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PubMedDate not supplied

CHA amicus curiae brief on physician-assisted suicide. Catholic Health Association.

The Catholic Health Association of the United States submitted an amicus curiae brief to the U.S. Supreme Court last October in support of petitioners Dennis C. Vacco, attorney general of the state of New York (in the case Vacco v. Timothy E. Quill, MD, et at.), and the state of Washington (in State of Washington, et al. v. Harold Glucksberg, MD, et al.). The brief was filed as the Court agreed to hear arguments on the issue of whether terminally ill people have a constitutionally protected right to physician-assisted suicide. In January 1997 the petitioners went before the Court to argue appeals to federal appellate rulings that struck down New York and Washington laws making physician-assisted suicide a crime. The Court is expected to rule in late June.

Catholicism↗
PubMed1984

Health facilities' obligations when a patient refuses treatment.

Recent cases involving the decisions of Elizabeth Bouvia and G. Ross Henninger to starve themselves to death highlight the ethical obligations of patients, health care facilities, and the courts. When a patient seeks the hospital's cooperation in his or her attempt to commit suicide, society's responsibility is not merely to restrain the patient from suicide but to offer physical care, financial aid, and personal support. The hospital's duty is to intervene, and the court's responsibility is to allow such intervention. The most compassionate way in which the hospital can help is to force-feed the patient. If a patient is mentally competent, the refusal to eat is morally wrong. The patient is morally not permitted to commit suicide, though the avoidance of treatment may be justified in cases when force-feeding would be considered an extraordinary means, because of the patient's age or physical condition, for example. If a patient is incompetent, the refusal to eat is not a fully rational act; for the hospital to refrain from force-feeding would not be considered cooperation in suicide, since the incompetent patient cannot commit suicide. To avoid court rulings that order compliance with a patient's wishes, health care facilities in the future may have to require patients or their families to agree in writing to treatment by ordinary means.

Adult↗
PubMed1988

Two ethical approaches to research on human beings.

Since World War II the Catholic Church and national and international study groups have issued separate sets of statements regarding the ethics of research involving human subjects. The Church and the study groups agree on several points, including the following: Research on human subjects is a vital part of scientific medicine. Ethical research requires the informed consent of the subject or proxy. Research on human subjects is therapeutic or nontherapeutic. The risk of harm involved in research must be considered in regard to the potential benefit. Research on human beings should be allowed only after appropriate research on animals. Researchers should practice equity in selecting subjects and scientific problems to be studied. The human subject or proxy should be free to withdraw from the research program at any time. The two sets of statements generally disagree about nontherapeutic research on embryos and about genetic research. They also disagree on the use of in vitro fertilization and embryo transplants to initiate pregnancy. The disagreements are due to dissimilar ethical systems. The Church bases ethical analysis on a study of the effect an action has on basic human goods. As a result of this analysis, the Church maintains that some human actions are good or evil in themselves. If the action is evil insofar as the natural needs and functions of a person are concerned, it is not ethically good simply because it results in a good outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Advisory Committees↗
PubMedDate not supplied

Evolution of Church teaching on prolonging life.

God gave us the gift of human life to show forth his goodness and love. We, in turn, show our love for God by respecting and fostering that gift. Thus it is not an act of responsible human love to willfully and directly end one's own or the life of another. At times, however, the choice of another good may justify the indirect surrender of human life--for example, martyrs who surrender their lives rather than deny God. From the earliest centuries of the Church, the main questions concerning care for life as an act of love for God focused on suicide and euthanasia. But as the possibility of prolonging life through medicine or surgery increased, theologians started questioning how much effort should be expended to stay alive. The terms "ordinary means" and "extraordinary means" to prolong life were gradually introduced in Catholic teaching over the centuries. "Ordinary means" originally were those readily at hand and available to all; "extraordinary means" were expensive, difficult to obtain, or inconvenient to arrange for the average person. Over the years, they were used to signify whether particular means were morally obligatory (ordinary) or morally optional (extraordinary). Today the terms "proportionate-disproportionate" and "burden-benefit" have replaced "ordinary" and "extraordinary" to a great extent.(ABSTRACT TRUNCATED AT 250 WORDS)

Catholicism↗
PubMedDate not supplied

Ethical decisions at the end of life.

A conference organised by Dr Gillian Ford, on behalf of the College Ethical and Palliative Medicine Committees, was held at the Royal College of Physicians of London on 24 March 1999. It attracted over 200 delegates, two-thirds of whom were doctors. Issues covered included hydration and dehydration in the dying patient, talking to patients and their families, the management of futility, caring for patients at home, listening to children, the limits of autonomy and a debate on the principle of 'double effect'.

Decision Making↗
PubMed2000

Sedation in the imminently dying patient.

Sedation is a clinically important therapeutic intervention in the imminently dying patient. As the patient with an advanced, irreversible illness nears the end of life, symptoms accumulate that are progressively more difficult to manage and that may become refractory to standard medical interventions. The most common of these intractable symptoms are pain, agitated delirium, dyspnea, and existential or psychological distress. Various therapeutic options available for relieving these symptoms include physician-assisted suicide, euthanasia, acceptance of unrelieved suffering, and terminal sedation. Some commentators have voiced concerns that sedating the imminently dying patient inevitably hastens death, and that this practice, in fact, is a surrogate form of physician-assisted suicide or euthanasia. Ethical arguments invoked to support the use of terminal sedation include the principle of double effect, which draws a moral distinction between the intention of an act (in this case, to relieve suffering) and its foreseen but unintended consequence (premature death). This author views sedation as a necessary, although risk-laden, procedure that, if practiced by trained, dedicated clinicians, maintains the physician's twin obligations to benefit patients and to "do no harm."

Procedural Sedation↗