Form Of Euthanasia Research Articles

Euthanasia and/or assisted suicide: for or against?

In the face of serious and untreatable health problems, a person may start thinking that the best and probably the only way out is death. In this case, it is not a natural death, but a death caused by someone. Death can be caused either by other people or by the sick person. If the death is caused by another person, it is important that the person’s actions do not contravene existing legislation. In the case of the subject in question, this can take the form of euthanasia or assisted suicide. In this article, the authors outline the legal and ethical aspects of euthanasia and assisted suicide in different countries, including cases in Estonian practice. The article presents points of departure from a debate that has been going on in Estonian society for years, some of which emphasise the need to legalise euthanasia and/or assisted suicide, while others support the belief that Estonia is not yet ready to legalise voluntary euthanasia. At present, the latter view prevails, which may also be the reason for the lack of political will. Keywords: a dignified departure; euthanasia; assisted suicide.

The Moral Dilemma of Euthanasia Through the Eyes of the Medical Society in Bulgaria.

With the development of human society, the question of the value and inviolability of human life begins to occupy a central place in the various social strata and social structures. With the adoption of the Universal Declaration of Human Rights after the Second World War, the basic postulates protecting the right to inviolability of human life were laid. The question focused on euthanasia has been discussed in several European countries, such as Germany, Ireland, France, and Italy, leading to considerable interest in the medical community in Bulgaria. A prospective study was performed using approved sample cards, analyzing the general knowledge of the medical community in the Republic of Bulgaria about euthanasia and assisted suicide over a period of four months, between January 2023 and May 2023. In this process, 623 people were surveyed, and the questionnaire included several targeted questions through electronically generated samples on the Microsoft Forms platform. The target group had doctors with and without a specialty in various fields of hospital and pre-hospital care, dentists, and students from the fields of medicine and dentistry. The results show that the majority of medical professionals clearly state their positive opinion on the adoption of a law to legalize euthanasia in the Republic of Bulgaria, clearly taking into account the fact that the right to life has always been and always will be the most absolute and fundamental human right. Contrary to the above, it is implied that it is inevitably linked to a quality and fulfilling life without suffering. Identically, they also answered that a person should have the right to know exactly when to end his own life. The medical society in Bulgaria clearly shows its positive opinion regarding the idea that the different forms of euthanasia (active euthanasia and assisted suicide) should be defined as morally and legally permissible. Our research confirms the Bulgarian medical community's opinion that the subject of the problems of euthanasia and its legal regulation are already ripe for public discussion, similar to many other European countries. The actual issue of euthanasia as a conclusion raises several questions related to the process of acceptance of standard algorithms for action in such cases where the same action is legalized by law. It also includes the process of acceptance of strict regulations by the countries for the so-called negative phenomenon "death tourism" and several other administrative actions related to the mandatory registration of every case of euthanasia, the implementation of mandatory consultations with a psychiatrist and psychologist for patients seeking euthanasia as the only possible option, and providing possible alternatives regarding their illness. This is the unchangeable cornerstone for standardizing the legalization process and acceptance of "good death" in Bulgaria. In its essence, euthanasia creates both a social and an ethical conflict in our modern society, appearing at the same time as a kind of "stress test" for the health system.

EUTHANASIA: BETWEEN THE RIGHT AND THE OFFENSE

The problem of legalization or continuation of the ban on euthanasia at the national level continues to cause wide public resonance. This problem is complex in nature, because it concerns not only medical issues, but also legal and bioethical issues. Euthanasia significantly increases the risks of abuse of this right for patients who wish to implement an appropriate dignified and meaningful end-of-life procedure to end suffering. The purpose of the article is to reveal the dualistic essence of euthanasia – as a person’s right to a dignified death, and as a criminal offense. The article focuses on modern scientific views on euthanasia, covering three aspects: 1) negative – support for the current ban on euthanasia; 2) positive – the need to create legal instruments to implement the right to voluntarily end one’s life; 3) alternative – supporters of which consider the possibility of replacing euthanasia with other procedures that are more humane from the point of view of bioethics (palliative care, voluntary refusal of treatment, etc.). Attention was drawn to the fact that the right to freely dispose of one’s own life is enshrined in national legislation. Yes, the patient’s refusal of medical intervention or treatment may result in the approaching moment of death. The spread of the international practice of further liberalization and expansion of the circle of states that support euthanasia procedures are emphasized. Attention is focused on the fact that the variety of procedures and forms of euthanasia does not allow to clearly determine which of them is the most acceptable from a legal point of view. At the same time, all such procedures and forms provide for one thing – the right of a terminally ill or chronically ill person to independently determine how and when to die. It was concluded that euthanasia is a person’s own choice and this is the most important thing in his awareness as a component of the right to life. The position regarding the possibility of its legalization in Ukraine in the future is supported.

