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Choice: Antigone, Sophocles (441 BC)
Published in Ewan Jeffrey, David Jeffrey, Enhancing Compassion in End-of-Life Care Through Drama, 2021
Dignity is a concept which is difficult to define. For some people dignity at the end of life means avoiding physical interventions such as tubes and catheters, the absence of pain, not being a burden to others and retaining control over one’s body and one’s decisions. For some the desire for a dignified death prompts a request for euthanasia or assisted suicide. The Voluntary Euthanasia Society was set up in 1935 and campaigned for the legalisation of euthanasia and assisted suicide. It changed its name to Dignity in Dying in 2006. The Swiss clinic which carries out assisted suicide is known as Dignitas. These uses of the word ‘dignity’ make an assumption that to die by assisted suicide or euthanasia is to guarantee a dignified death and that to die in another way is somehow undignified. However, a study from the Netherlands revealed that up to 14% of cases of euthanasia or assisted suicide were complicated by problems, such as failure of death, vomiting and muscle twitching.9
End of life
Published in Gary Chan Kok Yew, Health Law and Medical Ethics in Singapore, 2020
Proponents of physician-assisted euthanasia argue that terminally ill patients should have the right to choose death when the quality of life has deteriorated below a minimum threshold (in physical, mental, emotional and spiritual terms). This is often associated with the notion of a dignified death. van Zyl (2000, at p. 183) argued that allowing a person to die in such circumstances can be an act of “responsible benevolence” (provided it is based on scientific knowledge, expertise and practical wisdom in understanding the patient’s experiences) underpinned by the “virtue of respectfulness” (in order to advance the patient’s interests by taking into account his life’s plan, values and beliefs).
Education to promote dignity in healthcare
Published in Milika Ruth Matiti, Lesley Baillie, Paula McGee, Dignity in Healthcare, 2020
Liz Cotrel-Gibbons, Milika Ruth Matiti
Dignity is both a multifaceted and a personal concept. Each person has a personal concept of dignity which shapes their attitudes and actions. Healthcare professionals interact with clients and, in addition to enacting their own concept of dignified behaviour, have to develop an understanding of each client’s dignity and then provide conditions to promote the dignity of that client. In order to achieve this level of practice, healthcare professionals must develop an understanding of what dignity means both to themselves and to others, such as clients. This can lead to a dilemma, as values are embedded in a person’s self-concept and are difficult to change. Any challenge to a person’s values causes a need for them to review core aspects of themselves, which may lead to dissonance between who they are and who they feel/think they should be. A specific example is the debate about what constitutes a dignified death. On the one hand, there is the argument for the sanctity of life and promotion of dignity through palliative care, while on the other there is the right to self-determination including choosing when and how to die.
Thirty Years Later: An Oncologist Reflects on Kübler-Ross’s Work
Published in The American Journal of Bioethics, 2019
Early on, Dr. Kübler-Ross addressed the issue that continues to be for me the most difficult in caring for dying people. That is the dilemma of telling the truth about prognosis while still trying to maintain hope, a most confounding challenge for the clinician. Many writers and colleagues have touched on this, saying that even when a person is dying, there is hope for another day, for relief from suffering, for a dignified death (Back, Arnold and Quill 2003; Neff, Lyckholm and Smith 2003; Warm and Weissman 2000). While I am sure these are goals we strive for, I am not sure that is what the patient wants to hear. But telling people only what they want to hear can be dishonest, and is somewhat self-serving. You must strike a balance between delivering realistic news and maintaining optimism.
Faces Matter
Published in The American Journal of Bioethics, 2018
Zil Goldstein, Jess Ting, Rosamond Rhodes
(2) Providing these services is also required as a matter of justice because they promote fair equality of opportunity. Without cosmetic surgery to create the appearance of matching breasts or an unscarred face, mastectomy patients and burn victims would feel inhibited and incapable of participating in social interactions. Without access to the medical services that would address the needs of women who want assisted reproduction, they would be unable to share in the social experience of parenthood. Without bariatric surgery, people who are obese and unable to achieve significant and lasting weight loss by dieting will continue to experience ostracism, unemployment, and social stigma. Without access to palliation, people would have to endure pain and be unable to participate in work and other social opportunities. And without hospice care, some dying people would be denied the opportunity to have a dignified death. These are opportunities that the richest country in the history of the world should afford all its people.
Avoidable 30-day mortality analysis and failure to rescue in dysvascular lower extremity amputees
Published in Acta Orthopaedica, 2018
Christian Wied, Nicolai B Foss, Peter T Tengberg, Gitte Holm, Anders Troelsen, Morten T Kristensen
One-quarter of the deaths were highly expected in patients suffering preoperatively from the consequences of septic shock, severe sequelae after recent massive stroke, or unrecoverable respiratory failure. Nevertheless, they had surgery scheduled and performed. This is remarkable and leaves an impression of how selected patients could have a more dignified death than is the case today if more attention were paid to the possibility of non-surgical palliative treatment. Thus, for some patients, limb ischemia/severe infections along with serious co-morbidities are part of the death process, and a non-surgical approach might be more ethically correct. However, we acknowledge that an algorithm on how to select patients for non-surgical palliative treatment is difficult.