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PubMed2004

The meaning that young Israeli adults ascribe to the least undesirable death.

The study examines descriptions by 14 Israeli young adults of the least undesirable death. The transcripts of essays and interviews were analyzed by phenomenological methods to determine themes and interpret their synthesis into the essence of the phenomenon. The least undesirable death was perceived as multi-dimensional, based on 4 themes: the time, manner, and place in which death occurs, and the importance of death being beneficial to others. These themes represent 2 salient ideologies in Israeli society: autonomy of the individual (including control over his/her own life) and communitarian philosophy that calls for emphasis of the common good. These 2 forces, which pull in opposite directions, were captured in the essence of the phenomenon: least undesirable for self versus least undesirable for others. The results of this study call researchers and practitioners in the field of death and dying to move beyond the common uni-dimensional perception of a "good death" and to recognize that this is a multi-layered phenomenon in which the perspectives of self (autonomy) and others (communitarianism) do not necessarily mesh.

Adult↗
PubMed1988

Is dying a matter of ethics?

The decisions that must be made at the time of an anticipated death, ideally by the patient but often by family or caregivers, call forth our highest values and deepest beliefs. Dying with dignity means different things to different people but must take into account the patient's autonomy, pain status, and dominion.

Attitude to Death↗
PubMed2005

Instilling hope and respecting patient autonomy: reconciling apparently conflicting duties.

In contemporary American medical practice, certain physicians are critical and wary of the current emphasis on patient autonomy in medicine, questioning whether it really serves the complex needs of severely ill patients. Physicians such as Eric Cassell and Thomas Duffy argue that the duty of beneficence should override the duty to respect autonomy when conflicts arise in clinical situations. After evaluating their claim that severe illness robs patients of their autonomy, I will argue that this perceived conflict between beneficence and autonomy is ill-conceived, resting on misperceptions about both the capacity for autonomy and the meaning of hope. Considering insights on hope from phenomenologist Gabriel Marcel and theologian William Lynch, as well as drawing upon a case study involving a bone marrow patient, I claim that respecting and nurturing patients' capacity for autonomy is a necessary condition for acting beneficently and fostering authentic hope.

Beneficence↗
PubMed2004

Prescribing cannabis: freedom, autonomy, and values.

In many Western jurisdictions cannabis, unlike most other psychoactive drugs, cannot be prescribed to patients even in cases where medical professionals believe that it would ease the patient's pain or anxiety. The reasons for this prohibition are mostly ideological, although medical and moral arguments have been formulated to support it. In this paper, it is argued that freedom, properly understood, provides a sound ethical reason to allow the use of cannabis in medicine. Scientific facts, appeals to harm and autonomy, and considerations of symbolic value cannot consistently justify prohibitions.

Cannabis↗