scholarly journals Voluntary Stopping of Eating and Drinking in Swiss Outpatient Care

GeroPsych ◽  
2020 ◽  
pp. 1-9
Author(s):  
Sabrina Stängle ◽  
Wilfried Schnepp ◽  
Daniel Büche ◽  
André Fringer
Keyword(s):  
End Of Life ◽  
Outpatient Care ◽  
Assisted Suicide ◽  
Online Survey ◽  
Response Rate ◽  
Physician Assisted Suicide ◽  
Natural Death

Abstract. Besides physician-assisted suicide, there is another end-of-life practice under discussion: voluntary stopping of eating and drinking (VSED). In this study, we assess the occurrence of VSED in outpatient care and evaluate nurses’ attitudes about it. We recruited 395 nurses (24% response rate) in our online survey. The occurrence of VSED in Switzerland lies at 0.5%. Most nurses (84.6%) were aware of VSED, and 39.5% had experienced it with patients. VSED was mostly (70.3%) regarded as a natural death, and nearly all (95.1%) were willing to care for these patients; however, about one-quarter (26.5%) expressed moral concerns. Our results show that VSED occurs in rare cases, and that nurses are willing to accompany patients during this VSED, but express moral concerns.

Factors that Influence End-Of-Life Decision Making Amongst Attending Physicians

2021 ◽  
pp. 104990912110638
Author(s):  
Suraj Pai ◽  
Tracy Andrews ◽  
Amber Turner ◽  
Aziz Merchant ◽  
Michael Shapiro
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Work Experience ◽  
Assisted Suicide ◽  
Online Survey ◽  
Care Physician ◽  
University Hospital ◽  
Physician Assisted Suicide ◽  
Eol Care ◽  
Attending Physicians

Background: Medical advances prolong life and treat illness but many patients have chronically debilitating conditions that prevent them from making end-of-life (EOL) decisions for themselves. These situations are difficult to navigate for both patient and physician. This study investigates physicians’ feelings and approach toward EOL care, physician-assisted suicide (PAS), and euthanasia. Methods: An anonymous, self-administered online survey was distributed through the New Jersey Medical School servers and American College of Surgeons forums. The survey presented clinical EOL vignettes and subjective questions regarding PAS and euthanasia. Results: We obtained 142 responses from attending physicians. Respondents were typically male (61%), married (85%), identified as Christian (54%), had more than 20 years of experience (55%), and worked at a university hospital (57%). Religious beliefs and years of work experience seemed to be significant contributors in EOL decision making, whereas gender and medical specialty were not significantly influential. Conclusion: Factors such as years of work experience and religious belief may influence medical professionals’ opinions about PAS and euthanasia and their subsequent actions regarding EOL care. In many cases, the boundaries are blurred and require further study before concrete conclusions can be made.

scholarly journals Ethical considerations at the end-of-life care

2021 ◽  
Vol 9 ◽  
pp. 205031212110009
Author(s):  
Melahat Akdeniz ◽  
Bülent Yardımcı ◽  
Ethem Kavukcu
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Ethical Decision Making ◽  
Biomedical Ethics ◽  
Artificial Nutrition ◽  
Life Care ◽  
Ethical Challenges ◽  
Physician Assisted Suicide

The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care. The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide. Five ethical principles guide healthcare professionals in the management of these situations.

Is Presence Always Complicity? An Analysis of Presence, Its Moral Objects, and Scandal in Proximity to Physician-Assisted Suicide and Euthanasia

2021 ◽  
Vol 82 (3) ◽  
pp. 487-508
Author(s):  
Daniel Fleming
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Moral Action ◽  
Theological Ethics ◽  
Life Care ◽  
Physician Assisted Suicide ◽  
Recent Letter ◽  
Action Intention ◽  
Catholic Theological

Catholic chaplains and clinicians who exercise their vocations in contexts wherein physician-assisted suicide and euthanasia (PAS-E) are legal may need to confront the difficult question of whether or not their presence in proximity to these acts and the processes that govern them is consistent with Catholic ethics. Debate on this question to date has focused on complicit presence and scandal. Drawing on Catholic theological ethics and the vision for end-of-life care espoused in the Congregation for the Doctrine of the Faith’s recent letter, Samaritanus Bonus, I argue that some forms of presence in proximity to PAS-E are ethically justifiable. Core to this argument are the three elements of moral action: intention, object, and circumstance, alongside efforts to mitigate the risk of scandal informed by the teaching of Aquinas.