Futile Therapy versus Worthy Dying: Anthropological and Ethical Arguments

Nowadays, issues related to the final stages of life stand more and more at the centre of problems relating to life and health, which result, for example, from the demographic situation in highly developed societies. In the last decades of the twentieth century, an explosion of therapeutic possibilities in the field of technical medicine has caused such questions to be voiced more and more frequently: Should humans try to live as long as possible, or should they live as long as they can with dignity and then die with dignity? Despite the seemingly obvious answer, there is still considerable medical and social resistance to the policy of discontinuing futile therapy. There are probably many reasons for this situation, but one of the most important factors is that this is regarded as a form of euthanasia. This means that ineffective therapy administered to a terminally ill patient is prolonged, even when it increases their suffering and prolongs their agony. Therefore, it is reasonable to examine the relevant arguments for the right approach to treating a terminally ill person. The starting point should begin with the empirical facts about patients who are in the last stage of their life, and where there is reasonable doubt about the benefits of the treatment they are receiving. Since normative conclusions should not be directly derived from empirical data, it is necessary to collect anthropological arguments first. It is only the concept of what a human being is that is fundamental to the applied bioethics, according to which we can formulate ethical conclusions. Finally, theology will come to the fore and it can bring new perspectives on death and what is beyond death boundaries.

RACIAL-ETHNIC DISPARITIES IN ATTITUDES TOWARD PASSIVE AND ACTIVE EUTHANASIA

This paper examined racial/ethnic differences in opinions about passive euthanasia (withdrawing or withholding treatment), suicide, and physician-assisted suicide. Data came from 1,832 participants in the 2013 Pew Religion and Public Life Project. Respondents from all racial/ethnic backgrounds were most likely to favor multiple forms of euthanasia. However, persons of color had a wider variety of opinions about euthanasia than did non-Hispanic whites. In multivariate multinomial logistic regressions, non-Hispanic whites had a 63% chance of approving broadly of euthanasia, while non-Hispanic blacks had a 40% chance, and Hispanics, a 49% chance. Opposition to euthanasia was most common among people with multiple disadvantages (e.g., educational attainment, immigrant status). Neither trust in health care providers nor recent experience with the death of a loved one explained these group differences. Results highlight large differences of opinion between the people who set policy and practice guidelines and those who lack this power and access.

„Dobra śmierć” na tle regulacji prawnych w Polsce

The “right to life” of every human being, understood as independent of the will of the legislator, natural law, does not find in the current legal system a contrario, the “right to die”. In Polish law, not all forms of euthanasia are punishable. First of all, euthanasia is forbidden, i.e. killing a second person under the influence of compassion caused by a severe and incurable disease and related suffering, after the thought of art. 150 of the Act of 6 June 1997, the Penal Code. This is a privileged type of murder, i.e. threatened by a more lenient criminal sanction than an ‘ordinary’ murder. For the murder of euthanasia from 3 months to 5 years of imprisonment, however, there is the possibility of extraordinary mitigation of punishment, and even waiving its imposition. Of course, not every murder under the influence of compassion and on demand can be a milder responsibility for the offender. A person inflicted on demand by someone who is insane or moribund or underage will be an ‘ordinary’ murder. In addition, there must be serious reasons for the demand for homicide (severe suffering). It will not be euthanasia, but an ‘ordinary’ homicide committed at the request of eg a melancholy with a broken heart. Euthanasia is not only an action (eg injection of poison), but also abandonment (for example, not ordering a life-supporting drug – only for a doctor and nurse).

