scholarly journals The Concept of Dignity and Its Use in End-of-Life Debates in England and France

2016 ◽  
Vol 25 (3) ◽  
pp. 404-413 ◽  
Author(s):  
RUTH HORN ◽  
ANGELIKI KERASIDOU

Abstract:Dignity is one of the most controversial and yet commonly used terms in debates regarding end-of-life issues. The term “dignity” can take various meanings. For example, it can be used to denote the respect owed to an individual person, or to signify the intrinsic value of humankind as a whole. These two different understandings of dignity inevitably lead to different approaches to end-of-life decisionmaking.This article explores the meaning of the term “dignity” in two European countries, England and France. Our analysis compares public debates and legislation on end-of-life-related issues in these two countries. We argue that in England dignity is most commonly understood as respect for individual autonomy, whereas in France dignity usually signifies respect for humanity as a whole. We demonstrate that the difference in the conceptualization of the term leads to different ethical, and hence legal and practical, approaches to end-of-life issues and vulnerable patients. Our particular focus is on (1) withdrawing/withholding life-sustaining treatment, (2) respect for patient preferences, and (3) assistance in dying.Given the difference in the understanding of dignity, and the underlying philosophical approaches, it appears that there is still a long way to go before we can establish common guidelines on end-of-life decisions across Europe and beyond. However, clarifying the use of the term “dignity” in different discussions around Europe could hopefully facilitate this endeavor.

2004 ◽  
Vol 14 (4) ◽  
pp. 580-588 ◽  
Author(s):  
L. M. Ramondetta ◽  
G. Tortolero-Luna ◽  
D. C. Bodurka ◽  
D. Sills ◽  
K. Basen-Engquist ◽  
...  

We sought to explore the Society of Gynecologic Oncologists (SGO) members' opinions and decisions about end-of-life issues and incurable conditions. A survey was mailed to members of the SGO. Their responses were recorded on a Likert scale and entered into a database. The survey explored opinions, experiences, and decisions in managing terminally ill gynecologic oncology patients. Of 900 surveys, 327 were returned (response rate, 36%). Seventy-three percent were men, 89% were white, and 72% were of Christian denomination. Respondents believed that 97% of patients who are dying realize that they are dying but stated only 40% of these patients initiate conversations about end-of-life issues. In contrast, 92% of respondents stated that they initiate end-of-life discussions with patients. Ninety-two percent of respondents thought that the patients should be allowed to make end-of-life choices independently after the facts are given to them. However, 44% thought that it is important to influence the way information is presented, and 54% believe that the gynecologic oncologist (GO) controls the outcome of end-of-life discussions. Although the physicians' sex, race, religion, and age did not correlate with their treatment decisions, religion did correlate with less fear of death (P = 0.011) and less discomfort when talking with patients about death (P = 0.005). Fifty-four percent of respondents believed that the GO controls the outcome of end-of-life discussions, and 40% believe that their actions prolong the process of dying. Expanding our understanding of what motivates GOs to recommend continued treatment over palliation is important for preserving informed patient-motivated end-of-life decisions.


2002 ◽  
Vol 29 (2) ◽  
pp. 106-111 ◽  
Author(s):  
James L. Werth

The American Psychological Association's Working Group on Assisted Suicide and End-of-Life Decisions (2000) recently called for the development of resources to assist training programs in incorporating end-of-life issues into undergraduate and graduate courses. After explaining why teaching about the dying process is relevant to psychology, I provide suggestions for how instructors can include end-of-life issues and decisions in courses on ethical, legal, and professional issues; adult and life span development; counseling diverse populations; and assessment and diagnosis. Each section contains a brief review of key issues, provides sample discussion questions, and highlights appropriate references.


JAHR ◽  
2018 ◽  
Vol 9 (2) ◽  
pp. 185-203
Author(s):  
Pierre Mallia

This paper aims to identify common ground on end-of-life issues between the Islamic and Christian cultures. Since these two cultures are more and more coming to live in the same countries, it is important to acknowledge common ground since the laws of countries apply to all. The paper will deal with several issues, including the stopping of futile treatment, the administration of ordinary and extraordinary care, defining the difference between death and allowing one to die, and accepting death as sometimes being an inevitable and acceptable outcome. The paper will also discuss palliative care including pain relief and sedation. From here one delves into the case of Persistent Vegetative States and the morality of over-enthusiastic treatment which pushes people into this state. It will also focus on the differences, such as passive euthanasia and analyze whether this is merely a difference in the interpretation of terms. There is also a phenomenon in some countries on querying the removal futile treatment and on lacking a legal framework in general on end-of-life. At least one study shows concern on religious moral grounds. The conclusion attempts to identify the common grounds on the end-of-life and whether morality and laws in this regard are guided by religious positions. It is important that laws respect the moral normative values of populations, especially with pressure coming from more liberal positions. Even if practices such as euthanasia (the discussion of which is not the scope of this paper) are introduced in countries, it is important that health care (and legislation) recognizes the common moral ground, the lack of which may lead to more suffering.


2021 ◽  
Author(s):  
José António Ferraz Gonçalves

Abstract Background Doctors often deal with end-of-life issues other than assisted death, such as incompetent patients and treatment withdrawal, including food and fluids. Methods A link to a questionnaire was sent by email three times, at intervals of one week, to the doctors registered in the Northern Section of the Portuguese Medical Association. Results The questionnaire was returned by 1148 (9%) physicians. This study shows that only a minority of Portuguese doctors were willing to give one or more drugs in lethal doses to cognitively incompetent patients with an incurable, advanced, and progressive disease at the request of a family member or other close person, and even less would do it on their own initiative. Concerning the withdrawal of support of life measures in advanced and progressive diseases at the patient’s request, most doctors were in favor, but much fewer doctors agreed with the suspension of supportive life measures at the request of a family member, another close person, or by their own unilateral decision. However, concerning the suspension of food and fluids, fewer agreed with that action. Portuguese doctors favor the administration of drugs for suffering control, even foreseeing they could shorten life, Conclusion Most doctors in this study respect patients’ autonomy, but do not agree with measures decided by others that have an impact on patients’ survival. They also agree with the administration of drugs for suffering control, even considering the possibility of shortening life.


2005 ◽  
Vol 14 (3) ◽  
pp. 15-19 ◽  
Author(s):  
Melanie Fried-Oken ◽  
Lisa Bardach

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