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PubMed2006

On the impermissibility of euthanasia in Catholic healthcare organizations.

Roman Catholic healthcare institutions in the United States face a number of threats to the integrity of their missions, including the increasing religious and moral pluralism of society and the financial crisis many organizations face. These organizations in the United States often have fought fervently to avoid being obligated to provide interventions they deem intrinsically immoral, such as abortion. Such institutions no doubt have made numerous accommodations and changes in how they operate in response to the growing pluralism of our society, but they have resisted crossing certain lines and providing particular interventions deemed objectively wrong. Catholic hospitals in Belgium have responded differently to pluralism. In response to a growing diversity of moral views and to the Belgian Act of Euthanasia of 2002, Catholic hospitals in Belgium now engage in euthanasia. This essay examines a defense that has been offered of this practice of euthanasia in Catholic hospitals and argues that it is misguided.

Belgium↗
PubMed1996

Euthanasia: the law in the United Kingdom.

The regulation of euthanasia by the criminal law has tended to be one of the more contentious areas of medical law, and continues to be the subject of debate. Few areas of the criminal law have been so consistently the target of reformist pressure, and certainly few areas have so strongly resisted change. Understandably, legislators are unwilling to involve themselves in a matter of law reform which engenders such moral disagreement, and it is significant that only two jurisdictions-The Netherlands and the Australian Northern Territories-have made any substantial change in their legal practice in this area. In other countries, including the UK, the courts and legislators have consistently refused to remove the fundamental criminal law objection to the practice of euthanasia. This is not to say, of course, that the courts have failed to recognise the medical subtleties in medical treatment at the end of life; in several important decisions, the courts in Britain have considered the boundaries of the criminal law's protection of life and have offered guidelines for doctors facing the delicate issues associated with treating the dying patient. Yet, in spite of several helpful decisions from the courts, the basic principle remains firm: the criminal law does not countenance the taking of life, no matter how good the motive. This means that there are very clear legal limits to the extent to which doctors can follow their individual consciences in this area.

Adult↗
PubMed2005

End games: euthanasia under interminable scrutiny.

It is increasingly asserted that the disagreements of abstract principle between adversaries in the euthanasia debate fail to account for the complex, particular and ambiguous experiences of people at the end of their lives. A greater research effort into experiences, meaning, connection, vulnerability, and motivation is advocated, during which the euthanasia 'question' should remain open. I argue that this is a normative strategy, which is felicitous to the status quo and further medicalises the end of life, but which masquerades as a value-neutral assertion about needing more knowledge.

Depression↗
PubMed1981

In re Spring.

Explore the source record for details and available documents.

Decision Making↗
PubMed2005

Withdrawing life support from patients in a persistent vegetative state: the law in the Netherlands.

This article sets out how a case like that of ms. Schiavo is likely to be decided in a Dutch court and compares that with the law in the United States. In the Netherlands there is one case with striking similarities: the decision of the Arnhem Court of Appeal of 1989. After describing that case (which to a large extent still reflects the legal state of the art), comments are given on several aspects of the issue, such as the labelling of artifical feeding as a medical intervention, the role of the physician, the position of the proxy or surrogate, the ways to resolve dispute in case of conflict, and the significance of advance directives. The analysis will show that, although there is more consensus on the issue now than there was 16 years ago, there are still several questions that need to be addressed in the future.

Euthanasia, Passive↗
PubMed2005

Substituting a judgment of best interests: dignity and the application of objective principles to PVS cases in the U.K.

The mêlée that surrounded the last days of Terri Schiavo's life was reminiscent of a classical Greek tragedy. Much like Antigone, Ms. Schiavo became enmeshed in irresistible and opposite forces, resolved to use her situation as an arena for the determination of political and legal issues as diverse as the exercise of states' rights, the extent of individual rights, the role of the judiciary, the re-opening of the abortion debate, and the regulation of stem cell research. As Europeans watched the drama unfold, the forces at play in the United States clashed head-on, in a rhetorically inflammatory spectacle which, on this side of the Atlantic, left many aghast. Most unsettling was the prospect of individuals wielding the power of state and national legislatures in what was, ultimately, an intensely personal affair. In the United Kingdom, the struggle was a stark reminder of the differences, not only between British and American political culture, but between our approaches to legal issues which present themselves at the end of life. The existence of well-established procedures and principles, and the extensive involvement of neutral third parties and the courts in pursuit of an objective determination of an individual patient's 'best interests', are key to the conclusion that Terri Schiavo's case would have been handled at least as effectively and efficiently as it was by the courts in Florida and the United States. That issues of consent and capacity can be determined by British courts on the basis of generally applicable principles leads to the subsequent conclusion that a 'best interests' determination leaves significantly less scope for conflict than the individualistic, much more personal and determinative construct of the 'substituted judgment' test in the United States.

Euthanasia, Passive↗
PubMed1998

A compassionate response toward providing. Nutrition and hydration in vulnerable populations.

Ethical guidelines provide a valuable first step in thinking about a new model of caring--one that brings together an enhanced model of patient autonomy, a clearer understanding of the moral (as opposed to merely biologic) meaning of life and death, a consistent concern for human life, and a recovery of the gerontological nurse practitioner's role as advocate, counselor, educator, and healer of the human spirit. Instead of creating a slippery slope, the emerging consensus will place decisions to withhold or withdraw fluids and nutrition on even firmer ethical, legal, and moral ground. Even in cases involving severe and enduring illness, disability, and "helplessness," society's focus must be on life. By its very nature, every human life, without reference to its condition, has a value that no one rightfully can deny or measure. Recognition of that truth is the cornerstone on which American law is built. Society's acceptance of that fundamental principle explains why, from time immemorial, society through law has extended its protection to all, including, especially, its weakest and most vulnerable members (Brophy v. New England Sinai Hospital., Inc., 1986).

Advance Directives↗
PubMed2004

Ethical principles in end-of-life decisions in different European countries.

The majority of ICU deaths are preceded by a decision to limit treatment in some way. Decisions to withhold or withdraw treatment vary considerably depending on many factors including local practice, cultural and religious background, family and peer pressure. Here we will discuss the current situation across Europe, based on the findings from three large international studies.

Attitude to Death↗