Euthanasia In The United States Research Articles

Determination of Dairy Cattle Euthanasia Criteria and Analysis of Barriers to Humane Euthanasia in the United States: The Veterinarian Perspective.

Simple SummaryMaking and carrying out euthanasia decisions on dairy farms is complex and decisions are often challenging and multi-factorial. Training caretakers to be confident in their abilities to make timely decisions about euthanasia is critical. Veterinarians are often asked to serve in the role of training caretakers on euthanasia. Given the valuable role veterinarians play regarding dairy cattle euthanasia, the objective of this two-part study was to evaluate the main factors influencing euthanasia practices on dairy farms across the United States (US) by recruiting experienced dairy cattle veterinarians to participate in either an online survey (Part I) or in-person focus groups (Part II). Survey results indicated variability in health condition management amongst dairy cattle veterinarians, and only 60% of serviced facilities have a written euthanasia protocol in place. Three main themes of euthanasia decision-making were identified across focus group discussions and included logistical, animal, and human Factors. In addition, participants frequently expressed frustration with protocol limitations and requirements. These results suggest the need for the development and implementation of science-based standards to improve cattle welfare on-farm by promoting consistency in euthanasia decision-making across the US dairy industry.When dairy cattle become ill or injured to the extent that recovery is unlikely or impossible, on-farm euthanasia should be used as a tool to eliminate pain and suffering. Our study aimed to identify decision-making criteria and the most common factors considered by veterinarians when making and carrying out euthanasia decisions. Dairy cattle veterinarians were recruited to participate in an online survey (Part I, 61 surveys collected) or in one of three focus groups (Part II, 4–10 veterinarians/group, n = 22). Part I (survey): Surveyed veterinarians varied regarding health condition management and demonstrated a strong proclivity to treat compromised cattle, mirroring trends amongst dairy producers identified in previous research. Sixty percent of respondents indicated that most facilities for which they serve as the primary veterinarian have a written euthanasia protocol in place. Part II (focus groups): Three main themes about euthanasia decision-making (logistical, animal, and human) were identified from focus group discussions. Discussions focused primarily on logistical factors such as financial considerations and client/public perceptions. Development of specific standards for euthanasia, alongside interactive training programs for dairy veterinarians and producers are vital next steps to improving cattle welfare and consistency in euthanasia decision-making across the United States dairy industry.

Determination of Dairy Cattle Euthanasia Criteria and Analysis of Barriers to Humane Euthanasia in the United States: Dairy Producer Surveys and Focus Groups.

Simple SummaryMaking and carrying out euthanasia decisions is a complex, multi-factorial process and effective on-farm euthanasia training tools are needed to increase consistency throughout the dairy industry. This two-part study evaluated the main factors influencing euthanasia practices on dairy farms across the United States using dairy producer surveys (Part I) and focus groups (Part II). Survey results suggest that farm owners are most commonly responsible for making and carrying out euthanasia decisions on-farm and most dairy farmers treat and monitor compromised cattle for a variety of health conditions. Non-ambulatory cattle represent a severely compromised subpopulation of animals; however, they were selected to never be euthanized by 6.3% and 11.7% of survey respondents, respectively. Focus group discussions identified three main themes and 15 subthemes including animal, human and farm operation factors. Animal welfare and health status were frequently discussed and participants readily recognized the multi-factorial nature of on-farm euthanasia. Dairy producers are nuanced in their thinking about euthanasia decision making. However, the high variability in euthanasia timelines represents a significant animal welfare challenge. Training programs that focus on implementing specific standards for euthanasia is a critical next step and more research is needed to understand the factors influencing producer psychological perspectives regarding euthanasia decision making.There are currently no clear guidelines in the US and some other countries regarding euthanasia decision making timelines for dairy cattle that become injured or ill to the extent that recovery is unlikely or impossible. Our study aimed to identify decision making criteria and the most common factors considered when making and carrying out euthanasia decisions. Dairy producers were recruited to participate in a mailed survey (Part I, 307 completed surveys were returned) or in one of three focus groups (Part II, 8–10 producers/group, n = 24). Part I (survey): Farm owners were most commonly responsible for on-farm euthanasia and most respondents would treat and monitor compromised cattle for a majority of 15 health conditions. Responses were highly variable; for example, 6.3% and 11.7% of respondents would never euthanize a non-ambulatory cow or calf, respectively. Part II (focus groups): Three main themes (animal, human, and farm operation) were identified from discussion which focused primarily on animal welfare (16% of the discussion) and human psychology (16%). Participants expressed a desire to eliminate animal suffering by euthanizing, alongside a wide range of emotional states. Development of specific standards for euthanasia is a critical next step and more research is needed to understand the human emotions surrounding euthanasia decision making.

