scholarly journals Er det at blive gammel tilstrækkelig årsag til dødshjælp?

2020 ◽  
pp. 235-247
Author(s):  
Søren Holm
Keyword(s):  
Mental Illness ◽  
Elderly People ◽  
Assisted Suicide ◽  
The Elderly ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Wish To Die ◽  
The Right ◽  
The Relationship ◽  
Vulnerable Elderly

A proposal put forth in the Dutch Parliament suggests that anyone over the age of 75 should have a legally guaranteed right to physician-assisted suicide if they wish to die, unless the wish is the result of a mental illness. This chapter discusses three questions about the relationship between age and entitlement to assisted dying: 1) are there good reasons to introduce a purely age-determined criterion for a right to assisted dying; 2) would such an age criterion lead to problematic discrimination against the elderly, or alternatively to discrimination against people who are too young to meet the criterion; and 3) what is the relationship between an age criterion and a postulated duty to choose assisted dying in specific situations. The discussion of these three issues shows that there are no good reasons for introducing an age criterion for the right to die, that an age criterion is potentially discriminatory to both the elderly and the young, and that introducing an age criterion could lead to problematic pressure against vulnerable elderly people.

Szasz, suicide, and medical ethics

Thomas Szasz ◽  
2019 ◽  
pp. 55-64
Author(s):  
George J. Annas
Keyword(s):  
Mental Illness ◽  
Informed Consent ◽  
Suicide Prevention ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
The Subject ◽  
The Right ◽  
Suicidal Patients ◽  
Commit Suicide

Szasz objected to the medicalization of suicide, the legalization of suicide prevention, and especially the coercive role of psychiatry in this realm. He declared that, by medicalizing suicide, we banish the subject from discussion. What is meant by acceptable and unacceptable “suicide”? Who has a right to commit suicide? How does suicide implicate freedom? Does it reflect abortion jurisprudence? How do psychiatrists become suicide’s gatekeepers? Current phenomena (e.g., new physician-assisted suicide legislation) illuminate these and other issues (e.g., euthanasia, informed consent, informed refusal, the “right to die,”), all suggesting how Szasz would react to each. Suicide is legal, but is almost always considered a result of mental illness. Courts approve psychiatrists who want to commit “suicidal” patients involuntarily. Granting physicians prospective legal immunity for prescribing lethal drugs is, at best, a strange and tangential reaction to our inability to discuss suicide (and dying) rationally. Szasz got it right.

19. Medical Assistance in Dying

2019 ◽  
pp. 615-665
Author(s):  
G. T. Laurie ◽  
S. H. E. Harmon ◽  
E. S. Dove
Keyword(s):  
Medical Treatment ◽  
Assisted Suicide ◽  
Double Effect ◽  
Legal Aspects ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Medical Assistance ◽  
Philosophical Concept ◽  
Medical Assistance In Dying ◽  
The Relationship

This chapter discusses ethical and legal aspects of euthanasia and assisted dying. It first examines the non-voluntary termination of life, covering the relationship between medical treatment and assistance in dying as a matter of failure to treat, and the philosophical concept of ‘double effect’. The chapter then discusses activity and passivity in assisted dying; dying as an expression of patient autonomy; suicide and assisted suicide; physician-assisted suicide; and assisted dying in practice.

Ethics in cancer care

2019 ◽  
pp. 159-172
Keyword(s):  
Assisted Suicide ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
The United Kingdom ◽  
Drug Treatments ◽  
Potential Benefits ◽  
The Uk ◽  
The Right

The biomedical ethical principles of autonomy, beneficence, non-maleficence, and justice are well established, though they have been challenged by feminist and nursing ethics. Decision-making in practice requires a balance of not only ethical principles, but also legal and professional frameworks, alongside patient and family wishes. Cancer clinical trials raise ethical issues around the balance between risk and potential benefits to patients, and they may need support making the right decision about whether to participate. The rising cost of cancer drug treatments has raised difficult questions about which drugs should be authorized for use within the United Kingdom (UK)'s National Health Service. End-of-life care raises particularly challenging ethical issues. Mental capacity or competence is defined in law in the UK, and treatment decisions may be made on behalf of patients if they are assessed and found to lack capacity. However, patients and families are encouraged to make advance statements and decisions about treatment in the event of losing capacity. Decisions on whether to give, withdraw, or withhold treatment, artificial hydration and nutrition, and cardiopulmonary resuscitation (CPR) are sensitive, and should be based on assessment, consultation with family, and consideration of ethical, legal, and professional principles. Euthanasia and physician-assisted suicide (assisted dying) are highly contentious issues internationally and illegal in most countries. Some countries allow them under certain circumstances. In response to a patient asking about assisted dying, the nurse should listen to their concerns, be prepared to talk about the process of dying, and support them to establish their priorities.