EUTHANASIA OR PALLIATIVE CARE: LEGAL PRINCIPLES OF THE IMPLEMENTATION IN THE CONTEXT OF THE REALIZATION OF HUMAN RIGHTS TO LIFE

Introduction: The right to life - is natural inherent human right, the fundamental principle of the existence of mankind, recognized by all civilized countries. It is enshrined in numerous international and national legal acts as the most important benefit of a man. However, there are discussions about the use of euthanasia. Therefore, the problem of the legalization of euthanasia requires careful study. The aim: The purpose of this article is to analyze and systematize existing problems of the legalization of euthanasia. The main objective of the article is to study the legal grounds for the introduction of euthanasia in the context of realizing the right to life, to study the content of palliative care, to distinguish the barriers to its development, and to formulate propositions for their elimination. Materials and methods: Theoretical (analysis, synthesis, generalization, systematization, etc.) and empirical methods (observation, survey, classification, etc.) were used in the course of the research. Results: The author has revealed the negative attitude of medical staff to the possibility of using different forms of euthanasia during the study. The reasons for the positive attitude of patients, who were in the thermal stage to the euthanasia, have been determined. It has been established that the correction of most causes leads to a significant reduction in the percentage of positive attitude to euthanasia. The arguments of opponents and supporters of the legalization of euthanasia procedure have been analyzed. On this basis the author has proved the objective absence of legal grounds for the legalization of euthanasia procedure and direct violation of human rights to life. Conclusions: The author has proved the expediency of the development of palliative care as an alternative to euthanasia, has outlined the obstacles to its development, has offered to develop regulatory base for the legal regulation of the provision of palliative care, to establish the National Coordination Council on palliative and hospice care, to form the system of state control over the quality of provision of palliative care and observance of the rights of patients.

Law and Society - Euthanasia and Criminal Law

Abstract Euthanasia or "sweet death" is a topic that has sparked numerous debates throughout history. In Albania, the right to life is protected by Article 21 of the Constitution of the Republic of Albania. Regarding the individual's right to die in Albania, both forms of euthanasia, the passive and the active one, are considered criminal offenses and are punishable by law. The problem lies in the fact that such a definition is not found in the Albanian legislation, but such actions are considered as criminal by the interpretation of the law. In this topic we will study the perception of Albanians regarding euthanasia and whether the Albanian legislation should include this form of soft death or not. The protection of life in the country should take the dimensions of a sustainable protection. For this reason, in addition to the positive effects of improving life protection that derive from the application of the entirety of the various criminal justice programs and policies, also including the recent amendments to the Criminal Code of the Republic of Albania, a concrete and continuous protection should be provided in support of the right to life. I have always drawn a debate on this issue, which deals with the fundamental human right, with the most sacred right, that of life.

Fine vita in neonatologia. Una revisione sistematica

The concept of of life decisions, which refers to all decisions and practices relating to the stages of end of life, constitutes a specific and delicate aspect of medicalization of death, and may vary from advance directives for treatment (or living wills) to the various forms of euthanasia, involving the field of palliative care too. Italy, despite the ratification of the Oviedo Convention in 2001, unlike many other countries, has not yet adopted a law that guarantees people the right of choice before critical and irreversible pathologies, revealing a weak point whose implications and consequences are revealed clinically, legally and socially for both patients, families and doctors. If we look specifically at the end of life in the neonatalogical area, the issue becomes even more complex, revealing the most delicate aspects and levels of analysis in relation to the specificity of the case. This paper, according to the international current debate and through the Cochrane’s Systematic review, explores dynamics, priority references, and motivations behind the end of life decisions in a neonatal setting, in conditions of extreme prematurity or serious congenital malformations or chromosomal pathologies that are not compatible with life.

Court ruling on ending life support is right

Wilson talks about legal issues for life support. A judgment from the Court of Protection of England and Wales may make it easier for the families of people in such conditions to stop artificial feeding and let their loved one die without having to go through a lengthy and distressing legal process. It might seem like this could allow significant decisions to be made too easily, or even that the court is legalizing a form of euthanasia. In fact, this change is long overdue, and is in line with other Western countries, such as the US and Australia. The ruling concerns people who are left in a permanent vegetative or minimally conscious state, usually after they have received a brain injury and emerged from a coma into a state where they can breathe unaided but have almost no sign of awareness.

Евтаназія VS права на життя: проблема прав людини

У статті досліджується евтаназія як комплексна біоетична (медична, етична, правова, релігійна) проблема. Розглядаються різні форми евтаназії та аналізується правомірність їх застосування в контексті прав людини. Обґрунтовується неправомірність виділення права на смерть як зі змісту права на життя, так і як окремого права людини у міжнародному праві. Визначається необхідність розвитку державою паліативної допомоги як альтернативи евтаназії.

