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Results for “Euthanasia, Passive”

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PubMed1991

Medical ethics in the 1990s. Emphasis on death-and-dying issues will continue but social concerns will command increased attention.

During the 1990s medical ethics will undergo changes. Individual clinical issues, especially those related to death and dying, will continue to create conflict and preoccupy hospital staffs. But professional ethicists will focus on social concerns more frequently than they have in the past. Following are some of the most crucial ethical issues and directions they are likely to take in this decade: Clinical practice and the law will move toward less demanding standards of proof regarding the withdrawal of treatment from patients who are no longer competent. Public policy will set more lenient standards for judging whether a person would refuse artificial nutrition and hydration if he or she were able. Unless sensible people strengthen the distinction between active and passive euthanasia, more physicians and legislatures will move toward physician-assisted suicide. Those proposing a higher-brain definition of death, as opposed to whole-brain definitions, will gain ground with the general public, but not with legislators. New transplantation technologies will increase medical options but create more problems with paying for the procedures. As techniques are perfected, ethical questions will focus more on financing than on the source of transplantable material. AIDS treatment priorities will clash with other medical demands (e.g., treatment for breast cancer), and concerns about protecting both providers and patients from contracting AIDS will move policy toward routine testing. Progress in public argument will be made on the abortion issue. Members of ethics committees will have to be trained to address financing issues. Some medical schools and residency programs will add courses on the concept of character and on character development to their ethics programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed1990

[A difficult dilemma to resolve: aged patients refused for treatment by iterative hemodialysis. Ethical problem or medical choice? Reflections apropos of a questionnaire-inquiry].

An inquiry has been conducted amongst 185 french nephrologists so as to try to determine upon which criteria therapeutic choices for aged patients with chronic renal failure are made: conservative treatment or chronic dialysis? The fear of sharing the responsibility of an injustice towards some patients already handicapped by the disease or by their poor opportunity of social or family rehabilitation, the obsession of passive euthanasia and the refusal of taking into account the economic consequences of their choices, seem to conduct some nephrologists to accept anybody for a dialysis treatment. However, the quality of life enabled by the treatment, the possibility for the patient to enjoy a satisfactory social or family life, the environment of the patient, his degree of autonomy as well as, in some cases, the poor prognosis due to associated diseases, actually constitute the most determining factors of decision. The answer to this inquiry have moreover pointed out the necessity to provide right now for structures fitting the treatment by dialysis of an increasing number of elderly patients.

Aged↗
PubMed1993

[Dementia and ethics. From psychopharmacologic agents to living wills].

Psychotropics are to a great extent used in nursing homes to sedate and incapacitate the residents for social reasons. The very high prescription rate also reflects gerontophobic and dementophobic myths placing the old and disturbing patient beyond general accepted ethical rules. The problem is highlighted by the new Danish law concerning the uncurable ill patient. Under certain conditions it is now legal not to treat demented people for a life threatening but treatable physical illness. The boundaries between active and passive euthanasia seem more and more blurred concerning old demented patients.

Aged↗
PubMed2003

[Attitudes towards professional euthanasia in the range between grement in the society and personal preferences--results of a representative examination of the German general population].

Several surveys of the German population concerning the attitude towards euthanasia in patients with terminal illness yielded contradictory results, ranging from high acquisition to high refusal rates. After a critical discussion of the methodological concepts of these investigations, we present the results of a representative study of 1957 German persons (age range: 14 - 96 years) which was performed by the institute USUMA in February 2001. Four different types of euthanasia were included in the study: active, passive, and indirect euthanasia as well as physician's assisted suicide. The affirmative response categories were "declared will and unbearable pain", "declared will", "referred will", and "in the responsibility of the physician". Additionally, we asked to state the personal preference in the case of an own incurable illness. The resulting frequency distributions stress the autonomy of the patients (declared will) and the legal forms of professional euthanasia (passive and indirect euthanasia), independent from the degree of pain. The rank order of the hypothetic personal preferences was: passive euthanasia (26.1 %), active euthanasia (21.1 %), indirect euthanasia (13.1 %) and assisted suicide (6.2 %). For each category the hypothetic personal will to utilize euthanasia personally is markedly lower than the consent to legalize euthanasia in the society. This points to a diminished readiness of the population to seek for euthanasia. Persons aged 60 years and above deny all types of euthanasia significantly more often than younger persons. Persons with subjectively bad health status prefer the category "in the responsibility of the physician" more often than healthy subjects. The representative study proves that there is no polarized public opinion concerning euthanasia, rather there is a picture of high complexity.

Adolescent↗
PubMed2001

Nancy B and Nancy F.

In this article I provide a virtuous slippery slope argument which shows that there is no morally significant difference between passive and active euthanasia. At the top of the slope is an example of passive euthanasia; at the bottom, an example of active euthanasia. For each pair of cases down the slope there is nothing that sensibly makes a morally significant difference between the pair of cases. Thus, there is no morally significant difference between passive euthanasia and active euthanasia.

Ethics↗
PubMedDate not supplied

[Bioethics in the face of death].

We review death, thanatology and bioethics concepts and precepts, the value scale and hierarchization; the changes in death vision according to culture, religion and hierarchy, changes in perception of, according to culture, religion and mores in different communities and times, as well with scientific and technological advances. We analyzed patient's reactions to death, and the reactions of people close to them. We describe and analyze the principal bioethical dilemmas associated with death: therapeutic overkill or dysthanasia, passive and active euthanasia, assisted suicide, orthothanasia, and organ transplants. We discuss the relationship between death and science, bioethics and thanatology, as a necessary discipline today.

Attitude to Death↗
PubMed2001

Neonatal euthanasia: moral considerations and criminal liability.

Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice.

