School of Politics Philosophy and International Studies Module Handbook

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School of Politics Philosophy and International Studies

Module Handbook


Euthanasia, Physician-assisted Suicide, and

Death with Dignity
Module No: 30012
Level: 5
Semester: 1
Credit Value: 20
Module Leader: Prof. Raphael Cohen-Almagor
Pre-requisites: None

Co-requisites: None

Post-requisites: None

Anti-requisites: None

Total Contact: 10 x 2 hour weekly seminars

Assessment: Class presentation (20%)

Class participation (10%)

Final paper of 4,000 words (70%).

Staff contact: (Tel) 01482 465024



This handbook is available in alternative formats on request from the School

1. General Outline and Aims of the Module

2. Learning Outcomes

3. Method of Teaching

4. Module Assessment

4.1 Essay Plans and Draft Essays

4.2 Essay Submission

4.3 Essay Deadlines

4.4 Essay Format

4.5 Plagiarism

4.6 Essay Length

4.7 Class Presentations

5. Your Right of Appeal

6. Marking Criteria

7. Essay Titles

8. Lectures

9. Tutorial ‘Tips’

10. Reading List

11 Module Evaluation Questionnaires
PLEASE NOTE: The Department of Politics and International Studies operate a policy of continuous quality enhancement, reflecting on the previous year’s practice and specific feedback such as that gained through the Staff/Student Committee, to ensure that it provides the highest quality student experience possible. As a consequence we review, and where necessary revise our policies on a yearly basis. Where this has resulted in a change in the Department’s regulations year this will be indicated by a in the margin of this handbook.


This module addresses the following questions: (1) What notions are associated with the term “dignity”? (2) What does it mean to say that human life has an intrinsic value? (3) Whether or not life can be intrinsically important independently of the interests of the person concerned, i.e., how can we accommodate between the model of thinking which holds that human life is inherently valuable and the model of thinking which takes into consideration the autonomy, rights and interests of the individual. More specifically, how can we decide between, say, the duty of keeping a person alive and her right to keep her dignity (which may also be considered as an intrinsic value)? (4) What rights do people who suffer from an incurable disease possess?, and (5) what role and weight are assigned to economic considerations. Finally, (6) does a liberal society have a duty or some form of communal obligation to keep people alive? Here consideration will be given to the financial costs involved in keeping people alive for months, sometimes for years. The module will reflect on the experiences of various countries as they address end-of-life issues: The United Kingdom, The Netherlands, Belgium, Switzerland and the USA.

By the end of the module students should:

  • be able to think critically about end of life issues.

  • be versed with the situation in the western world.

  • understand relevant concepts: autonomy, consent, living will, physician-assisted suicide, euthanasia, mercy killing

  • be able to critically examine the relationships between patients, their families and physicians.

PLEASE NOTE: the following sections should be read in conjunction with the University’s Quality Handbook which contains all the relevant Programme Regulations and is available at: You should also consult the Student Handbook which is available at:

Teaching will be by way of weekly seminars conducted by Professor Cohen-Almagor.
Attendance at ALL CLASSES is compulsory and will be monitored accordingly. Failure to attend compulsory classes is a disciplinary offence. Students are also required to attend punctually. Students who arrive ten or more minutes after the scheduled start of a class will be marked as absent, though they will be permitted to remain in the class and to participate.
Students should be aware that, under Paragraph 4(a) of the University’s Programmes Regulations - Honours Degrees, a student who has not met the specified module requirements relating to attendance may be denied the right of re-assessment in that module. Persistent non-attendance may, in accordance with Paragraph 27(a), result in exclusion from assessment and/or termination of a student’s programme of study.

4.1 Essay plans and draft essays

In order to ensure equity, students may submit an essay plan, consisting of headings and sub-headings, of no more than one side of A4 paper. Alternatively students may discuss with tutors the broad plan of their essay. Tutors will not comment on draft essays. Please note that the purpose of submitting an essay plan or discussing an essay is to gain advice on essay content. Students concerned about essay preparation and writing skills (e.g. footnoting, bibliography, use of English etc.) should refer back to the Department’s study skills programme and/or seek advice from the University’s Study Advice Service. (For further details see

4.2 Essay Submission

All assessed coursework must be submitted using ‘turnitinUK’, an anti-plagiarism software package. This software compares essays against a number of sources and produces a report indicating the extent to which the essay matches these sources. Markers are then required to consider the matches indicated to ensure that, where the work of others has been used, it has been appropriately referenced.