Terminalna sedacja - między opieką paliatywną a eutanazją

The aim of this article is a presentation of the problem of terminal sedation as a special medical procedure, an alternative to euthanasia and physician assisted death. Terminal sedation is consist in narcotizing the patient in the last stage of terminal disease, sometimes with discontinued nutrition and hydration until death. The goal of this procedure is to eliminate pain and suffering without causing death of the patient. The opponents of this method claim that terminal sedation is a form of euthanasia. The supporters see the difference because the intention of physician must relieve unbearable suffering when the other procedures are useless. The terminal sedation has to be last resort in palliative care and the decision making process must be very careful. In case of applying this radical method the basis should be always the informed consent of the patient and the respect for the dying person.

Deactivation of Left Ventricular Assist Devices: Differing Perspectives of Cardiology and Hospice/Palliative Medicine Clinicians

BackgroundBeliefs around deactivation of a left ventricular assist device (LVAD) vary substantially among clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians. Methods and ResultsWe administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed-methods design was used. From October through November 2011, 7168 individuals were sent the survey and 440 responded. Three domains emerged: (1) LVAD as a life-sustaining therapy; (2) complexities of the process of LVAD deactivation; and (3) legal and ethical considerations of LVAD deactivation. Most respondents (cardiology 92%; HPM 81%; P = .15) believed that an LVAD is a life-sustaining treatment for patients with advanced heart failure; however, 60% of cardiology vs 2% of HPM clinicians believed a patient should be imminently dying to deactivate an LVAD (P < .001). Additionally, 87% of cardiology vs 100% of HPM clinicians believed the cause of death following LVAD deactivation was from underlying disease (P < .001), with 13% of cardiology clinicians considering it to be a form of euthanasia or physician-assisted suicide. ConclusionCardiology and HPM clinicians have differing perspectives regarding LVAD deactivation. Bridging the gaps and engaging in dialog between these 2 specialties is a critical first step in creating a more cohesive approach to care for LVAD patients.

Terminal Sedation – Good Medicine? Good Ethics? Good Law?

&lt;p&gt;&lt;em&gt;&lt;span style="font-family: Times New Roman; font-size: medium;"&gt;The use of sedation at the end of life is becoming increasingly common, yet its ethics and lawfulness have not been as widely discussed as might have been expected. In this article, the primary focus is on what is known as ‘terminal sedation’, with particular reference to the use of sedation without the provision of assisted nutrition and hydration (‘ANH’). It is argued that, where ANH is not contraindicated by patient wellbeing itself, close scrutiny of the practice is required. There are both ethical and legal reasons why a move towards appropriate regulation is appropriate. The urgency of doing this is evidenced by the variety in practices throughout the world, with some commentators suggesting that the decision whether or not to instigate terminal sedation may be influenced by more than clinical indications for its use (in which case, it may be perilously close to a form of euthanasia). Indeed, it may be argued that there is little that differentiates terminal sedation from a form of euthanasia. Moreover, the relatively common exclusion of existential suffering as an indication for terminal sedation is questioned. Were this also to be accepted as a valid indicator for terminal sedation (without the provision of ANH) it becomes even more urgent that an adequate regulatory framework is developed and that the ethics of the practice are appropriately explored and clarified.&lt;/span&gt;&lt;/em&gt;&lt;/p&gt;

Opinión de los profesionales de una unidad de cuidados intensivos sobre la limitación del esfuerzo terapéutico

ObjectiveTo determine the opinion held by professionals in an intensive care unit on the limitation of therapeutic effort process at the end-of-life (LTE). To collect this information, and then use it to improve the basic aspects that the LTE have on the quality of care by intensive care unit staff. Material and methodsA prospective descriptive study was carried out in the Intensive Care Unit of a third level public university hospital. A questionnaire was prepared that included questions on their demographic profile and others to provide an ethical valuation profile, as well as to find out the knowledge and information that the professional had on the LTE. Descriptive study of the sample and comparative statistics were performed using the chi-squared statistical test. ResultsA total of 65 valid questionnaires were obtained from a convenience sample of 70 professionals. Almost all of them (98%) were in favour of the limitation of therapeutic effort. The LTE was considered as some kind of euthanasia (active or passive) in up to 28% of the replies, valuations by professional categories is shown in. More than three-quarters (77%) had the belief that not to start treatment was not the same as withdrawing an already established treatment. Just over half (52%) of the respondents believe the value that should have more weight when considering LET would be the prognosis of the current illness of the patient, and 46% the future quality of life of the patient. The economic cost of treatment to be applied was not considered in any case. ConclusionsThe LTE is approved by the majority of professionals in our Intensive Care Unit. Although a non-negligible percentage understood it as a form of euthanasia.

