Legalization Of Euthanasia Research Articles

RIGHT TO LIFE: EVOLUTION OF A UNIVERSAL INTERNATIONAL STANDARD

This article examined the content of the international legal standard for ensuring and protecting the right to life, the implementation of which should be guided by the states parties to the international Covenant on civil and political rights in 1966. Based on the General Comments of the UN Human Rights Committee adopted under article 6 of the Covenant, the author attempts to trace the evolutionary development of the universal standard of the right to life due to the social needs of the international community. The main content of the study is an analysis of the draft of the General Comment No. 36, in which the Committee, summarizing the international and domestic practice of member states, presented its views on the current content of the right to life, as well as the comments of states on the text of the proposed draft. Such controversial issues in the context of the right to life as the problem of death penalty, legalization of euthanasia and a number of others are considered. In conclusion, the author assesses the interpretation activities of the Human Rights Committee.

The right to euthanasia: for or against?

The purpose of the research is to determine the feasibility of introducing euthanasia in Ukraine based on the analysis of world experience. Euthanasia is the most controversial and ambiguous topic of scientifi research, which is on the brink of medicine and law. Euthanasia is the type of behavior of the medical offir (action, inaction or decision) committed consciously and intentionally, and also aimed at ending the unbearable suffring (physical, mental, moral and other characters), carried out on a repeated and unambiguous request of the patient (and his legal representative), subject to his complete, timely and objective awareness of the consequences of such interference resulting from the death of the patient. In the world there is no single approach to the issues of legalization of euthanasia. Today, the tendency towards legalization of passive euthanasia in the legal order of some economically developed countries is developing. However, this was preceded by a serious social controversy on this issue with the widest possible involvement of it, in the law, medicine, bioethics, philosophy, sociology and other sciences. However, in spite of the established trends, euthanasia in none of its forms can be considered as a suffient legal basis for depriving a person of his life and the corresponding termination of his right to life. The priority direction of development should be not the legalization of euthanasia, but the development of palliative care, which aims to eliminate pain and provide comprehensive support to patients, members of their families, and others.

Nurses' use of conscientious objection and the implications for conscience.

To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice. Interpretive phenomenology was used to guide this study. Data were collected from 2016 - 2017 through one-on-one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings. Iterative, phased analysis using line-by-line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO. Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses' conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice. Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience-based COs. This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses' conscience rights are indicated to address nurses' conscience issues in practice settings.

The genealogy of death: A chronology of U.S. organizations promoting euthanasia and assisted suicide.

In the early 20th century, a political movement to secure access to euthanasia and assisted suicide began in the United States. The multitude of organizations associated with this effort has undergone an array of mergers, splits, and name changes, channeled through two progenitor organizations-the Euthanasia Society of America and the Hemlock Society. A few chronologies mapping the metamorphoses of these organizations are available, but they are not accessible in the medical literature. Moreover, they are not comprehensive, lack consistency, and are not rigorously validated. As debates about the legalization of euthanasia and assisted suicide continue, it is important to have a common understanding of the history behind these developments, including recognition of the factors driving these adaptations. In this paper, we offer a comprehensive and definitive history to aid those interested in knowing the roots of these organizations and those that are still active today.

Consistency and contrast effects in moral evaluation of euthanasia

Euthanasia is a highly controversial topic. One of the arguments against legalisation of euthanasia is that it would lead to an attitudinal slippery slope effect; that is, a shift in attitudes toward euthanasia even toward cases which were not legalised. The present study tested a possible mechanism which may lead to such shift in two experiments. Participants judged morality of euthanasia in two hypothetical scenarios describing patients requesting euthanasia. We found that participants who first evaluated a case of a non-terminally ill patient suffering from fatigue afterward considered euthanasia for a terminally ill patient suffering from pain more morally right than participants who evaluated euthanasia in the latter case first. Furthermore, we found that presenting the case of the patient suffering from fatigue before asking about attitudes toward legality of euthanasia led participants to oppose it more. The study suggests that public’s expressed attitudes toward legality of euthanasia might be easily influenced by a choice of illustrative examples. However, the change in attitudes predicted by the slippery slope effect was not observed.

The attitudes, role & knowledge of mental health nurses towards euthanasia because of unbearable mental suffering in Belgium: A pilot study

Introduction Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. Aim To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. Methods A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n=133) as a pilot study. Self-administered questionnaires were provided to mental health nurses. Results Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Discussion Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Implications for Practice Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision-making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions.

