German Nurses, Euthanasia and Terminal Care: a Personal Perspective

2009 ◽  
Vol 16 (2) ◽  
pp. 231-237 ◽  
Author(s):  
Constanze Giese
Keyword(s):  
Terminal Care ◽  
Assisted Suicide ◽  
Present Situation ◽  
Professional Associations ◽  
Public Debate ◽  
Personal Perspective ◽  
Physician Assisted Suicide ◽  
End Of Life Decisions ◽  
History Of ◽  
Professional Care

The nursing profession in Germany is facing a public debate on legal and ethical questions concerning euthanasia on request and physician-assisted suicide. However, it seems questionable if the profession itself, individual nurses or the professional associations are prepared to be involved in such a public debate. To understand this hesitation, the present situation is considered in the light of the tradition and history of professional care in Germany. Obedience to medical as well as to religious authorities was long part of nurses' professional identity, but is no longer relevant. The lack of reflection and discussion on how to take a balanced view of ethical and political questions concerning nursing, and the role and responsibility of nurses in end-of-life decisions and situations of caring for dying people are discussed using the situation of nurses in the Netherlands as a comparison.

scholarly journals Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa D. Bergman ◽  
H. Roeline W. Pasman ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Psychiatric Disorders ◽  
Assisted Suicide ◽  
Public Debate ◽  
Main Diagnosis ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age Related ◽  
Attending Physician ◽  
Complex Cases

Abstract Background In the Netherlands, euthanasia or physician-assisted suicide (EAS) is allowed if due care criteria are met. One criterion is consultation of a second independent physician, often SCEN physicians. The public debate about EAS focuses on patients with psychiatric disorders, dementia, and tired of living, as complex cases. What complexities SCEN physicians perceive during consultation is unknown. This study aims to assess the frequency of EAS consultations that are perceived difficult by SCEN physicians, to explore what complexities are perceived by SCEN physicians during consultation, and to assess what characteristics are associated with difficult consultations. Methods Data from 2015 to 2017 from an annual cross-sectional survey among SCEN physicians was used. In 2015, the survey focused on the most difficult consultation that year and in 2016/2017 on the most recent consultation. Frequencies of coded answers to an open-ended question were done to explore what complexities SCEN physicians perceived during their most difficult consultation. Univariable and multivariable logistic regression analyses were used to assess what characteristics were associated with difficult consultations. Results 21.6% of cases consulted by SCEN physicians is perceived difficult. Complexities that SCEN physicians perceive were mainly in contact with patients (79.7%) and in the assessment of due care criteria (41.0%). Characteristics that were associated with a higher likelihood of a consultation being difficult are the attending physician being less certain to perform the EAS, patients staying in the hospital, main diagnosis heart failure/CVA, and accumulation of age-related health problems/psychiatry/dementia, and the presence of a psychiatric disorder, or psychosocial or existential problems besides the main diagnosis. Characteristics that were associated with a lower likelihood of a consultation being difficult are high patient’s age and physical suffering as reason to request EAS. Conclusion Complexities perceived by SCEN physicians in EAS consultations are not limited to the ‘complex’ cases present in the current public debate about EAS, e.g. patients with psychiatric disorders, dementia, and tired of living. Attention for these complexities in intervision could indicate if there is a need among SCEN physicians to enhance knowledge and skills in training and to receive specific support in intervision on these complexities.

Choose Your Medicine

2021 ◽  
Author(s):  
Lewis A. Grossman
Keyword(s):  
Social History ◽  
Assisted Suicide ◽  
The United States ◽  
Physician Assisted Suicide ◽  
Therapeutic Choice ◽  
Medical Licensing ◽  
American Law ◽  
History Of ◽  
Botanical Medicine ◽  
Patient Advocacy Groups

Choose Your Medicine is the first comprehensive history of the concept of freedom of therapeutic choice in the United States. It draws on legal history and the history of medicine (as well as political, intellectual, cultural, and social history) to examine the ways that persistent but evolving notions of a right to therapeutic choice have affected American law, regulation, and policy from the country’s origins to the present. It describes social movements and legal efforts dedicated to resisting government measures denying individuals an unfettered choice among therapeutic products and methods. The targets of this activism have included, among others, state medical licensing statutes, FDA restrictions on the distribution of unapproved drugs, state and federal prohibitions against medical marijuana, formulary limitations in government insurance programs, abortion restrictions, and prohibitions on physician-assisted suicide. The narrative’s protagonists range from unschooled supporters of botanical medicine in the early nineteenth century to sophisticated cancer patient advocacy groups in the twenty-first. The book considers how all of these examples, taken together, fit within the broader development of the idea of freedom of therapeutic choice in American history and law.

Physician-Assisted Suicide and Euthanasia: The Pharmacist's Perspective

2000 ◽  
Vol 40 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Mark E. Schneiderhan
Keyword(s):  
Assisted Suicide ◽  
Lethal Dose ◽  
Physician Assisted Suicide ◽  
Critical Position ◽  
End Of Life Decisions ◽  
The Individual ◽  
Effective Use ◽  
Pharmaceutical Agents ◽  
Special Responsibility

Pharmacists are in a critical position when pharmaceutical agents are prescribed for the purpose of physician-assisted suicide and/or euthanasia and they may need to decide whether dispensing a lethal dose of a medication is ethically and morally acceptable for a patient. In many cases, pharmacists may not even be aware that prescriptions are intended for physician-assisted suicide and/or euthanasia. Pharmacists have a special responsibility to protect patients who are contemplating end-of-life decisions such as physician- assisted suicide and euthanasia. Pharmaceutical care (“Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life … ”) requires that the pharmacist not only understands the medications but also the individual patient and the complexities of their lives and suffering. Only in this way can pharmacists provide safe and effective use of medications for the patients they serve.