Use of turnitinUK requires electronic submission of essays. Consequently, you must complete a two stage submission process, submitting an electronic copy AND a hard copy of your essay. Until you have completed both of these stages you will be deemed not to have satisfied the submission requirements. It is your responsibility to ensure that you leave yourself sufficient time to complete the whole submission process.

Firstly, you must submit an electronic copy of your essay. Instructions on how to do this, including on how to acquire a turnitinUK ‘paper ID number’ verifying your essay submission are provided below. You must follow them carefully. You will not be able to submit the hard copy of your essay without the relevant turnitinUK ‘paper ID number’.

  • To submit the electronic copy of your essay you should proceed as follows:

○ Go to

○ Click

Log in by entering your university email address and the turnitinUK password which has been emailed to your university email account by turnitinUK.

○ This will take you to your turnitinUK homepage, on which are listed the modules for which you are registered this semester.

○ Click the title of the module for which you wish to submit an essay.

○ Click the icon which appears in the submit column.

○ Enter a submission title, attach the file which contains your essay and click submit.

Please note that turnitinUK accepts the following formats: Microsoft Word, WordPerfect, RTF, PDF, Post-Script, plain text, and HTML)

○ Check that you have submitted the correct essay for this module and then click .

○ A digital receipt will now appear on screen. Directly below the title of the essay you have submitted you will see your ‘paper ID’ number. Write it down. This number is unique to the particular essay you have submitted for the module. You must enter this number when you complete the cover sheet which accompanies the submission of the hard copy of your essay.
Secondly, you must submit a hard copy of your essay. The hard copy submission must be an exact copy of the electronic copy. You must not alter it in any way. Submission of non-identical copies of your essay may be deemed to constitute use of unfair means and will be dealt with accordingly.

  • To submit the hard copy of your essay you should proceed as follows:

Essays must be handed into the Politics Departmental Office.

○ You must attach a completed Departmental essay receipt form to your essay. Essays will not be accepted without a fully completed cover sheet attached.

○ You must submit your essay by the deadline indicated in this module handbook. The date/time at which you submit the hard copy of your essay will be deemed to be the formal point of submission. Penalties for late submission will be calculated from this date/time

