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Results for “Euthanasia, Passive”

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PubMed1997

End-of-life issues for very elderly women: incurable and terminal illness.

Important demographic realities may have an impact on a woman's end-of-life options. The vast majority of Americans age 85 and older are women, and they are much more likely than their male counterparts to be widowed, live alone, live below the poverty line, or die in a nursing home. Although pain is not inevitable among the terminally ill, it is vastly undertreated, and elderly women are at heightened risk for undertreatment. Pain and other physical and psychological symptoms should be treated aggressively, according to well-delineated principles of palliative care, including avoiding painful, unwanted treatments that only serve to prolong the dying process. Patients have the right to refuse unwanted treatment, even if this would result in death, and patients who lack decisional capacity can refuse these treatments through an authorized surrogate decision maker. Formal, written advance directives are particularly important for older women, who may be the group least likely to desire life-sustaining treatment. Dying patients also have the right to receive adequate analgesia or sedation for intractable symptoms, even if it might hasten death. Societal and legal consensus has been reached that forgoing treatment and receiving adequate symptom control are permissible, while significant moral and legal debate over the permissibility of euthanasia and assisted suicide continues.

Advance Directives↗
PubMed2000

The ethics of withholding and withdrawing dialysis therapy in infants.

Pediatric nephrologists may encounter infants with renal failure who have either unexpectedly survived lung hypoplasia at birth or whose renal failure could be treated but comorbid conditions exist. As a member of the health care team, the pediatric nephrologist may be asked to guide therapeutic intervention with parents, family members, and other care-givers. We present a case study that illustrates some of the difficulties that may arise when conflicting social and economic pressures, as well as public opinion and legal authority, enter the decision-making process. Clinical, theoretical, legal, and economic considerations involved in the ethical decision process are presented. Some tentative guidelines for approaching such dilemmas are offered bearing in mind a goal of consensual decision making.

Ethics, Medical↗
PubMed1982

The Arthur case.

Explore the source record for details and available documents.

Criminal Law↗
PubMed1993

Killing, letting die, and withdrawing aid.

One of the aims of this article is to contribute to the identification of the empirical criteria governing the use of the concepts of killing and letting die. I will not attempt a comprehensive analysis of the concepts but will limit the inquiry to certain problematic cases -- namely, cases involving the removal or withdrawal of life-supporting aid or protection. The analysis of these cases will, however, shed light on the criteria for distinguishing killing and letting die in other cases as well. My overall aims in the article are partly constructive and partly skeptical. I hope to advance our understanding of the nature of the distinction between killing and letting die. This, I believe, will enable us to defend the moral relevance of the distinction against certain objections -- in particular, objections that claim that the distinction fails to coincide with commonsense moral intuitions. Yet I will suggest that, as we get clearer about the nature of the distinction and the sources of its intuitive appeal, it may seem that the intuitions it supports are not so well grounded as one could wish.

Abortion, Induced↗
PubMed1996

Euthanasia and the law.

This paper examines why the law concerns itself with euthanasia. The nature of the right to life and its protection in law is explored. Such a right demands legal intervention to prohibit, or at least control, involuntary and non-voluntary euthanasia. Voluntary euthanasia is not a violation of the individual's right to life as such, so on what grounds can law limit autonomy by prohibiting such conduct? It is suggested that, while concepts of sanctity of life still play a part in the legal debate, fears of abuse in any scheme for voluntary euthanasia largely explain the reluctance of many jurisdictions to follow the example of The Netherlands. Finally, the paper asks whether reform and regulation of voluntary euthanasia are as attractive options as they are sometimes portrayed.

Adult↗
PubMed1997

Nevada nurses' attitudes regarding physician-assisted suicide.

This descriptive study of Nevada nurses (N = 539) indicates that nurses are evenly divided on the issue of physician-assisted suicide (PAS). Using hypothetical cases, the survey compares nurses' beliefs regarding withdrawal of life-support measures (92% agree, n = 489), double-effect euthanasia (85% agree, n = 447), PAS (53% agree, n = 280), and active euthanasia (44% agree, n = 235). Responses to arguments supporting or rejecting the legalization of PAS are presented. Arguments include: patient autonomy, relief of pain and suffering, death with dignity, decreased quality of life, relief of psychological and financial burdens, sacredness of life, use of adequate comfort measures, unenforceability of safeguards, the professional ethical code, and inappropriate motives. Seventy-five percent (n = 400) of Nevada nurses indicate they personally feel PAS may be justified in selected cases. Only 46% (n = 240) would be willing to participate in PAS if it were legalized. Selected written comments from respondents are included.

Adult↗
PubMed1990

Should a ventilator be removed at a patient's request? An ethical analysis.

The request of a ventilator-dependent quadriplegic person to be removed from the ventilator presents the health care team with an ethical dilemma. Application of ethical principles to case facts guides the decision maker. The ethical principle of autonomy requires that persons be respected and free to determine their course in life. The ethical principle of beneficence requires the health care team to actively benefit or do good for the patient. The ethical principle of nonmaleficence requires the health care team to refrain from harming a patient. The ethical duty of fidelity requires the nurse to be faithful to commitments made to patients. Ethical principles and duties are clear and straightforward. The decision of how they apply to a given case is not. However, applying them to a case, while not providing definitive answers, will provide the certainty that the decision was the best possible in a particular set of circumstances. An increasing number of cases similar to Joe's is being resolved in favor of discontinuing the ventilator. Emotional havoc could be the result to nurses who care for these patients. Individuals and institutions must begin planning strategies to deal with these and similar ethical dilemmas. Strategies might include anticipatory counseling, ethical decision making education programs and utilization of a nurse trained in ethics as a staff resource person. Nurses should attend and be involved in discussions of institutional ethics committees.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Just how unlawful is "euthanasia"?

Those who campaign for law reform to permit "euthanasia" may seek different things and at least some of what they seek may already be permissible under the criminal law of England and Wales. In this paper I examine one means whereby the criminal law delivers outcomes acceptable to the euthanasia lobby, that is the curious notion of "causation" deployed by the law, which adds a value override to the more usual notion of factual causation such that, for example, if medical treatment falls within the acceptable range as normal and proper, the pre-existing injury or illness is treated as exclusively the cause of death and the doctor escapes criminal liability, even where the medical treatment will shorten life to the certain knowledge, possibly even the wish, of the doctor. Thus the law may already be delivering a range of outcomes--euthanasia in a weak sense--acceptable to the euthanasia lobby. If so, it achieves this by stealth. That is inappropriate to the doctor-patient relationship, which is one of trust. So there is a strong case for greater transparency. Moreover, there are limits to the acceptable outcomes which an unreformed criminal law can deliver and in a range of cases the criminal law condemns the doctor to impotence and the patient to a prolonged, miserable and undignified death. So there is also a case for going beyond the current law and legalising euthanasia in a strong sense.

Criminal Law↗