Determination of swine euthanasia criteria and analysis of barriers to euthanasia in the United States using expert opinion

AbstractTimely euthanasia on swine farms can help to reduce the incidence of poor welfare outcomes for compromised pigs (Sus scrofa) when recovery is prolonged or impossible. Timely euthanasia relies upon caretakers’ abilities to identify compromised pigs and administer euthanasia in various environments. To determine appropriate timelines and most common reasons for on-farm euthanasia, an online survey was conducted with members of the United States National Pork Board. Additionally, two focus groups were conducted to investigate barriers and possible solutions associated with timely euthanasia. Clinical signs related to poor locomotion (57.6%), prolapses (47.2%), and hernias (43.5%) were identified by the greatest percentage of respondents who believed immediate euthanasia was warranted, while a greater percentage of respondents believed euthanasia was not warranted for clinical signs related to the integumentary (90.3%), reproductive (75.8%), and respiratory (67.5%) systems. The most common reason for euthanasia was poor body condition in pre-weaned piglets and non-ambulatory or severely weak for both breeding and non-breeding pigs. In the focus groups, two themes were identified when evaluating barriers to euthanasia on-farm, and participants agreed that making timely decisions relies upon several dimensions of risk analysis. An unsupportive farm culture was identified as a critical barrier to timely euthanasia decision-making, suggesting that caretaker characteristics may play a role in the success of any timely euthanasia programme. This present study has highlighted areas for future research and demonstrated the need to extend educational efforts both to swine industry leaders and producers to improve overall animal welfare by ensuring timely euthanasia in swine.

Book Review

The Modern Art of Dying:. History of Euthanasia in the United States By Shai J. Lavi. Princeton. Princeton University Press. 2005.

Ask the Expert: Exploring the Clinician's Concern About Physician-Assisted Suicide

Ask the Expert: Exploring the Clinician's Concern About Physician-Assisted Suicide

The Modern Art of Dying: A History of Euthanasia in the United States. By Shai J. Lavi Princeton, NJ: Princeton University Press, 2005. Pp. 240. $29.95 cloth.

The Modern Art of Dying: A History of Euthanasia in the United States. By Shai J. Lavi. Princeton, NJ: Princeton University Press, 2005. Pp. 240. $29.95 cloth. As Lavi writes at the beginning of the last chapter of his book, Our study of euthanasia in America began with colonial times, when the word still signified a pious blessed by the grace of God. It continued with the medicalization of in the nineteenth century, which was soon followed by attempts to legalize the hastening of death. The struggle to legalize euthanasia took a radical turn with the founding of the Euthanasia Society of America, when proposals to hasten were applied to handicapped and mentally retarded patients. The final section of this study compared the legalization of euthanasia with two alternative means of actively hastening death: the sublegal act of legal dosing and the supralegal act of mercy killing (p. 163). In his study, awarded the ASA Sociology of Law section book prize, Lavi explains how has moved from to technique, from an experience overseen by a minister and family to one of overseen by doctors and constructed by law. This study charts how medicalization, expertise, and regulation cohere, elevating to a social problem and developing strategies to foreshorten life-or, intervening to allow to occur. Lavi's work represents the best of sociolegal scholarship: it is impressive for its clear conceptualization, its marshalling of an impressive array of historical and cultural evidence, and its lucid, clear, and elegant writing. Lavi convincingly argues that how we die reveals a great deal about how we live. He maps the changing meaning of euthanasia, but rather than asking the expected-how did law and medical technique change the way we die?-Lavi asks, instead, why have law and medical technique come to play important and distinct roles in the way we die? The answer is delivered in three parts. Chapter 1 considers the Colonial way of in America, focusing on the Methodists. For the Methodists, dying was a work of art (p. 39). Death was, in a sense, a part of where the death-bed became a microcosm of Methodist life (p. 39). Methodists were not concerned with the pain of dying, but rather with a death in which pain was overcome (p. 39). Gradually, doctors intervened and, with this, a role conflict emerged between minister and doctor-allowing, as subsequent chapters argue-the emergence of over at the deathbed scene. Chapter 2 considers the emergence of the medical profession and the ways it balanced the contending images/demands of hope and with pain and suffering. …