4.3 Submission Deadlines

The Department has a strict policy with regard to the late submission of essays and it is essential that you are familiar with this. Generally, essay submission dates are standardised across each academic year. This means that you will have several essays to submit on one day, but it does not mean that you should start work on them all at the same time! Time management is an essential study skill and it is your responsibility to ensure that all stipulated deadlines are complied with.
Essay extensions will not be given under any circumstances. Students should always endeavour to submit work on time, but if you are unable to do so you should submit the work as soon as reasonably possible, accompanied by a mitigating circumstances form (on which you must explain why your essay was late) and supporting documentary evidence (e.g. a medical certificate). What is likely to be deemed to be ‘reasonable’ will vary depending on the circumstances and you are strongly advised to contact your Head of Year regarding this matter. Please note, however, that whilst Heads of Year are able to advise on appropriate timeframes for submission, they cannot give extensions.
Mitigating circumstances must be submitted within 7 days of the essay submission date if your mitigating circumstances are to be considered by the Department. If you fail to submit your mitigating circumstances within this 7 day limit they may only be considered by the Department with the permission of the University’s Student Progress Committee. A mitigating circumstances form can be obtained from the Departmental Office, via the Department’s eBridge site, or at
At the end of the semester, the Department’s Academic Progress Committee (DAPC) will consider evidence submitted by students who have failed to comply with submission deadlines and decide whether any penalty should be applied. In the absence of evidence demonstrating good cause, a deduction of five percentage points (marks) per day will be levied (excluding weekends and Bank holidays). The imposition of penalties begins from the deadline on the day of submission (12.00 noon), with the deduction of a further five percentage points for every subsequent 24 hours which pass without submission. PLEASE NOTE: Marks deducted WILL NOT be indicated on essay feedback sheets. Students will be notified in writing by the Departmental Office of any marks deducted by the DAPC. (Examples: The following assume a submission deadline of 12.00pm (noon), Monday, 1st December; late submission without good cause; and that, without penalty, the essay would receive a mark of 60%. Example 1: Essay submitted at 3.00pm on Monday 1st December. Outcome: Essay deducted 5 percentage points and receives a mark of 55%. Example 2: Essay submitted at 11.00am on Wednesday, 3rd December. Outcome: Essay deducted 10 percentage points and receives a mark of 50%. Example 3: Essay submitted at 3.00 pm on Wednesday, 3rd December. Outcome: Essay deducted 15 percentage points and receives a mark of 45%.)
Please note that computer problems (e.g. printing problems, corrupted or unreadable discs, incompatible software, lost or stolen hardware etc.) will not be accepted as grounds for late submission. The Department will assume that you have taken all reasonable steps to protect your work. It is, therefore, strongly recommended that you backup your work on a regular basis and that you use of the University shared drive. Alternatively, emailing your work to yourself will ensure that it is not lost.
Students should be aware that, under Paragraph 4(a) of the University’s Programmes Regulations - Honours Degrees, a student who has not met the specified module requirements relating to submission of assessed work may be denied the right of re-assessment in that module. Failure to attend exams as scheduled may also adversely affect your chance of being referred in a module should you fail to pass it. Persistent failure to comply with submission deadlines may, in accordance with Paragraph 27(a), result in exclusion from assessment and/or termination of a student’s programme of study.
Students with a registered disability, officially recognised by the University’s Disability Service should consult the Department’s Disabilities Tutor regarding the submission schedule for their essays. As appropriate, the Disabilities Tutor will authorise staggered deadlines, but these must be formally applied for and agreed. Once agreed these deadlines must be strictly adhered to. Work submitted other than in accordance with this agreed schedule will be dealt with in accordance with the procedures outlined above.

4.4 Essay Format

Essays must be word-processed. Essays will be retained to allow for double marking and (where necessary) external verification. Students wishing to have a copy of their essay returned should submit work in duplicate.

Essays must be correctly referenced. Students are advised to use the system of annotation laid out in the Departmental Student Handbook. Quotations MUST be indicated either by the use of quotation marks or by indentation of the quoted text; use of a footnote is not, on its own, sufficient. Please also note that references are required not only when using a direct quotation. They must also be included when summarising, paraphrasing or interpreting arguments put forward by another scholar. Annotating essays is an integral part of essay writing and is, therefore, one of the many elements taken into account in marking work. Accordingly, essays which are not correctly referenced will be penalised. Failure to correctly reference may also give rise to an allegation of plagiarism (see Section 4.5 below).
A full bibliography, arranged alphabetically by author surname, should also be attached to the end of essays. The bibliography must contain all sources referred to, including sources of general use but not specifically cited in the footnotes.

4.5 Plagiarism and ‘self-plagiarism’

Plagiarism - passing off the work of others as your own - is a serious academic offence. It is considered to be a use of ‘unfair means’ and the University, Faculty and Department have clear policies to deal with it. ‘Self-plagiarism’ is also strictly prohibited. Self-plagiarism is the submission of a piece of work, in part or in whole, on more than one occasion and may be considered to be a form of unfair means. All allegations of plagiarism (and all other matters relating to the use of unfair means) will be referred to the Dean of Faculty and will be dealt with in accordance with University regulations under the Code of Practice on the Use of Unfair Means available at All students should fully apprise themselves of these documents.

4.6 Essay Length

This module handbook clearly specifies the maximum length of the essay which you must submit. Your essay must not exceed this limit. Essays which exceed the stipulated maximum word length, even by one word, will be penalised as set out below. There are two reasons for this: firstly, being able to produce work of a specified length is an important skill and an integral part of essay writing; secondly, ensuring that students’ work does not exceed a stipulated word length makes essay based assessment more equitable.

