Terminal Sedation: Palliative Care for Intractable Pain, Post Glucksberg and Quill

2003 ◽  
Vol 29 (1) ◽  
pp. 45-76
Author(s):  
Rob McStay
Keyword(s):  
Palliative Care ◽  
Supreme Court ◽  
Assisted Suicide ◽  
Life Support ◽  
Intractable Pain ◽  
Terminal Sedation ◽  
Physician Assisted Suicide ◽  
The Right ◽  
Artificial Life Support ◽  
Unconscious State

In 1997, the U.S. Supreme Court tacitly endorsed terminal sedation as an alternative to physician-assisted suicide, thus intensifying a debate in the legal and medical communities as to the propriety of terminal sedation and setting the stage for a new battleground in the “right to die” controversy. Terminal sedation is the induction of an unconscious state to relieve otherwise intractable distress, and is frequently accompanied by the withdrawal of any life-sustaining intervention, such as hydration and nutrition. This practice is a clinical option of “last resort” when less aggressive palliative care measures have failed. Terminal sedation has also been described as “the compromise in the furor over physician-assisted suicide.”Medical literature suggests that terminal sedation was a palliative care option long before the Supreme Court considered the constitutional implications of physician-assisted suicide. Terminal sedation has been used for three related but distinct purposes: (1) to relieve physical pain; (2) to produce an unconscious state before the withdrawal of artificial life support; and (3) to relieve non-physical suffering.

scholarly journals ASPEK ETIKA DAN LEGAL EUTHANASIA

2018 ◽  
Vol 18 (3) ◽  
Author(s):  
Taufik Suryadi ◽  
Kulsum Kulsum
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Assisted Suicide ◽  
Life Support ◽  
Medical Science ◽  
Final Decision ◽  
Physician Assisted Suicide ◽  
Definition Of Death ◽  
Definition Of

Abstrak. Isu-isu tentang akhir kehidupan (end of life) selalu menarik untuk dibicarakan. Penentuan akhir kehidupan ini sering menjadi dilema bagi para dokter karena apabila dokter tidak memahami tentang pengambilan keputusan akhir hidup pasien ia akan menghadapi konsekuensi bioetika dan medikolegal. Terdapat beberapa istilah yang berkaitan dengan isu akhir kehidupan yaitu euthanasia, withholding and withdrawal life support, physician assisted suicide, dan  palliative care. Dengan berkembangnya ilmu kedokteran dan teknologi, definisi kematian menjadi sulit ditentukan karena dengan bantuan alat canggih kedokteran kehidupan ‘dapat diperpanjang’. Dari kenyataan inilah maka timbul pertanyaan serius: “Sampai kapan dokter harus mempertahankan kehidupan?. Apakah semua jenis pengobatan dan perawatan yang dapat  memperpanjang hidup manusia itu harus selalu diberikan?”.Dari permasalahan ini dapat didiskusikan tentang euthanasia ditinjau dari sudut bioetika dan medikolegal. Kata kunci: euthanasia, aspek bioetika, aspek medikolegal  Abstract .The issues of end of life are always interesting to discussed. This final determination of life is often a dilemma for doctors because if the doctor does not understand the final decision of the patient's life he will face the consequences of bioethics and medicolegal. There are several terms related to the issues of end of life that is euthanasia, withholding and withdrawal life support, physician assisted suicide, and palliative care. With the development of medical science and technology, the definition of death becomes difficult to determine because with the help of advanced medical devices 'life can be extended'. It is from this fact that a serious question arises: "How long should doctors maintain life? Are all types of cure and care that can extend the life of a human should always be given? "From this issues can be discussed about euthanasia in terms of bioethics and medicolegal. Keywords: euthanasia, bioethics aspect, medicolegal aspect

Gut Reactions

2009 ◽  
Vol 20 (9) ◽  
pp. 1059-1063 ◽  
Author(s):  
Daniel C. Wisneski ◽  
Brad L. Lytle ◽  
Linda J. Skitka
Keyword(s):  
Supreme Court ◽  
Assisted Suicide ◽  
Legal Status ◽  
Controversial Issues ◽  
Physician Assisted Suicide ◽  
Moral Conviction ◽  
Nationally Representative ◽  
The Right ◽  
The U.S ◽  
Moral Convictions

Theory and research point to different ways moral conviction and religiosity connect to trust in political authorities to decide controversial issues of the day. Specifically, we predicted that stronger moral convictions would be associated with greater distrust in authorities such as the U.S. Supreme Court making the “right” decisions regarding controversial issues. Conversely, we predicted that stronger religiosity would be associated with greater trust in authorities. We tested these hypotheses using a survey of a nationally representative sample of Americans (N = 727) that assessed the degree to which people trusted the U.S. Supreme Court to rule on the legal status of physician-assisted suicide. Results indicated that greater religiosity was associated with greater trust in the U.S. Supreme Court to decide this issue, and that stronger moral convictions about physician-assisted suicide were associated with greater distrust in the U.S. Supreme Court to decide this issue. Also, the processes underlying religious trust and distrust based on moral convictions were more quick and visceral than slow and carefully considered.

