Good Care of Dying Patients: The Alternative to Physician-Assisted Suicide and Euthanasia

Due to globalizing trend of homogenisation of culture, changes in the health care delivery system and market economics infringing on the practice of medicine, there has been a gradual shift in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As the subject has gained worldwide prominence, we want to review this topic from Islamic perspective due to its significance in medical ethics and clinical practice.

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Can Physician-Assisted Suicide Be Regulated Effectively?

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.1996.tb01856.x ◽

1996 ◽

Vol 24 (3) ◽

pp. 225-232 ◽

Cited By ~ 8

Author(s):

Franklin G. Miller ◽

Howard Brody ◽

Timothy E. Quill

Keyword(s):

Health Care ◽

New York ◽

Palliative Care ◽

Assisted Suicide ◽

Terminally Ill ◽

Great Promise ◽

Physician Assisted Suicide ◽

On Demand ◽

Premature Deaths ◽

Dying Patients

With breathtalung speed, traditional criminal prohibitions against assisted suicide have been declared unconstitutional in twelve states, including California and New York. This poses great promise and great peril. The promise is that competent terminally ill patients, as a compassionate measure of last resort, will have the option of putting an end to their suffering by physician-assisted suicide (PAS). More sigmficant, legally permitting this controversial option may be a catalyst for doctors, health care institutions, and society to improve the care of the dying. PAS should be limited only to those relatively few competent patients who continue to suffer intolerably despite unrestrained efforts to palliate and who face a continued existence that they regard as worse than death. When dying patients know they will not be abandoned to miserable and pointless suffering if palliative care fails, they will be fortified to cope better with the process of dying.The immediate peril is that PAS will become a quick fix, available on demand to any patient diagnosed as terminally ill, thus bypassing palliative care and producing premature deaths.

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

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2012.00647.x ◽

2012 ◽

Vol 40 (1) ◽

pp. 66-84 ◽

Cited By ~ 4

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.

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Oregon v. Ashcroft: The Battle over the Soul of Medicine

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180103123158 ◽

2003 ◽

Vol 12 (3) ◽

pp. 310-321 ◽

Cited By ~ 1

Author(s):

BEN A. RICH

Keyword(s):

Assisted Suicide ◽

The United States ◽

Physician Assisted Suicide ◽

Death With Dignity ◽

War Of Attrition ◽

Dying Patients ◽

Medical Disputes ◽

Aid In Dying ◽

Death With Dignity Act ◽

Dignity Act

When one considers the protracted and continuing struggle of the citizens of Oregon to include physician-assisted suicide (also known as “physician aid in dying”) among the panoply of measures available to dying patients and the physicians who care for them, the depth and breadth of the issue becomes inescapable. The potential intractability of the dispute is illustrated by the very fact, noted in the preceding parenthetical phrase, that consensus eludes us on even the most basic of semantic points—how we are to most aptly characterize the conduct in question? The case featured in this issue's The Caduceus in Court must be examined as the latest battle in a long war of attrition waged by opponents of physician-assisted suicide against the Oregon Death with Dignity Act (“the Oregon Act”). After briefly reviewing that history, I will then consider the details of Oregon v. Ashcroft and the implications of the litigation not only for the care of dying patients but also for the regulation of medical practice in the United States and, more broadly still, the search for resolution of serious medical disputes in a democratic society.

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

Care Management Journals ◽

10.1891/cmaj.7.1.41 ◽

2006 ◽

Vol 7 (1) ◽

pp. 41-44 ◽

Cited By ~ 1

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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Attitudes toward euthanasia and physician assisted suicide: A survey among medical students, oncology clinicians, and palliative care specialists

Palliative & Supportive Care ◽

10.1017/s1478951506060329 ◽

2006 ◽

Vol 4 (3) ◽

pp. 251-255 ◽

Cited By ~ 28

Author(s):

M.C. MARINI ◽

H. NEUENSCHWANDER ◽

F. STIEFEL

Keyword(s):

Health Care ◽

Palliative Care ◽

Medical Students ◽

Health Care Professionals ◽

Assisted Suicide ◽

Psychiatric Patients ◽

Cancer Center ◽

Physician Assisted Suicide ◽

Dying Patients ◽

The University

Objective: The aim of this study was to compare the results of surveys about attitudes toward euthanasia and related issues that was conducted among palliative care specialists, health care professionals of a cancer center, and first- and second-year medical students.Methods: By means of an anonymous questionnaire with different hypothetical scenarios concerning physician assisted suicide (PAS) and related issues, 726 members of the Swiss Association for Palliative Care (SAPC), 148 health care professionals of the Institute of Oncology of Italian speaking Switzerland (IOSI), and 140 medical students of the University of Fribourg, Switzerland, were surveyed.Results: Among palliative care specialists a decreasing number supported PAS, direct active euthanasia (DAE), DAE for psychiatric patients, DAE in incompetent patients, and life terminating acts without explicit request (LAWER). Professionals of the cancer center were more in favor of DAE and PAS than palliative care specialists, but less in favor than medical students.Significance of results: Significant variations among different professionals exist in attitudes toward euthanasia. The hypothesis that familiarity with the care of severely ill and dying patients is an important underlying factor explaining variance has been confirmed by these surveys.

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Physician-Assisted Suicide as a Constitutional Right

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.1996.tb01853.x ◽

1996 ◽

Vol 24 (3) ◽

pp. 198-206 ◽

Cited By ~ 1

Author(s):

John E. Linville

Keyword(s):

Assisted Suicide ◽

Courts Of Appeals ◽

Physician Assisted Suicide ◽

Recent Success ◽

Dying Patients ◽

Life Sustaining Treatment ◽

Nutrition And Hydration ◽

Constitutional Right ◽

The Right ◽

Circuit Courts

The legal treatment of physician-assisted suicide (PAS) is in flux. Reform has been impelled by several forces, including the recent success of novel constitutional arguments in the Ninth and Second Circuit Courts of Appeals. I will review and discuss Compassion in Dying v. State of Washington and Quill v. Vacco, addressing the constitutional arguments, and then briefly considering the attractions and difficulties of these new constitutional theories.Before 1990, state criminal laws dealing with assisted suicide had reached a remarkably stable consensus: suicide was not illegal, but assisting suicide was a criminal action with no distinction typically made between physicians and others who assisted. The details of the relevant criminal law varied from state to state. Some states had criminal statutes specifically addressing assisted suicide, while others treated the practice under more general homicide statutes. But in no state was it clearly legal for a physician to prescribe a lethal medication at the request of a dying patient. While remarkable legal developments took place during the 1970s and 1980s regarding other aspects of the rights of dying patients (including the right to refuse resuscitation and other life-sustaining treatments and the right to withdraw from life-sustaining treatment including nutrition and hydration), there was relative quiescence regarding the law of PAS.

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Euthanasia and Related Practices Worldwide

Crisis ◽

10.1027/0227-5910.19.3.109 ◽

1998 ◽

Vol 19 (3) ◽

pp. 109-115 ◽

Cited By ~ 9

Author(s):

Michael J Kelleher † ◽

Derek Chambers ◽

Paul Corcoran ◽

Helen S Keeley ◽

Eileen Williamson

Keyword(s):

Assisted Suicide ◽

International Association ◽

Active Euthanasia ◽

Physician Assisted Suicide ◽

Passive Euthanasia ◽

Medical Practitioners ◽

General Acceptance ◽

International Importance ◽

Controversial Area ◽

Active And Passive Euthanasia

The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The “slippery slope” argument is briefly considered.

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