Developments in the practice of physician-assisted dying: perceptions of physicians who had experience with complex cases

2016 ◽  
Vol 44 (5) ◽  
pp. 292-296 ◽  
Author(s):  
Marianne C Snijdewind ◽  
Donald G van Tol ◽  
Bregje D Onwuteaka-Philipsen ◽  
Dick L Willems
Keyword(s):  
The Netherlands ◽  
Assisted Suicide ◽  
Secondary Analysis ◽  
Public Debate ◽  
Complex Case ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Physician Assisted Dying ◽  
The Right ◽  
The Way

BackgroundSince the enactment of the euthanasia law in the Netherlands, there has been a lively public debate on assisted dying that may influence the way patients talk about euthanasia and physician-assisted suicide (EAS) with their physicians and the way physicians experience the practice of EAS.AimTo show what developments physicians see in practice and how they perceive the influence of the public debate on the practice of EAS.MethodsWe conducted a secondary analysis of in-depth interviews with 28 Dutch physicians who had experience with a complex case of EAS. Respondents were recruited both by the network of physicians working for SCEN (Support and Consultation for Euthanasia in the Netherlands) as well as via a national questionnaire, wherein participating physicians could indicate their willingness to be interviewed.ResultsThree themes came up in analysing the interviews. First, the interviewed physicians experienced a change in what (family of) patients would expect from them: from a role as an involved caregiver to being the mere performer of EAS. Second, interviewees said that requests for EAS based on non-medical reasons came up more frequently and wondered if EAS was the right solution for these requests. Last, respondents had the impression that the standards of EAS are shifting and that the boundaries of the EAS regulation were stretched.ConclusionsThe perceived developments could make physicians less willing to consider a request for EAS. Our results also raise questions about the role of physicians and of EAS in society.

Physician-Assisted Suicide: Where to Draw the Line?

2000 ◽  
Vol 9 (3) ◽  
pp. 407-410 ◽  
Author(s):  
ERNLÉ W.D. YOUNG
Keyword(s):  
Public Policy ◽  
Assisted Suicide ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Assisted Death ◽  
Policy Issues ◽  
Moral Distinction ◽  
Physician Assisted Dying ◽  
Hippocratic Tradition

In brief compass, I will touch on three of the central ethical and public policy issues that divide those who are opposed to physician-assisted dying from those who are supportive of this practice. These are: (1) the moral distinction (if any) between actively hastening death and passively allowing to die; (2) how to interpret the Hippocratic tradition in medicine with respect to physician-assisted death; and (3) whether physician-assisted suicide can be effectively regulated. I shall summarize the arguments pro and con with respect to each issue, and also indicate my own position.

scholarly journals Er det at blive gammel tilstrækkelig årsag til dødshjælp?

2020 ◽  
pp. 235-247
Author(s):  
Søren Holm
Keyword(s):  
Mental Illness ◽  
Elderly People ◽  
Assisted Suicide ◽  
The Elderly ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Wish To Die ◽  
The Right ◽  
The Relationship ◽  
Vulnerable Elderly

A proposal put forth in the Dutch Parliament suggests that anyone over the age of 75 should have a legally guaranteed right to physician-assisted suicide if they wish to die, unless the wish is the result of a mental illness. This chapter discusses three questions about the relationship between age and entitlement to assisted dying: 1) are there good reasons to introduce a purely age-determined criterion for a right to assisted dying; 2) would such an age criterion lead to problematic discrimination against the elderly, or alternatively to discrimination against people who are too young to meet the criterion; and 3) what is the relationship between an age criterion and a postulated duty to choose assisted dying in specific situations. The discussion of these three issues shows that there are no good reasons for introducing an age criterion for the right to die, that an age criterion is potentially discriminatory to both the elderly and the young, and that introducing an age criterion could lead to problematic pressure against vulnerable elderly people.

EUTHANASIA

Think ◽  
2021 ◽  
Vol 20 (58) ◽  
pp. 93-102
Author(s):  
Lynne Bowyer
Keyword(s):  
Assisted Suicide ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
The Impact ◽  
The Way

ABSTRACTIn this article I consider the impact of euthanasia/physician-assisted suicide on the way we live and the relationships we have. I argue that embracing the practice of assisted dying is a deficient form of care that will erode the respectful and responsible human bonds that hold us all well in community.

How Health Care Institutions in the Netherlands Approach Physician Assisted Death

1996 ◽  
Vol 32 (3) ◽  
pp. 179-196 ◽  
Author(s):  
Herman H. Van Der Kloot Meijburg
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
End Of Life ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Professional Expertise ◽  
Assisted Death ◽  
Health Care Institutions ◽  
The Individual ◽  
The Way

There is a need for reassessing the specific responsibilities of health care institutions in cases of euthanasia and physician assisted suicide. For many patients health care institutions have become their end-of-life setting. With regard to patients' decisions toward the end of life, hospitals carry three responsibilities of their own: first, they must attend to the needs of the individual patient; second, they are responsible for offering professional expertise and their experience to the patient; and third, they must execute the responsibilities entrusted to them by society. In the way health care institutions cope with institutional decisions toward the end of life, they fulfill an exemplary function. In this contribution we will explore these institutional responsibilities by looking at the developments in The Netherlands.

