Euthanasia: a word no longer to be used or abused

Kuiper, Michael; Whetstine, Leslie M.; Holmes, John L; Streat, Stephen; Burrows, Richard; Seppelt, Ian; Crippen, David

doi:10.1007/s00134-006-0489-7

Cited by 14 publications

(14 citation statements)

References 4 publications

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“…They are correct in pointing out that end-of-life (EOL) decisions on treatment withdrawal require terminological clarity [3,4]. Hence, we agree with the authors concerning the difference between chronic diseases and painful terminal illness or persistent vegetative state (PVS) that require constitutive, temporary or life-sustaining treatment.…”

mentioning

confidence: 45%

A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

et al. 2011

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confidence: 45%

A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

et al. 2011

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“…Introducing adjectives (ie, active, voluntary, involuntary or nonvoluntary) to the word euthanasia only adds confusion to the debate on end-of-life decisions. We agree with the opinion that clearly-defined terms should be used to describe exactly what actions are taking place (eg, withdrawal of treatment, continuation of care, relief of pain, deactivation of medical devices, allowing to die, assisting to die) so as to improve our understanding of what really goes on during end-of-life decisions [2]. The descriptive term of physician-assisted death (dying) is widely used in the medical literature, replacing other emotive terms such as physician-assisted suicide and euthanasia [3-8].…”

Section: Introductionmentioning

confidence: 87%

“…The literature demonstrates that there is little agreement on the meaning of the term "euthanasia" [2]. Introducing adjectives (ie, active, voluntary, involuntary or nonvoluntary) to the word euthanasia only adds confusion to the debate on end-of-life decisions.…”

Section: Introductionmentioning

confidence: 99%

End-of-life discontinuation of destination therapy with cardiac and ventilatory support medical devices: physician-assisted death or allowing the patient to die?

Rady¹,

Verheijde²

2010

BMC Med Ethics

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BackgroundBioethics and law distinguish between the practices of "physician-assisted death" and "allowing the patient to die."DiscussionAdvances in biotechnology have allowed medical devices to be used as destination therapy that are designed for the permanent support of cardiac function and/or respiration after irreversible loss of these spontaneous vital functions. For permanent support of cardiac function, single ventricle or biventricular mechanical assist devices and total artificial hearts are implanted in the body. Mechanical ventilators extrinsic to the body are used for permanent support of respiration. Clinical studies have shown that destination therapy with ventricular assist devices improves patient survival compared to medical management, but at the cost of a substantial alteration in end-of-life trajectories. The moral and legal assessment of the appropriateness and permissibility of complying with a patient's request to electively discontinue destination therapy in a life-terminating act in non-futile situations has generated controversy. Some argue that complying with this request is ethically justified because patients have the right to request withdrawal of unwanted treatment and be allowed to die of preexisting disease. Other commentators reject the argument that acceding to an elective request for death by discontinuing destination therapy is 'allowing a patient to die' because of serious flaws in interpreting the intention, causation, and moral responsibility of the ensuing death.SummaryDestination therapy with cardiac and/or ventilatory medical devices replaces native physiological functions and successfully treats a preexisting disease. We posit that discontinuing cardiac and/or ventilatory support at the request of a patient or surrogate can be viewed as allowing the patient to die if--and only if--concurrent lethal pathophysiological conditions are present that are unrelated to those functions already supported by medical devices in destination therapy. In all other cases, compliance with a patient's request constitutes physician-assisted death because of the pathophysiology induced by the turning off of these medical devices, as well as the intention, causation, and moral responsibility of the ensuing death. The distinction between allowing the patient to die and physician-assisted death is pivotal to the moral and legal status of elective requests for death by discontinuing destination cardiac and/or ventilatory medical devices in patients who are not imminently dying. This distinction also represents essential information that must be disclosed to patients and surrogates in advance of consent to this type of therapy.

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“…“Involuntary Passive Euthanasia” used for FLST is a term long discarded and is no longer in contemporary medical usage. [61] In fact this term only refers to practices during the Holocaust in Nazi Germany. [62] In fact, in countries where Euthanasia is legal, it is applicable only to competent, non critically ill patients.…”

Section: Guidelines Summarymentioning

confidence: 99%

Guidelines for end-of-life and palliative care in Indian intensive care units: ISCCM consensus Ethical Position Statement

Chawla¹,

Kapadia²,

Rajagopalan³

et al. 2012

Indian Journal of Critical Care Medicine

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Euthanasia: a word no longer to be used or abused

Cited by 14 publications

References 4 publications

A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

End-of-life discontinuation of destination therapy with cardiac and ventilatory support medical devices: physician-assisted death or allowing the patient to die?

Guidelines for end-of-life and palliative care in Indian intensive care units: ISCCM consensus Ethical Position Statement

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