a presentation on the needs to preserve lives
Thank you so much for this. I appreciate your channel.
excellent video, very useful series for my upcoming imperial interview!
Wonderfully put together!
This is extremely useful, especially for my upcoming interview! Thank you.
excellent, Can you do one similar video on abortion?
I love your videos, they are very educational and useful. I use them as a guide to respond case studies in my health care ethics class (hope you don't mind). Great work!
This is really interesting, I'm glad you did this video. It feeds back to what I was saying in the comments on another video, about euthanasia with animals. Vets put animals to sleep for a number of reasons, but the relevant one in this case is to relieve suffering. I can't quite wrap my head around that it's not available in the UK for terminally ill or those in chronic pain to have a legal way to end this suffering, when it's done up and down the country to animals.
Additionally, animals can't tell us and consent, whereas humans can- so why is this a dilemma?
Ali Abdaal would there be a lot of support with doctors for the law to be changed?
Agreed - This is an archaic law and I think the law should be changed to reflect today's times and what is and isn't at the boundaries of medical advances. And reviewed frequently to reflect continuing advances in medicine. Vets put animals to sleep to relieve suffering and I cannot wrap my head around it too, how euthanasia in certain cases is not available in the UK, when it would clearly be in the best interest of the patient to relive suffering at end of life stages.It is interesting to note that some 20 years ago euthanasia may have been performed on small animals because those may have been the limitations of veterinary intervention, whereas today, the very same conditions may be treatable. It is an interesting field that needs more research and support and perhaps open public debates. In cases of withdrawal of treatment, isn't that harsh? What kind of death would a patient have if they are in excruciating pain as a direct result of withdrawal of treatment, with perhaps hours or days of suffering before finally dying, as opposed to dying under euthanasia, quickly and with perhaps little pain because of its speed? Yet, withdrawal of treatment is somehow acceptable. A very gray line indeed. Arguably, it can be said its just semantics, because after all doing northing and withdrawing treatment may be constituted as "doing harm"? And isn't euthanasia meant to mean "a good death" in Greek? I myself am unsure of how I feel about the subject, although, anybody reading the above may guess I am leaning on the pro side. Perhaps I am. However, if ever made legal, there would have to be clear guidelines so as to insure that the procedures and processes are not abused and death not occurring unnecessary. Just some points to consider. Thanks for the video, as always very interesting and educational :) x PS. If I've upset anyone, it was not intended. Just some points to consider x
I’ve always wondered this exact same thing. Vets say things like it’s an act of kindness, it would be cruel not to end the animal’s suffering. It’s a no-brainer for vets, but doctors are expected to (potentially) let a human suffer in agony till the very end regardless of their wishes 🤔
Interesting point about consent too
Speciesism is the answer you're looking for
Ali I've been watching your vids for quite some time and I'd like to say thank you so much for your time and efforts to educate us on so many different topics . Keep it up :-) can you also do a vid talking about how to deal with addictions ?
Thank you so much for this video!
It is a very important topic to debate in our society
quite informative ,good one .
Great one once again.👌Thanks a lot
We are always concerned about the right to life why are we not concerned about the right to die or be euthanized. Sometimes a soul may need to die for the right reasons such as painful illness, old age, alone in the world, can't pick up your life from being poor - out on the streets, or criminal who is so bad he should not be aloud to live. I do not want to live the end of my life being cared for like a new born child if I could be euthanized humanely. The best way would being put to sleep with an anesthetic and then having the blood drained from my body until my heart stops beating. That is a saints death. Please share this with as many souls as you can. God bless you all and it is not a sin to be voluntarily euthanized.
The doctrine of double effect vis a vis morphine or heroin depends on the dose used. Sounds very much like Lillian would have benefitted from 1 gram IV stat. Dr Cox is both humane and enormously courageous. As is the patient.
I love these videos. Keep it up
This is PERFECT, thank you (haven't even pressed play yet haha). Did some reading up around this subject a couple of weeks ago so I'm going to watch this video with my dinner to consolidate all that learning and also gain some newer perspectives!
Thanks for this vid guys - looking forward to the next one. :)
PM
Thank uuuu these are sooo useful
Thought I put Ali on double speed oopsy
I have a question: if the drug potassium chloride is only useful to stop someone’s heart, why is it available in clinical settings?
Terrific video, thanks so much.
Its often used to correct dangerously low levels of potassium in the blood (hypokalaemia) often caused by diuretics or profuse intestinal fluid loss.
