Contempo: ethical issues of human embryos research and physician-assisted suicide

JAMA ◽  
1995 ◽  
Vol 274 (17) ◽  
pp. 1344b-1344
Author(s):  
C. A. Tauer
1997 ◽  
Vol 12 (6) ◽  
pp. 298-309 ◽  
Author(s):  
John J. Paris ◽  
J. Cameron Muir ◽  
Frank E. Reardon

The findings of the SUPPORT study, the largest, most comprehensive and costly study ever undertaken on decision making for critically ill patients, revealed a wide ranging gap between patient preferences and physician behavior with regard to treatment decisions for seriously ill patients. The ethical issues raised by that disparity are intensified as we enter into a market-driven managed care delivery system. This essay explores recent ethical and legal developments on several emerging issues: the decision making process; DNR orders; brain death; withdrawal of treatment; physician assisted suicide; and the constraints of managed care.


The biomedical ethical principles of autonomy, beneficence, non-maleficence, and justice are well established, though they have been challenged by feminist and nursing ethics. Decision-making in practice requires a balance of not only ethical principles, but also legal and professional frameworks, alongside patient and family wishes. Cancer clinical trials raise ethical issues around the balance between risk and potential benefits to patients, and they may need support making the right decision about whether to participate. The rising cost of cancer drug treatments has raised difficult questions about which drugs should be authorized for use within the United Kingdom (UK)'s National Health Service. End-of-life care raises particularly challenging ethical issues. Mental capacity or competence is defined in law in the UK, and treatment decisions may be made on behalf of patients if they are assessed and found to lack capacity. However, patients and families are encouraged to make advance statements and decisions about treatment in the event of losing capacity. Decisions on whether to give, withdraw, or withhold treatment, artificial hydration and nutrition, and cardiopulmonary resuscitation (CPR) are sensitive, and should be based on assessment, consultation with family, and consideration of ethical, legal, and professional principles. Euthanasia and physician-assisted suicide (assisted dying) are highly contentious issues internationally and illegal in most countries. Some countries allow them under certain circumstances. In response to a patient asking about assisted dying, the nurse should listen to their concerns, be prepared to talk about the process of dying, and support them to establish their priorities.


2021 ◽  
pp. 1161-1169
Author(s):  
Lars Johan Materstvedt

According to international convention, physician aid-in-dying includes euthanasia and physician-assisted suicide, both of which are voluntarily requested forms of medicalized killings. In the former, a physician injects the patient with lethal drugs, whereas in the latter, the patient self-administers such drugs. The two practices differ fundamentally from non-treatment decisions and from the last-resort treatment, palliative sedation, and details of the differences are outlined in the chapter. Physician aid-in-dying differs considerably in appearance, depending on which normative ethical theory is taken as the point of departure and how various theories can be used either to reject or to defend physician aid-in-dying. The chapter also discusses alternative ways for palliative care physicians to relate to physician aid-in-dying.


2011 ◽  
Vol 18 (3) ◽  
pp. 341-355 ◽  
Author(s):  
Iva Sorta-Bilajac ◽  
Ksenija Baždarić ◽  
Morana Brkljačić Žagrović ◽  
Ervin Jančić ◽  
Boris Brozović ◽  
...  

The aim of this study was to assess nurses’ and physicians’ ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N = 364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services.


Crisis ◽  
1998 ◽  
Vol 19 (3) ◽  
pp. 109-115 ◽  
Author(s):  
Michael J Kelleher † ◽  
Derek Chambers ◽  
Paul Corcoran ◽  
Helen S Keeley ◽  
Eileen Williamson

The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The “slippery slope” argument is briefly considered.


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