The Modern Art of Dying: A History of Euthanasia in the United States

Most scholarly discourse on euthanasia has taken place in contemporary medical, legal, and socioeconomic contexts in clinical care and/or bioethical settings. That has changed, however, with the publication of two important books: Ian Dowbiggin's Concise History of Euthanasia: Life, Death, God, and Medicine (2005) and the title here reviewed. Shai J. Lavi, who teaches law and sociology at Tel Aviv University, traced how the concept of euthanasia “as the medical hastening of death as a characteristically modern way of dying” (p. 3) emerged from a Judeo-Christian concept of “death blessed by the grace of God” (p. 5). In six cogently argued, well-documented chapters Lavi explained how the Protestant ethic of dying (examined mostly through Methodist deathbed “biography”) transformed an art into what he terms “the rule of technique” (p. 11, emphasis added). Lavi emphasized that the rule of technique referred to mastery as a means unto itself. How that change came about forms the central theme of the book: Dying was thrust increasingly into the public arena when it became less an affair of family and community and more a part of medical care. Lavi argued that the modern question raised by euthanasia is: What does it tell us about ourselves? The answer is troubling, for in the end, according to Lavi, we have subordinated real human freedom to technique. Indeed, even the relatively recent development of informed consent ensures that “the patient's autonomy is structured within the regulatory regime of modern medicine” (p. 168). Interestingly, Dowbiggin's recent history offers a similar cautionary theme. Whether one agrees or disagrees with Lavi's conclusions, his historical account of the metamorphosis of dying from a religious epiphanic moment into a process of technical mastery deserves careful consideration by historians and bioethicists.

Book Review: The Modern Art of Dying: A History of Euthanasia in the United States

Book Review: The Modern Art of Dying: A History of Euthanasia in the United States

The modern art of dying: history of euthanasia in the United States

Acknowledgments ix Introduction: The Ethics of the Deathbed: Euthanasia from Art to Technique 1 Chapter One: The Holy Craft of Dying: The Birth of the Modern Art of Dying 14 Chapter Two: Medical Euthanasia: From Aiding the Dying to Hastening Death 41 Chapter Three: Legalizing Euthanasia: The Role of Law and the Rule of Technique 75 Chapter Four: Euthanasia as Public Policy: The Euthanasia Society of America 99 Chapter Five: Lethal Dosing: Technique beyond the Law 126 Chapter Six: Mercy Killing: The Limits of Technique 144 Epilogue: Art and Technique, Death and Freedom 163 Appendix: Mercy Killing: Case History 173 Notes 181 Bibliography 211 Index 223

The modern art of dying: A history of euthanasia in the United States

The modern art of dying: A history of euthanasia in the United States

US physicians' attitudes concerning euthanasia and physician-assisted death: A systematic literature review

Although numerous reports exist in the literature regarding health care professionals' opinions towards euthanasia and the general public's views, few studies have conducted a systematic review of literature on physicians' views on this topic. As medical doctors are the individuals involved with active voluntary euthanasia (AVE) and physician-assisted death (PAD), their opinions need to be known. The purpose of our study was to conduct a systematic literature review of research studies regarding physicians' attitudes on euthanasia in the United States between 1991 and 2000. Electronic searches of data bases yielded 54 articles related to the topic; final count of articles fitting our criteria was 39. The results revealed a limited uniformity in the questions asked. Sample size varied from 39 to 2805. Response rates ranged from 20 to 100 percent. Most data gathering occurred from questionnaires. Physicians' attitudes favoring legalization of PAD and AVE ranged from 31 to 71 percent. Responses to the acceptance of PAD ranged from 14 to 66 percent, whereas AVE acceptance responses varied from 23 to 63 percent. Eleven to 63 percent of physicians had received requests for PAD or AVE. If made legal, about one-third agreed to participate in PAD—a lesser amount agreed to AVE. Overall, less than five percent have performed AVE, with slightly higher percentages for PAD. Physicians' opinions towards PAD and AVE varied, although with more favorable responses to PAD. Generally, these medical doctors are not prepared to perform PAD and AVE. As many physicians have been asked to participate in PAD and AVE, the medical profession needs to ensure that doctors are knowledgeable and able to respond to such a request.

Physician-assisted suicide: the legal slippery slope.

In Oregon, physicians can prescribe lethal amounts of medication only if requested by competent, terminally ill patients. However, the possibility of extending the practice to patients who lack decisional capacity exists. This paper examines why the legal extension of physician-assisted suicide (PAS) to incapacitated patients is possible, and perhaps likely. The author reviews several pivotal court cases that have served to define the distinctions and legalities among "right-to-die" cases and the various forms of euthanasia and PAS. Significant public support exists for legalizing PAS and voluntary euthanasia in the United States. The only defenses against sliding from PAS to voluntary euthanasia are adhering to traditional physician morality that stands against it and keeping the issue of voluntary euthanasia legally framed as homicide. However, if voluntary euthanasia evolves euphemistically as a medical choice issue, then the possibility of its legalization exists. If courts allow PAS to be framed as a basic personal right akin to the right to refuse treatment, and if they rely on right-to-die case precedents, then they will likely extend PAS to voluntary euthanasia and nonvoluntary euthanasia. This would be done by extending the right to PAS to incapacitated patients, who may or may not have expressed a choice for PAS prior to incapacity.

