Acceptability Of Physician-assisted Suicide Research Articles

Overcoming Acceptance of Physician-Assisted Suicide

Acceptance of Physician-Assisted Suicide has been on the rise, especially in recent years. However, it is the position of the Catholic church that this practice denies the inherent dignity of all human beings from the point of conception to natural death. The Art of Dying, a classic Catholic text recently translated into English, provides a more compassionate, faithful, and dignified approach to end-of-life care that recognizes the rights of the dying, as well as their loved ones, while remaining faithful to the teachings of the Church.

Romanian Lay People’s and Health Professionals’ Views about the Acceptability of Physician-Assisted Suicide

The conditions under which Physician-Assisted-Suicide (PAS) would be considered as acceptable among Romanians were examined. In July 2015-May 2016, 212 lay people and 52 health professionals judged the acceptability of PAS in 36 realistic vignettes composed of all combinations of four factors: the patient’s age, the level of incurability of the illness, the type of suffering, and the patient’s request for PAS. A majority of lay people (51%) and health professionals (85%) were opposed to PAS, quite irrespective of conditions. The most important factors determining acceptability were, for 36% of lay people, request for PAS and, for 18%, advanced age.

Results From a Survey of American Geriatrics Society Members' Views on Physician-Assisted Suicide.

Physician-assisted suicide (PAS) is a controversial practice, currently legal in nine states and the District of Columbia. No prior study explores the views of the American Geriatrics Society (AGS) membership on PAS. We surveyed 1488 randomly selected AGS members via email. A total of 369 AGS members completed the survey (24.8% response rate). We conducted bivariate correlation analyses of beliefs related to support for PAS. We also conducted qualitative analysis of open-ended responses. There was no consensus regarding the acceptability of PAS, with 47% supporting and 52% opposing this practice. PAS being legal in the respondent's state, belief that respect for autonomy alone is sufficient to justify PAS, and intent to prescribe or support requests for PAS if legal in state of practice all correlated with support for PAS. There was no consensus on whether the AGS should oppose, support, or adopt a neutral stance on PAS. Most respondents believed that PAS is more complex among patients with low health literacy, low English proficiency, disability, dependency, or frailty. Most respondents supported mandatory palliative care consultation and independent assessments from two physicians. Themes identified from qualitative analysis include role of the medical profession, uncertainty of the role of professional organizations, potential unintended consequences, autonomy, and ethical and moral considerations. There was no consensus among respondents regarding the acceptability of PAS. Respondents expressed concern about vulnerable older populations and the need for safeguards when responding to requests for PAS. Ethical, legal, and policy discussions regarding PAS should consider vulnerable populations. J Am Geriatr Soc 68:23-30, 2019.

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Togolese lay people's and health professionals’ views about the acceptability of physician-assisted suicide

AimTo study the views on the acceptability of physician-assisted-suicide (PAS) of lay people and health professionals in an African country, Togo.MethodIn February–June 2012, 312 lay people and 198 health professionals...

Physician-assisted suicide in psychiatry and loss of hope

In the Netherlands, euthanasia and physician-assisted suicide (PAS) are considered acceptable medical practices in specific circumstances. The majority of cases of euthanasia and PAS involve patients suffering from cancer. However, in 1994 the Dutch Supreme Court in the so-called Chabot-case ruled that “the seriousness of the suffering of the patient does not depend on the cause of the suffering”, thereby rejecting a distinction between physical (or somatic) and mental suffering. This opened the way for further debate about the acceptability of PAS in cases of serious and refractory mental illness. An important objection against offering PAS to mentally ill patients is that this might reinforce loss of hope, and demoralization. Based on an analysis of a reported case, this argument is evaluated. It is argued that offering PAS to a patient with a mental illness who suffers unbearably, enduringly and without prospect of relief does not necessarily imply taking away hope and can be ethically acceptable.

