Euthanasia Archives - Page 10 of 13 - Protection of Conscience Project Library

Reporting of euthanasia and physician-assisted suicide in the Netherlands: Descriptive study

Hilde Buiting, Johannes Van Delden, Bregje D Onwuteaka-Philipsen, Judith Rietjens, Mette Rurup, Donald Van Tol, Joseph Gevers,Paul Van Der Maas,Agnes Van Der Heide

Abstract
Background: An important principle underlying the Dutch Euthanasia Act is physicians’ responsibility to alleviate patients’ suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient’s request, the patient’s suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees’ attention. . . .

Conclusion: Dutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees’ control seems to focus on (unbearable) suffering and on procedural issues.

Buiting H, Delden JV, Onwuteaka-Philipsen BD, Rietjens J, Rurup M, Tol DV et al. Reporting of euthanasia and physician-assisted suicide in the Netherlands: Descriptive study. BMC Medical Ethics. 2009;10(1).

The Attitude of Flemish Palliative Care Physicians to Euthanasia and Assisted Suicide

Bert Broeckaert, Joris Gielen, Trudie Van Iersel, Stef Van Den Branden

Abstract
Surveys carried out among palliative care physicians have shown that most participants do not support euthanasia and assisted suicide. Belgium, however, is one of the few countries in the world in which voluntary euthanasia is allowed by law. The potential influence of this legal dimension thus warranted a study of the attitudes of Belgian palliative care physicians toward euthanasia and assisted suicide. . . .The majority of the physicians favour legalisation on assisted suicide. There is no significant association between the euthanasia clusters and attitudes toward assisted suicide. We conclude that although most Flemish palliative care physicians agree that there may be circumstances in which a euthanasia request is justified, they also strongly believe in the effects of good palliative care and want the ‘palliative filter’ to be included in the law on euthanasia. Religion and worldview are an important factor determining attitudes towards euthanasia.

Broeckaert B, Gielen J, Iersel TV, Branden SVD. The Attitude of Flemish Palliative Care Physicians to Euthanasia and Assisted Suicide. Ethical Perspectives. 2009;16(3):311-335.

Belgian euthanasia law: a critical analysis

Raphael Cohen-Almagor

Abstract
Some background information about the context of euthanasia in Belgium is presented, and Belgian law on euthanasia and concerns about the law are discussed. Suggestions as to how to improve the Belgian law and practice of euthanasia are made, and Belgian legislators and medical establishment are urged to reflect and ponder so as to prevent potential abuse.

Cohen-Almagor R. Belgian euthanasia law: a critical analysis. J Med Ethics. 2009;35(7):436-439.

(Working Paper) Conscientious Oppression: Conscientious Objection in the Sphere of Sexual and Reproductive Health

Marcelo Alegre

Yale Law School Lillian Goldman Law Library

Abstract
Although for centuries conscientious objection was primarily claimed by those who for religious or ethical reasons refused to join the ranks of the military (whether out of a general principle or in response to a particular violent conflict), in recent decades a significant broadening of the concept can be seen. In Thailand, for example, doctors recently refused medical attention to injured policemen suspected of having violently repressed a demonstration. In Argentina a few public defenders have rejected for conscientious reasons to represent individuals accused of massive human rights violations. In different countries all over the world there are doctors who refuse to perform euthanasia, schoolteachers who reject to teach the theory of evolution, and students who refuse to attend biology classes where frogs are dissected.

Alegre M. (Working Paper) Conscientious Oppression: Conscientious Objection in the Sphere of Sexual and Reproductive Health. 2009;1-34.

Euthanasia policy and practice in Belgium: Critical observations and suggestions for improvement

Raphael Cohen-Almagor

Abstract
The essay opens with some background information about the context of euthanasia in Belgium. It proceeds by discussing the Belgian law on euthanasia and concerns about the law, its interpretations and implementation. Finally, the major developments and controversies since the law came into effect are discussed. Suggestions as to how to improve the Belgian law and circumscribe the practice of euthanasia are made, urging Belgian legislators and the medical establishment to reflect and study so as to prevent potential abuse of vulnerable patients.

The article’s methodology is based on critical review of the literature supplemented by interviews I conducted in Belgium with leading scholars and practitioners in February 2003 and February 2005. The interviews were conducted in English, usually in the interviewees’ offices. The interviews were semi-structured. I began with a list of twenty-four questions but did not insist on answers to all of them if I saw that the interviewee preferred to speak about subjects that were not included in the original questionnaire. The length of interviews varied from one to two and a half hours. After completing the first draft I sent the manuscript to my interviewees as well as to some leading experts for critical review and comments. The comments received were integrated into this final version of the essay. In 2008, while writing the final draft, I approached my interviewees and some other well-known experts and invited their comments and updates. Responses received by mid-January 2009 were integrated into the article.