Amount over word limit

Marks deducted

Up to 25%


Over 50%

10 marks

25 marks

Mark of zero awarded

You must declare the word length of your essay on the cover sheet. It is your responsibility to provide a word count which is accurate and which complies fully with the regulations stated in this handbook. The word count which you declare will be taken to be definitive. Please note, however, that declaring an inaccurate word count may be deemed to constitute the use of unfair means.

Please note that citation footnotes/references and your bibliography must not be included as part of the declared word count. However, textual footnotes must be included in the word count. A citation footnote is one which simply shows the source(s) you have used e.g. J. Goldstein, International Relations (4th Edition) (New York: Longman, 2000) A textual footnote is one which is composed of prose and which is intended to provide the reader with information additional to that contained within the main body of text.

4.7 Class Presentations

Each student must make two assessed tutorial presentation. Presentation topics and presenters will be decided upon during the first tutorial session.

Each tutorial presentation should be 20 minutes long and must be accompanied by a one-page summary to be prepared before the session. Copies of the summary must be handed out to the tutor and all students present at the beginning of the tutorial.
Assessment of the work shall be based on content as well as presentation of the work (oral as well as written summary). Presentation dates and topics can only be changed with the explicit agreement of the tutor. In such circumstances the student is responsible for finding another student willing to switch with them. Failure to present your agreed tutorial paper (without valid excuse) at the appointed date and time will result in a mark of zero for the assessment. It should also be noted that failure to meet the specified module requirements relating to assessed tutorial presentations may result in denial of the right of reassessment for the module.

You have the right to appeal against decisions taken regarding your academic progress, including the award of a qualification. You may not, however, appeal against academic judgement. For further information see Impartial advice on appeals is available from the Students’ Union Advice Centre (details available at or the Senior Tutor responsible for students within the Department of Politics and International Studies. The Senior Tutor is currently Dr Nigel Young. Dr Young can be contacted by telephone on 465442 or by email at
Choose one of the following titles (1st Essay):


  1. Should euthanasia or physician-assisted suicide be legalized in the United Kingdom?

  2. Should the United Kingdom adopt the Groningen Protocol?  

3.   Under which circumstances terminal sedation is justified? 

4.   Should physicians assist demented people to die?

Essay Deadline: 12.00pm (noon) 26 April 2015.

1. The Right to die with Dignity - Terminology
2. Mercy Killing – Euthanasia and Physician Assisted Suicide
3. The Role of Physicians
4. The Role of the Patient's Beloved People/Families

5. The Role of Politicians

6. Ethics of Allocation of Scarce Resources
7. CASE STUDIES: The United Kingdom
8. CASE STUDIES: The Netherlands

9. CASE STUDIES: Belgium

10. CASE STUDIES: Switzerland
In preparing for tutorials you should note the following points:

  • The reading material in this reading list is split into two basic categories. Firstly, a number of core texts are listed. These should be referred to throughout the module, prior to the reading listed for each tutorial. Rather than single out a particular text for purchase, it is recommended that you coordinate your purchases with friends/other students in your tutorial group or with whom you otherwise study. This way, in preparing for tutorials, you will have immediate access to a wider range of material.

  • In addition to core texts, specific texts are listed for each tutorial topic. The literature listed here does not constitute an exhaustive reading list. Students should use their initiative in preparing for classes; use the library’s computer system to search out material and in particular refer to the extensive range of journals available.

  • When referring to books use your common sense. For guidance this reading list often cites specific book chapters, but many of the books referred to will have been published in a number of editions and in each edition chapters may have changed. For this reason it is important that you use the chapter references for guide purposes only.

  • Consider your fellow students. Inevitably library resources are not infinite; we don’t have a copy of every book for every student. Do not take books out of the library and have them sitting, unused, in your room while others strive to get hold of them. Photocopying requisite chapters and returning the book immediately to the shelf maximises access for others. This method also allows you to write on or highlight the photocopied text without damaging the original copy.

