Decisions and Responsibilities at the End of Life: Euthanasia and Clinically Assisted Death

1996 ◽  
Vol 2 (3) ◽  
pp. 229-245
Author(s):  
Hazel Biggs
Keyword(s):  
End Of Life ◽  
Medical Practice ◽  
Patient Autonomy ◽  
Medical Technology ◽  
Moral Dilemma ◽  
Individual Autonomy ◽  
Assisted Death ◽  
Ethical Duty ◽  
Advanced Medical Technology ◽  
The Absolute

The advent of advanced medical technology and its ability to prolong living and dying has, together with greater patient autonomy, inspired increasing awareness of euthanasia and assisted death. Doctors confronted by distressed patients seeking treatments, which may be construed as euthanasia, can experience a profound moral dilemma that emanates from the conflict between their ethical duty to relieve suffering, and the responsibilities imposed upon them by the law. Respect for individual autonomy is central to modem medical practice; but the absolute endorsement of the patient’s right to autonomy at the end of life may compromise the clinician’s professional and ethical integrity. This paper details the uneasy equilibrium between the rights of patients and the responsibilities of doctors at the end of life.

Befriending Everyday Life When Bringing Technology Into the Private Sphere

2016 ◽  
Vol 27 (6) ◽  
pp. 843-854 ◽  
Author(s):  
Catharina Lindberg ◽  
Cecilia Fagerström ◽  
Ania Willman ◽  
Bengt Sivberg
Keyword(s):  
Everyday Life ◽  
Patient Autonomy ◽  
Medical Technology ◽  
Care Process ◽  
Private Sphere ◽  
Lived Body ◽  
Advanced Medical Technology ◽  
Long Time ◽  
To Come ◽  
Phenomenological Interview

We present the findings of our phenomenological interview study concerning the meaning of being an autonomous person while dependent on advanced medical technology at home. This was elucidated in the participants’ narratives as befriending everyday life when bringing technology into the private sphere. We discovered four constituents of the phenomenon: befriending the lived body, depending on good relationships, keeping the home as a private sphere, and managing time. The most important finding was the overall position of the lived body by means of the illness limiting the control over one’s life. We found that the participants wanted to be involved in and have influence over their care to be able to enjoy autonomy. We therefore stress the importance of bringing the patients into the care process as chronic illness will be a part of their everyday life for a long time to come, hence challenging patient autonomy.

scholarly journals Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics

1999 ◽  
Vol 15 (suppl 1) ◽  
pp. S15-S25 ◽  
Author(s):  
José Luiz Telles de Almeida ◽  
Fermin Roland Schramm
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Medical Practice ◽  
Paradigm Shift ◽  
Medical Technology ◽  
Moral Dilemma ◽  
Ethical Practice ◽  
Ethical Theories ◽  
Philosophical Debate ◽  
The 1960S

Both the increasing incorporation of medical technology and new social demands (including those for health care) beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

End-of-Life Care Issues

2017 ◽  
Author(s):  
Linda P. Darrell
Keyword(s):  
End Of Life ◽  
21St Century ◽  
End Of Life Care ◽  
Medical Technology ◽  
Racial Awareness ◽  
Life Care ◽  
Unexpected Death ◽  
Multidisciplinary Assessment ◽  
Advanced Medical Technology ◽  
The Impact

The perspective of end-of-life care has changed over the years. People are living longer, fuller lives due to advanced medical care and technology along with an increased interest in healthier lifestyles. The focus of end-of-life care has expanded to include accidental and sudden, unexpected death, chronic illness, anticipated death from longevity, and illnesses impacting children. An expanded perspective of end-of-life care must account for the challenges and changes of service delivery within a multi-cultural 21st-century milieu. The significance of advanced medical technology and improved lifestyles is an important component of a primary multidisciplinary assessment to understand the impact of such a life-altering occurrence as end-of-life care. Equally as important is a culturally inclusive perspective to accommodate the significance of longevity due to improved lifestyles, advanced medical technology, ethnicity, spirituality, and racial awareness. This article will explore the multiple concerns surrounding end-of-life care issues from an expansive worldview.