Ethics in cancer care

2019 ◽  
pp. 159-172
Keyword(s):  
Assisted Suicide ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
The United Kingdom ◽  
Drug Treatments ◽  
Potential Benefits ◽  
The Uk ◽  
The Right

The biomedical ethical principles of autonomy, beneficence, non-maleficence, and justice are well established, though they have been challenged by feminist and nursing ethics. Decision-making in practice requires a balance of not only ethical principles, but also legal and professional frameworks, alongside patient and family wishes. Cancer clinical trials raise ethical issues around the balance between risk and potential benefits to patients, and they may need support making the right decision about whether to participate. The rising cost of cancer drug treatments has raised difficult questions about which drugs should be authorized for use within the United Kingdom (UK)'s National Health Service. End-of-life care raises particularly challenging ethical issues. Mental capacity or competence is defined in law in the UK, and treatment decisions may be made on behalf of patients if they are assessed and found to lack capacity. However, patients and families are encouraged to make advance statements and decisions about treatment in the event of losing capacity. Decisions on whether to give, withdraw, or withhold treatment, artificial hydration and nutrition, and cardiopulmonary resuscitation (CPR) are sensitive, and should be based on assessment, consultation with family, and consideration of ethical, legal, and professional principles. Euthanasia and physician-assisted suicide (assisted dying) are highly contentious issues internationally and illegal in most countries. Some countries allow them under certain circumstances. In response to a patient asking about assisted dying, the nurse should listen to their concerns, be prepared to talk about the process of dying, and support them to establish their priorities.

Autonomy, Human Dignity, and the Right to Healthcare: A Dutch Perspective

2010 ◽  
Vol 19 (3) ◽  
pp. 321-328 ◽  
Author(s):  
MARTIN BUIJSEN
Keyword(s):  
The Netherlands ◽  
Medical Ethics ◽  
Human Dignity ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Ethics Policy ◽  
The Right

Dutch medical ethics policy is renowned for being highly liberal, due largely to the Dutch law on euthanasia. The Netherlands is one of the very few countries in which euthanasia performed by physicians and physician-assisted suicide (PAS) has been legalized. Acts of euthanasia and PAS go unpunished, provided certain conditions are fulfilled.

The adaptation of design thinking in auditing

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Linda MEIJER-WASSENAAR ◽  
Diny VAN EST
Keyword(s):  
The Netherlands ◽  
Design Thinking ◽  
Public Organizations ◽  
Design Framework ◽  
The Right ◽  
The Way

How can a supreme audit institution (SAI) use design thinking in auditing? SAIs audit the way taxpayers’ money is collected and spent. Adding design thinking to their activities is not to be taken lightly. SAIs independently check whether public organizations have done the right things in the right way, but the organizations might not be willing to act upon a SAI’s recommendations. Can you imagine the role of design in audits? In this paper we share our experiences of some design approaches in the work of one SAI: the Netherlands Court of Audit (NCA). Design thinking needs to be adapted (Dorst, 2015a) before it can be used by SAIs such as the NCA in order to reflect their independent, autonomous status. To dive deeper into design thinking, Buchanan’s design framework (2015) and different ways of reasoning (Dorst, 2015b) are used to explore how design thinking can be adapted for audits.

Prawne aspekty eutanazji w Holandii

2016 ◽  
Vol 14 (3) ◽  
pp. 243-253
Author(s):  
Grzegorz Stefanowicz
Keyword(s):  
The Netherlands ◽  
Assisted Suicide ◽  
Public Authority ◽  
Dutch Society ◽  
On Demand ◽  
Limited Length ◽  
The Law ◽  
Death On Demand ◽  
The Way

This article undertakes to show the way that has led to the statutory decriminalization of euthanasia-related murder and assisted suicide in the Kingdom of the Netherlands. It presents the evolution of the views held by Dutch society on the euthanasia related practice, in the consequence of which death on demand has become legal after less than thirty years. Due attention is paid to the role of organs of public authority in these changes, with a particular emphasis put on the role of the Dutch Parliament – the States General. Because of scarcity of space and limited length of the article, the change in the attitudes toward euthanasia, which has taken place in the Netherlands, is presented in a synthetic way – from the first discussions on admissibility of a euthanasia-related murder carried out in the 1970s, through the practice of killing patients at their request, which was against the law at that time, but with years began more and more acceptable, up to the statutory decriminalization of euthanasia by the Dutch Parliament, made with the support of the majority of society.

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