Euthanasia and the right to die: a comparative view

Chapter 1 Death and Dying in Historical Perspective Chapter 2 The Fundamental Issues Chapter 3 Euthanasia in the United States and Canada Chapter 4 Euthanasia in the Netherlands, the United Kingdom, Germany, and Switzerland, Spain , and France Chapter 5 Euthanasia in Australia, China, Japan, and India Chapter 6 Euthanasia in Colombia, South Africa, Iran, and Israel Chapter 7 Toward a Workable Social Policy Chapter 8 Notes Chapter 9 Suggested Reading Chapter 10 Index

A National Survey of Physician-Assisted Suicide and Euthanasia in the United States

MEIER, DIANE E.; EMMONS, CAROL-ANN; WALLENSTEIN, SYLVAN; QUILL, TIMOTHY; MORRISON, SEAN R.; CASSEL, CHRISTINE K. Author Information

A national survey of physician-assisted suicide and euthanasia in the United States.

Although there have been many studies of physician-assisted suicide and euthanasia in the United States, national data are lacking. In 1996, we mailed questionnaires to a stratified probability sample of 3102 physicians in the 10 specialties in which doctors are most likely to receive requests from patients for assistance with suicide or euthanasia. We weighted the results to obtain nationally representative data. We received 1902 completed questionnaires (response rate, 61 percent). Eleven percent of the physicians said that under current legal constraints, there were circumstances in which they would be willing to hasten a patient's death by prescribing medication, and 7 percent said that they would provide a lethal injection; 36 percent and 24 percent, respectively, said that they would do so if it were legal. Since entering practice, 18.3 percent of the physicians (unweighted number, 320) reported having received a request from a patient for assistance with suicide and 11.1 percent (unweighted number, 196) had received a request for a lethal injection. Sixteen percent of the physicians receiving such requests (unweighted number, 42), or 3.3 percent of the entire sample, reported that they had written at least one prescription to be used to hasten death, and 4.7 percent (unweighted number, 59), said that they had administered at least one lethal injection. A substantial proportion of physicians in the United States report that they receive requests for physician-assisted suicide and euthanasia, and about 7 percent of those who responded to our survey have complied with such requests at least once.

Towards the right to be killed? Treatment refusal, assisted suicide and euthanasia in the United States and Canada.

This chapter describes some dominant trends of American and Canadian law in relation to treatment refusal, physician-assisted suicide and euthanasia. Although common law in both countries recognizes the right of patients to refuse treatment, problems have arisen, especially in the US, over treatment refusal on behalf of incompetent patients. One response has been to enact advance-directive legislation, promoting the use of living wills and proxy appointments. Courts have also specified criteria for withholding and withdrawing treatment from incompetent patients. The notion of a "right to die', developed in court cases on treatment refusal, is now being invoked to support the legalization of assisted suicide. Courts are generally reluctant to recognize an extention of this right. Debates and court cases following the recent initiative to legalize assisted suicide in Oregon and the Sue Rodriguez case in Canada's Supreme Court, which resulted in a special report of a Canadian Senate Committee, are of major importance for the development of law in this area.

CQ interview: Margaret Battin, Howard Brody, Patricia Marshall, and Robyn Shapiro on physician-aided death.

In The Netherlands, the close relationship between doctor and patient over time can be viewed as an advantage in protecting the patient. Is it possible to implement this aspect of euthanasia in the United States?

Physician-assisted suicide and euthanasia in the United States. Legal and ethical observations.

Physician-assisted suicide and euthanasia in the United States. Legal and ethical observations.

Euthanasia. Historical, ethical, and empiric perspectives.

Debates about the ethics of euthanasia date from ancient Greece and Rome. In 1870, S. D. Williams, a nonphysician, proposed that anesthetics be used to intentionally end the lives of patients. Between 1870 and 1936, a debate about the ethics of euthanasia raged in the United States and Britain. These debates predate and invoke different arguments than do debates about euthanasia in Germany. Recognizing the increased interest in euthanasia, this article reviews the definitions related to euthanasia, the historical record of debates concerning euthanasia, the arguments for and against euthanasia, the situation in the Netherlands, and the empirical data regarding euthanasia in the United States.

'It's Over, Debbie' and the Euthanasia Debate

The apparent act of mercy killing described in It's Over, Debbie in the A PIECE OF MY MIND column in the Jan 8,1988, issue of JAMA 1 stimulated substantial reaction from the medical profession, the public, the media, and legal authorities. At press time, we have received more than 150 letters. Eighteen examples are published in this issue, 2 as are two representative commentaries. 3,4 Most of the early letters were from physicians and tallied about 4:1 against the action the physician described and 3:1 againstThe JOURNALfor publishing the essay. Reactions from the public and media were delayed but were extraordinary in volume and duration. Purpose and Process of Publication We published It's Over, Debbie to provoke responsible debate within the medical profession and by the public about euthanasia in the United States in 1988. 5 We believe that JAMA is the right place for issues in American