Developments in the practice of physician-assisted dying: perceptions of physicians who had experience with complex cases

2016 ◽  
Vol 44 (5) ◽  
pp. 292-296 ◽  
Author(s):  
Marianne C Snijdewind ◽  
Donald G van Tol ◽  
Bregje D Onwuteaka-Philipsen ◽  
Dick L Willems
Keyword(s):  
The Netherlands ◽  
Assisted Suicide ◽  
Secondary Analysis ◽  
Public Debate ◽  
Complex Case ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Physician Assisted Dying ◽  
The Right ◽  
The Way

BackgroundSince the enactment of the euthanasia law in the Netherlands, there has been a lively public debate on assisted dying that may influence the way patients talk about euthanasia and physician-assisted suicide (EAS) with their physicians and the way physicians experience the practice of EAS.AimTo show what developments physicians see in practice and how they perceive the influence of the public debate on the practice of EAS.MethodsWe conducted a secondary analysis of in-depth interviews with 28 Dutch physicians who had experience with a complex case of EAS. Respondents were recruited both by the network of physicians working for SCEN (Support and Consultation for Euthanasia in the Netherlands) as well as via a national questionnaire, wherein participating physicians could indicate their willingness to be interviewed.ResultsThree themes came up in analysing the interviews. First, the interviewed physicians experienced a change in what (family of) patients would expect from them: from a role as an involved caregiver to being the mere performer of EAS. Second, interviewees said that requests for EAS based on non-medical reasons came up more frequently and wondered if EAS was the right solution for these requests. Last, respondents had the impression that the standards of EAS are shifting and that the boundaries of the EAS regulation were stretched.ConclusionsThe perceived developments could make physicians less willing to consider a request for EAS. Our results also raise questions about the role of physicians and of EAS in society.

scholarly journals Differences between the Sexes in the Relationship between Chronic Pain, Fatigue, and QuickDASH among Community-Dwelling Elderly People in Japan

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 630
Author(s):  
Satoshi Shimo ◽  
Yuta Sakamoto ◽  
Takashi Amari ◽  
Masaaki Chino ◽  
Rie Sakamoto ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Elderly People ◽  
Physical Disability ◽  
The Elderly ◽  
Daily Basis ◽  
Community Dwelling ◽  
Negative Effects ◽  
The Relationship ◽  
Elderly Healthcare ◽  
Disability Research

Chronic pain and fatigue have negative effects on the health, ADL, work, and hobbies of the elderly. As the proportion of people 65 years of age and older in the population increases, chronic pain and disability research regarding this group is receiving more consideration. However, little empirical evidence of the association between chronic pain, fatigue, and physical disability between the sexes is available. This study investigated the association between chronic pain, fatigue, and instrumental activities of daily living among community-dwelling elderly people by sex in Japan. Concerning the presence of chronic pain, 61% of males and 78% of females reported chronic pain, indicating that many elderly people living in the community suffer from chronic pain and fatigue on a daily basis. The number of sites of chronic pain was higher in females than in males (p = 0.016), with more chronic pain in the knees (p < 0.001) and upper arms (p = 0.014). Regarding chronic pain, males showed a higher correlation with QuickDASH-DS (rs = 0.433, p = 0.017) and QuickDASH-SM (rs = 0.643, p = 0.018) than females. Furthermore, fatigue also showed a higher correlation with QuickDASH-W (rs = 0.531, p = 0.003) in males than in females. These results indicate that the association between chronic pain, fatigue, and QuickDASH differed between the sexes among community-dwelling elderly people in Japan. A better understanding of the risk factors for elderly chronic pain and fatigue among sexes will facilitate the development of elderly healthcare welfare and policies.

scholarly journals The Doctor–Patient Relationship: Does Christianity Make a Difference?

