Sedation, Suicide, and the Limits of Ethics


Book Description

In this book, James Dunson explores end-of-life ethics including physician-assisted suicide (PAS) and continuous sedation until death. He argues that ethical debates currently ignore the experience of the dying patient in an effort to focus on policy creation, and proposes that the dying experience should instead be prioritized and used to inform policy development. The author makes the case that PAS should be recognized as a legally and morally permissible option for a very particular kind of patient: terminally ill with fewer than six months to live and capable of conscious consent. Since focusing on the patient's experience of this end-of-life dilemma transforms some of the basic concepts we use to engage in the PAS debate, the argument has implications for patient care and the training of medical professionals.




Physician-Assisted Death


Book Description

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.




Sedation at the End-of-life: An Interdisciplinary Approach


Book Description

The book’s main contribution is its interdisciplinary approach to the issue of sedation at the end-of-life. Because it occurs at the end of life, palliative sedation raises a number of important ethical and legal questions, including whether it is a covert form of euthanasia and for what purposes it may legally be used. Many of the book chapters address the first question and almost all deal with a specific form of the second: whether palliative sedation should be used for those experiencing “existential suffering”? This raises the question of what existential suffering is, a topic that is also discussed in the book. The different chapters address these issues from the perspectives of the relevant disciplines: Palliative Medicine, Bioethics, Law and Theology. Hence, helpful accounts of the clinical and historical background for this issue are provided and the importance of drawing accurate ethical and legal distinctions is stressed throughout the whole book. So the volume represents a valuable contribution to the emerging literature on this topic and should be helpful across a broad spectrum of readers: philosophers, theologians and physicians.




Assisted Death


Book Description

Ethical and legal issues concerning physician-assisted suicide and euthanasia are very much on the public agenda in many jurisdictions. In this timely book L.W. Sumner addresses these issues within the wider context of palliative care for patients in the dying process. His ethical conclusion is that a bright line between assisted death and other widely accepted end-of-life practices, including the withdrawal of life-sustaining treatment, pain control through high-dose opioids, and terminal sedation, cannot be justified. In the course of the ethical argument many familiar themes are given careful and thorough treatment: conceptions of death, the badness of death, the wrongness of killing, informed consent and refusal, the ethics of suicide, cause of death, the double effect, the sanctity of life, the 'active/passive' distinction, advance directives, and nonvoluntary euthanasia. The legal discussion opens with a survey of some prominent prohibitionist and regulatory regimes and then outlines a model regulatory policy for assisted death. Sumner concludes by defending this policy against a wide range of common objections, including those which appeal to slippery slopes or the possibility of abuse, and by asking how the transition to a regulatory regime might be managed in three common law prohibitionist jurisdictions.




Thomas Szasz


Book Description

Thomas Szasz wrote over thirty books and several hundred articles, replete with mordant criticism of psychiatry, in both scientific and popular periodicals. His works made him arguably one of the world's most recognized psychiatrists, albeit one of the most controversial. These writings have been translated into several languages and have earned him a worldwide following. Szasz was a man of towering intellect, sweeping historical knowledge, and deep-rooted, mostly libertarian, philosophical beliefs. He wrote with a lucid and acerbic wit, but usually in a way that is accessible to general readers. His books cautioned against the indiscriminate power of psychiatry in courts and in society, and against the apparent rush to medicalize all human folly. They have spawned an eponymous ideology that has influenced, to various degrees, laws relating to mental health in several countries and states. This book critically examines the legacy of Thomas Szasz - a man who challenged the very concept of mental illness and questioned several practices of psychiatrists. The book surveys his many contributions including those in psychoanalysis, which are very often overlooked by his critics. While admiring his seminal contribution to the debate, the book will also point to some of his assertions that merit closer scrutiny. Contributors to the book are drawn from various disciplines, including Psychiatry, Philosophy and Law; and are from various countries including the United States, Canada, New Zealand, United Kingdom and the Netherlands. Some contributors knew Thomas Szasz personally and spent many hours with him discussing issues he raised in his books and articles. The book will be fascinating reading for anyone interested in matters of mental health, human rights, and ethics.




Continuous Sedation at the End of Life


Book Description

This book brings together clinicians, ethicists and lawyers to put the practice of continuous sedation under a critical spotlight.




The Case Against Assisted Suicide


Book Description

In The Case against Assisted Suicide: For the Right to End-of-Life Care, Dr. Kathleen Foley and Dr. Herbert Hendin uncover why pleas for patient autonomy and compassion, often used in favor of legalizing euthanasia, do not advance or protect the rights of terminally ill patients. Incisive essays by authorities in the fields of medicine, law, and bioethics draw on studies done in the Netherlands, Oregon, and Australia by the editors and contributors that show the dangers that legalization of assisted suicide would pose to the most vulnerable patients. Thoughtful and persuasive, this book urges the medical profession to improve palliative care and develop a more humane response to the complex issues facing those who are terminally ill.




Dying in America


Book Description

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.




Ending Life


Book Description

Margaret Pabst Battin has established a reputation as one of the top philosophers working in bioethics today. This work is a sequel to Battin's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted suicide in Oregon and the Netherlands to furor over proposed restrictions of scheduled drugs used for causing death, and the development of "NuTech" methods of assistance in dying. Battin's new collection covers a remarkably wide range of end-of-life topics, including suicide prevention, AIDS, suicide bombing, serpent-handling and other religious practices that pose a risk of death, genetic prognostication, suicide in old age, global justice and the "duty to die," and suicide, physician-assisted suicide, and euthanasia, in both American and international contexts. As with the earlier volume, these new essays are theoretically adroit but draw richly from historical sources, fictional techniques, and ample factual material.




Clinical Ethics in Anesthesiology


Book Description

Ethical issues facing anesthesiologists are more far-reaching than those involving virtually any other medical specialty. In this clinical ethics textbook, authors from across the USA, Canada and Europe draw on ethical principles and practical knowledge to provide a realistic understanding of ethical anesthetic practice. The result is a compilation of expert opinion and international perspectives from clinical leaders in anesthesiology. Building on real-life, case-based problems, each chapter is clinically focused and addresses both practical and theoretical issues. Topics include general operating room care, pediatric and obstetrical patient care, the intensive care unit, pain practice, research and publication, as well as discussions of lethal injection, disclosure of errors, expert witness testimony, triage in disaster and conflicts of interest with industry. An important reference tool for any anesthesiologist, whether clinical or research-oriented, this book is especially valuable for physicians involved in teaching residents and students about the ethical aspects of anesthesia practice.