End of life decision making in healthcare in the prism of Council of Europe’s Human Rights Standards

2021 ◽  
Vol 2(24) ◽  
pp. 137-155
Author(s):  
Daria Bieńkowska
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
End Of Life ◽  
Assisted Suicide ◽  
Individual Autonomy ◽  
Council Of Europe ◽  
The Subject ◽  
Human Rights Standards ◽  
End Of Life Decision ◽  
Life Decision

The issue of decisions made at the end of life relating to the so-called “Right to death”, “death in dignity”, which in the literature on the subject is referred to as end-of-life decision making in the legal and medical space, arouses the interest of lawyers and doctors, and due to the specific gravity of the topic, it is also the subject of public debate. This article presents the issue of end-of-life decision making in health care in the light of the standards of the Council of Europe. The main purpose of the problem outlined in this way will be to analyze the legal admissibility of decisions concerning the end of life at the request of the interested person in the legal and human perspective. The summary indicates that despite the lack of a consensus in contemporary Europe as to the understanding of human rights, and hence the admissibility of active euthanasia and assisted suicide, the situation may change with the increasing emphasis on individual autonomy in medical law.

Agency and Communion in End-of-Life Decision-Making

2016 ◽  
Vol 25 (2) ◽  
pp. 87-106 ◽  
Author(s):  
Raymond C. Hawkins
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Assisted Suicide ◽  
Autonomous Agent ◽  
Life Transition ◽  
Small Community ◽  
Small Communities ◽  
Agency And Communion ◽  
End Of Life Decision ◽  
Life Decision

Both the assisted suicide and the hospice or palliative medicine movements are alike in that each weighs the wishes of the patient and family for end-of-life medical decisions. The balancing of agency and communion within small communities of support may provide the opportunity to inform end-of-life decision-making and acceptance of the dying process. In this sense, the spirit of “communitas” may instill faith that the ending of one’s life journey is both reasonable and meaningful. The role of the small community of support may be akin to that of the guide who assists the aging or dying person through the dialectic of being an autonomous agent and a communicant in the end-of-life transition.

scholarly journals 重審生命倫理學視域下身體話語的地位——以臨終決策為線索

2015 ◽  
Vol 13 (1) ◽  
pp. 83-94
Author(s):  
Jue WANG
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Personal Identity ◽  
Ethical Issues ◽  
Family Members ◽  
The Body ◽  
Confucian Ethics ◽  
Individual Autonomy ◽  
End Of Life Decision ◽  
Life Decision

LANGUAGE NOTE | Document text in Chinese; abstract also in English.對於生命終極的關懷，臨終決策是現代生命倫理學不可忽視的一個重大話題。本文試圖從身體的角度論證當代生命倫理學話語由於失落了身體而陷入一場深刻的危機。具體而言，本文將通過對臨終決策困境的分析展示危機的根源，論證身體經驗及相關倫理關係是生命倫理學不可或缺的基礎。作者認為，只有作為身體倫理，生命倫理學才能充分實現它的學術追問和學科理念。身心二元論只是一個虛構，身體性存在才是人格同一性的真正基礎。因此，建設生命倫理學不只是擁抱某些抽象的自主原則，或是某些精緻的道德主體的體系，更關鍵的問題是要回答“我們希望成為何等樣的人，希望將來生活在怎樣的世界中”。How is the body articulated in language and discourse during end-of-life decision making? How do individuals and their family members represent and define the relationships between person, body, and self? Recently, studies have been conducted on the decision-making process in the field of end-of-life care. Most researchers focus on patients’ determination (vis-à-vis physicians’ beneficence), which gives rise to a plethora of issues, such as patients’ self-identity, self-continuity, relationships, freedom of choice,and rights.In this paper, end-of-life decision making is considered from the perspective of the relationship between the body and one’s personal identity. It is argued that the current bioethical discourse on individual autonomy and patients’ rights is inadequate to address the ethical issues relating to end-of-life decision making. Instead of purely theoretically conceptualizing the sovereignty of the patient over his or her body, the author explores the issue in relation to the phenomenology of lived-body experience as described by the American bioethicist Margret P. Battin. The rights available to the patient are not the only significant issue during end-of-life decision-making; aspects of the patient’s physicality are also relevant. Discourse on representations of the body and embodied action/autonomy aids our understanding of end-of-life choices. Finally, these body-related issues are linked with the Confucian understanding of what a person is. According to Confucian ethics, personal identity should not be viewed as an abstract “thing”; instead, it is defined by a person’s relationships with others, especially family members, in his/her most vulnerable moments.DOWNLOAD HISTORY | This article has been downloaded 138 times in Digital Commons before migrating into this platform.

scholarly journals Autonomy – A leading principle in the end-of-life decision making?