  • When using electronic resources you must be discerning. Many recognised, refereed journals are now available on-line and these are an invaluable resource. At the other end of the scale is a vast array of material posted by people who know little if anything about the topic on which they have chosen to write. So it is crucial that you remember that anyone can post anything; see, for example, my guide to open-heart surgery!

  • Some of the material you are asked to read is difficult. The language used and arguments forwarded are often complex. Don’t be afraid! You won’t understand everything that you read, but then, if it were that simple, people wouldn’t be able to build careers arguing about the issues raised.

  • Finally, remember that the key in preparing for tutorials is that you should be able to make a worthwhile contribution to the topic of debate. You may find it advantageous to work in groups in preparing for tutorials (though work on essays should be yours and yours alone!) as discussing matters in this way can often help clarify them. Group working also allows for the division of labour, hence maximising the amount of material you can cover, and the sharing of books etc. Whichever working practice you adopt, it is not necessarily expected that you read everything listed, but it is expected that you read something!


The most important readings are:

Raphael Cohen-Almagor, The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law (Piscataway, NJ.: Rutgers University Press, 2001).
Raphael Cohen-Almagor, Euthanasia in the Netherlands: The Policy and Practice of Mercy Killing (Dordrecht: Springer-Kluwer, 2004).

Items in BOLD infra are compulsory. The rest are optional but it is expected that class presenters will relate to the optional readings in their respective presentations. The optional material is designed to help you in the writing of your essays.

Seminar 1:

The Right to die with Dignity - Terminology
Why phenomenology is important?

What are the contested terms?

Can you think of other medical concepts and terms that do not necessarily serve the best interests of the patients?

Critique of reading


Cohen-Almagor, Raphael, "Language and Reality at the End of Life", The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law (Piscataway, NJ.: Rutgers University Press, 2001), chap. 1.
Derse, Arthur, “Is there a lingua franca for bioethics at the end of life?”, Journal of Law, Medicine and Ethics, Vol. 28, No. 3 (Fall 2000), pp. 279-284.

Cohen-Almagor, Raphael, “A Concise Rebuttal”, Journal of Law, Medicine and Ethics, Vol. 28, No. 3 (Fall 2000), pp. 285-286.


* Smith, Stephen W., End-of-Life Decisions in Medical Care (Cambridge: Cambridge University Press, 2012), pp. 128-144.

Seminar 2:
Mercy Killing – Euthanasia and Physician Assisted Suicide
Autonomy: The Rights and Interests of the Individual

What does the sanctity-of-life doctrine claim?

What does the quality-of-life doctrine claim?

What is the difference between active and passive euthanasia?

What interests do patients have?

What are the main differences between Dworkin and Cohen-Almagor?

Critique of reading


Cohen-Almagor, Raphael, “Sanctity and Quality of Life in Medical Ethics”, in The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law (Piscataway, NJ.: Rutgers University Press, 2001), chaps. 3, 4, 5.
Dworkin, Ronald, Life's Dominion (New York: Knopf, 1993), chaps. 7, 8.


* Beauchamp, Tom L. “The Autonomy Turn in Physician-Assisted Suicide”, in R. Cohen-Almagor (ed.), Medical Ethics at the Dawn of the 21st Century (New York: New York Academy of Sciences, 2000), pp. 111-126.

* Smith, Stephen W., End-of-Life Decisions in Medical Care (Cambridge: Cambridge University Press, 2012), pp. 74-93.


* Cohen-Almagor, Raphael, The Boundaries of Liberty and Tolerance (Gainesville, FL.: University Press of Florida, 1994), chap. 1.

* Klemens Kappel and Peter Sandoe, “QALYs, Age and Fairness”, Bioethics, Vol. 6 (1992), pp. 297-316.

Seminar 3:

The Role of Physicians
What do you think of Dr. Kevorkian’s conduct?

What is the role of the doctor?

Should physicians propose euthanasia to their patients?

What do we learn from the experience of other countries?

