Campbell, Lorna Jane

2018-01-31T11:41:02Z

2018-01-31T11:41:02Z

2004

Such is the powerful, emotive nature of the subject of euthanasia that its reach stretches beyond the pages of specialised medical journals or the conference rooms of an interested few. Despite this, investigation into the historical origins of current euthanasia debates has, until very recently, been a neglected area of academic interest. Contemporary euthanasia debates are often presented in a manner where the values at stake are viewed as essentially a historical and my thesis seeks to address this imbalance.

Beginning in the late nineteenth century and continuing throughout the twentieth century, the medical profession and lay writers in Britain mobilised an array of philosophical and technical arguments in order either to support or oppose euthanasia. My thesis elucidates and explores these arguments, tracing them through two centuries of changing attitudes towards death, suffering and pain. The thesis starts by examining how powerful pain-relieving drugs that rendered the patient unconscious were adopted into the repertoire of nineteenth-century medical practice. Then, with the position of this new form of pain relief consolidated, the first lay demands for euthanasia surfaced in the form of proposals that the incurable, suffering patient be made irrevocably unconscious so as to secure a medically-managed, painless death.

Moving into the twentieth century, the official line of the medical profession was one that defended the use of pain relief that potentially shortened life but contested any suggestion that death be brought about at the patient's request. However, by the middle of the twentieth century, support for legalised euthanasia was more sustained and organised. The question of pain - whether it could be relieved and how it was to be managed - was now entrenched in the debate over euthanasia. It was in this context that the hospice movement emerged, where sophisticated pain-relieving technologies were harnessed with a distinct ideology that rejected legalised euthanasia. As I explore at the end of my thesis, this provided an institutional 'solution' to the problem of how to care for the dying patient in pain as well as a template for an 'ideal' form of death that stood as an alternative to legalised euthanasia.

Informed by the methodological approaches of history and sociology, my analysis incorporates close readings of unpublished archive literature, set alongside wider surveys of pertinent primary and secondary sources. I focus on the process of how the values and ideas connected with arguments over euthanasia were articulated, placing particular emphasis on the way in which the negotiation and interpretation of medical practice fed into debates about the management of death. Throughout the thesis, I examine how the concept of 'natural' death was mobilised in a variety of ways, serving as part of the rhetorical strategies used by those on both sides of the debate. I conclude that the medical profession's commitment to the Hippocratic principle, that the physician should not kill, involved the accommodation of medical interventions in order to relieve pain in the dying patient. At the same time, however, this tended to exclude any notion that such interventions disrupted the concept of 'natural' death. This negotiation between principle and practice, I contend, is central to understanding historical arguments over euthanasia and, indeed, remains an ongoing process underpinning the construction of current debates.

http://hdl.handle.net/1842/27753

The University of Edinburgh

Annexe Thesis Digitisation Project 2017 Block 16

Already catalogued

Principle and practice : an analysis of nineteenth and twentieth century euthanasia debates (1854-1969)

Thesis or Dissertation

PhD Doctor of Philosophy