2013 ◽  
Vol 3 (2) ◽  
pp. 19
Author(s):  
Helena Peterková
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Assisted Suicide ◽  
Legal Concept ◽  
Competent Patient ◽  
Patient’S Autonomy ◽  
The World ◽  
The Will ◽  
End Of Life Decision ◽  
Life Decision

Objective: The objective of this paper is to introduce some of the most specific legal regulations on informed consent and patient’s will and to show the limits of the recognition of patient’s autonomy, especially as the end-of-life issues are regarded. Autonomy of a competent patient is often presented as an overwhelming argument in the end-of-life debate, regardless whether in the context of life termination on request or in the decision making about withdrawal or withholding of the treatment. Despite of the general opinion, that decriminalization of life termination on request is legitimately based on the respect for the patient’s wishes to die, even in the world most liberal end-of-life law of Benelux countries the legal concept seems to be built in a considerably different and more sophisticated way, as it does not solely rely on the request of the patient to be administered the lethal dose. Basically, the will of a competent patient to be let die is to be understood as a reason for the doctors to omit the further medical treatment, even if this omission leads to death of the patient. To the contrary, no actively caused death, as well as actively caused grievous injuries which are not a result of an acknowledged proper treatment, can be pleaded lawful with the reference to the consent of the patient. With this paper, the extent of exercising patient’s autonomy concerning the specific law on euthanasia in some European countries was examined to show on these examples the perhaps too overestimated factual impact of the autonomy principle in the medical law. Methods: Whilst comparing the most liberal legal systems in the world (among others the Swiss and Dutch ones) in which either life termination on request and/or assisted suicide was conditionally decriminalised, a critical analysis was performed to show to what extent and under which circumstances represents the will of a competent patient a defence to a doctor who provided the patient with life termination on request or assisted suicide or let the patient die. Results: According to the analysis, in no legal jurisdiction in the world the will (incl. consent and request) of the patient as such can serve as a full defence; for decriminalisation of the life termination on request or assisted suicide the fulfilment of other criteria must be reached. Conclusions: Although the will of the patient can with no doubt be understood as a conditio sine qua non for decriminalisation of life termination on request and/or assisted suicide, without being accomplished with other legal requirements it cannot be pleaded as full defence. Therefore, as the area of end-of-life decision making is concerned, the primacy of principle of autonomy should not be automatically taken for granted.

End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making

2011 ◽  
Author(s):  
Udo Schuklenk ◽  
Johannes J. M. van Delden ◽  
Jocelyn Downie ◽  
Sheila McLean ◽  
Ross Upshur ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Royal Society ◽  
Expert Panel ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals “What Would You Do?”: How Cat Owners Make End-of-Life Decisions and Implications for Veterinary-Client Interactions

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1114
Author(s):  
Katherine Littlewood ◽  
Ngaio Beausoleil ◽  
Kevin Stafford ◽  
Christine Stephens
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
End Of Life ◽  
Companion Animals ◽  
Chronically Ill ◽  
Future Research ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Cats are the most common companion animals in New Zealand. Advances in veterinary care means that cats are living longer and there are many older cats. End-of-life decisions about cats are complicated by owner–cat relationships and other psychosocial factors. Our study explored the ways in which end-of-life decisions were being made by owners of older and chronically ill cats in New Zealand and the role of their veterinarian in the process. Qualitative data were gathered via retrospective semi-structured interviews with 14 cat owners using open-ended questions. Transcripts of these interviews were explored for themes using template analysis and nine themes were identified. Four were animal-centered themes: cat behavior change, pain was a bad sign, signs of ageing are not good, and the benefits of having other people see what owners often could not. Five were human-centered themes: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good veterinarian to manage end of life, veterinary validation that owners were doing the right thing, and a strong desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided but continuity of care was important. Future research aimed at exploring the veterinarian’s perspective during end-of-life decision making for cats would be a valuable addition to the topic.

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