The Good Death, Virtue, and Physician-Assisted Death: An Examination of the Hospice Way of Death

1995 ◽  
Vol 4 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Franklin G. Miller
Keyword(s):  
Terminal Illness ◽  
Assisted Suicide ◽  
Hospice Care ◽  
Death And Dying ◽  
Good Death ◽  
Voluntary Euthanasia ◽  
Assisted Death ◽  
Comfort Care ◽  
The Face ◽  
The Right

The problem of physician-assisted death (PAD), assisted suicide and active euthanasia, has been debated predominantly in the ethically familiar vocabulary of rights, duties, and consequences. Patient autonomy and the right to die with dignity vie with the duty of physicians to heal, but not to kill, and the specter of “the slippery slope” from voluntary euthanasia as a last resort for patients suffering from terminal illness to PAD on demand and mercy killing of “hopeless” incompetent patients. Another dimension of the debate over PAD concerns the evaluative question of what constitutes a good death. At stake are Issues of character and virtue in the face of death and dying and their Implications for legitimizing the practice of PAD. Critics of PAD argue that “natural” death in the context of comfort care, as provided by hospice programs, is the good death. In contrast, PAD amounts to an easy way out, an evasion of the ultimate human challenge and task of dying. Because hospice care is clearly preferable to PAD, the former should be encouraged and the latter remain prohibited.

A Communitarian Approach to Physician-Assisted Death

1997 ◽  
Vol 6 (1) ◽  
pp. 78-87 ◽  
Author(s):  
Franklin G. Miller
Keyword(s):  
Assisted Suicide ◽  
Well Being ◽  
Self Determination ◽  
Social Goal ◽  
Medical Assistance ◽  
Assisted Death ◽  
Relief Of Suffering ◽  
The Face ◽  
The Right ◽  
Timing Of Death

The standard argument in favor of the practice of voluntary physician-assisted death, by means of assisted suicide or active euthanasia, rests on liberal, individualistic grounds. It appeals to two moral considerations: (1) personal self-determination—the right to choose the circumstances and timing of death with medical assistance; and (2) individual well-being—relief of intolerable suffering in the face of terminal or incurable, severely debilitating illness. One of the strongest challenges to this argument has been advanced by Daniel Callahan. Callahan has vigorously attacked the practice of physician-assisted death and the goal of legalization as deep affronts to values of community: “By assuming that the relief of suffering is a goal important enough to legitimate killing as a way of achieving it, we corrupt the idea of such relief as a social goal and duty. We cease helping to bear one another's suffering, but eliminate altogether the person who suffers. We thereby jeopardize both the future of self-determination and the kind of community that furthers its members' capacity to bear one another's suffering. Why bear what can be eliminated altogether?” In another passage Callahan remarks, “For there is a deep sense in which suicide and euthanasia are likely to represent, at least in part, a failure of the community, whether that of the intimate community of family and friends, or the larger civic community, to respond to the needs of another.”

scholarly journals THE PRINCIPLE OF QUALITY OF LIFE VERSUS SANCTITY OF LIFE IN THE EUTHANASIA DEBATE: WHERE DOES ISLAMIC LAW STANDS?

2012 ◽  
Vol 19 (1) ◽  
Author(s):  
Omipidan Bashiru Adeniyi
Keyword(s):  
Quality Of Life ◽  
Terminal Illness ◽  
Assisted Suicide ◽  
Islamic Law ◽  
The Other ◽  
Western World ◽  
Sanctity Of Life ◽  
World Today ◽  
The Right

The trend in most part of the western world today is the agitations for a person to have the right to take his own life, when such life, becomes unbearable due to pain, being the result of a severe or terminal illness. This is the position of proponents of the concept of euthanasia and assisted suicide. Opponents of the concept on the other hand are of the view that no matter the circumstances, a person should not take his own life because he has contributed nothing to its creation. They therefore uphold the sanctity of life as against its quality. This paper seeks to examine the relative arguments and will address the position of Islamic law governing the euthanasia debate.

