Embracing slippery slope on physician-assisted suicide and euthanasia could have significant unintended consequences

Buturovic, Zeljka

doi:10.1136/medethics-2020-106089

Cited by 12 publications

(18 citation statements)

References 4 publications

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“…In this study, which was designed within the framework of the methodology of medical ethics, the bionic transformation of human body is discussed in the light of the slippery slope argument. The slippery slope argument is frequently used in the field of medical ethics for the critical evaluation of the decisions regarding the beginning and end of life [15][16][17], fair allocation of limited resources, the transplantation-related issues [18,19]. In composite tissue transplantation, some of the opportunities offered by advanced technological developments may include practices that can serve to reconstruct human body.…”

Section: Methodsmentioning

confidence: 99%

Bionic construction of the human body in the light of the slippery slope argument

Keleş

2022

Health Sci. Q.

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Composite tissue transplantation has gained a new dimension in line with advanced technological developments. In extremity losses, the traditionally implemented procedure is to enable the extremity to regain its functionality through replantation instead of transplantation. On the other hand, innovative studies are also carried out to support and strengthen the human body and improve the problematic body functions for increasing patients’ quality of life. Studies on developing biomechatronic systems, which are related to biology, neurology, biophysics, mechanics, biomedical and tissue engineering, electronics, and computer sciences, are in progress, which indicates that a transformation has occurred in the approaches to composite tissue transplantation. This study aims to generate ideas about determining a conventional limit in the interventions towards the human body against the technological and scientific developments and to perform a value analysis on such interventions. This study was designed within the framework of the methodology of medical ethics and in the light of the slippery slope argument. The process of transformation from the medical procedures that aim to protect patients’ bodily integrity to the innovative practices that provide an opportunity to bionically turn healthy human bodies into the half machine and half-human is investigated in the light of the slippery slope argument. This study indicated that the value-related problems regarding this issue are related to the principles of respect for autonomy, beneficence, non-maleficence, and justice. The limit to be determined for the practices that aim to protect the patients’ bodily integrity and increase their quality of life and that are not life-saving depends on the distinction between an ill body and a healthy body. A meticulous clinical perspective and legislative regulations that prevent the instrumentalization of humans are required so as not to roll down to undesirable places on a slope. Advanced technological developments are implemented in medicine, protecting human dignity should be adopted as a fundamental value.

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Section: Methodsmentioning

confidence: 99%

Bionic construction of the human body in the light of the slippery slope argument

Keleş

2022

Health Sci. Q.

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“…For example, economic pressures are a reality in most health systems, with the risk that providing MAiD is far more cost-effective than medical care to chronically ill patients [9] Furthermore, some of the people requesting MAiD-NT are likely to be a source of usable organs for transplantation. Strengthening the link between MAiD and organ donation could damage the trust in medical, professional and public health authorities [10]. Therefore, MAiD-NT is extremely dangerous, especially when extended to minors and people with psychiatric disorders, as well as in those whose cognitive impairments (e.g.…”

Section: The Moral Debate About Maid-nt In Psychiatry and Unsolved Pr...mentioning

confidence: 99%

“…It is however true that some who consider MAiD acceptable for people in a terminal somatic condition face a series of challenges in people with mental illness as follows: the ethical distinction between helping a dying person die peacefully versus providing death to a non-dying person; the unpredictability of prognosis of non-terminal conditions such as most mental illnesses; the difficulty that MAiD-NT may put vulnerable or marginalized people at risk of seeking death as a relief from poverty, loneliness, or other psychosocial stressors [10,[20][21][22][23][24]. For example, Trachsel and Jox [25 ••] examined the criteria for MAiD-NT in Switzerland and considered the criteria put forward by the Swiss Academy of Medical Sciences, namely, intolerable suffering due to severe illness or functional limitations (and acknowledged as such by a physician), are not sufficient.…”

Section: The Moral Debate About Maid-nt In Psychiatry and Unsolved Pr...mentioning

confidence: 99%

Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders

Grassi

Folesani

Marella

et al. 2022

Curr Psychiatry Rep

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Purpose of Review Over the last 30 years, medical assistance in dying (MAiD) including euthanasia (EU) and physician-assisted death (or suicide, PAS) has become the center of a large debate, particularly when these practices have involved people with psychiatric illness, including resistant depression, schizophrenia, personality, or other severe psychiatric disorders. We performed a review utilizing several databases, and by including the most relevant studies in full journal articles investigating the problem of MAiD in patients with psychiatric disorders but not in physical terminal conditions (non-terminal, MAiD-NT). Recent Findings Literature has shown that a small percentage of people with psychiatric disorders died by MAiD-NT in comparison with patients with somatic diseases in terminal clinical conditions (e.g., cancer, AIDS). However, the problem in the field is complex and not solved yet as confirmed by the fact that only a few countries (e.g., the Netherlands, Belgium, Luxemburg) have legalized MAiD-NT for patients with psychiatric disorders, while most have maintained the practices accessible only to people with somatic disease in a terminal phase. Also, how to make objective the criterion of irremediability of a mental disorder; how to balance suicide prevention with assisted suicide; how to avoid the risk of progressively including in requests for MAiD-NT vulnerable segments of the population, such as minors, elderly, or people with dementia, in a productive-oriented society, are some of the critical points to be discussed. Summary The application of MAiD-NT in people with psychiatric disorders should be further explored to prevent end-of-life rights from contradicting the principles of recovery-oriented care.

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“…From an ethical perspective, this would represent a significant paradigm shift from existing standards of care in neuropsychiatry, where suicide is seen as something to be prevented rather than permitted under supervision ( Serafini et al, 2016 ; D'Anci et al, 2019 ); this could also lead to a “slippery slope” phenomenon where PAS is seen as the simplest or most cost-effective intervention for any difficult-to-treat neuropsychiatric disorder, particularly in vulnerable populations. This would further erode trust in the healthcare system and impede care among patients with such disorders ( Buturovic, 2020 ). Such a concern is not merely theoretical; there is already evidence from a Belgian series that women are far more likely to undergo PAS for dementia or mood disorders than men ( Dierickx et al, 2017 ).…”

Section: Pitfalls Inherent In the Practice Of Pas In The Specific Case Of Dementiamentioning

confidence: 99%

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

Rajkumar

2021

Front. Sociol.

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There has been an increasing drive towards the legalization of physician-assisted suicide (PAS) in patients with dementia, particularly in patients with advanced disease and severe cognitive impairment. Advocacy for this position is often based on utilitarian philosophical principles, on appeals to the quality of life of the patient and their caregiver(s), or on economic constraints faced by caregivers as well as healthcare systems. In this paper, two lines of evidence against this position are presented. First, data on attitudes towards euthanasia for twenty-eight countries, obtained from the World Values Survey, is analyzed. An examination of this data shows that, paradoxically, positive attitudes towards this procedure are found in more economically advanced countries, and are strongly associated with specific cultural factors. Second, the literature on existing attitudes towards PAS in cases of dementia, along with ethical arguments for and against the practice, is reviewed and specific hazards for patients, caregivers and healthcare professionals are identified. On the basis of these findings, the author suggests that the practice of PAS in dementia is not one that can be widely or safely endorsed, on both cultural and ethical grounds. Instead, the medical field should work in collaboration with governmental, social welfare and patient advocacy services to ensure optimal physical, emotional and financial support to this group of patients and their caregivers.

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Embracing slippery slope on physician-assisted suicide and euthanasia could have significant unintended consequences

Cited by 12 publications

References 4 publications

Bionic construction of the human body in the light of the slippery slope argument

Bionic construction of the human body in the light of the slippery slope argument

Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

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