A Completed Life

The Netherlands is debating a highly sensitive extension of the conditions for legal euthanasia.

Neuroznanstvena dekonstrukcija ideologiziranog »beznađa« vegetativnoga stanja

Recentna neuroznanstvena istraživanja propituju dosadašnju predrasudu o vegetativnom stanju kao »beznadnom« stanju. Rezultati ovih otkrića ne samo da ruše već postojeće predrasude prema osobama u vegetativnom stanju, već daju i nov uvid u epistemološku problematiku točnosti dijagnosticiranja aktualnog stanja, popraćenu etičkim i društvenim implikacijama. Pružajući bolje razumijevanje same naravi svijesti i svjesnosti, upućuju na oblik moralne i socijalne odgovornosti prema tim osobama ne ostavljajući mjesta za »beznađe«. Stoga je prvotni cilj ovoga rada prikazati kako se uz razvitak uvida u stanje osoba s poremećajem svijesti, na samom početku paralelno razvijala i predrasuda »beznađa« kao nuspojava nedovoljnog i neadekvatnog znanja o naravi svijesti kod osoba u vegetativnom stanju. Ova ustaljena predrasuda imala je direktan utjecaj na donošenje kliničkih odluka o mjerama održavanja na životu: od povlačenja nutricije i hidratacije – do pitanja kardio-pulmonarnog oživljavanja pa onda do odvajanja od respiratora, smatrajući da osoba nema nade za oporavak nakon uspostave dijagnoze vegetativnog stanja. Stoga, ova predrasuda »beznađa« ne samo da nije ostavila duboko utaban, moralno upitan put za izvođenje pasivne eutanazije, već je, štoviše, bila iskorištena i ispolitizirana kao jedan od glavnih argumenata i primjera pro-eutanazijskih pokreta u borbi za ozakonjenje same eutanazije.

The living dead? Perception of persons in the unresponsive wakefulness syndrome in Germany compared to the USA

BackgroundThe extent to which people ascribe mind to others has been shown to predict the extent to which human rights are conferred. Therefore, in the context of disorders of consciousness (DOC), mind ascription can influence end of life decisions. A previous US-American study indicated that participants ascribed even less mind to patients with unresponsive-wakefulness-syndrome (UWS) than to the dead. Results were explained in terms of implicit dualism and religious beliefs, as highly religious people ascribed least mind to UWS. Here, we addresses mind ascription to UWS patients in Germany.MethodsWe investigate the perception of UWS patients in a large German sample (N = 910) and compare the results to the previous US data, addressing possible cultural differences. We further assess effects of medical expertise, age, gender, socio-economic status and subjective knowledge about UWS in the German sample.ResultsUnlike the US sample, German participants did not perceive UWS patients as “more dead than dead”, ascribing either equal (on 3 of 5 items) or more (on 2 items) mental abilities to UWS patients than to the dead. Likewise, an effect of implicit dualism was not replicated and German medically trained participants ascribed more capabilities to UWS patients than did a non-medical sample. Within the German sample, age, gender, religiosity and socio-economic status explained about 15% of the variability of mind ascription. Age and religiosity were individually significant predictors, younger and more religious people ascribing more mind. Gender had no effect.ConclusionResults are consistent with cross-cultural differences in the perception of UWS between Germany and the USA, Germans ascribing more mind to UWS patients. The German sample ascribed as much or more but not less mind to a UWS patient than to a deceased, although within group variance was large, calling for further research. Mind ascription is vital, because, in times of declining resources for healthcare systems, and an increasing legalization of euthanasia, public opinion will influence UWS patients’ rights and whether ‘the right to die’ will be the only right conceded to them.

Attitude Towards Euthanasia among Students of Arts College-A Comparative Study

This study was undertaken to study the awareness and perception about euthanasia among arts students and to compare the regional differences, if any. This cross-sectional study was conducted at different colleges in Mangalore (representing south) and Srinagar and Jammu (representing north) among 400 arts students. The students responded to self-administered questionnaires that comprised of ten questions. A total of 400 students participated in the study, 200 from South and 200 from North between the age group of 17 to 21 years. The majority of participants (85%) from north and 70% from south were against introducing a law permitting the practice of euthanasia. 78% of participants from north and 46% from south were of the opinion that it should not be allowed. The participants were questioned that if euthanasia is allowed, who according to them should do it, and it was found that majority of the participants from north were of the opinion that euthanasia should be decided by the family whereas participants from south believed that euthanasia should be decided by the doctor. The main concern of respondents in south (52%) regarding euthanasia was that it can be misused in different situations, whereas in north the participants (55%) were against euthanasia based on their religious belief. Majority of students were against the legalization of euthanasia. Further study should be conducted to know the awareness and perception of euthanasia among the general population.

