The Euthanasia Debate Palliative care on the 'slippery                 slope’ towards euthanasia?

Materstvedt, Lars Johan

doi:10.1191/0269216303pm796oa

Cited by 21 publications

(16 citation statements)

References 22 publications

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“…As the GPs believed without exception that their patient's end-of-life quality had been improved considerably by taking this step, it appears that they acted out of compassion and chose what they believed to be the least bad option in a medically futile situation. Whether compassion alone may in some cases justify this practice remains subject to intense debate however [29]. …”

Section: Discussionmentioning

confidence: 99%

Physician reports of medication use with explicit intention of hastening the end of life in the absence of explicit patient request in general practice in Belgium

et al. 2010

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BackgroundAlthough the incidence of the use of life-ending drugs without explicit patient request has been estimated in several studies, in-depth empirical research on this controversial practice is nonexistent. Based on face-to-face interviews with the clinicians involved in cases where patients died following such a decision in general practice in Belgium, we investigated the clinical characteristics of the patients, the decision-making process, and the way the practice was conducted.MethodsMortality follow-back study in 2005-2006 using the nationwide Sentinel Network of General Practitioners, a surveillance instrument representative of all GPs in Belgium. Standardised face-to-face interviews were conducted with all GPs who reported a non-sudden death in their practice, at home or in a care home, which was preceded by the use of a drug prescribed, supplied or administered by a physican without an explicit patient request.ResultsOf the 2690 deaths registered by the GPs, 17 were eligible to be included in the study. Thirteen interviews were conducted. GPs indicated that at the time of the decision all patients were without prospect of improvement, with persistent and unbearable suffering to a (very) high degree in nine cases. Twelve patients were judged to lack the competence to make decisions. GPs were unaware of their patient's end-of-life wishes in nine cases, but always discussed the practice with other caregivers and/or the patient's relatives. All but one patient received opioids to hasten death. All GPs believed that end-of-life quality had been "improved considerably".ConclusionsThe practice of using life-ending drugs without explicit patient request in general practice in Belgium mainly involves non-competent patients experiencing persistent and unbearable suffering whose end-of-life wishes can no longer be ascertained. GPs do not act as isolated decision-makers and they believe they act in the best interests of the patient. Advance care planning could help to inform GPs about patients' wishes prior to their loss of competence.

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Section: Discussionmentioning

confidence: 99%

Physician reports of medication use with explicit intention of hastening the end of life in the absence of explicit patient request in general practice in Belgium

et al. 2010

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“…The name is misleading; they ought to be described as ‘murder clinics’ since the patient's life was taken against his or her will23—regardless of the motivation for doing so, whether it be compassion, economic considerations or other rationales 26. In a more recent example of involuntary medicalised killing, physician Wilfred van Oijen was convicted of murdering one of his patients by the Dutch Supreme Court in 2002.…”

Section: What Euthanasia Is Not: the Concept Of ‘Life Ending Acts Witmentioning

confidence: 99%

“…These are probably acts of compassionate murder26—what may also be termed ‘mercy killing’. They would also fit our suggested category of murderous paternalism.…”

Section: May Medical Murder Be Legitimate? Autonomy Versus Justice Anmentioning

confidence: 99%

“…Now if one thinks that medical murder is always wrong—and the inclination to think so is strong indeed in the aftermath of Nazi medicine26—by implication, autonomy is given supremacy and therefore blocks both justice and mercy in the case of B. Nevertheless, provided one sincerely believes that lethal injection is the ‘only (humane) way out’ of state S in which competent patient A finds himself and non-competent patient B is also in S, how can one deny B the very same?…”

Section: May Medical Murder Be Legitimate? Autonomy Versus Justice Anmentioning

confidence: 99%

“…One key question, however, must be commented upon here—namely, whether or not compassionate murder26 may ever be legitimate. In philosophy, a standard formal definition of murder is ‘unjustified killing’ and hence the answer apparently is ‘no’.…”

Section: May Medical Murder Be Legitimate? Autonomy Versus Justice Anmentioning

confidence: 99%

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Medical murder in Belgium and the Netherlands

Materstvedt

Magelssen

2016

J Med Ethics

Self Cite

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This article is a response to Raphael Cohen-Almagor's paper entitled 'First do no harm: intentionally shortening lives of patients without their explicit request in Belgium'. His paper deals with very important matters of life and death, however its concept usage is in part misleading. For instance, the fact that medical murder takes place both in Belgium and the Netherlands is missed. Cohen-Almagor calls such acts 'worrying' and considers them to be 'abuse'. However, it remains an open question whether or not there can be such a thing as legitimate murder in a medical context. From the combined perspectives of justice and the duty to end unbearable suffering, there might be. Thus, key arguments for euthanasia are also prominent in an argument for medical murder.

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Ethical Considerations in Palliative Care

Marron,

Uveges

2023

Palliative Care in Hematologic Malignancies and Serious Blood Disorders

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The Euthanasia Debate Palliative care on the 'slippery slope’ towards euthanasia?

Cited by 21 publications

References 22 publications

Physician reports of medication use with explicit intention of hastening the end of life in the absence of explicit patient request in general practice in Belgium

Physician reports of medication use with explicit intention of hastening the end of life in the absence of explicit patient request in general practice in Belgium

Medical murder in Belgium and the Netherlands

Ethical Considerations in Palliative Care

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