Dignity through Thick and Thin

2017 ◽  
Author(s):  
L. W. Sumner
Keyword(s):  
End Of Life ◽  
Assisted Death

Some critics have argued that the concept of dignity has outlived whatever usefulness it ever had, at least in bioethics. However, the concept of dignity has the annoying habit of turning up on both sides of the debate about the ethics and legality of physician-assisted death. This chapter distinguishes two conceptions of dignity: a thick one (commonly invoked by the pro side), which is derived from the experiences of patients at the end of life, and a thin one (often utilized by the anti side), which is rooted in a Kantian ethic. The chapter then provides reasons for preferring the former to the latter.

Medical Practice Variations in End-of-Life Care

2013 ◽  
pp. 1-14
Author(s):  
Michael Hammer ◽  
Hans Olav Melberg ◽  
Robert Fowler
Keyword(s):  
End Of Life ◽  
Medical Practice ◽  
End Of Life Care ◽  
Life Care ◽  
Practice Variations

How might legalization be achieved?

2017 ◽  
Author(s):  
L. W. Sumner
Keyword(s):  
End Of Life ◽  
Legal Regime ◽  
Assisted Death

What kind of legal regime should advocates aim for? The main business of this book is done. We have explored the nature, history, and ethics of physician-assisted death and the case that can be made for and against allowing it as a legal end-of-life option....

Patient autonomy and participation in end-of-life decision-making: An interpretive-systemic focus group study on perspectives of Asian healthcare professionals

2019 ◽  
Vol 18 (4) ◽  
pp. 425-430 ◽  
Author(s):  
Oindrila Dutta ◽  
Priya Lall ◽  
Paul Victor Patinadan ◽  
Josip Car ◽  
Chan Kee Low ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Patient Autonomy ◽  
Healthcare Professionals ◽  
Program Effectiveness ◽  
Self Determination ◽  
Truth Telling ◽  
Focus Group Study ◽  
Eol Care ◽  
Care Decision

AbstractObjectivesAsia's first national advance care planning (ACP) program was established in Singapore in 2011 to enhance patient autonomy and self-determination in end-of-life (EoL) care decision-making. However, no known study has examined the extent to which ACP in Singapore successfully met its aims. The purpose of the current study was to examine the attitudes of local healthcare professionals on patients’ autonomy in decision-making at the EoL since they strongly influence the extent to which patient and family wishes are fulfilled.MethodsGuided by the Interpretive-Systemic Framework and Proctor's conceptual taxonomy of implementation research outcomes, an interview guide was developed. Inquiries focused on healthcare professionals’ attitudes towards ACP, their clinical experiences working with patients and families, and their views on program effectiveness. Sixty-three physicians, nurses, medical social workers, and designated ACP coordinators who were actively engaged in ACP facilitation were recruited from seven major hospitals and specialist centers in Singapore through purposive sampling. Twelve interpretive-systemic focus groups were conducted, recorded, transcribed, and analyzed using a thematic analysis.ResultsThe extent to which patients in Singapore can exert autonomy in EoL care decision-making is influenced by five themes: (i) collusion over truth-telling to patient, (ii) deferment of autonomy by patients, (iii) negotiating patient self-determination, (iv) relational autonomy as the gold standard and (v) barriers to realization of patient choices.Significance of resultsHealthcare practitioners in Asian communities must align themselves with the values and needs of patients and their family and jointly make decisions that are consistent and congruent with the values of patients and their families. Sensitivity towards such cross-cultural practices is key to enhancing ACP awareness, discourse, and acceptability in Asian communities.

Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?

2009 ◽  
Vol 18 (2) ◽  
pp. 237-247 ◽  
Author(s):  
Guy David ◽  
Lorens A. Helmchen ◽  
Robert A. Henderson
Keyword(s):  
Medical Technology ◽  
Advanced Medical Technology
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