Very educative thnx❤
Here in Victoria, Australia it is legal and definitely not seen as murder! Pt autonomy is prioritised
Great video! I found the part about passive euthanasia extremely useful as it cleared a lot of confusion.
Could you please do a video discussing the Charlie Gard case?
Thank God that doctor is still in practice because we need more doctors like him . Im sorry but it true and im sure alot who say they want assisted suicide. You no right to judge. You have no idea
It's not a thorny issue. Do you care more about alleviating suffering, or in "adhering to your principles at any cost"?
Heyy, I really love this topic and I want to do it for my EPQ. However, people are telling me that euthanasia is a very typical and popular subject for EPQ hence I will not stand out. Are there any medical related topics that you believe are worth writing about or recommend for the EPQ?
Hi! I’ve just completed my EPQ, I receive my results tomorrow! I completed my report on the Liverpool Care Pathway ( an unsuccessful Care Pathway implemented into the NHS for palliative Care which has now been abolished). I found this area really interesting! Also, don’t worry about standing out, any research project will have its own flare and unique style!
Thanks for all the advice. I will let u know my final choice of topic. And good luck ahah xx tell me how it goes
@@thatunknowngirl8358 So what did you do for your EPQ?
Let's get real: Suicide:
There are many ways a human can die. Besides all the 'normal' ways, consider also the following:
1. Suicide by cop: Someone does something that causes the police to kill them.
2. Suicide by criminal: Someone does something that causes them to be killed by a criminal.
(Even some police utilize this one so as to 'die a hero' and their family still can get benefits).
3. Suicide by 'accident': Someone has an 'accident' that kills them.
4. Suicide by 'ignorance': Whatever society tells people to do to stay healthy, do the opposite.
* Suicide numbers are probably higher than what is reported. And suicide is not always connected with a mental illness as if often claimed:
5. Some military people go on 'suicide missions' for a greater cause.
(And they are seen and treated as a hero.)
6. Some people risk their own life to try to save others.
(And they also are seen and treated as a hero.)
* So, suicide can be done by a fully sane individual too. For them, it's just the 'right' thing to do. For a 'greater cause'.
7. And then also, some people who choose to die, can free up resources for those who want to continue to live. (An act of charity and love).
* Suicide is claimed to be associated with mental illness, and that is simply not always true.
* Legalize suicide, or at least make suicide not illegal. Doesn't a person have the individual 'right' to end their own life? It's their life, isn't it? Otherwise, society should be fully responsible for taking care of every single human's basic needs, otherwise, society is mandating an unfunded mandate, making people stay alive without providing the necessary resources to do so. Society would be making 'slaves' of individuals for as long as the individuals are alive. And not taking full care of those 'slaves' either. And don't worry society, even where suicide is legal, there are still enough humans alive to keep society going. Let those who want to end their own life, do so, legally. You will still survive, although not eternally, at least not from this Earth. Such is life until life is no more.
Great videos, really wish there was an American version of you!
Me too! It’d be so helpful
Thank you very much
You say Passive Euthanasia, anything to do with the word Euthanasia in particular has intent of ending someones life, which is illegal. Withdrawing medical treatment has the same intent, Doctors know full well what will happen. You can dress it up and rephrase it to fit your ethics however you like.
I've watched both my parents die, Mum after about 10 years with dementia the last 3 were painful to witness, and my Dad within 10 months after suffering a stroke, who also developed a form of dementia due to a series of mini strokes, his legs no thicker than my arms. The issue with my parents is because of the dementia, neither would have been considered to have been of sound mind to be able to make any decisions regarding dying with dignity anyway, had it been legal.
But the suffering of both my parents could have been relieved much earlier, if only we had the appropriate laws in place.
sorry to hear
Thank you so much guys!
Thank you so much, I really appreciate your channel
Defining laws around the concept of intent seems like a very slippery slope, and fairly easy to manipulate. Since intent cannot always be quantified, I personally think it might be unreasonable to enforce laws around it. But, I suppose a moral and ethics debate might not be what the interviewers are looking for.
excellent video! I found it really interesting!
It’s not right for people to suffer through a slow and painful death and is also not right for people to suffer with chronic or mental illness if there is no cure for them. We shouldn’t have to be human test subjects if we are unlucky enough to have an illness or injury which there is no cure for. Maybe the reason they don’t allow us to do so is for the profit that is gained through our pain and suffering. How much money will it take per euthanasia for the govt to change their mind?
great vid! thx
do you have a second one after 2 years of Dr ing?