Death with “dignity”: The wedge that divides the disability rights movement from the right to die movement

2011 ◽  
Vol 30 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susan M. Behuniak
Keyword(s):  
Human Rights ◽  
Assisted Suicide ◽  
Personal Autonomy ◽  
Right To Die ◽  
Disability Rights ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
A Value ◽  
The Right

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives—one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how “dignity” serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use “dignity” to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary—a finding that offers opportunities for dialogue and perhaps even advances in public policy.

End of Life Communication

2016 ◽  
Author(s):  
Maureen P. Keeley
Keyword(s):  
End Of Life ◽  
Terminal Illness ◽  
Death And Dying ◽  
Family Members ◽  
Terminally Ill ◽  
Comfort Care ◽  
Hospice Volunteers ◽  
End Of Life Decision ◽  
And Control ◽  
End Of Life Communication

End of life communication includes both verbal and nonverbal messages that transpire following a diagnosis of a terminal illness and death. The circumstances that occur at the end of life create opportunities for unique and important communication. Specifically, communication at the end of life is impacted by numerous and complicated factors: First, cultural views on death and dying often determine what is talked about, when it can be talked about, and who is included in the conversations. Second, the fears, desires, and needs of the terminally ill must be taken into account at the end of life as it is their personal end of life journey. Third, the nature of the relationships between the terminally ill and their family and friends have tremendous influence on the nature and topics of conversations that will be shared. Fourth, interactions with healthcare professionals (preferably with palliative care specialists) tend to be more task focused, emphasizing end of life decision making and comfort care for the terminally ill. Fifth, as people are tending to live longer with terminal illness and often doing so far from their family, professional caregivers and hospice volunteers are also engaging in meaningful and significant communication with the terminally ill. Communication at the end of life often determines whether or not the dying are allowed to die with dignity, with some control over their final wishes, and whether they are ultimately able to obtain some peaceful closure. Within close relationships communication at the end of life has the potential for authentic conversations that bring people closer, heal old wounds, and allow the terminally ill and close others to create some final memories and to say goodbye to one another. Communication at the end of life with health professionals has the potential for both the terminally ill and their family members to have greater satisfaction with end of life decisions and control of pain for the terminally ill, as well as better outcomes regarding grief and bereavement following the death for family members. For hospice volunteers and professional caregivers, communication at the end of life teaches the necessity and complexities of interactions at the end of life for the larger society.

Death with “dignity”: The wedge that divides the disability rights movement from the right to die movement

2011 ◽  
Vol 30 (01) ◽  
pp. 17-32
Author(s):  
Susan M. Behuniak
Keyword(s):  
Human Rights ◽  
Assisted Suicide ◽  
Personal Autonomy ◽  
Right To Die ◽  
Disability Rights ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
A Value ◽  
The Right

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives—one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how “dignity” serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use “dignity” to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary—a finding that offers opportunities for dialogue and perhaps even advances in public policy.

scholarly journals “It’s Like a Death Sentence but It Really Isn’t” What Patients and Families Want to Know About Hospice Care When Making End-of-Life Decisions

2019 ◽  
Vol 37 (9) ◽  
pp. 721-727
Author(s):  
Channing E. Tate ◽  
Grace Venechuk ◽  
Elinor J. Brereton ◽  
Pilar Ingle ◽  
Larry A. Allen ◽  
...  
Keyword(s):  
Focus Groups ◽  
End Of Life ◽  
Family Caregivers ◽  
Terminal Illness ◽  
Hospice Care ◽  
Death Sentence ◽  
Theory Approach ◽  
Snowball Sampling ◽  
The Right ◽  
Grounded Theory Approach

Background: Hospice is underutilized, due to both lack of initiation from patients and late referral from clinicians. Prior research has suggested the reasons for underuse are multifactorial, including clinician and patient lack of understanding, misperceptions about the nature of hospice care, and poor communication during end-of-life discussions about hospice care. Little is known about the decisional needs of patients and families engaging in hospice decision-making. Objectives: To understand the decisional needs of patients and families making decisions about hospice care. Methods: We conducted focus groups with family caregivers and hospice providers and one-on-one interviews with patients considering or enrolled in hospice care. We identified participants through purposeful and snowball sampling methods. All interviews were transcribed verbatim and analyzed using a grounded theory approach. Results: Four patients, 32 family caregivers, and 27 hospice providers participated in the study. Four main themes around decisional needs emerged from the interviews and focus groups: (1) What is hospice care?; (2) Why might hospice care be helpful?; (3) Where is hospice care provided?; and (4) How is hospice care paid for? Discussion: Hospice may not be the right treatment choice for all with terminal illness. Our study highlights where patients’ and families’ understanding could be enhanced to assure that they have the opportunity to benefit from hospice, if they so desire.