The role of religion

Critique of reading


Kevorkian, Jack, Prescription: Medicide (Buffalo, N.Y.: Prometheus Books, 1991), chap. 11.
Singer, Peter A., "Should Doctors Kill Patients?", CMAJ, Vol. 138 (June 1988), pp. 1000-1001.
Ganzini, Linda, Heidi D. Nelson, Terri A. Schmidt, Dale F. Kraemer, Molly A. Delorit, Melinda A. Lee, “Physicians’ Experiences with the Oregon Death with Dignity Act,” New England Journal of Medicine, Vol. 342, No. 8 (February 24, 2000).

Video: 60 Minutes with Jack Kevorkian


* Faber-Langendoen, Kathy and Jason T.H. Karlawish, “Should Assisted Suicide Be Only Physician Assisted?,” Annals of Internal Medicine, Vol. 132 (21 March 2000): 482-487.

* Roy, David J, John R. Williams and Bernard M. Dickens, Bioethics in Canada (Scarborough, Ont.: Prentice Hall, 1994), chap. 5.
* Elliott, Carl, “Philosophers’ Assisted Suicide and Euthanasia”, BMJ, Vol. 313 (1996), p. 1088.
* Cohen-Almagor, Raphael, Euthanasia in the Netherlands: The Policy and Practice of Mercy Killing (Dordrecht: Springer-Kluwer, 2004), chap. 8.


* Blendon, Robert J. et al, "Physicians' Perspectives on Caring for Patients in the United States, Canada and West Germany", New England J. of Medicine, Vol. 328, No. 14 (1993), 1011-1016.

* “Doctors' Religious Beliefs Strongly Influence End-of-Life Decisions, Study Finds”, Science Daily (26 August 2010),

* “UK Doctors Consistently Oppose Euthanasia and Assisted Suicide”, Science Daily (9 March 2011),

Seminar 4:

The Role of the Patient’s Beloved People/Families
Should we insist that only families have part in the decision-making process?

What part should families play?

How do we prevent potential abuse?

Critique of the reading.


Hardwig, John, “The Problem of Proxies with Interests of Their Own,” in Is There A Duty to Die? (New York and London: Routledge, 2000): 45-60.
Cohen-Almagor, Raphael, The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law (Piscataway, NJ.: Rutgers University Press, 2001), chap. 6.
Beauchamp, Tom L. and James F. Childress, Principles of Biomedical Ethics (New York: Oxford University Press, 1994, 4th edition): 170-188.

Seminar 5:

The Role of Politicians
To what extent should politicians intervene in end-of-life issues?

What criteria should guide end-of-life legislation?

To what extent should the law intervene in end-of-life issues?

The relationships between ethics and policy making

Critique of the readings.


Smith, David and Sarah-Kate Templeton, “Public in strong backing for right to assisted suicide”, The Sunday Times (14 December 2008).

Michael Schiavo v Jeb Bush, Sixth Judicial Circuit, Florida (May 2004).
Call for debate on suicide laws”, BBC News (31 July 2009),

Hirsch, Afua, “Assisted suicide ban forcing terminally ill to die early, Lords told”, The Guardian (2 June 2009).

Holmes, David,Legalise assisted suicide, UK Commission urges”, The Lancet, Vol. 379, Issue 9810 (7–13 January 2012), p. 15.


* Dyer, Clare, “Purdy wins battle for clarity of law for people who accompany relatives abroad for assisted suicide”, BMJ 339 (2009), p. b3131.


* The Commission on Assisted Dying, “The current legal status of assisted dying is inadequate and incoherent...” (London: Demos, 2011).

Seminar 6:

The Ethics of Allocation of Scarce Resources
What health model is preferable?

How do we need to allocate scarce resources?

Is Callahan’s model just?

How should we relate to the futility argument?

Critique of the reading.

Callahan, Daniel, The Troubled Dream of Life (N.Y.: Simon and Schuster, 1993), pp. 198-219.
Helft, Paul R. Mark Siegler and John Lantos, “The Rise and Fall of the Futility Movement,” New England Journal of Medicine, Vol. 343, No. 4 (27 July 2000): 293-296.

Video: Near Death


* Roy, David J, John R. Williams and Bernard M. Dickens, Bioethics in Canada (Scarborough, Ont.: Prentice Hall, 1994), chap. 14.

