When Hospice Fails: The Limits of Palliative Care

1994 ◽  
Vol 29 (4) ◽  
pp. 291-301 ◽  
Author(s):  
Barbara J. Logue
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Assisted Suicide ◽  
Patient Autonomy ◽  
Right To Die ◽  
Active Euthanasia ◽  
Important Place ◽  
Palliative Approach ◽  
The Right

Hospice is the best-known example of palliative care. Advocates maintain that good palliative care precludes any need for suicide, assisted suicide, or euthanasia for suffering patients near the end of life. This article examines the feasibility of the palliative approach for all patients, showing that reasonable people may refuse even the most exemplary care for themselves or an incompetent relative. Palliative care should always have an important place in medicine. Yet medical realities and the alleviation of pointless suffering necessitate that policymakers consider other options, including “active” euthanasia, consistent with patient autonomy and the right to die.

The “Right to Die” (DRAFT)

2018 ◽  
Author(s):  
Robert C. Macauley
Keyword(s):  
Medical Treatment ◽  
End Of Life ◽  
Pain Medication ◽  
Palliative Sedation ◽  
Patient Rights ◽  
Right To Die ◽  
Active Euthanasia ◽  
Passive Euthanasia ◽  
Life Sustaining Treatment ◽  
The Right

Formerly referred to as “passive euthanasia,” forgoing life-sustaining medical treatment came to be accepted in the 1970s based on a patient’s right to privacy. In order to achieve this societal shift, the practice was clearly distinguished from active euthanasia, which was universally rejected. Over the ensuing decades, other permutations of “the right to die”—including receiving intensive pain medication at the end of life and palliative sedation—were considered and accepted to varying degrees. Modern advocates of euthanasia now argue that it is not, in fact, so different from forgoing life-sustaining medical treatment, which endangers the critical consensus that lies at the heart of the patient rights movement. Voluntarily stopping eating and drinking is also discussed, as well as the ethical equivalence of withdrawing and withholding life-sustaining treatment.

scholarly journals Should euthanasia and assisted suicide be legal?

2019 ◽  
Vol 20 (1) ◽  
pp. 45-75
Author(s):  
Hrvoje Vargić
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
The Netherlands ◽  
Assisted Suicide ◽  
Self Determination ◽  
Right To Die ◽  
The Right ◽  
Key Terms

The article examines whether countries should legalize euthanasia and assisted suicide. Firstly, context of the debate is provided by defining the key terms and giving the overview of how the debate evolved throughout history. The arguments in favor of legalizing euthanasia and assisted suicide are addressed, namely the argument from autonomy and self–determination and the claim for the “right to die with dignity”. The consequences which were showed to occur in the countries which legalized euthanasia and/or assisted suicide are analyzed, and the case study on the Netherlands and Belgium is made. Finally, the model for the dignity–respecting health–care is proposed followed by the call for bigger accessibility and funding for palliative care.

When choosing death is an affirmation of life: A public remembrance of our family’s journey

2017 ◽  
Vol 114 (3) ◽  
pp. 414-423
Author(s):  
H. James Hopkins ◽  
Karen D. Hopkins
Keyword(s):  
Pancreatic Cancer ◽  
End Of Life ◽  
Assisted Suicide ◽  
Major Surgery ◽  
Right To Die ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
The Road ◽  
The Family ◽  
The Right

This article is a theological reflection written four months after the death, at age 80, of Nedra Faye Hathaway, mother to co-author Karen and mother-in-law to co-author Jim. Nedra chose to end her life on October 24, 2016, over a year after being diagnosed with pancreatic cancer, almost eleven months after major surgery to remove her pancreas and four months after learning the cancer was still present even after eighteen chemotherapy treatments. For many years Nedra, an Oregonian, had been a proponent of the right to die with dignity. She had supported Oregon’s approval of “Death with Dignity” law. Different states refer to this as physician-assisted suicide, right to die, or euthanasia. After moving to California to reside with her daughter and son-in-law, Nedra was diagnosed with pancreatic cancer, a diagnosis that eventually led to the conclusion that she had only months to live. After choosing to participate in California’s newly approved End of Life Option Act, Nedra agreed to contribute as part of an educational panel to support the Act. She wowed the participants of the Program. She expressed her strong belief in her right to make end-of-life decisions, appreciation for programs such as the one in which she was participating, her desire to see more states adopt Death with Dignity legislation, and her personal gratitude to each of the professionals who volunteer to support patients who make choices like hers. She also said, “I recognize there is a difference in supporting me in this process and agreeing with me at every turn in the road.” Following her participation on this panel nothing more was said to her by family members, initially uncomfortable with her decision, about taking her end-of-life medication. In the end, on a legal level, the family found that, with Nedra, they supported the adoption of “right-to-die” legislation by additional states. While they do not think that the choice she made will be the best choice for every person and every family, they acknowledge that simply having the right to choose the time and place of her death brought Nedra comfort; simultaneously, the family found themselves hoping they would have the same right regardless of which state they lived in.

