Euthanasia And Other Medical Decisions Concerning The End Of Life

Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993.

claim was that he had faced a conflict of duties pitting his legal duty not to kill against his duty as a physician to relieve his patient’s unbearable suffering. He was acquitted on the important grounds of conflict of duty. These grounds are based on a concept in Dutch law called "force majeure" 4 which recognizes extenuating circumstances such as conflicts of duty. The acquittal was upheld by the Lower Court of Alkmaar, but revoked by an Amsterdam court of appeal. The case went on to the Supreme Court, but before the Supreme Court's decision was issued, the Royal Dutch Medical Association (RDMA) attempted to clarify the criteria for euthanasia that many within the profession already accepted. The RDMA proposed that physicians be permitted to perform euthanasia provided that a set of procedures had been met. Variously stated, the guidelines contain the following central provisions: Voluntary, competent, explicit, and persistent requests on the part of the • patient; Requests based on full information; • The patient is in a situation of intolerable and hopeless suffering (either • physical or mental); No further acceptable alternatives to euthanasia. All alternatives • acceptable to the patient for relief of suffering having been tried; Consultation with at least one other physician whose judgment can be • 5 expected to be independent. Indirectly, these guidelines became the criteria prosecutors used to decide whether or not to bring charges.

The Bill was published as HLB 4, session 2004-05 (ISBN 01084188390). This volume contains a selection of the 14,000 personal letters and other submissions received by the Committee with regards to their inquiry into the Bill.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

This deeply informed history traces the controversial record of "mercy-killing," a source of heated debate among doctors and laypeople alike. Dowbiggin examines evolving opinions about what constitutes a good death, taking into account the societal and religious values placed on sin, suffering, resignation, judgment, penance, and redemption. He also examines the bitter struggle between those who stress a right to compassionate and effective end-of-life care and those who define human life in terms of either biological criteria, utilitarian standards, a faith in science, humane medical treatment, the principle of personal autonomy, or individual human rights. Considering both the influence of technological and behavioral changes in the practice of medicine and the public's surprising lack of awareness of death's many clinical and biological dimensions, this book raises profound personal and collective questions on the future of euthanasia.

This is a book about a controversial issue—whether doctors should be licensed by law to supply lethal drugs to terminally ill patients. It is written primarily for those who want to find a path through the thickets of a subject that transcends many fields of expertise. The authors have considerable experience of the matters about which they write, involving both research and hands-on medical care of dying people. They are not neutral about ‘assisted dying’: they are not convinced that the law is in need of change. However, the book employs an evidence-based approach and brings much-needed clarity to such complex issues as how the existing law works, how medical practice operates at the end of life, and what has been the experience of jurisdictions that have gone down the ‘assisted dying’ road. Above all, the book shows respect for the views of others who may judge the evidence differently.