* Cohen-Almagor, Raphael, “Ethical and Financial Considerations in Allocating Healthcare Resources: A Comparative Analysis”, in The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law (Piscataway, NJ.: Rutgers University Press, 2001), Appendix.
* Jackson, Emily and John Keown, Debating Euthanasia (Portland: Hart, 2012), pp. 128-136.

Seminar 7:

What is the present legal situation in Britain?

Is it suitable for Britain or should it change?

If it should change, in what form?

Critique of reading.


Queen on the application of Dianne Pretty v. Director of Public Prosecutions and Secretary of State for the Home Department [2001] UKHL 61 (29 November 2001).

R (on the application of Nicklinson and another) v Minister of Justice [2014] UKSC 38.


* Airedale NHS Trust v. Bland, [1993] 1 All ER.
* Nicklinson v Ministry of Justice & Ors [2012] EWHC 304 (QB) (12 March 2012),


* Finnis, J.M., "Bland: Crossing the Rubicon", The Law Quarterly Rev., Vol. 109 (July 1993), pp. 329-337.

* Keown, John, "Doctors and Patients: Hard Case, Bad Law, 'New' Ethics", Cambridge L. J., Vol. 52, No. 2 (1993), pp. 209-213.

Seminar 8:

What are the main differences between the Netherlands and Belgium?

Which model is preferable? Why?

Is there abuse in the Netherlands and Belgium?

Do they present a good model to follow?

Critique of reading.


Onwuteaka-Philipsen, B.D., A. van der Heide, D. Koper, I. Keij-Deerenberg, J.A.C. Rietjens, M.L. Rurup, A.M. Vrakking, J.J. Georges, M.T. Muller, G. van der Wal, P.J. van der Maas, "Euthanasia and Other End-of-life Decisions in the Netherlands in 1990, 1995, and 2001," Lancet, Vol. 362 (August 2, 2003): 395–399.
Cohen-Almagor, Raphael, Euthanasia in the Netherlands: The Policy and Practice of Mercy Killing (Dordrecht: Springer-Kluwer, 2004), chaps. 1, 2.
Jackson, Emily and John Keown, Debating Euthanasia (Portland: Hart, 2012), pp. 118-128.

Video: Death on Request


* Nys, Herman, "Euthanasia in the Low Countries: A Comparative Analysis of the Law Regarding Euthanasia in Belgium and the Netherlands," Ethical Perspectives, Issue 9/2 (June 2002): 73–85.

* Battin, Margaret P., “Voluntary Euthanasia and the Risks of Abuse: Can We Learn Anything from the Netherlands”?, Law, Medicine and Health Care, Vol. 20, Nos. 1-2 (Spring-Summer 1992), pp. 133-143.


* Griffiths, John, “Effective Regulation of Euthanasia and Other Medical Behavior that Shortens Life”, in Ejan Mackaay (ed.), Uncertainty and the Law (Montreal: Editions Themis, 1999), pp. 61-94.

* Battin, Margaret P., The Least Worst Death (New York: Oxford University Press, 1994).
* van Leeuwen, Evert, and Gerrit Kimsma, “Problems Involved in the Moral Justification of Medical Assistance in Dying: Coming to Terms with Euthanasia and Physician Assisted Suicide”, in R. Cohen-Almagor (ed.), Medical Ethics at the Dawn of the 21st Century (New York: New York Academy of Sciences, 2000).
* Fenigsen, R. “Mercy, Murder and Morality: Perspectives on Euthanasia. A Case Against Dutch Euthanasia”, Hastings Center Report, Vol. 19, No. 1 (Supp.) (1989), pp. 22-30.

Seminar 9:

What are the main differences between the Netherlands and Belgium?

Which model is preferable? Why?

Is there abuse in the Netherlands and Belgium?

Do they present a good model to follow?

Critique of reading.

Euthanasia in Belgium: 10 Years On”, Dossier of the European Institute of Bioethics (2012).

