scholarly journals On the ethics of withholding and withdrawing medical treatment

2014 ◽  
Vol 9 ◽  
Author(s):  
Massimo Reichlin
Keyword(s):  
Medical Treatment ◽  
End Of Life ◽  
Active Euthanasia ◽  
Voluntary Active Euthanasia ◽  
Lateral Amyotrophic Sclerosis

A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it.

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.

Die Grundsätze der Bundesärztekammer zur ärztlichen Sterbebegleitung

1999 ◽  
Vol 43 (1) ◽  
pp. 85-96 ◽  
Author(s):  
Mirjam Zimmermann ◽  
Ruben Zimmermann
Keyword(s):  
Medical Association ◽  
End Of Life ◽  
Assisted Suicide ◽  
Treatment Decisions ◽  
Voluntary Euthanasia ◽  
Active Euthanasia ◽  
Medical Decisions ◽  
German Medical Association ◽  
Voluntary Active Euthanasia

Abstract The guidelines of the >German Medical Association< for doctors treating the dying passed on 11. Sept. 1998 are trying to provide an ethically justified frame for medical decisions conceming the end of life. In certain justified cases they allow non-treatment decisions and allevation of pain and symptoms that might cause the patient's death while they strictly reject voluntary active euthanasia, non-voluntary euthanasia or assisted suicide

scholarly journals Managing Profound Suffering at the End-of-Life: Should expanding access to continuous deep sedation be the priority?

2016 ◽  
Vol 4 ◽  
Author(s):  
Jeffrey Kirby
Keyword(s):  
End Of Life ◽  
Healthcare Provider ◽  
Assisted Suicide ◽  
Deep Sedation ◽  
Patient Access ◽  
Active Euthanasia ◽  
Physician Assisted Suicide ◽  
Continuous Deep Sedation ◽  
Voluntary Active Euthanasia

This paper argues that in addressing and managing profound suffering at the end-of-life, the priority should not be the legalization of physician-assisted suicide or voluntary active euthanasia in jurisdictions where these practices are not currently available. Rather, concerted efforts should be made by society and the healthcare provider community to expand patient access to proportionate distress-relieving sedation and continuous deep sedation.

Aid-in-Dying: Should We Decriminalize Physician-Assisted Suicide and Physician-Committed Euthanasia?

1992 ◽  
Vol 18 (4) ◽  
pp. 369-394 ◽  
Author(s):  
Maria T. CeloCruz
Keyword(s):  
Medical Journal ◽  
Assisted Suicide ◽  
Active Euthanasia ◽  
Physician Assisted Suicide ◽  
Journal Articles ◽  
News Stories ◽  
Voluntary Active Euthanasia ◽  
Aid In Dying

Recent news stories, medical journal articles, and two state voter referenda have publicized physicians’ providing their patients with aid-in-dying. This Note distinguishes two components of aid-in-dying: physician-assisted suicide and physiciancommitted voluntary active euthanasia. The Note traces these components’ distinct historical and legal treatments and critically examines arguments for and against both types of action. This Note concludes that aid-in-dying measures should limit legalization initiatives to physician-assisted suicide and should not embrace physician-committed voluntary active euthanasia.

Of dilemmas and tensions: a qualitative study of palliative care physicians’ positions regarding voluntary active euthanasia in Quebec, Canada

2018 ◽  
Vol 45 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Emmanuelle Bélanger ◽  
Anna Towers ◽  
David Kenneth Wright ◽  
Yuexi Chen ◽  
Golda Tradounsky ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Patient Autonomy ◽  
Research Question ◽  
Interpretive Description ◽  
Active Euthanasia ◽  
Semistructured Interviews ◽  
Voluntary Active Euthanasia ◽  
Research Questions ◽  
Insight Into

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia (VAE). Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation.

Medical Treatment of the Cardiac Patient Approaching the End of Life

2005 ◽  
pp. 363-400
Author(s):  
Lofty L. Basta ◽  
W. Daniel Doty ◽  
Michael D. D. Geldart
Keyword(s):  
Medical Treatment ◽  
End Of Life ◽  
Cardiac Patient

Legal Issues in Death and Dying

2014 ◽  
Author(s):  
Alan Meisel
Keyword(s):  
Medical Treatment ◽  
End Of Life ◽  
Death And Dying ◽  
Federal Court ◽  
Legal Issues ◽  
Court Cases ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
Right To Refuse Treatment ◽  
Consent To Medical Treatment

This article examines the legal issues surrounding death and dying, emphasizing how clinical practice with respect to end-of-life decisions has been shaped by rights and autonomy. It shows how state and federal court decisions, beginning with the Karen Ann Quinlan case in 1975, led to the emergence of a consensus about the legality of withholding and withdrawing life-sustaining medical treatment. It considers three important court cases in 1972 involving “informed consent” to medical treatment, followed by other cases such as those involving Quinlan in 1975 and Nancy Cruzan in 1990. It then considers two modes of analyzing the propriety of end-of-life decisions that arose mostly from judicial opinions: the “state interests” approach and the “categorical” approach. It also discusses the explanations offered by the courts as to why foregoing life-sustaining medical treatment does not result in legal culpability for physicians, including causation, intent, right to refuse treatment, and palliative care.

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