ACCEPTABILITY FOR FRENCH PEOPLE OF PHISICIAN-ASSITED SUICIDE

Our aim was to understand better how people judge the acceptability of physician-assisted suicide (PAS). We found that, for people in France of all ages and for elderly people with life-threatening illnesses, acceptability is an additive combination of the number of requests for PAS, the patient's age, the amount of physical suffering, and the degree of curability of the illness, not only when judging for hypothetical patients, but also for their spouses and for themselves. PAS can be highly acceptable to people even when the patient does not satisfy all the criteria of legislation about PAS.

Psycho-oncology and the terminally ill patient

This paper discusses difficulties faced by the terminally ill cancer patient and the case for psychological help. The hospice movement that started 40 years ago has made great strides in assisting people achieve the so-called ‘good’ death. Communication between patients, clinicians and family members is still cause for concern. Issues such as denial, discussing bad news and distancing strategies by health professionals are reviewed. The dying patient is described and illustrated by a case example, together with how delirium and pain can be managed. Finally, some recent evidence, about increasing acceptance of physician-assisted suicide, is discussed.

Life-sustaining treatment and assisted death choices in depressed older patients.

The major purpose of this study was to examine the effect of depressed mood in older, medically ill, hospitalized patients on their preferences regarding life-sustaining treatments, physician-assisted suicide (PAS), and euthanasia and to determine the degree to which financial constraints affected their choices. Cross-sectional study. General medical hospital. One hundred fifty-eight medically hospitalized, nondemented patients age 60 or older, mean age 74.1 (range 60-94). The sample was divided, based on Center for Epidemiologic Studies-Depression (CES-D) scores, into a depressed group (n = 71) and a nondepressed control group. Subjects underwent a structured interview evaluating their life-sustaining treatment choices and whether they would accept or refuse PAS or euthanasia under a variety of hypothetical conditions. These choices were reevaluated with the introduction of financial impact. In addition, assessment included measures of depression, suicide, cognition, social support, functioning, and religiosity. Depression was found to be highly associated with acceptance of PAS and euthanasia in most hypothetical clinical scenarios in addition to patients' current condition. Compared with nondepressed people, depressed respondents were 13 times as likely to accept PAS when considering their current condition (95% confidence interval [CI] 1.68-110.98), and over twice as likely to accept PAS when facing a hypothetical terminal illness or coma. Depression alone was weakly associated with life-sustaining treatment choices but, when financial impact was introduced, significantly more depressed subjects refused treatment options they had previously desired than did nondepressed subjects. The presence of suicidal ideation, even passive ideation, was strongly predictive of life-sustaining treatment refusals and increased interest in PAS and euthanasia. Depression's effect on acceptance of PAS was confirmed by logistic regression, which also showed that religious coping was significantly correlated with less interest in PAS in two hypothetical scenarios. CONCLUSION. Depressed subjects and even subjects with subtle, passive suicidal ideation were markedly more interested in PAS and euthanasia than nondepressed subjects in hypothetical situations. Depressed subjects were also particularly vulnerable to rejecting treatments if financial consequences might have resulted.

Pain management at the end of life

Abstract Pain at the end of life is often undertreated, yet clearly defined management strategies have demonstrated that pain at the end of life can be prevented. Although many barriers to effective pain management exist, the primary care physician is in a pivotal role to coordinate the management of pain through a multidisciplinary approach. Two types of pain, nociceptive and neuropathic, have been described, and appropriate management requires identifying which type of pain is present. The World Health Organization has proposed the "three-step analgesic ladder" approach to painmanagement whereby nonopioid, opioid, and adjuvant analgesics are used based on the type and intensity of pain. Although opioids are the mainstay of severe pain management, misconceptions exist regarding the significance of drug dependence and addiction. Through appropriate knowledge of opioid dosing intervals and titration, healthcare practitioners can effectively manage severe pain at the end of life; pain should not be used to justify the acceptance of physician-assisted suicide or euthanasia. Through the ethical principle of the " double effect," opioids intended to control pain at the end of life can be administered even if such administration hastens the dying process. Physicians can and should enhance the quality of life of their dying patients by enabling them to avoid pain.