Child Abuse↗
PubMed2002

[Euthenasia: attitudes, wishes and behavior of the public, patients and physicians].

The lack of compatibility in conventional medical treatment for patients suffering from terminal diseases or severe disabilities has become one of the more difficult problems of developed countries. Different types of passive and active euthanasia have been adopted as solutions to these new problems. These solutions, however, raise ethical and professional dilemmas, as well as controversies regarding economic and policy-making issues. This situation of social confusion and the publics anxiety regarding end-of-life care are reflected in the literature review, which shows significant discrepancies between physicians and the public in attitudes, preferences and behavior regarding the preferred and existent medical treatment at the end of life. The publics preferences regarding end-of-life care are relatively stable over time. However, the readiness of the public and physicians to accept these solutions increases over time. Considering these controversial solutions and the publics wishes to participate in the decision making process regarding end-of-life care, an increase in open communication and the degree of cooperation among physicians and their patients and family members is suggested. Advancing the treatment methods for severely ill patients, and improving the education of professional caregivers is another essential need. The development of satisfactory treatment alternatives for patients at the end of life may prevent the Israeli society from debating active euthanasia and lead to clear social agreements on passive euthanasia, including the developing of legal options which will enable people, who are interested, to gain control over their end-of-life care.

Attitude of Health Personnel↗
PubMed1992

Euthanasia and abortion: personality correlates for the decision to terminate life.

The study addresses three research questions: (a) How well do level of conservatism and religiosity predict attitudes toward passive and active euthanasia? (b) What is the relationship between attitudes toward abortion and attitudes toward euthanasia? (c) How do personality variables relate differentially to these attitudes? Subjects were 168 Australian adults (68 men, 100 women). Initial analysis indicated no sex differences in attitudes toward the study's criterion variables. Descriptive statistics indicated general support for active and passive euthanasia and for abortion, although the majority of the respondents were found to be more accepting of passive than of active euthanasia. Multiple regression analyses indicated that level of conservatism was the most consistent predictor of attitudes toward euthanasia and abortion, whereas religiosity was found significantly to predict attitudes toward abortion only.

Abortion, Induced↗
PubMed1995

Euthanasia and the healthcare professional.

Euthanasia, often called mercy killing, is the act of inducing death often on terminally ill individuals for reasons assumed to be merciful. Euthanasia can be active or passive, and voluntary or involuntary. Voluntary euthanasia indicates the patient's full consent to terminate life, whereas involuntary euthanasia indicates the lack of patient's consent. Active euthanasia means the termination of life using an agent such as a drug, whereas passive euthanasia refers to the withholding a potentially life-prolonging treatment. Euthanatizing agents terminate life through various mechanisms, causing physical damage, direct or indirect tissue hypoxia, depression of the nervous system. Euthanasia is an issue filled with moral and ethical, as well as legal dilemmas that cannot be avoided. As members of the health care team, pharmacists may be asked to provide advice involving some form of euthanasia.

Euthanasia↗
PubMed2005

[Notes on euthanasia].

In the Judeo-Christian tradition, human life is held to be sacred, a semblance of the divine and a gift from God which the individual cannot dispose of at his or her own will. Hence, these monotheistic religions have made of the crime of murder a transgression of God's own commandment not to kill and have extended the applicability of this commandment to the practice of euthanasia and suicide. On the other hand, some non-religious traditions offer plausible reasons favoring euthanasia. This is a delicate matter for physicians, since the Hippocratic tradition forbids euthanasia and because as care-givers they must also bear the psychological, moral and emotional burden of carrying it out. Physicians are trained to preserve life but not to bring it to an end. As human beings, they must always respect the principle of nonmaleficence, and as physicians they must always respect as well the principle of beneficence. It is difficult to accept the fact that ending a human life can be an act of beneficence. In order to differentiate between passive and active euthanasia, the concept of proportionality of medical acts must be brought into consideration. For instance, using high doses of opiates to alleviate pain or withholding the use of an extraordinary method of treatment are not passive acts aimed at ending the life of a terminally ill patient, but medical acts that are reasonable, judicious and proportionate to the condition and irreversibility of a patient's illness. Therefore, so-called passive euthanasia cannot be considered the same as euthanasia. On the other hand, medically assisted suicide is a deceitful form of active euthanasia. The aim of this act is to cause death and the physician is morally responsible for such a death, since he is providing the means for bringing a human life to an end. Many times the desire to die expressed by terminally ill elderly and helpless patients is a request for help and an expression of reproach against a society that allows for their abandonment and neglect.

Euthanasia, Active↗
PubMed1992

Active management of the dying patient.

OBJECTIVE: To document the process of managing the dying patient in the intensive care unit (ICU) and thus to broaden community debate about an issue that is usually only discussed at a theoretical or philosophical level. SETTING: A six-bed ICU in Liverpool Hospital, a 419-bed teaching institution in the southwestern area of Sydney. PATIENTS: Twenty-seven patients, seen over a nine-month period, who had curative treatment withdrawn or withheld. The mean age of the patients was 68 years and the severity of illness, by the APACHE II scoring system, ranged from 12 to 45. INTERVENTIONS: Twenty-three of the 27 patients were mechanically ventilated and 11 were receiving inotropic support. Medical staff usually initiated discussions and sought staff consensus that the patient should be allowed to die (on 23 of 27 occasions). Most relatives (25 of 27) accepted this decision. Support therapies and routine care were stopped according to policy guidelines. Sedatives and narcotics were used in some patients (18 of 27). Twenty-one patients died in the ICU and six in the general ward areas. CONCLUSION: Introduction of a policy to guide management of dying patients in intensive care has been accepted by staff. Most dying patients are now managed in accordance with these guidelines. Further discussion and debate of this important issue, by health professionals and society as a whole, is required.

Adult↗