Cohen-Almagor R. Euthanasia policy and practice in Belgium: Critical observations and suggestions for improvement. Issues Law Med. 2009 Spring;24(3):187-218.

Anesthetizing the public conscience: lethal injection and animal euthanasia

(The Lethal Injection Debate: Law and Science)

Ty Alper

Extract
People are never executed using the anesthetic-only procedure that veterinarians and shelter workers use on animals. And animals are never euthanized by the three-drug formula prison officials use on human beings. As detailed in this Article, the veterinary and animal welfare communities widely condemn the use of neuromuscular blocking agents such as pancuronium. Particularly given the popular assumption that execution of humans by lethal injection is no different than “putting an animal to sleep,” the condemnation of the use of curariform drugs in the euthanasia context should give courts pause when assessing the risks of the three-drug formula under the Eighth Amendment. . . The Humane Society mandates a method of euthanasia the primary benefit of which is that it is actually humane. At a time when the public’s trust in the administration of capital punishment in this country appears to be eroding, the states, on the other hand, have clung to a method whose primary benefit is that it looks humane- but that in reality risks the unnecessary infliction of excruciating pain and suffering.

Alper T. Anesthetizing the public conscience: lethal injection and animal euthanasia (The Lethal Injection Debate: Law and Science). Fordham Urban Law J. 2008;35(4):817-856.

Conscientious commitment

Bernard M. Dickens

Extract
In some regions of the world, hospital policy, negotiated with the health ministry and police, requires that a doctor who finds evidence of an unskilled abortion or abortion attempt should immediately inform police authorities and preserve the evidence. Elsewhere, religious leaders forbid male doctors from examining any part of a female patient’s body other than that being directly complained about. Can a doctor invoke a conscientious commitment to medically appropriate and timely diagnosis or care and refuse to comply with such directives?

Dickens BM. Conscientious commitment. Lancet [Internet]. 2008 Apr 12; 371(9620): 1240 – 1241

Nurses’ involvement in the care of patients requesting euthanasia: a review of the literature

Nele Del Bal, Chris Gastmans, Bernadette Dierckx de Casterlé

Abstract
OBJECTIVES: The aim of this paper is to thoroughly examine the involvement and experiences of nurses in the care of mentally competent, adult patients requesting euthanasia (i.e. administration of lethal drugs by someone other than the person concerned with the explicit intention of ending a patient’s life, at the latter’s explicit request) by means of a literature review. . .
CONCLUSIONS: Nurses can make a significant contribution to the quality of care by assisting and counseling patients and their families, physicians, and their nursing colleagues in a professional manner, even in countries where euthanasia is not legal. However, research on nurses’ involvement in euthanasia has methodological and terminological problems,leading to our recommendation for more carefully designed qualitative studies that explore in-depth the experiences of nurses in caring for patients requesting euthanasia.

Bal ND, Gastmans C, de Casterlé BD. Nurses’ involvement in the care of patients requesting euthanasia: a review of the literature. Int J Nurs Studies. 2008;45(4):626-644.

Foreword: The Role of Religion in Health Law and Policy

William J Winslade, Ronald A Carson

Extract
This symposium issue explores several continuing controversies at the intersection of Law, Ethics, Healthcare, Politics, Health Policy and Religion: abortion, contraception, the status of embryos, stem cell research, IVF, personal and professional autonomy, end- of-life decisions, and religiously based health care systems. The multiple values associated with each of these topics strain and threaten to usurp the effectiveness of our legal system to regulate them.

Winslade WJ, Carson RA. Foreword: The Role of Religion in Health Law and Policy. Houston Journal of Health Law & Policy. 2006 Sep;6(2):245-248.

Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia On Participating Physicians

Kenneth R Stevens

Extract
Conclusion
Physician participation in assisted suicide or euthanasia can have a profound harmful effect on the involved physicians. Doctors must take responsibility for causing the patient’s death. There is a huge burden on conscience, tangled emotions and a large psychological toll on the participating physicians. Many physicians describe feelings of isolation. Published evidence indicates that some patients and others are pressuring and intimidating doctors to assist in suicides. Some doctors feel they have no choice but to be involved in assisted suicides. Oregon physicians are decreasingly present at the time of the assisted suicide. There is also great potential for physicians to be affected by countertransference issues in dealing with end-of-Iife care, and assisted suicide and euthanasia..

Stevens KR. Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia On Participating Physicians. The Linacre Quarterly. 2006;73(3).