Physician-Assisted Suicide and Other Forms of Euthanasia in Islamic Spiritual Care.

The muteness in the Qur'an about suicide due to intolerable pain and a firm opposition to suicide in the hadith literature formed a strong opinion among Muslims that neither repentance nor the suffering of the person can remove the sin of suicide or mercy 'killing' (al-qatl al-rahim), even if these acts are committed with the purpose of relieving suffering and pain. Some interpretations of the Islamic sources even give advantage to murderers as opposed to people who commit suicide because the murderers, at least, may have opportunity to repent for their sin. However, people who commit suicide are 'labeled' for losing faith in the afterlife without a chance to repent for their act. This paper claims that Islamic spiritual care can help people make decisions that may impact patients, family members, health care givers and the whole community by responding to questions such as 'What is the Islamic view on death?', 'What is the Islamic response to physician-assisted suicide and other forms of euthanasia?', 'What are the religious and moral underpinnings of these responses in Islam?'

Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey

BackgroundEuthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia.MethodsA large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses.ResultsRejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate.ConclusionEuthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

Attitudes towards euthanasia among Greek intensive care unit physicians and nurses

ObjectivesTo investigate the attitudes of Greek intensive care unit (ICU) medical and nursing staff towards euthanasia. BackgroundICU physicians and nurses deal with end-of-life dilemmas on a daily basis. Therefore, the exploration of their stances on euthanasia is worthwhile. MethodsThis was a descriptive quantitative study conducted in three ICUs in Athens. The convenience sample included 39 physicians and 107 nurses. ResultsOf respondents, 52% defined euthanasia inaccurately, as withholding or withdrawal of treatment, while 15% ranked limitation of life-support among the several forms of euthanasia, together with active shortening of the dying process and physician – assisted suicide. Only one third of participants defined euthanasia correctly. While 59% of doctors and 64% of nurses support the legalization of active euthanasia, just 28% and 26% of them, respectively, agree with it ethically. ConclusionsConfusion prevails among Greek ICU physicians and nurses regarding the definition of euthanasia. The majority of staff disagrees with active euthanasia, but upholds its legalization.

Euthanasia outside Europe

The passive form of euthanasia is legalized almost in every civilized country. Its active form is not a generally accepted legal institution. In Europe, active euthanasia is legalized only in The Netherlands, Belgium, Luxembourg and Switzerland. In Australia, the Act on the Rights of the Terminally Ill of 1995 legalized the institution of assisted suicide, which is not identical to active euthanasia. The difference lies in the fact that legalized active euthanasia means that the author of a murder is not punishable (under certain circumstances), whilst assisted suicide is not about murder, rather about suicide. In the first case, the patient is killed on his or her request by someone else. In the second case, the patient himself or herself executes the act of self-killing (by the assistance of a healthcare worker). In Australia, the institution of assisted suicide was repealed in 1997. Assisted suicide is legal in four USA member states: in Vermont, Washington, Montana and Oregon. In Uruguay, the active form of euthanasia has been legal since 1932.

Euthanasia: Act of charity, or murder?

Euthanasia is defined as a “good death”. It encompasses different forms of death: passive, active, indirect, with or without the consent of the patient, assisted suicide, even elective abortion may be considered a form of euthanasia. Some argue in favour of euthanasia based on the right of the patient to decide about his own life. Others claim that different societies set different standards and norms of behaviour. Those who are opposed to euthanasia base their arguments on the Hippocratic Oath and the Ten Commandments. Their argument is further reinforced by new therapies, possible diagnosis errors, even rare cases of self-regression of cancer. We also discuss herein the negative impact of legalizing euthanasia, and briefly refer to four cases of patients as illustrative examples against euthanasia.