What Kind of Death

Many books have been published about physician-assisted death. This book offers a comprehensive and in-depth examination of that subject, but it also extends the discussion to a broader range of end-of-life decisions including suicide, palliative care and sedation until death. In every jurisdiction that has laws permitting some kind of physician-assisted death, a central point of controversy is whether such assistance should only be available to dying patients, or to everyone who wants to end his life. The right to determine the manner and time of one's own death, however, does not necessarily mean that physicians should be permitted to cooperate in ensuring a quick and peaceful death. In this book, Govert den Hartogh considers the fundamental and practical matters - including concrete issues of legal regulation - related to end-of life decision making. He proposes a two-tiered system. Everyone should have access to humane means of ending his life, if his decision to end it is voluntary, well-considered and durable. But doctors should only participate in a joint action of ending the patient's life on his request if they also are convinced of acting in the patient's best interests, in particular by ending intolerable and unrelievable suffering. And perhaps there is reason to restrict that second service to dying patients. The whole argument, however, depends on the extent to which, in both tiers of the system, we can design legal safeguards that will enable us to trust judgments about the requesting person's request and about his suffering. The book considers much new evidence in regard to this issue. What Kind of Death will appeal to researchers and advanced students working in bioethics, applied ethics, philosophy of law and health law.

Govert den Hartogh is Emeritus Professor of Moral Philosophy at the University of Amsterdam, The Netherlands

Chapter 1. Introduction Part I: Suicide Chapter 2. Determining the manner and time of your own death Chapter 3. The invisibility of rational suicide Chapter 4. Which actions should we count as suicides? Chapter 5. What is implied by the right to suicide? Part II: Palliative care and palliative sedation Chapter 6. Suffering and dying well: on the proper aim of palliative care Chapter 7. Continuous deep sedation and homicide Chapter 8. Sedation until death: indications Part III: Euthanasia Chapter 9. Euthanasia and the right to self-determination Chapter 10. Ending lives with and without request Chapter 11. The risks of legalization Chapter 12. The Dutch and Belgian euthanasia laws: Potemkin villages? Part IV: Hard cases Chapter 13. Mental illness Chapter 14. Death wishes of the elderly Chapter 15. The authority of advance directives Chapter 16. Designing a regulatory system