scholarly journals Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective

2020 ◽  
Vol 17 (17) ◽  
pp. 6147 ◽  
Author(s):  
Rebecca H. Lehto ◽  
Carrie Heeter ◽  
Jeffrey Forman ◽  
Tait Shanafelt ◽  
Arif Kamal ◽  
...  
Keyword(s):  
Mental Health ◽  
Terminal Illness ◽  
Hospice Care ◽  
Death And Dying ◽  
Structured Interview ◽  
Organizational Level ◽  
Physical And Mental Health ◽  
Care Workers ◽  
Hospice Workers ◽  
And Coping

Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice care workers who provide care to patients at end of life. Six focus groups and one semi-structured interview were conducted with mixed group of social workers, managers, nurses, hospice aides, chaplains, support staff, and a physician (n = 19). Findings from the groups depicted both rewards and challenges of hospice caregiving. Benefits included intrinsic satisfaction from the work, receiving positive patient and family feedback, and teamwork. Challenges reflected issues with workload, technology issues, administrative demands, travel-related problems, communication and interruptions, difficulties with taking time off from work and maintaining work-life integration, and coping with witnessing grief/loss. Hospice workers glean satisfaction from making meaningful differences in the lives of patients with terminal illness and their family members. It is an expected part of the job that certain patients and situations are particularly distressing; team support and targeted grief support is available for those times. Participants indicated that workload and administrative demands rather than dealing with death and dying were the biggest contributors to burnout. Participants reported episodic symptoms of burnout followed by deliberate steps to alleviate these symptoms. Notably, for all except one of the participants, burnout was cyclical. Symptoms would begin, they would take steps to deal with it (e.g., taking a mental health day), and they recovered. At an organizational level, a multipronged approach that includes both personal and occupational strategies is needed to support professional caregivers and help mitigate the stressors associated with hospice work.

Right to Life in the American Medical System

1996 ◽  
Vol 45 (6) ◽  
pp. 1151-1161
Author(s):  
Denis Cavanagh
Keyword(s):  
Public Schools ◽  
Terminal Illness ◽  
Assisted Suicide ◽  
Human Life ◽  
Hippocratic Oath ◽  
Physician Assisted Suicide ◽  
Legalize Abortion ◽  
The Right ◽  
Supreme Court Rulings ◽  
The Impact

The article deals with the impact of the so called “culture of death” on medical practice in United States (US). In fact, in America, while the pretence is being kept up on the importance of the Hippocratic oath and the evangelic benevolence of the Good Samaritan, the strategy of the secular humanists is to try to make these irrelevant in the twin interests of social convenience and fiscal security. This campaign has been quietly waged in the media, in the courts, in public schools and universities. According this strategy, the threats to human life are, namely, two: abortion and euthanasia. On the first issue, in US the situation is discouraging because the US Supreme Court rulings Roe v. Wade and Doe v. Bolton in 1973, that have made abortion a woman’s choice for any reason in the first and second trimester and available with medical consultation for almost any reason in the third trimester of pregnancy. Regarding the euthanasia, the campaign strategy is following the same pattern as that used to legalize abortion: the Euthanasia Lobby is claiming that millions of people in America are suffering unbearable pain because of terminal illness and so ought to have the right to end their pain with physician- assisted suicide. On the contrary, the author assert that there is no right to destroy any human life or participate in its destruction and there is no good moral reason for abortion or euthanasia, including the physician-assisted suicide. Finally, the author think that it is vital that Catholic activists, allied with Christian church-going brethren, should resist with all the power they can muster to the “culture of death”.

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