Bilsen, J. J. Cohen, K. Chambaere et al. “Medical end-of-life practices under the euthanasia law in Belgium”, New England Journal of Medicine, 361 (2009), pp. 1119–1121.
Chambaere, K., J. Bilsen, J. Cohen et al., Physician-assisted deaths under the Euthanasia Law in Belgium: a population-based survey”, Canadian Medical Association Journal, 182(9) (2010).


* Provoost, Veerle et al., "Medical End-of-life Decisions in Neonates and Infants in Flanders", Lancet, Vol. 365 (2005), pp. 1315-1320.

* Cohen-Almagor, Raphael, “Belgian Euthanasia Law - Critical Analysis”, Journal of Medical Ethics, Vol. 35, Issue 7 (2009), pp. 436 – 439.   
* Cohen-Almagor, Raphael, “First Do No Harm: Pressing Concerns Regarding Euthanasia in Belgium”, The International Journal of Law and Psychiatry, Vol. 36 (2013), pp. 515-521.


* Cohen-Almagor, Raphael, “Euthanasia Policy and Practice in Belgium: Critical Observations and Suggestions for Improvement”, Issues in Law and Medicine, Vol. 24, No. 3 (Spring 2009), pp. 187-218.

Seminar 10:

Should we insist that only physicians prescribe PAS?

Is PAS universal right to all people, notwithstanding their nationality?

Should there be an explicit law?

Should we insist that patients suffer from an incurable disease?

Should we insist that end-of-life decision-making be left to the State?

Critique of reading.


Hurst Samia A., and A. Mauron, "Assisted Suicide and Euthanasia in Switzerland: Allowing a Role for Non-physicians," British Medical Journal, Vol. 326 (February 1, 2003): 271–273.
Bosshard, G., S. Fischer and W. Bar, "Open Regulation and Practice in Assisted Dying – How Switzerland Compares with the Netherlands and Oregon," Swiss Medical Weekly, Vol. 132 (October 12, 2002): 527–534.
Ziegler, Stephen J., “Collaborated Death: An Exploration of the Swiss Model of Assisted Suicide for Its Potential to Enhance Oversight and Demedicalize the Dying Process”, Journal of Law, Medicine and Ethics (summer 2009): 318-330.
Gentleman, Amelia, “Inside the Dignitas House”, The Guardian (Wednesday 18 November 2009).

Video: Terry Pratchett: Choosing to Die


* Black, Isra, “Suicide Assistance for Mentally Disordered Individuals in Switzerland and the State’s Positive Obligation to Facilitate Dignified Suicide”, Medical Law Review, Vol. 20 (Winter 2012): 157-166.


* Wagner B. Muller J, Maercker A., “Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide”, European Psychiatry 27 (2012), pp. 542–546.

Seminar 11:

Case Studies: USA
Is the Oregon model a good model to follow?

How does it compare to the Dutch, Belgian and Swiss model?

What are its strengths?

What are its weaknesses?

Critique of reading.

Steinbrook, Robert, “Physician-Assisted Death — From Oregon to Washington State”, New England Journal of Medicine Vol. 359 (December 2008), pp. 2513-2515.

O’Reilly, Kevin B., “Physician-assisted suicide legal in Montana, court rules”, American Medical News (January 18, 2010),
Finlay, I. G. and R. George, “Legal physician-assisted suicide in Oregon and The Netherlands: evidence concerning the impact on patients in vulnerable groups: another perspective on Oregon’s data”, J Med Ethics, Vol. 37 (2011), pp. 171-174.


* Cohen-Almagor, R. and Monica G. Hartman, “The Oregon Death with Dignity Act: Review and Proposals for Improvement”, Journal of Legislation, Vol. 27, No. 2 (2001), pp. 269-298.

* Ganzini, L., Nelson H et al., “Physicians’ Experiences with the Oregon Death with Dignity Act”, Vol. 342 No. 8, The New England J. of Medicine (2000), pp. 557-563.


* Oregon’s Death with Dignity Act‐‐2011, Oregon Public Health Division,


At the end of each module students have the opportunity to fill in a Module Evaluation Questionnaire, through which they feedback on the respective module. This provides staff with valuable information to consider when reviewing their modules. Below you will find a summary of the feedback received for this module last year, accompanied by the module coordinator’s response.


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