Ethical and Legal Issues in Intensive Care

1997 ◽  
Vol 12 (6) ◽  
pp. 298-309 ◽  
Author(s):  
John J. Paris ◽  
J. Cameron Muir ◽  
Frank E. Reardon
Keyword(s):  
Decision Making ◽  
Managed Care ◽  
Assisted Suicide ◽  
Ethical Issues ◽  
Care Delivery ◽  
Physician Behavior ◽  
Physician Assisted Suicide ◽  
Emerging Issues ◽  
Ethical And Legal Issues ◽  
Seriously Ill Patients

The findings of the SUPPORT study, the largest, most comprehensive and costly study ever undertaken on decision making for critically ill patients, revealed a wide ranging gap between patient preferences and physician behavior with regard to treatment decisions for seriously ill patients. The ethical issues raised by that disparity are intensified as we enter into a market-driven managed care delivery system. This essay explores recent ethical and legal developments on several emerging issues: the decision making process; DNR orders; brain death; withdrawal of treatment; physician assisted suicide; and the constraints of managed care.

scholarly journals Euthanasia and Physician-Assisted Suicide: A Review from Islamic Point of View

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Yousuf RM ◽  
Mohammed Fauzi AR
Keyword(s):  
Assisted Suicide ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Point Of View ◽  
Medical Community ◽  
Physician Assisted Suicide ◽  
Dying Patients ◽  
Practice Of Medicine ◽  
The Subject ◽  
Lay Public

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.

Requests for euthanasia and physician-assisted suicide and the availability and application of palliative options

2006 ◽  
Vol 4 (4) ◽  
pp. 399-406 ◽  
Author(s):  
MARIJKE C. JANSEN-VAN DER WEIDE, ◽  
BREGJE D. ONWUTEAKA-PHILIPSEN ◽  
GERRIT VAN DER WAL
Keyword(s):  
Decision Making ◽  
Observational Study ◽  
General Practitioners ◽  
Assisted Suicide ◽  
Medical Futility ◽  
Physician Assisted Suicide

Objective: This study investigated the palliative options available when a patient requested euthanasia or physician-assisted suicide (EAS), the extent to which the options were applied, and changes in the patient's wishes.Methods: In an observational study, 3614 general practitioners (GPs) filled in a questionnaire and described their most recent request for EAS (if any) (n = 1,681).Results: Palliative options were still available in 25% of cases. In these cases options were applied in 63%; in 46% of these cases patients withdrew their request. Medication other than antibiotics, which was most frequently mentioned as a palliative option (67%), and applied most frequently (79%), together with radiotherapy, most frequently resulted in patients withdrawing their request.Significance of results: GPs include the availability of palliative options in their decision making when considering EAS. The fact that not all options are applied or, if applied, the patient persists in the request is related to autonomy of the patient, the burden on the patient, and medical futility of the option.

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.

Right to Die

2019 ◽  
pp. 71-74
Author(s):  
Elizabeth Ford
Keyword(s):  
Decision Making ◽  
Supreme Court ◽  
Assisted Suicide ◽  
Right To Die ◽  
Surrogate Decision Making ◽  
Physician Assisted Suicide ◽  
Life Sustaining Treatment ◽  
Surrogate Decision ◽  
The U.S ◽  
Right To Refuse

Chapter 7 describes three cases that involve an individual’s right, in certain circumstances, to choose death. Cruzan v. Missouri is more specifically about a right to refuse life-sustaining treatment and surrogate decision-making; Washington v. Glucksberg and Vacco v. Quill are physician-assisted suicide cases, both decided on the same day by the U.S. Supreme Court and both declaring the practice unconstitutional.

An Advance Request: The Accessibility of Medical Assistance in Dying (MAID) for Patients Who Loose Decision-Making Capacity

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Natasha Harris
Keyword(s):  
Decision Making ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Medical Assistance ◽  
Waiting Period ◽  
Medical Assistance In Dying ◽  
Decision Making Capacity

Since the legalization of Medical Assistance in Dying (MAID) in Canada in 2016, there have been discussions regarding the extension of this service to patients who lose decision-making capacity but have made a prior advance request for physician-assisted suicide. Both caregivers and physicians have shown some support for allowing patients to make advance requests for MAID. The proposed changes to the legislation would remove the mandatory 10 day waiting period and include a waiver of final consent for those who loose decision-making capacity following their MAID request.

scholarly journals Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications

2015 ◽  
Vol 13 (5) ◽  
pp. 1399-1409 ◽  
Author(s):  
Peter Hudson ◽  
Rosalie Hudson ◽  
Jennifer Philip ◽  
Mark Boughey ◽  
Brian Kelly ◽  
...  
Keyword(s):  
Palliative Care ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Research Community ◽  
Legal Issues ◽  
Care Provision ◽  
Physician Assisted Suicide ◽  
Training Research ◽  
Ethical And Legal Issues ◽  
Practical Implications

AbstractObjective:Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated—particularly around ethical and legal issues—and the surrounding controversy shows no signs of abating. Responding to EAS requests is considered one of the most difficult healthcare responsibilities. In the present paper, we highlight some of the less frequently discussed practical implications for palliative care provision if EAS were to be legalized. Our aim was not to take an explicit anti-EAS stance or expand on findings from systematic reviews or philosophical and ethico-legal treatises, but rather to offer clinical perspectives and the potential pragmatic implications of legalized EAS for palliative care provision, patients and families, healthcare professionals, and the broader community.Method:We provide insights from our multidisciplinary clinical experience, coupled with those from various jurisdictions where EAS is, or has been, legalized.Results:We believe that these issues, many of which are encountered at the bedside, must be considered in detail so that the pragmatic implications of EAS can be comprehensively considered.Significance of Results:Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care before further consideration is given to allocating resources for legalizing euthanasia and physician-assisted suicide.

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