Empirical research in the debate on physician-assisted suicide and voluntary euthanasia

2007 ◽  
Vol 2 (3) ◽  
pp. 129-132
Author(s):  
Stephen W Smith
Keyword(s):  
Empirical Data ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Sufficient Evidence ◽  
Voluntary Euthanasia ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Select Committee ◽  
End Of Life Decisions ◽  
The Uk

This article explores the use of empirical data when considering whether to legalize physician-assisted suicide (PAS) and voluntary euthanasia. In particular, it focuses on the evidence available to the Select Committee for the Assisted Dying for the Terminally Ill Bill on whether or not covert euthanasia is taking place in the UK under the current prohibition of PAS and voluntary euthanasia. The article shows that there is an insufficient evidentiary basis to make any claims about the extent of covert euthanasia within the UK, although there is sufficient evidence to conclude that instances of covert euthanasia do happen. The article also calls for more research to be conducted in order to determine the rate of covert euthanasia in order to inform debate about the legalization of end-of-life decisions such as PAS and voluntary euthanasia.

The Lost History of the Ninth Amendment

2009 ◽  
Author(s):  
Lash Kurt T
Keyword(s):  
Supreme Court ◽  
Assisted Suicide ◽  
Primary Sources ◽  
Physician Assisted Suicide ◽  
Patriot Act ◽  
The People ◽  
Wide Range ◽  
History Of ◽  
The Right ◽  
Ninth Amendment

The Ninth Amendment has had a remarkably robust history, playing a role in almost every significant constitutional debate in American history, including the controversy over the Alien and Sedition Acts, the struggle over slavery, and the constitutionality of the New Deal. Until very recently, however, this history has been almost completely lost due to a combination of historical accident, mistaken assumptions, and misplaced historical documents. Drawing upon a wide range of primary sources, most never before included in any book on the Ninth Amendment or the Bill of Rights, this book recovers the lost history of the Ninth Amendment and explores how its original understanding can be applied to protect the people's retained rights today. The most important aspect of this book is its presentation of newly uncovered historical evidence which calls into question the currently presumed meaning and application of the Ninth Amendment. The evidence not only challenges the traditional view regarding the original meaning of the Ninth Amendment, it also falsifies the common assumption that the Amendment lay dormant prior to the Supreme Court's “discovery” of the clause in Griswold v. Connecticut . As a history of the Ninth Amendment, the book recapitulates the history of federalism in America and the idea that local self-government is a right retained by the people. This issue has particular contemporary salience as the Supreme Court considers whether states have the right to authorize medicinal use of marijuana, refuse to assist the enforcement of national laws like the Patriot Act, or regulate physician-assisted suicide. The meaning of the Ninth Amendment has played a key role in past Senate confirmation hearings for Supreme Court justices and the current divide on the Court regarding the meaning of the Ninth Amendment makes it likely the subject will come up again during the next set of hearings.

To die, to sleep, perchance to dream? A response to DeMichelis, Shaul and Rapoport

2019 ◽  
Vol 45 (12) ◽  
pp. 832-834 ◽  
Author(s):  
Joel L Gamble ◽  
Nathan K Gamble ◽  
Michal Pruski
Keyword(s):  
Palliative Care ◽  
Medical Ethics ◽  
End Of Life ◽  
Assisted Suicide ◽  
Palliative Sedation ◽  
Physician Assisted Suicide ◽  
Medical Assistance ◽  
End Of Life Decisions ◽  
Medical Assistance In Dying ◽  
Life Decisions

In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (WOC). We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions that were generally accepted long before MAID was legal or considered ethical. Forgetting or misunderstanding the analyses would naturally lead one to think MAID and other end-of-life decisions are morally equivalent. Yet as we recall these well-developed analyses, it becomes clear that approving of some forms of sedation and WOC does not commit one to MAID. Paediatric patients and their families can rationally and coherently reject MAID while choosing palliative care and WOC. Finally, the authors do not substantiate their claim that MAID is like palliative care in that it alleviates suffering. It is thus unreasonable to use this supposition as a warrant for their proposed policy.

The Influence of Death Attitudes and Knowledge of End of Life Options on Attitudes toward Physician-Assisted Suicide

2009 ◽  
Vol 58 (4) ◽  
pp. 299-311 ◽  
Author(s):  
Steven W. Kopp
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Assisted Suicide ◽  
Health Care Policy ◽  
Physician Assisted Suicide ◽  
End Of Life Decisions ◽  
Death Attitudes ◽  
Attitudes Toward Death ◽  
Attitudinal Factors ◽  
Life Options

End of life decisions, such as physician-assisted suicide (PAS), have continued to be controversial as health care policy, moral, and individual health care issues. This study considers knowledge of end of life options and death attitudes as predictors of attitudes toward PAS. Data were gathered from approximately 300 adults through a mailing sent to a household research panel. Validated measures of attitudes toward PAS, knowledge about that state's assisted suicide laws, demographics, and attitudes toward death as measured through the Death Attitude Profile-Revised (DAP-R) were collected and analyzed. The data indicate that attitudes toward PAS are a function of knowledge of end of life options as well as death attitudinal factors.

Sign in / Sign up

Export Citation Format

Share Document