Argumenty w sporze o legalizację eutanazji i wspomaganego samobójstwa. Część I

Celem artykulu jest prezentacja argumentow uzywanych w debacie nad legalizacją eutanazji i wspomaganego samobojstwa. Przeciwnicy legalizacji wyzej wymienionych procedur poslugują sie argumentem moralnym ze świetości zycia oraz argumentem poza moralnym z rowni pochylej. Zalozeniem argumentu świetości zycia jest niemoralnośc wszelkich form zabijania terminalna choroba i związane z nią cierpienie nie są okolicznościami usprawiedliwiającymi przerwanie zycia. Ochrona zycia stanowi fundament funkcjonowania spoleczenstwa. Argument rowni pochylej opiera sie na nastepującym zalozeniu: jeśli uczyniony zostanie wyjątek od zasady nienaruszalności zycia w postaci np. eutanazji lub wspomaganego samobojstwa osob terminalnie chorych, ktore są pelnoletnie i wyrazają wolną od naciskow prośbe, w konsekwencji doprowadzi to do zabijania osob chorych, starych czy kalekich bez ich zgody lub nawet wbrew ich woli. Chodzi tu o zmiany w świadomości spolecznej, ktore mogą doprowadzic do zakwestionowania wartości zycia ludzkiego. Mozliwe jest takze wystąpienie trudnych do kontrolowania naduzyc. Zwolennicy przyspieszania śmierci formulują dwa argumenty moralne: argument z autonomii jednostki i argument z jakości zycia. Argument z autonomii jednostki jest przedstawiany jako wyraz szacunku do czlowieka i dokonywanych przez niego wyborow. Kazdy ma prawo zdecydowac kiedy wlasne zycie przestaje byc dla niego wartością, w szczegolności zaś w przypadku choroby i cierpienia, a zatem wybrac tzw. godną śmierc bez cierpienia i zalezności od innych. Zwolennicy tego argumentu stwierdzają, ze zasada autonomii moze byc rownie wazna lub nawet wazniejsza od zasady nienaruszalności zycia, jednocześnie jest ona odpowiedzią na paternalizm medyczny. Wlaśnie tego argumentu uzyto w panstwach, ktore zalegalizowaly eutanazje i wspomagane samobojstwo (panstwach Beneluksu, Kanadzie oraz w nastepujących stanach w USA: Oregonie, Waszyngtonie, Montanie, Vermoncie, Kalifornii, Dystrykcie Kolumbii oraz Kolorado). Kolejny argument zwolennikow dopuszczalności eutanazji i wspomaganego samobojstwa to argument moralny z jakości zycia, zaklada on, ze w pewnych okolicznościach zycie i jego kontynuacja nie stanowią dobra dla osoby. Argument z jakości zycia polega na oszacowaniu czy zycie ma dla chorego wartośc, czy tez pozostaje tylko ciezarem lub ogranicza sie do biologicznego trwania, jak np. w przypadku osob w przetrwalym stanie wegetatywnym. Nalezy zaznaczyc, ze to jaka zostanie uzyta argumentacja bedzie mialo wplyw na ksztalt przyszlych rozwiązan prawnych związanych z medycznie wspomaganą śmiercią.

The issue of legalizing euthanasia in Ukraine: foreign experience

This article is devoted to the issue of euthanasia legalization expediency in Ukraine. On the example of countries in Europe and America, an analysis was made of the phenomenon of euthanasia, its impact on legislation and society. The author highlights the peculiarities of euthanasia in each analyzed country. As a conclusion, the author substantiates the ambiguity of this issue and draws attention to the risks that may arise as a result of the legalization of euthanasia in Ukraine.