scholarly journals IS THE RIGHT TO DIE WITH DIGNITY CONSTITUTIONALLY GUARANTEED? BAXTER V MONTANA* AND OTHER DEVELOPMENTS IN PATIENT AUTONOMY AND PHYSICIAN ASSISTED SUICIDE

Obiter ◽  
2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Suhayfa Bhamjee
Keyword(s):  
Supreme Court ◽  
Assisted Suicide ◽  
Patient Autonomy ◽  
Voluntary Euthanasia ◽  
Right To Die ◽  
Physician Assisted Suicide ◽  
Right To Life ◽  
The Supreme Court ◽  
The Right

This article examines the question of whether the right to life encompasses the right to die with dignity. It looks at the concepts of autonomy and paternalism as they exist as major themes on either side of the debate. Physician Assisted Suicide (Voluntary Euthanasia) has come under the spotlight in several jurisdictions, not just our own. Most recently in Montana, USA, the issue came before the Supreme Court for deliberation. The states of Washington and Oregon have legislations specific to PAS, legitimizing assisted suicide and removing wrongfulness from the actions of a physician who assists in the prescribed manner. Montana does not have specific legislation, but instead relied on the clauses of its Constitution, and it was held that the right to die with dignity is constitutionally guaranteed in that state. Here, argument is made suggesting that the right to die with dignity, in other words, to seek and easy passing through PAS, is also guaranteed in our Constitution.

scholarly journals 77 National Audit of Care At the End of Life (NACEL)—Round Two Findings

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
D Hibbert
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Service ◽  
Palliative Care Service ◽  
Care Plan ◽  
Specialist Palliative Care ◽  
Experience Of Care ◽  
Outcomes Of Care ◽  
Specialist Palliative Care Service ◽  
The Right

Abstract   NACEL is a national comparative audit of the quality and outcomes of care experienced by the dying person and those important to them during the final admission in acute and community hospitals in England and Wales. Mental health inpatient providers participated in the first round but excluded from the second round. NACEL round two, undertaken during 2019/20, comprised: Data was collected between June and October 2019. 175 trusts in England and 8 Welsh organisations took part in at least one element of NACEL (97% of eligible organisations). Key findings include Recognising the possibility of imminent death: The possibility that the patient may die was documented in 88% of cases. The median time from recognition of dying to death was 41 hours (36 hours in the first round). Individual plan of care: 71% of patients, where it had been recognised that the patient was dying (Category 1 deaths), had an individualised end of life care plan. Of the patients who did not have an individualised plan of care, in 45% of these cases, the time from recognition of dying to death was more than 24 hours. Families’ and others’ experience of care: 80% of Quality Survey respondents rated the quality of care delivered to the patient as outstanding/excellent/good and 75% rated the care provided to families/others as outstanding/excellent/good. However, one-fifth of responses reported that the families’/others’ needs were not asked about. Individual plan of care: 80% of Quality Survey respondents believed that hospital was the “right” place to die; however, 20% reported there was a lack of peace and privacy. Workforce Most hospitals (99%) have access to a specialist palliative care service. 36% of hospitals have a face-to-face specialist palliative care service (doctor and/or nurse) available 8 hours a day, 7 days a week. NACEL round three will start in 2021.

Terminal Sedation: Palliative Care for Intractable Pain, Post Glucksberg and Quill

2003 ◽  
Vol 29 (1) ◽  
pp. 45-76
Author(s):  
Rob McStay
Keyword(s):  
Palliative Care ◽  
Supreme Court ◽  
Assisted Suicide ◽  
Life Support ◽  
Intractable Pain ◽  
Terminal Sedation ◽  
Physician Assisted Suicide ◽  
The Right ◽  
Artificial Life Support ◽  
Unconscious State

In 1997, the U.S. Supreme Court tacitly endorsed terminal sedation as an alternative to physician-assisted suicide, thus intensifying a debate in the legal and medical communities as to the propriety of terminal sedation and setting the stage for a new battleground in the “right to die” controversy. Terminal sedation is the induction of an unconscious state to relieve otherwise intractable distress, and is frequently accompanied by the withdrawal of any life-sustaining intervention, such as hydration and nutrition. This practice is a clinical option of “last resort” when less aggressive palliative care measures have failed. Terminal sedation has also been described as “the compromise in the furor over physician-assisted suicide.”Medical literature suggests that terminal sedation was a palliative care option long before the Supreme Court considered the constitutional implications of physician-assisted suicide. Terminal sedation has been used for three related but distinct purposes: (1) to relieve physical pain; (2) to produce an unconscious state before the withdrawal of artificial life support; and (3) to relieve non-physical suffering.

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