Voluntary active euthanasia.
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American Medical Association↗
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[Voluntary, active euthanasia].
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Euthanasia↗
[Voluntary active euthanasia--attitude among nursing students].
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Adult↗
Active euthanasia and forgoing life-sustaining treatment: can we hold the line?
Public sentiment in favor of permitting voluntary active euthanasia creates a dilemma for a bioethics rooted in a libertarian notion of autonomy. At stake in the active euthanasia debate is actually a question of power--the individual's assertion of sovereignty over the timing and circumstances of his or her own death. Also at stake is society's unwillingness to impose a conception of the good--and a good dying--on individuals whose personal values and conceptions of the good may differ. In order both to reject voluntary active euthanasia and to affirm the patient's right to forgo life-sustaining treatment, some societal conception of the good must be developed and agreed upon to counter unbridled claims of individual self-sovereignty over dying. Pragmatic arguments alone, such as the need to maintain confidence in the doctor-patient relationship, will not be sufficient.
Beneficence↗
Affirming voluntary and active euthanasia from a theological-ethical perspective.
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Christianity↗
Doctors can kill--active euthanasia in South Africa.
Medical practitioners in South Africa will be given the legal right to end the lives of terminally ill patients. This is the practice of active euthanasia, the procedure whereby a medical doctor or a professional nurse can end the life of a terminally ill patient at the patient's request, by providing or administering a lethal dosage of a drug. Voluntary active euthanasia is included in a Draft Bill--The End of Life Decisions Act--which form part of a report of the South African Law Commission, wherein regulations regarding the end-of-life decisions are formulated. Specifically, it provides that a medical practitioner may under certain conditions stop the treatment of a patient whose life functions are being maintained artificially. Further, that a competent person may refuse life-sustaining treatment if he chooses to die. A medical practitioner may also give effect to a patient's living will in which the patient has requested the cessation of treatment. The Act also provides for the options of active voluntary euthanasia or physician-assisted suicide.
Decision Making↗
Euthanasia: the way we do it, the way they do it.
Although the Netherlands, Germany, and the United States are alike in having aging populations who die primarily of deteriorative diseases, they face end-of-life dilemmas quite differently. In the United States, withholding and withdrawing of treatment are the only legally recognized means for easing dying. In Holland, voluntary active euthanasia is also practiced; in (West) Germany, assisted suicide is a legal option, usually outside the medical setting. This paper examines objections to these three practices, and observes the differences in the background cultures. Rather than reliance on any of the three, it argues that physician-assisted suicide in terminal illness is the practice most compatible with the United States' special characteristics.
Attitude to Death↗
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↗
Aid-in-dying: should we decriminalize physician-assisted suicide and physician-committed euthanasia?
Recent news stories, medical journal articles, and two state voter referenda have publicized physicians' providing their patients with aid-in-dying. This Note distinguishes two components of aid-in-dying: physician-assisted suicide and physician-committed voluntary active euthanasia. The Note traces these components' distinct historical and legal treatments and critically examines arguments for and against both types of action. This Note concludes that aid-in-dying measures should limit legalization initiatives to physician-assisted suicide and should not embrace physician-committed voluntary active euthanasia.
Ethics, Medical↗
Voluntary euthanasia and the nurse: an Australian survey.
This article presents the results of a survey of the attitudes and practices of nurses in Victoria with regard to requests for active or passive help in dying from patients who were suffering from a terminal or incurable disease. Questionnaires were sent to 1942 nurses who had been selected at random, 943 nurses (49%) of whom returned completed questionnaires. The survey indicates that a clear majority of those who responded to the questionnaire support active voluntary euthanasia. Many nurses have collaborated with doctors in the provision of active voluntary euthanasia and a few have acted without consulting a doctor. Seventy-eight per cent of nurses thought the law should be changed to allow doctors to take active steps to bring about a patient's death under some circumstances; and 65% of nurses indicated that they would be willing to collaborate with doctors in the provision of active voluntary euthanasia if it were legal.
Adult↗
A good death: is euthanasia the answer?
Euthanasia--particularly active voluntary euthanasia--and assisted suicide are subjects of continuing controversy. Historical attitudes, current concerns, the situation in the Netherlands, and the positions of various medical associations are reviewed. Major arguments for and against active euthanasia are presented, with special consideration to the role that health care providers might be asked to perform should active euthanasia and assisted suicide be given societal sanction. The authors conclude that better pain management and A willingness to provide care within already established ethical and legal guidelines, not the legalization of active euthanasia and assisted suicide, are the appropriate responses to current proposals for assistance in dying.
Attitude↗
[Euthanasia and the doctrine of double effect].
