Balancing Autonomy And Traditional Values In Treating Terminally Ill Patients: Towards Locating The Right Questions For Japan

Author(s):  
David N. Weisstub
Author(s):  
Keren Dopelt ◽  
Dganit Cohen ◽  
Einat Amar-Krispel ◽  
Nadav Davidovitch ◽  
Paul Barach

The demand for medical assistance in dying remains high and controversial with a large knowledge gap to support optimal patient care. The study aimed to explore physicians’ attitudes regarding euthanasia and examine the factors that related to these attitudes. We surveyed 135 physicians working at a tertiary-care hospital in Israel. The questionnaire was comprised of demographic and background information, DNR procedure information, encounters with terminally ill patients, familiarity with the law regarding end-of-life questions, and Attitudes toward Euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should be allowed, while 29% thought that physicians should preserve a patients’ life even when they expressed the wish to die. A negative statistically significant relationship was found between the level of religiosity and attitudes toward euthanasia. The physicians’ attitudes towards euthanasia are quite positive when compared to other countries. The data shows a conflict of values: the sacredness of human life versus the desire to alleviate patients’ suffering. The Coronavirus-19 outbreak reinforces the importance of supporting physicians’ efforts to provide ethical and empathic communication for terminally ill patients. Future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to end-of-life requests.


Author(s):  
Rebecca Dresser

This chapter addresses access to unapproved drugs. Some terminally ill patients enroll in research as a way to gain access to experimental drugs. Other patients want to try the drugs without enrolling in research. The US Food and Drug Administration permits patients to do so under certain circumstances, but critics say the government rules are too restrictive. “Right to try” advocates campaign for laws permitting more liberal access, telling heart-wrenching stories about patients desperate to obtain experimental drugs. But the picture they present is one-sided. It disregards the negative impact that more liberal access policies may have on the drug trials that benefit society at large, and it ignores stories conveying the harm that can come from access to experimental drugs. These factors belong in the debate too.


2017 ◽  
Vol 44 (3) ◽  
pp. 204-205 ◽  
Author(s):  
Ruth Horn

In 2016, a law came into force in France granting terminally ill patients the right to continuous deep sedation (CDS) until death. This right was proposed as an alternative to euthanasia and presented as the ‘French response’ to problems at the end of life. The law draws a distinction between CDS and euthanasia and other forms of sympton control at the end of life. France is the first country in the world to legislate on CDS . This short report describes the particular context and underlying social values that led to this piece of legislation, and explores its meaning in the wider French context.


2018 ◽  
Vol 45 (3) ◽  
pp. 190-197 ◽  
Author(s):  
Lynn A Jansen ◽  
Steven Wall ◽  
Franklin G Miller

Drawing the line on physician assistance in physician-assisted death (PAD) continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill that can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill.


2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 122-122
Author(s):  
Andrea Martani ◽  
◽  
◽  

"In the last few years, the debate whether terminally ill patients should have access to experimental treatments without governmental supervision has intensified. The so-called “Right-to-Try” (RTT) doctrine has become popular especially in the United States, where the federal parliament passed a bill allowing such practices. As many other policies concerning patients’ autonomy in end-of-life circumstances, the appropriateness of RTT has often been challenged. In this context, some authors recently put forward the argument that states where it is allowed to request physician assisted suicide (PAS) should also necessarily recognize a RTT. In the authors’ own words: “if states can give a terminally ill patient the right to die using medications with 100% probability of being unsafe and ineffective against his/her disease [i.e. the substances used for PAS], they should also be able to grant terminally ill patients a right to try medications with less than 100% probability of being unsafe and ineffective [i.e. ET]”. In this contribution, I will question this argument by underlying three flaws in the authors’ comparison of RTT and PAS. First, there is a fundamental distinction in the nature of the choices between the two situations concerning the (un)certainty of their outcomes. Second, the number of actors (and their potential conflicting interests) involved in these two situations is different. Third, the authors’ understanding of the object of patients’ rights in PAS is partially incorrect. I will conclude by arguing that, although reasons might exist to support RTT, such comparison with PAS is not one of them. "


1978 ◽  
Vol 6 (2) ◽  
pp. 215-244
Author(s):  
C.G. Schoenfeld

Traditional arguments for and against mercy killing are first discussed, and it is concluded that this is a subject upon which moral and intelligent men may disagree. Then, the disparity between the law's condemnation of mercy killing and society's usual failure to punish it is stressed, as are the ways in which modern medical technology has intensified the plight of the hopelessly ill and their families. Much of this is then detailed in an analysis of the celebrated Quinlan case. Problems faced by physicians in dealing with the hopelessly ill are considered, as is the view—found wanting—that these physicians should have the right to decide whether terminally ill patients should live or die. Finally, a psychoanalytic explanation of the disparity between the law in words and the law in action is offered.


1985 ◽  
Vol 15 (3) ◽  
pp. 263-269 ◽  
Author(s):  
Karolynn Siegel ◽  
Peter Tuckel

In recent years societal attitudes toward suicide among the terminally ill have become increasingly tolerant. These sentiments have become embodied in “Rational Suicide” movements. The central underlying premise of the rational suicide position is that terminally ill patients (of which the cancer patient has served as the prototypal case) have a greater propensity for suicide growing out of their desire to escape overwhelming pain and despair. This assumption is found to be unsubstantiated when examined in light of existing statistical and clinical data. In addition, the implications of providing legal sanctions to safeguard the right of the terminally ill to end their own lives are explored.


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