scholarly journals EXPLORING THE CONCEPT OF UBUNTU IN RELATION TO DYING WITH DIGNITY IN PALLIATIVE AND HOSPICE CARE

Obiter ◽  
2018 ◽  
Vol 39 (2) ◽  
Author(s):  
Ntokozo Mnyandu
Keyword(s):  
Palliative Care ◽  
Human Dignity ◽  
Assisted Suicide ◽  
Hospice Care ◽  
Physician Assisted Suicide ◽  
Dying With Dignity ◽  
The Supreme Court ◽  
The Right ◽  
Hospice And Palliative Care ◽  
Court Of Appeal

The Supreme Court of Appeal in Minister of Justice and Correctional Services v Estate Stransham-Ford raised more questions than the answers it provided. However, of note is the enquiry it made regarding the implications of palliative care in relation to whether the criminality of physician-assisted suicide and physician- administered euthanasia infringes a person’s dignity. In response, this paper aims to reconstruct – through the lens of Ubuntu – our understanding of human dignity and draw links with how the values of compassion and survival, which underpin Ubuntu, enjoin us as a re-affirmation of human dignity, to strive towards making hospice and palliative care readily available. Ultimately, this is done for the benefit of providing constitutionally sound reasons for why greater emphasis should be placed on palliative and hospice care when it comes to dying with dignity. To this effect, a conceptual framework of human dignity that is based on Ubuntu is summarised. This is done for the purpose of properly aligning the understanding of the right to dignity to one that represents our constitutional dispensation and ethos. Flowing from this is an extract of the values of compassion and survival that underpin Ubuntu. These values are then used to gain a lucid perspective, as to why – in our pursuit of providing a dignified death for terminally ill patients – greater emphasis should be placed on hospice and palliative care.

The Lost History of the Ninth Amendment

2009 ◽  
Author(s):  
Lash Kurt T
Keyword(s):  
Supreme Court ◽  
Assisted Suicide ◽  
Primary Sources ◽  
Physician Assisted Suicide ◽  
Patriot Act ◽  
The People ◽  
Wide Range ◽  
History Of ◽  
The Right ◽  
Ninth Amendment

The Ninth Amendment has had a remarkably robust history, playing a role in almost every significant constitutional debate in American history, including the controversy over the Alien and Sedition Acts, the struggle over slavery, and the constitutionality of the New Deal. Until very recently, however, this history has been almost completely lost due to a combination of historical accident, mistaken assumptions, and misplaced historical documents. Drawing upon a wide range of primary sources, most never before included in any book on the Ninth Amendment or the Bill of Rights, this book recovers the lost history of the Ninth Amendment and explores how its original understanding can be applied to protect the people's retained rights today. The most important aspect of this book is its presentation of newly uncovered historical evidence which calls into question the currently presumed meaning and application of the Ninth Amendment. The evidence not only challenges the traditional view regarding the original meaning of the Ninth Amendment, it also falsifies the common assumption that the Amendment lay dormant prior to the Supreme Court's “discovery” of the clause in Griswold v. Connecticut . As a history of the Ninth Amendment, the book recapitulates the history of federalism in America and the idea that local self-government is a right retained by the people. This issue has particular contemporary salience as the Supreme Court considers whether states have the right to authorize medicinal use of marijuana, refuse to assist the enforcement of national laws like the Patriot Act, or regulate physician-assisted suicide. The meaning of the Ninth Amendment has played a key role in past Senate confirmation hearings for Supreme Court justices and the current divide on the Court regarding the meaning of the Ninth Amendment makes it likely the subject will come up again during the next set of hearings.

Killing and Allowing to Die: Another Look

1998 ◽  
Vol 26 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Daniel P. Sulmasy
Keyword(s):  
Supreme Court ◽  
Assisted Suicide ◽  
Life Support ◽  
Physician Assisted Suicide ◽  
Important Distinction ◽  
Court Of Appeals ◽  
The U.S

One of the most important questions in the debate over the morality of euthanasia and assisted suicide is whether an important distinction between killing patients and allowing them to die exists. The U.S. Supreme Court, in rejecting challenges to the constitutionality of laws prohibiting physician-assisted suicide (PAS), explicitly invoked this distinction, but did not explicate or defend it. The Second Circuit of the U.S. Court of Appeals had previously asserted, also without argument, that no meaningful distinction exists between killing and allowing to die. That court had reasoned that if this were so, it would be discriminatory to allow persons on life support to end their lives by removing such treatment, while those who are not connected to life support would be denied similar access to death.

Palliative Care/Physician-Assisted Dying: Alternative or Continuing Care?

2006 ◽  
Vol 7 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Marion Malakoff
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Advance Directives ◽  
Assisted Suicide ◽  
Life Support ◽  
Care Physician ◽  
Physician Assisted Suicide ◽  
Dying Patients ◽  
Physician Assisted Dying ◽  
Wrongful Death

End-of-life care for dying patients has become an issue of importance to physicians as well as patients. The debate centers around whether the option of physician-assisted suicide cuts off, or diminishes the value of, palliative care. This ongoing attention makes the crafting of advance directives from patients detailing their end-of-life choices essential. Equally important is the appointment of a health care surrogate. The surrogate, when the patient is too ill to make decisions, should be empowered to make them in his stead. No American court has found a clinician liable for wrongful death for granting a request to refuse life support. An entirely separate issue is that of legalized physician-assisted suicide. As of this writing, only Oregon has made this legal (see Gonzales v. Oregon). It is likely that this issue will be pursued slowly through the state courts, making advance directives and surrogacy all the more crucial.

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