A Pro-Choice Response to New York’s Reproductive Health Act

On 22 January 2019, New York state passed the Reproductive Health Act (RHA), which specifies three circumstances under which a healthcare provider may perform an abortion in New York: (1) the patient is within twenty-four weeks of pregnancy, (2) the fetus is non-viable, or (3) the abortion is necessary to protect the patient’s life or health. The first one, that of abortion being accessible within the first twenty-four weeks of pregnancy, is not unique to New York, as many other states allow medical professionals to provide abortions during this time. The latter two have caused significant controversy because they detail certain circumstances in which abortions would be accessible after twenty-four weeks. This paper will focus on these latter two circumstances. I will first argue that any debate or discussion about (2) must go beyond the conventional debate about the ethics of abortion and incorporate, more appropriately, a discussion on euthanasia and the ethics of end-of-life care for nascent human life. In particular, it requires us to consider the morality of non-voluntary active euthanasia for non-viable fetuses, rather than just a discussion of the ethics of late term abortions. When it comes to (3), I will argue that assessing its moral permissibility actually raises some legitimate moral concerns, even from a reproductive rights perspective. On certain readings, it seems as if condition (3) would allow for the termination of a healthy fetus for reasons not related to the mother’s physical health or life. If this is the case, I argue, the right to an abortion would be construed as a right to fetal termination, rather than just fetal evacuation. However, I will argue that there are good reasons that pro-choice advocates should interpret the right to an abortion as a right to fetal evacuation instead of termination, and if this is the case, a woman should not be able to demand the death of a healthy fetus if ending the pregnancy safely via fetal evacuation would suffice.

Euthanasia in Serbia: Attitudes of Students of Law and Medicine

Background Voluntary active euthanasia represents one of the key topics in the contemporary world medicine, law, religious, ethical and moral issues. Serbia considers legalization of this procedure. Between the others, it is important to examine the student’s attitudes regarding this issue. Methods Data were obtained from the faculties of law and medicine, from the universities of Kragujevac and Niš, Serbia. Data were collected during the second half of 2017. The research included 214 students. Due to the nature, subject and hypothesis of the research, the authors used descriptive method and the method of the theoretical content analysis. Results Generally, 54% of the students are in favor of legalization of the voluntary active euthanasia. 62, 4% would take part in the referendum on the legalization euthanasia. Conclusion The results obtained in the survey on euthanasia on a sample of law and medical students in Niš and Kragujevac indicate that choice of the faculty (law or medicine) influences the structure (share) of responses to particular questions to some extent. However, this influence does not provide ground for conclusion that students’ opinion on legalization and application of euthanasia depends on fact they study law or medicine.

Of dilemmas and tensions: a qualitative study of palliative care physicians’ positions regarding voluntary active euthanasia in Quebec, Canada

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia (VAE). Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation.

Managing Profound Suffering at the End-of-Life: Should expanding access to continuous deep sedation be the priority?

This paper argues that in addressing and managing profound suffering at the end-of-life, the priority should not be the legalization of physician-assisted suicide or voluntary active euthanasia in jurisdictions where these practices are not currently available. Rather, concerted efforts should be made by society and the healthcare provider community to expand patient access to proportionate distress-relieving sedation and continuous deep sedation.