2021 ◽  
Vol 27 (1) ◽  
pp. 1-13
Author(s):  
James J Delaney
Keyword(s):  
Assisted Suicide ◽  
Clinical Encounter ◽  
Patient Relationship ◽  
Physician Assisted Suicide ◽  
Doctor Patient Relationship ◽  
Moral Tradition ◽  
Practice Of Medicine ◽  
Christian Understanding ◽  
The Relationship ◽  
Perinatal Hospice

Abstract The nature of the doctor–patient relationship is central to the practice of medicine and thus to bioethics. The American Medical Association (in AMA principles of medical ethics, available at: https://www.ama-assn.org/delivering-care/ethics/patient-physician-relationships, 2016) states, “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.” In this issue of Christian Bioethics, leading scholars consider what relevance (if any) Christianity brings to the relationship between physician and patient: does Christianity make a difference? The contributors consider this question from several different perspectives: the proper model of medicine, the role that the Christian moral tradition can play in medicine in a secular pluralistic society, how a Christian understanding of virtue can inform practices such as perinatal hospice and physician-assisted suicide, and whether or not appeals to Christian values can (or should) ground a physician’s right to conscientious objection.

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.

Mourning and Reminiscence: Parallel Psychotherapeutic Processes for Elderly People

1989 ◽  
Vol 28 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Linda L. Viney ◽  
Yvonne N. Benjamin ◽  
Carol Preston
Keyword(s):  
Elderly People ◽  
The Elderly ◽  
Relevant Information ◽  
Theoretical Explanation ◽  
Personal Construct ◽  
Elderly Persons ◽  
Personal Construct Theory ◽  
Psychotherapeutic Processes ◽  
Construct Theory ◽  
The Relationship

Mourning and reminiscence are therapeutic processes common in therapeutic work with the elderly. However, a theoretical explanation of why they are effective has been lacking. Personal construct theory accounts for both in terms of the search of elderly persons for validation of their construct systems. In this article, this explanation of the parallel psychotherapeutic processes is explored, together with relevant information from the literature on mourning and reminiscence. Therapeutic case studies illustrate the characteristics of the two processes and the relationship between them.

scholarly journals Euthanasia and suicide: a medical and social discourse

2021 ◽  
Vol 25 (1) ◽  
pp. 107-112
Author(s):  
V. N. Ostapenko ◽  
I. V. Lantukh ◽  
A. P. Lantukh
Keyword(s):  
Quality Of Life ◽  
Assisted Suicide ◽  
Human Life ◽  
Modern Science ◽  
Physician Assisted Suicide ◽  
Adequate Quality ◽  
The Subject ◽  
Strong Explosion ◽  
The Right

Annotation. The problem of suicide and euthanasia has been particularly updated with the spread of the COVID-19 pandemic, which caused a strong explosion of suicide, because medicine was not ready for it, and the man was too weak in front of its pressure. The article considers the issue of euthanasia and suicide based on philosophical messages from the position of a doctor, which today goes beyond medicine and medical ethics and becomes one of the important aspects of society. Medicine has achieved success in the continuation of human life, but it is unable to ensure the quality of life of those who are forced to continue it. In these circumstances, the admission of suicide or euthanasia pursues the refusal of the subject to achieve an adequate quality of life; an end to suffering for those who find their lives unacceptable. The reasoning that banned suicide: no one should harm or destroy the basic virtues of human nature; deliberate suicide is an attempt to harm a person or destroy human life; no one should kill himself. The criterion may be that suicide should not take place when it is committed at the request of the subject when he devalues his own life. According to supporters of euthanasia, in the conditions of the progress of modern science, many come to the erroneous opinion that medicine can have total control over human life and death. But people have the right to determine the end of their lives while using the achievements of medicine, as well as the right to demand an extension of life with the help of the same medicine. They believe that in the era of a civilized state, the right to die with medical help should be as natural as the right to receive medical care. At the same time, the patient cannot demand death as a solution to the problem, even if all means of relieving him from suffering have been exhausted. In defense of his claims, he turns to the principle of beneficence. The task of medicine is to alleviate the suffering of the patient. But if physician-assisted suicide and active euthanasia become part of health care, theoretical and practical medicine will be deprived of advances in palliative and supportive therapies. Lack of adequate palliative care is a medical, ethical, psychological, and social problem that needs to be addressed before resorting to such radical methods as legalizing euthanasia.

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