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Biomedical subjects

H Kuhse

Publications and source records attributed to H Kuhse.

At least 19 recordsLinked to original sources
PubMed1991

Prolonging dying is the same as prolonging living--one more response to Long.

In earlier publications, we had argued that Paul Ramsey is inconsistent because he simultaneously asserts that (i) 'all our days and years are of equal worth' and (ii) 'that it is permissible to refrain from prolonging the lives of some dying patients'. Thomas Long has suggested that we have not shown that Paul Ramsey is inconsistent. Ramsey and we, he holds, start from incommensurable metaphysical views: for Ramsey, the dying process has religious significance--God is calling his servant home. While it is normally a good thing to keep a patient alive, it would, for Ramsey, show deafness to God's call to keep a dying patient alive. It is true we do not share Paul Ramsey's religious views. It is, however, not necessary to rely on any particular metaphysical views to refute Ramsey's position. For Ramsey's view to be internally consistent, Ramsey would have to be able to distinguish between dying and non-dying patients. We examine some of Ramsey's examples and show that his practical judgements do not allow us to draw this distinction. This means that, contra Long, we hold fast to our charge that Ramsey's view is inconsistent.

Adult↗
PubMed1991

[Ethical problems in extreme prematurity].

I examine the question whether it is always morally obligatory to sustain the life of a premature infant and come to the conclusion that this is not the case. Touching on questions concerning the value of life, I argue that it is not always in a premature infant's best interests to have its life sustained. I sharply distinguish my patient-centered perspective from that of the Nazis. Finally, I raise the question of how a premature infant should be treated when the decision has been made to allow it to die.

Child Advocacy↗
PubMed1989

The quality/quantity-of-life distinction and its moral importance for nurses.

In this paper we reject the "sanctity-of-life" view, which holds that all human lives, irrespective of their quality or kind, are equally valuable and inviolable. We argue that health-care professionals intent on acting in the patients' best interests cannot avoid quality-of-life judgments--for there is a close link between the quality, and kind of life, a patient has and her best interests. This paper reflects on some of these issues.

Decision Making↗
PubMed1988

Doctors' practices and attitudes regarding voluntary euthanasia.

We report the results of a survey of the attitudes and practices of doctors in Victoria with respect to requests for active help in dying from patients who were suffering from a terminal or incurable disease. Questionnaires were sent to 2000 Victorian doctors who had been selected at random, 869 of whom returned completed questionnaires. The survey indicates that a clear majority of those who responded to the questionnaire support active voluntary euthanasia and that many doctors have provided active help in dying. Forty per cent of doctors indicated that they would practise active voluntary euthanasia if it were legal. We compare the results of our survey with a recent telephone survey of British general practitioners.

Adult↗
PubMed1988

Age and the allocation of medical resources.

How are we to decide where our scarce medical resources are most effectively spent? The notion of a quality-adjusted-life-year has been proposed as a way of doing this. Some economists appear to think that this can be done without making ethical assumptions. We examine the application of this notion to the treatment of premature newborns, and especially to comparisons between the value of medical care for newborns, and the value of medical care for older people. We find that some highly questionable ethical assumptions are involved in such comparisons.

Aged↗
PubMed1988

Resolving arguments about the sanctity of life: a response to Long.

Thomas Long has argued that there is an irreconcilable metaphysical difference between the views of those who, like ourselves, believe that on quality-of-life grounds it is sometimes justifiable to end the life of a severely handicapped infant, and those who, like Paul Ramsey, reject this view. Because of this metaphysical difference, Long considers it impossible for our arguments to refute Ramsey's position. We disagree.

Persons with Disabilities↗
PubMed1987

Attitudes of Australian neonatal paediatricians to the treatment of extremely preterm infants.

A questionnaire survey was carried out to identify areas of consensus or disagreement in the attitudes and practices of Australian neonatal paediatricians with regard to the treatment of extremely preterm infants. Considerable variation was found in the estimated chances of survival and disability among respondents. The majority of neonatal paediatricians advocated prompt resuscitation and initiation of neonatal intensive care at birth, although all believed life-support treatment should be withdrawn in those instances where medical complications develop resulting in near certainty of death or life with total incapacity. The predominant view was for parents to be involved in the decision-making process for withdrawal of life-support and for the neonatal intensive care policy to be made known to the parents. Information from this survey which raised concerns included the variability in the estimate of the potential for survival, the lack of relevance of the law to everyday practices in the neonatal intensive care units, the small minority of respondents who felt that life-and-death decisions should be made by medical staff alone, and the reluctance of some neonatal paediatricians to inform parents about the policies of their unit.

Adult↗
PubMed1985

Euthanasia--again. "Letting die" is not in the patient's best interests: a case for active euthanasia.

Recent discussions in the Journal on the subject of euthanasia have relied on intuitive appeals to distinctions traditionally considered to be morally relevant, such as the distinction between acts and omissions (or killing and letting die), or ordinary and extraordinary means of treatment. These discussions remained inconclusive. However, the question of euthanasia no longer remains inconclusive if one adopts the perspective suggested by the United States President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and by the World Medical Assembly--that a doctor should act in his or her patient's best interests. From this vantage point, it is argued, there will be instances when active euthanasia is the proper cause of action.

Ethics, Medical↗