Consider the following:
Nature is our greatest ally in so far as Nature gives us life and a place to live it, AND Nature is also our greatest enemy that is going to take it all away. (Basically, Nature has the first and last say concerning life).
It's human's laws (written and unwritten) as to how humans live their life while they have it to live. Humans can write laws any way they want to, to say whatever they want those laws to say. If humans want things to be a certain way in life, just change the laws, (excepting Nature which does not care one bit about us or our human laws). And while Nature's law does not appear to change, human's laws can change, and often do.
How exactly do we, individually and as a society of individuals, want to exist while we do exist? And who decides? And by what authority do they and they alone get to decide?
Should I decide how you should exist? Should you decide how I should exist? Should others decide how we both should exist? Should we decide how others should exist? And who decides in how to even decide? And by what authority do they and they alone get to decide?
And no matter what we decide, Nature is still going to kill us all off in the end, one way or another. We are only fooling ourselves believing that our life ultimately matters. Nature has apparently already decide before we even ever were. We never had a chance to survive throughout all of future eternity.
Our true destiny is as follows:
1. We are all going to die one day from something.
2. We are all going to forget everything we ever knew and experienced.
3. We are all going to be forgotten one day in future eternity as if we never ever existed at all in the first place.
Life itself is all ultimately meaningless in the grand scheme of things. (OSICA)
this is helpful. do you have anyone that I can talk to regarding euthanasia ? it is
for me .
is there in any ways that i could send emails to you?
Can someone identify the music for me? It's really dreamy and I love the pacing. Thanks in advance
Darude- sandstorm
Really great video but I absolutely hate the background music :))
What is it on your left eyelid?
Is withdrawing treatment WITH THE INTENT for it to lead to death illegal ?
@@aliabdaal this is a good little peak behind the curtain, I appreciate it.
Wait why do they need to get the Youth in Asia? Do the Asian kids do the Assisted Suicide part?
Ok I get it that active euthanasia is illegal, but isn't one of the 4 pillars of medicine "autonomy". Shouldn't we give more weightage to a person's conscious will...
The whole video:
The moral ethics of assisted suicide
The end of the video:
I revamped my living room come look
Thank youu ,,
This piano is kinda creepy as background music for the subject matter of discussion.
Only video I don't have to increase playback speed. 🙄
I can only speak or type for myself I would love to be put to sleep (transferred to a better world with some help in a pain free way) my decision my life my body
Why is there loud piano music interrupting the speakers? It became so annoying that I clicked it off.
It's hard to think of hypotheticals until you;re actually in the situation. Its easy for us to judge and make those judgments. Its all case by case I feel. Are you being humane by ending suffering and how good is palliative care. You love a person enough not make them want to suffer, that is love for a human
The advance directive that patients can use to say that they refuse a treatment that could save their life or a DNACPR form, are they not forms of euthanasia? I don't know I confuse those situations with euthanasia.
Ali Abdaal that is a lot clearer, thank you. A really useful video
Canada has MAiD ( Medical Assistance in Dying ) , a protocol which is working very well ! As well Marijuana is legal in Canada ! Why is the UK still in the Dark Ages ?
I don’t understand the difference between passive euthanasia and withdrawing/withholding treatment
Passive euthanasia would be withholding treatment with intent to kill the patient (I believe), and withholding treatment on its own should be looked at as if the treatment isn't helpful anymore, so your intent isn't to end their life, but stop the treatment as it isn't useful
@@jorgia2889 ah ok I get it now thank you!
Consider the following:
All the 'right to lifers' who believe that life itself is so sacred, then why do they support war and those who support war? For 'right to lifers', isn't even the death of our enemies wrong? And if life itself can be ended in war, and that is somehow okay, then that should surely open the door for legalizing suicide, or at least making suicide not illegal. Ending life is ending life.
Humans put animals to sleep that are suffering, and call it 'humane'. But yet keep humans alive no matter how much they might be suffering.
And note apparent reality also:
1. We are all going to die one day from something.
(The actual evidence for this is overwhelming).
2. We are all going to forget everything we ever knew and experienced.
(While modern science does not fully know what consciousness is, memories and thoughts all appear to require a correctly functioning physical brain for those things to occur. When the physical brain stops functioning for it's final time, 'we die', for all of future eternity. The sum total of our existence is only what we leave behind, including how our existence affected the larger society that we existed in. And for as long as humans have existed for, there has always been humans left in the larger society for human life to have continued meaning and purpose to.)
