How do we die?

2016 ◽  
Vol 35 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Bonnie Stabile ◽  
Aubrey Grant
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Hospice Care ◽  
Good Reason ◽  
The Elderly ◽  
The United States ◽  
Medical Intervention ◽  
Current Approach ◽  
Physician Assisted Suicide ◽  
Policy And Practice

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers’ final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring “death with dignity” cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome — despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices

1997 ◽  
Vol 6 (2) ◽  
pp. 189-204 ◽  
Author(s):  
Timothy E. Quill ◽  
Gerrit Kimsma
Keyword(s):  
United States ◽  
The Netherlands ◽  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Ethical Climate ◽  
The United States ◽  
Policy Implications ◽  
Life Care ◽  
Physician Assisted Suicide

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

The Oxford Handbook of Ethics at the End of Life

2014 ◽  
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Clinical Decision Making ◽  
Death And Dying ◽  
The United States ◽  
Dark Side ◽  
Human Beings ◽  
Cultural Issues ◽  
Physician Assisted Suicide ◽  
Persons With Disabilities

This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients’ values has been recognized as the essential moral component of clinical decision making. Technology’s promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability to control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book has six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations, such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as ways to address the psychosocial and ethical problems of death and dying.

scholarly journals End-of-Life Issues in the United States after Terri Schiavo: Implications for Social Work Practice

10.18060/1841 ◽  
2011 ◽  
Vol 12 (2) ◽  
pp. 164-180 ◽  
Author(s):  
Darrel Montero
Keyword(s):  
United States ◽  
End Of Life ◽  
Assisted Suicide ◽  
Work Practice ◽  
The United States ◽  
Social Work Practice ◽  
Physician Assisted Suicide ◽  
Life Issues ◽  
The Status ◽  
End Of Life Issues

The very public death of Terri Schiavo in 2005 alerted Americans to what is a growing ethical, medical, and social crisis: the status of end-of-life issues and decisions in the United States. Currently, Oregon is the only state to give terminally ill patients the right to end their lives, with physicians’ help, if they so choose. Public opinion data from 1977 to the present show that Americans support greater rights for individuals facing end-of-life decisions--up to and including physician-assisted suicide and euthanasia. This paper considers the status of end-of-life issues in the United States after Terri Schiavo’s death and examines the opportunities for advocacy by social workers who serve clients and families encountering this complex and controversial issue.

Hospice Care and the Bereavement Process in Two Countries: Experience from the United States and the Netherlands

2001 ◽  
Vol 9 (2) ◽  
pp. 173-189
Author(s):  
Robert L. Wrenn ◽  
Zbigniew Zylicz ◽  
David E. Balk
Keyword(s):  
United States ◽  
The Netherlands ◽  
Outcomes Research ◽  
Assisted Suicide ◽  
Hospice Care ◽  
The United States ◽  
Physician Assisted Suicide ◽  
Bereavement Care ◽  
Hospice Organization

The authors examine the bereavement process within hospice programs in the United States and in the Netherlands. Topics covered include brief histories of hospice within each country, circumstances that constrain bereavement outcomes research, approaches to hospice bereavement services in each country including bereavement program protocols developed by the National Hospice Organization for programs in the United States, issues of bereavement care and physician-assisted suicide, and an overall comparison of hospice bereavement services in each country.

Introduction

2015 ◽  
Author(s):  
Stuart J. Youngner ◽  
Robert M. Arnold
Keyword(s):  
Assisted Suicide ◽  
Death And Dying ◽  
The Elderly ◽  
The United States ◽  
Cultural Issues ◽  
Physician Assisted Suicide ◽  
Persons With Disabilities ◽  
Early Twenty ◽  
Continuous Sedation ◽  
Hospice And Palliative Care

This volume explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues, Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities, and Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

scholarly journals Currently Accepted Practices That Are Known to Lead to Death, and PAS: Is There an Ethically Relevant Difference?

1998 ◽  
Vol 7 (4) ◽  
pp. 375-381 ◽  
Author(s):  
THOMAS A. CAVANAUGH
Keyword(s):  
Public Policy ◽  
End Of Life ◽  
Assisted Suicide ◽  
Lethal Dose ◽  
Medical Intervention ◽  
Physician Assisted Suicide ◽  
Relevant Difference ◽  
Relieve Pain

A number of common and generally noncontroversial practices in the care of patients at the end of life lead to their deaths. For example, physicians honor a patient's refusal of medical intervention even when doing so leads to the patient's death. Similarly, with a patient's or surrogate's consent, physicians administer sedatives in order to relieve pain and distress at the end of life, even when it is known that doing so will cause the patient's death. In contemporary U.S. public policy, these practices are accepted as ethical and legal while physician-assisted suicide (PAS) is—for the most part—rejected in current U.S. law and public policy. Some think, however, that if one accepts practices that are known to lead to a patient's death, then one cannot reasonably reject a patient's request for a lethal dose of medication so that she may kill herself (PAS).

Rights Discourse and Assisted Suicide

2001 ◽  
Vol 27 (1) ◽  
pp. 45-99
Author(s):  
Penney Lewis
Keyword(s):  
United States ◽  
Assisted Suicide ◽  
Public Awareness ◽  
The United States ◽  
Medical Professionals ◽  
Physician Assisted Suicide ◽  
Criminal Trials ◽  
Supreme Courts ◽  
Rights Discourse ◽  
Law Professors

The debate surrounding the legalization of assisted suicide has been galvanized in recent years by reports of specific cases of assisted suicide, primarily involving physicians such as Kevorkian and Quill, and by impassioned pleas for legalization and assistance in suicide from individuals suffering in the throes of terminal or agonizing diseases, such as Sue Rodriguez. Media attention on criminal trials of individuals accused of assisting in a suicide has heightened public awareness of the issue. The constitutionality of criminal prohibitions on assisted suicide has been tested in various jurisdictions, and has recently been considered by the Supreme Courts of both the United States and Canada. Following two narrowly unsuccessful attempts to enact dignified death provisions by referenda in Washington and California, Oregon voters passed the first of such proposed laws in November 1994, providing for physician-assisted suicide under certain specified conditions. Attempts to introduce legislation to legalize assisted suicide in other jurisdictions have been galvanized by the success in Oregon. A model statute has been drafted by a group of law professors, philosophers and medical professionals.

scholarly journals Ethical considerations at the end-of-life care

2021 ◽  
Vol 9 ◽  
pp. 205031212110009
Author(s):  
Melahat Akdeniz ◽  
Bülent Yardımcı ◽  
Ethem Kavukcu
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Ethical Decision Making ◽  
Biomedical Ethics ◽  
Artificial Nutrition ◽  
Life Care ◽  
Ethical Challenges ◽  
Physician Assisted Suicide

The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care. The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide. Five ethical principles guide healthcare professionals in the management of these situations.

The Practice of Euthanasia and Physician-Assisted Suicide in the United States

JAMA ◽  
1998 ◽  
Vol 280 (6) ◽  
pp. 507 ◽  
Author(s):  
Ezekiel J. Emanuel ◽  
Elisabeth R. Daniels ◽  
Diane L. Fairclough ◽  
Brian R. Clarridge
Keyword(s):  
United States ◽  
Assisted Suicide ◽  
The United States ◽  
Physician Assisted Suicide
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