End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices

1997 ◽  
Vol 6 (2) ◽  
pp. 189-204 ◽  
Author(s):  
Timothy E. Quill ◽  
Gerrit Kimsma
Keyword(s):  
United States ◽  
The Netherlands ◽  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Ethical Climate ◽  
The United States ◽  
Policy Implications ◽  
Life Care ◽  
Physician Assisted Suicide

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

The Oxford Handbook of Ethics at the End of Life

2014 ◽  
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Clinical Decision Making ◽  
Death And Dying ◽  
The United States ◽  
Dark Side ◽  
Human Beings ◽  
Cultural Issues ◽  
Physician Assisted Suicide ◽  
Persons With Disabilities

This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients’ values has been recognized as the essential moral component of clinical decision making. Technology’s promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability to control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book has six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations, such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as ways to address the psychosocial and ethical problems of death and dying.

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

scholarly journals End-of-Life Issues in the United States after Terri Schiavo: Implications for Social Work Practice

10.18060/1841 ◽  
2011 ◽  
Vol 12 (2) ◽  
pp. 164-180 ◽  
Author(s):  
Darrel Montero
Keyword(s):  
United States ◽  
End Of Life ◽  
Assisted Suicide ◽  
Work Practice ◽  
The United States ◽  
Social Work Practice ◽  
Physician Assisted Suicide ◽  
Life Issues ◽  
The Status ◽  
End Of Life Issues

The very public death of Terri Schiavo in 2005 alerted Americans to what is a growing ethical, medical, and social crisis: the status of end-of-life issues and decisions in the United States. Currently, Oregon is the only state to give terminally ill patients the right to end their lives, with physicians’ help, if they so choose. Public opinion data from 1977 to the present show that Americans support greater rights for individuals facing end-of-life decisions--up to and including physician-assisted suicide and euthanasia. This paper considers the status of end-of-life issues in the United States after Terri Schiavo’s death and examines the opportunities for advocacy by social workers who serve clients and families encountering this complex and controversial issue.

How do we die?

2016 ◽  
Vol 35 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Bonnie Stabile ◽  
Aubrey Grant
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Hospice Care ◽  
Good Reason ◽  
The Elderly ◽  
The United States ◽  
Medical Intervention ◽  
Current Approach ◽  
Physician Assisted Suicide ◽  
Policy And Practice

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers’ final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring “death with dignity” cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome — despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

scholarly journals Are the Distinctions Drawn in the Debate about End-of-Life Decision Making “Principled”? If Not, How Much Does it Matter?

2012 ◽  
Vol 40 (1) ◽  
pp. 66-84 ◽  
Author(s):  
Yale Kamisar
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Good Death ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
Dying Patients ◽  
Aid In Dying ◽  
End Of Life Decision ◽  
Life Decision

I sometimes wonder whether some proponents of physician-assisted suicide (PAS) or physician-assisted death (PAD) think they own the copyright to such catchy phrases as “death with dignity” and “a good death” so that if you are against PAS or PAD, then you must be against a dignified death or a good death. If one removes the quotation marks around phrases like “aid-in-dying” or “compassionate care for the dying,” I am not opposed to such end-of-life care either. Indeed, how could anybody be against this type of care?I do not want to abandon dying patients anymore than Dr. Timothy Quill does. Although, unfortunately, it will not always be easy to achieve the desired result, I agree with him that it ought to be a goal of medicine “to help people die well, to help them receive a good death” — or at least “the best possible” death under the circumstances. I part company with Professor Quill, however, when he urges us to change the law in the majority of our states so that in some circumstances patients may achieve a “good death” or a “dignified” one by means of lethal drugs.

Sign in / Sign up

Export Citation Format

Share Document