3. We are all going to be forgotten one day in future eternity as if we never ever existed at all in the first place.
(Future eternity being a really, really long time. Plus, without a successful space program, [if it's even actually possible to do for various reasons], all life from this Earth is going to die and go extinct. Or so the current analysis indicates.)
4. Life itself is all ultimately meaningless in the grand scheme of things. And sure, life itself matters to life itself, but only as long as life itself still exists. It's just that life itself is not always going to exist, at least not from this Earth. Successful space program (if it's even actually possible to do), OR die and go extinct. Those are the choices, if we even have a choice.
* And note: 'God' does not actually exist except for as a concept, we do not have a 'soul', and certainly not an immortal conscious soul, we do not have a conscious afterlife, and certainly not an actual eternal conscious afterlife throughout all of future eternity. And if we did, well, this life would not be the end. Let people die if they want to and let them move on to the next phase of living.
* Legalize suicide, or at least make suicide not illegal.
Jum. ,,,,bbhh kopp
,
Discard comment discard
@@richardhincemon9423 If you wanted your comment to be discarded, then why did you post it?
sounds like the doctor needs to just say what the UK government what they want to hear
Music is creepy while debating this topic..
Palliative care means relieving suffering. If it takes death to do that, then it should be included.
music is annoying, but thanks!
Who are these kids? ❤️
please talk a bit slower but interesting stuff
dude u say passive euthanasia is different bc ur intend is not to kill someone bc „the treatment is not in their best interest anymore“ but that means u can say „life is not in their best interest“💀💀
In the Netherlands it is legal ! A dokter may refuse to do that always ! Is sameone let to die (with passive euthanasie )no saffering? You can make a choise you can take ,the meddicine your self onder direction of a dokter ,or as an infuse ! Here was that a lot of people had taken their own life becouse the saffering was to hard to bare annymore! Taken an overdosering morfine is a hard and a horrible way to go ,even as a young girl over here, she yump under the train and Look terrebly ! For the parends not a prittey sight to see! Here it is useable to write a note and geven that to your dokter ,for a time that you are unable to say that (beter is to held that note recent and make at least every 4/5 yaers a new one! I had cancer for two tames an i had those last wil given to my docter! It gave my a sort of pease!
,
Is that a guy or girl on the right? Just curious. I can't figure it out.
I been considering the old cya-later-alligator and was wondering when this will be made over-the-counter
We could have done without the sad music. Its annoying
Can someone help me I would like to die with dignity it is my life if I had a choice I would stop my conception long time ago
I'm so sorry that you feel this way, do you have anyone to talk to?
@@eniola8160 No. She was euthanized in Oregon. She had a brain cancer.
The problem with the Dr Cox case is really he took the matters in his own hands…….yes the patient was suffering, and the patient expressed their suffering, but Dr Cox was playing God to terminate the patient life himself.
Ali. You keep talking about your educational company. What is it about?
How do you render more humane assistance to the dieing patient, instead of any form of the three listed in the video coverage please?
The piano player makes people want to die faster.
bruhhhhhhhhhhhhhh. the other video is blocckeeeeddd
Inversion...
pain free death is humane yeah dehumanization
майя кристалинская топ-топ🍳
Czlowieku, ja się mecze. to są męki. jeżeli nie przeszedłeś przez lata nieszczęść upadlania to tego nie zrozumiesz you will never know what it is like to give birth
🐋
you goint too fast
Pls slow down speaking.
I beg for mercy killing for years. If I died 30 years ago it would save me from hell on Earth. If I wasn't conceived it would be even better. I did not ask to be conceived. Each person is different. It is my horrible life after all and my body and my soul.
U were commenting the same thing on this vid last year.. Are u ok? What’s wrong?
"Now the serpent was more subtil than any beast of the field which the LORD God had made."
"Beware of false prophets, which come to you in sheep's clothing, but inwardly they are ravening wolves."
"Thou Shalt not Kill."
Bam! The Truth is so simple.
This doesn't prove anything but the fact that some people love to use religion to make others suffer
I don't believe in your imaginary god so why should I have to abide by your childish beliefs
This kinda convince me why I can't be a doctor. Working as medical lab technologist are the most suitable for me perhaps.🥲😅