Twenty-Five Years after<i>Quinlan</i>: A Review of the Jurisprudence of Death and Dying

Cantor, Norman L.

doi:10.1111/j.1748-720x.2001.tb00339.x

Cited by 43 publications

(8 citation statements)

References 12 publications

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“…Despite a number of state courts in the USA echoed Quinlan and Cruzan on the patient's prerogative to refuse treatment[51], the recent case of Theresa Marie (Terri) Schiavo seemed to call into question past legal and ethical consensuses[52]. In 1990, Theresa Marie (Terri) Schiavo, 26 years of age, had a cardiac arrest and experienced severe hypoxia for several minutes.…”

Section: Discussionmentioning

confidence: 99%

Quality of Reporting on the Vegetative State in Italian Newspapers. The Case of Eluana Englaro

et al. 2011

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BackgroundMedia coverage of the vegetative state (VS) includes refutations of the VS diagnosis and describes behaviors inconsistent with VS. We used a quality score to assess the reporting in articles describing the medical characteristics of VS in Italian newspapers.Methodology/Principal FindingsOur search covered a 7-month period from July 1, 2008, to February 28, 2009, using the online searchable databases of four major Italian newspapers: Corriere della Sera, La Repubblica, La Stampa, and Avvenire. Medical reporting was judged as complete if three core VS characteristics were described: patient unawareness of self and the environment, preserved wakefulness (eyes open), and spontaneous respiration (artificial ventilator not needed). We retrieved 2,099 articles, and 967 were dedicated to VS. Of these, 853 (88.2%) were non-medical and mainly focused on describing the political, legal, and ethical aspects of VS. Of the 114 (11.8%) medical articles, 53 (5.5%) discussed other medical problems such as death by dehydration, artificial nutrition, neuroimaging, brain death, or uterine hemorrhage, and 61 (6.3%) described VS. Of these 61, only 18 (1.9%) reported all three CORE characteristics and were judged complete. We found no differences among the four investigated newspapers (Fisher's exact = 0.798), and incomplete articles were equally distributed between journalistic pieces and expert opinions (χ2 = 1.8854, P = 0.170). Incorrect descriptions of VS were significantly more common among incomplete articles (13 of 43 vs. 1 of 18; Fisher's exact P = 0.047).Conclusions/SignificanceCore VS characteristics are rarely reported in Italian newspaper articles, which can alter adequate comprehension of new developments and (mis)inform political, legal, and ethical decisions.

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Section: Discussionmentioning

confidence: 99%

Quality of Reporting on the Vegetative State in Italian Newspapers. The Case of Eluana Englaro

et al. 2011

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“…As indications for their use expand, clinicians will encounter more requests for their withdrawal near the end of life. Despite a clear ethical and legal precedent regarding the cessation of life-sustaining therapies, [1][2][3][4] there is still considerable controversy surrounding the withdrawal of pacemakers. We describe the case of a terminally ill, pacemaker-dependent patient who requested to have her pacemaker turned off near the end of life.…”

Section: Introductionmentioning

confidence: 99%

Is Pacemaker Deactivation at the End of Life Unique?: A Case Study and Ethical Analysis

Whitlock

Goldberg²,

Singh

2011

Journal of Palliative Medicine

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Although there has been considerable controversy regarding the deactivation of pacemakers near the end of life, clinicians can expect to face more requests for pacemaker withdrawal as the number of implants grows. Despite a clear ethical and legal precedent, these requests may elicit significant psychological and moral distress on the part of the clinical team. We illustrate some of the difficulties clinicians may face by describing the case of a patient with end-stage heart failure who asked to have her pacemaker turned off near the end of life. We discuss the challenges in determining pacemaker dependency, differing attitudes toward deactivating pacemakers versus other cardiac devices, and how the issues of perceived burden and timing of death may contribute to a clinician's sense of moral distress.

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“…In the 1970s, the ability of competent individuals to control medical interventions led to support for advance directives that enabled individuals, either through living wills or health care proxies, to express their values and preferences about medical treatment when they would no longer be competent to make decisions. In the landmark case in re Quinlan , the New Jersey Supreme Court found that “Karen’s choice [to decline medical treatment], if she were competent to make it, would be vindicated by the law” and “should not be discarded solely because her condition prevents her conscious exercise of the choice.”…”

Section: Essaymentioning

confidence: 99%

Advance Directives for Refusing Life‐Sustaining Treatment in Dementia

Steinbock¹,

Menzel²

2018

Hastings Center Report

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Aid‐in‐dying laws in the United States have two important restrictions. First, only patients who are terminally ill, defined as having a prognosis of six months or less to live, qualify. Second, at the time the patients take the lethal medication, they must be competent to make medical decisions. This means that an advance directive requesting aid in dying for a later time when the patient lacks decision‐making capacity would be invalid. However, many people are more concerned about avoiding living into severe dementia for years—a time when they will lack decision‐making capacity—than they are about preventing suffering or the loss of dignity or autonomy for a few months at the end of life. Gillian Bennett is an example of someone determined not to live into severe dementia. She opted for preemptive suicide in 2014, explaining why in a letter she posted online: “Every day I lose bits of myself, and it’s obvious that I am heading toward the state that all dementia patients eventually get to: not knowing who I am and requiring full‐time care.” A major problem with Bennett’s solution, however, is that the individual is likely thereby to be giving up some “good time.” A legal alternative to preemptive suicide is to create an advance directive stating the circumstances under which one wants not to receive any lifesaving or life‐sustaining treatment, even the most basic and noninvasive. This option is our focus in this paper: how to create effective advance directives to avoid living into severe dementia. To be relevant to progressive dementia, the directive would need to state what kinds of care should be withheld and when. At the same time, advance directives for severe dementia face serious challenges. Before addressing these, we review the normative force of directives themselves.

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Twenty-Five Years afterQuinlan: A Review of the Jurisprudence of Death and Dying

Cited by 43 publications

References 12 publications

Quality of Reporting on the Vegetative State in Italian Newspapers. The Case of Eluana Englaro

Quality of Reporting on the Vegetative State in Italian Newspapers. The Case of Eluana Englaro

Is Pacemaker Deactivation at the End of Life Unique?: A Case Study and Ethical Analysis

Advance Directives for Refusing Life‐Sustaining Treatment in Dementia

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