Direct active euthanasia is prohibited in most countries while passive and indirect is not. However, many arguments against the legalization of voluntary active euthanasia are flawed. Ethical differences between active and passive or indirect euthanasia are difficult to maintain especially when the passivity of the actor causes death. The crucial point is not activity or passivity but respect for the autonomy of individual human beings. In particular there appears to be little ethical difference between active and indirect euthanasia. Indirect euthanasia has often been justified by the principle of double effect, which traces back to Thomas Aquinas. But resorting to this rule contains a logical fallacy. The principle of double effect does not allow foreseen and unwanted adverse effects of an action to occur when they are avoidable. In terminal sedation, an example for indirect euthanasia, hypoxemia and dehydration can easily be prevented by respirator therapy and fluid administration. Therefore the rule of double effect is not applicable. Indirect and direct active euthanasia cannot be ethically distinguished by resorting to the principle of double effect.
Double Effect Principle↗
An international perspective of active euthanasia: attitudes of nurses in seven countries.
This exploratory study examines the ethical justification that cancer care and dementia care nurses gave for active voluntary euthanasia. A convenient sample of 319 nurses working in seven countries was interviewed using a structured interview guide. The great majority of the nurses could not ethically justify active voluntary euthanasia. Even if the law changed, only 96 of the total sample viewed active voluntary euthanasia as ethical. For those nurses who could ethically justify active voluntary euthanasia, the majority did so because of the patients' suffering.
Adult↗
Advance directives for voluntary euthanasia: a volatile combination?
Defenders of patient autonomy have successfully supported the legal adoption of advance directives. More recently, some defenders of patient autonomy have also supported the legalization of voluntary active euthanasia. This paper explores the wisdom of combining both practices. If euthanasia were to become legal, should it be permitted by advance directives? The paper juxtaposes the most significant doubts about advance directives, with the most significant doubts about euthanasia. It argues that the doubts together raise more concern about the combined practices than about either euthanasia or advance directives separately. Not all cases of voluntary euthanasia by advance directive are equally problematic, however. Advance directives can help in the defense of euthanasia for patients who make the request in advance and reaffirm it under circumstances of severe suffering.
Advance Directives↗
Killing and caring: is euthanasia incompatible with care?
The issue of euthanasia continues to be surrounded by controversy, particularly in relation to its moral status and more recently, the significance that health professionals should attach to the principle of respect for patient autonomy. Increasing knowledge and expertise in the field of palliative care has also led to claims that the provision of effective palliative care services render discussion about the introduction of euthanasia unnecessary. By reviewing and analysing the arguments put forward in support of the continued ban on voluntary active euthanasia, this paper suggests that these arguments largely fail to address the notion of patient autonomy and concludes that even with provision and access to palliative care service, euthanasia could be considered a moral option which is not necessarily incompatible with care.
Beneficence↗
Physician-assisted suicide, euthanasia, and Christian bioethics: moral controversy in Germany.
Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients' wishes, be made in light of commonly shared values, unless these violate the principle of "in dubio pro vita". The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life.
Advance Directives↗
Professed religious affiliation and the practice of euthanasia.
Attitudes towards active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) among 1,238 doctors on the medical register of New South Wales varied significantly with self-identified religious affiliation. More doctors without formal religious affiliation ('non-theists') were sympathetic to AVE, and acknowledged that they had practised AVE, than were doctors who gave any religious affiliation ('theists'). Of those identifying with a religion, those who reported a Protestant affiliation were intermediate in their attitudes and practices between the agnostic/atheist and the Catholic groups. Catholics recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic medical respondents who had been so requested, recorded that they had taken active steps to bring about the death of patients.
Attitude of Health Personnel↗
Euthanasia, virtue ethics and the law.
Following the recent revival of virtue ethics, a number of ethicists have discussed the moral problems surrounding euthanasia by drawing on concepts such as compassion, benevolence, death with dignity, mercy, and by inquiring whether euthanasia is compatible with human flourishing. Most of these writers assert, or simply assume, that their arguments concerning the morality of euthanasia also support their views with regard to legislation. I argue, against these writers, that legislation cannot and should not be based on our moral and religious beliefs concerning whether euthanasia allows a person to die a good death. I then outline an Aristotelian approach to the role of law and government in a good society, according to which the task of the legislator is not to ensure that people actually act virtuously, but is instead to make it possible for them to choose to live (and die) well by ensuring that they have access to the goods that are necessary for flourishing. In the second half of the paper I apply this approach to the question of whether voluntary active euthanasia should be legalised by asking (1) whether euthanasia always deprives people of the necessary conditions for flourishing, and (2) whether the option to request euthanasia is ever necessary for flourishing.
Chronic Disease↗