Helping a loved one die: the act of assisted dying in New Zealand

Assisted dying although illegal in New Zealand, is often in the spotlight and surrounded by much debate. Moreover, while sentencing may take into account the motivation (ending of suffering) of those who assist, this is done on a case-by-case basis, with the process and resulting punishment extremely taxing on the offender psychologically, physically and emotionally. The present study explored the personal experiences of family members who had assisted with the death of a loved one and resulting consequences (legal, emotional, psychological). The goal was to explore how someone made sense of their personal experience with assisted dying. Semi-structured interviews were conducted with three participants. Findings suggest that the act of assisted dying was motivated primarily by altruistic reasons, driven by empathy and compassion towards a suffering loved one. The act of assisted dying resulted in unforeseeable life-changing events such as imprisonment, activism for legalisation of euthanasia, and loss of significant relationships. The overall experience was characterised by coping strategies, predominantly negative emotional states, and a deliberate defiance of established legal and medical systems. Participants represented a sub-group of altruistic offenders. Findings draw attention to the four principles of medical ethics – autonomy, beneficence, non-maleficence and justice in relation to assisted dying.

Legalization Of Euthanasia And Physician-Assisted Dying: Condemnation Of Physician Participation

The topic of physician-assisted dying has always been a controversial topic raising a strong ethical dilemma. Currently six states in USA (Oregon, Vermont, Washington, Montana, California, Colorado) have developed regulations legalizing physician-assisted dying (medical euthanasia). We propose that physicians, because of their Hippocratic oath, should be exempted of participating in it. We suggest experts in professional assisted dying (“Euthanasia Specialists”) be ethically and to some degree medically trained to perform such a task when deemed appropriate.

International Association for Hospice and Palliative Care Position Statement: Euthanasia and Physician-Assisted Suicide.

Background: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement.Purpose: To describe the position of the IAHPC regarding Euthanasia and PAS.Method: The IAHPC formed a working group (WG) of seven board members and two staff officers who volunteered to participate in this process. An online search was performed using the terms “position statement”, “euthanasia” “assisted suicide” “PAS” to identify existing position statements from health professional organizations. Only statements from national or pan-national associations were included. Statements from seven general medical and nursing associations and statements from seven palliative care organizations were identified. A working document including a summary of the different position statements was prepared and based on these, an initial draft was prepared. Online discussions among the members of the WG took place for a period of three months. The differences were reconciled by email discussions. The resulting draft was shared with the full board. Additional comments and suggestions were incorporated. This document represents the final version approved by the IAHPC Board of Directors.Result: IAHPC believes that no country or state should consider the legalization of euthanasia or PAS until it ensures universal access to palliative care services and to appropriate medications, including opioids for pain and dyspnea.Conclusion: In countries and states where euthanasia and/or PAS are legal, IAHPC agrees that palliative care units should not be responsible for overseeing or administering these practices. The law or policies should include provisions so that any health professional who objects must be allowed to deny participating.

Aspekty etyczno-prawne legalizacji eutanazji na świecie w latach 2000-2015

New humanism or post-humanism? Ethical and legal aspects of the legalization of euthanasia in the world in the years 2000-2015 The main aim of this article is to outline the discussion on euthanasia that affects the basic issues of human life – the foundation of human dignity, sense of pain and suffering, conception of the afterlife, quality and value of life, etc. All the indications are that the process of the legalization of euthanasia will develop in the coming decades. Today we need a new paradigm of bioethics, built on the basis of a new humanism which will allow us to adequately analyze such phenomena as death, suffering and dying. The new paradigm of bioethics can be an effective tool in the dispute over the death on request.

Euthanasia in Belgium: trends in reported cases between 2003 and 2013.

In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient's explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients' sociodemographic and clinical profiles, as well as decision-making and performance characteristics. We used the database of all euthanasia cases reported to the Federal Control and Evaluation Committee on Euthanasia in Belgium between Jan. 1, 2003, and Dec. 31, 2013 (n = 8752). The committee collected these data with a standardized registration form. We analyzed trends in patient, decision-making and performance characteristics using a χ2 technique. We also compared and analyzed trends for cases reported in Dutch and in French. The number of reported euthanasia cases increased every year, from 235 (0.2% of all deaths) in 2003 to 1807 (1.7% of all deaths) in 2013. The rate of euthanasia increased significantly among those aged 80 years or older, those who died in a nursing home, those with a disease other than cancer and those not expected to die in the near future (p < 0.001 for all increases). Reported cases in 2013 most often concerned those with cancer (68.7%) and those under 80 years (65.0%). Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so (p < 0.001). Among cases reported in Dutch, the proportion in which the person was expected to die in the foreseeable future decreased from 93.9% in 2003 to 84.1% in 2013, and palliative care teams were increasingly consulted about the euthanasia request (from 34.0% in 2003 to 42.6% in 2013). These trends were not significant for cases reported in French. Since legalization of euthanasia in Belgium, the number of reported cases has increased each year. Most of those receiving euthanasia were younger than 80 years and were dying of cancer. Given the increases observed among non-terminally ill and older patients, this analysis shows the importance of detailed monitoring of developments in euthanasia practice.

Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe.

The increasing legalization of euthanasia and physician-assisted suicide worldwide makes it important to understand related attitudes and practices. To review the legal status of euthanasia and physician-assisted suicide and the available data on attitudes and practices. Polling data and published surveys of the public and physicians, official state and country databases, interview studies with physicians, and death certificate studies (the Netherlands and Belgium) were reviewed for the period 1947 to 2016. Currently, euthanasia or physician-assisted suicide can be legally practiced in the Netherlands, Belgium, Luxembourg, Colombia, and Canada (Quebec since 2014, nationally as of June 2016). Physician-assisted suicide, excluding euthanasia, is legal in 5 US states (Oregon, Washington, Montana, Vermont, and California) and Switzerland. Public support for euthanasia and physician-assisted suicide in the United States has plateaued since the 1990s (range, 47%-69%). In Western Europe, an increasing and strong public support for euthanasia and physician-assisted suicide has been reported; in Central and Eastern Europe, support is decreasing. In the United States, less than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or less have complied. In Oregon and Washington state, less than 1% of licensed physicians write prescriptions for physician-assisted suicide per year. In the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such requests. Between 0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal. The frequency of these deaths increased after legalization. More than 70% of cases involved patients with cancer. Typical patients are older, white, and well-educated. Pain is mostly not reported as the primary motivation. A large portion of patients receiving physician-assisted suicide in Oregon and Washington reported being enrolled in hospice or palliative care, as did patients in Belgium. In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population. Euthanasia and physician-assisted suicide are increasingly being legalized, remain relatively rare, and primarily involve patients with cancer. Existing data do not indicate widespread abuse of these practices.

The right to death. Fiction or reality?

Abstract The present article is part of a dense literature – result of a perennial debate – that has polarized societies for a long time and has evident reverberations in the present. It deals with “the right to death”, trying to offer some answers referring to its existence in fact and the way in which it is perceived by different states and diverse entities with juridical nature. In the first part of the paper, it is insisted upon the right to life, so that subsequently, to speak in detail about a “right to death” and the moral and juridical implications of using such phrases. There are analyzed different states of the world found on one part or the other of the barricade in what concerns the legality of euthanasia and assisted suicide – considered the two hypostasis of the right in question. It is offered, as well, an analysis of the Convention for the Protection of Human Rights and Fundamental Freedoms, mentioning that, paradoxically, while it cannot be modified so that it allows the appearance of some new rights, it can tacitly accept the creation by some states that have adhered to it of some rights antagonistic with those presented in its text. The conclusion, is that not any liberalization movement of a social action – quantified through the request of a right – has as a direct result a progress of the respective society, especially when the action creates something diametrically opposed to some fundamental functioning norms, such as, by excellence, the granting of the protection of life of all individuals.

The right to die: beyond academia.

The world's first legal euthanasia death occurred in the Australian City of Darwin on Sunday 22 September 1996 when Bob Dent ended his life under the Northern Territory's short-lived Rights of the Terminally Ill Act 1995. Dent's death intensified argument about euthanasia in Australia, transforming the debate from a textbook discussion in social ethics into a vigorous and divisive social dispute. The day before he ended his life, Dent dictated a letter, written down by his wife. This description of his experience with terminal illness is graphic-the letter, his last effort to bring the plight of those living with terminal illness to public consciousness. In this paper I outline issues from the perspective of those, who like Bob Dent, the choice to die with dignity is personal and urgent. Rather than approach the issue purely from the theoretical, academic debate therefore, I present aspects that are largely unknown unless the experience of life-denying symptoms becomes real. From these aspects, dilemmas and consequences emerge that are not framed through the academic debate and in this way, I argue for the possibility of a framework that could change the law.