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Patient autonomy and criminal law
Published in Paweł Daniluk, Patient Autonomy and Criminal Law, 2023
However, the so-called indirect active euthanasia, defined as the use of means to relieve suffering (palliative care), e.g., morphine, which may have the effect of shortening the patient's life, is generally regarded as permissible.48 Also, passive euthanasia in the sense of withholding life-sustaining medical treatment (either by not initiating treatment or by terminating it at some point) is not treated as a criminal offence, provided certain conditions are met.49 This kind of euthanasia is generally justified by the patient's will not to be kept alive. Assisting or inciting suicide is legally prohibited only in cases of selfish motives (Art. 115 CC). The law therefore generally allows assisted suicide, for example enabling a person to obtain the necessary lethal pharmaceuticals, which the person wishing to commit suicide then takes without any external assistance. This contrast in legislation between Switzerland and other countries, e.g., the United Kingdom, and the existence of several right-to-die organisations in Switzerland that provide help with any medical, administrative and social procedures related to the assisted suicide,50 has led to a phenomenon described by some as ‘suicide tourism'.51
The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
In the 1981 movie Whose Life is it Anyway, actor Richard Dreyfuss portrayed a sculptor’s fight to end his own life with the assistance of his doctor after he was paralyzed in a car accident. By early 1990s a consensus had emerged in the United States that passive euthanasia, letting a patient die as a result of a competent patient’s or family’s valid decision to terminate treatment, was permissible but active euthanasia, assistance by a physician in hastening a patient’s death—perceived as killing—was not permissible even when requested by a patient or a patient’s family. Reflecting this consensus, several states had laws on their books that explicitly prohibited assisted suicide. The constitutional question raised by such laws was whether a terminally ill patient has a constitutional right to PAS under the US Constitution.
Ethics and dying
Published in Rodger Charlton, Primary Palliative Care, 2018
Passive euthanasia is said to occur when circumstances are created in which death can occur, rather than the death being actively caused. Thus in these circumstances a patient’s life is ended by someone declining to perform a life-saving act or withholding treatment, rather than actively giving therapy to terminate their life. The concept of an omission of treatment and its distinction from an active killing was used to justify the stopping of artificial feeding in the Bland case [Airedale NHS Trust v. Bland (1993) 1 All ER 521]. Many people would not agree morally with the above distinction. For example, when can one say that an omission becomes an action? In an incurable disease, when should nature’ be allowed to take its course?
The ongoing discussion on termination of life on request. A review from a German/European perspective
Published in International Journal of Psychiatry in Clinical Practice, 2021
Hitherto, in Germany euthanasia has not been regulated by special legislation. Passive euthanasia and indirect euthanasia by physicians under strict conditions, such as agreement of the patient and relatives, was and still is prevalent to a certain degree, for example on palliative care wards, although not much is formalised. If criticised, physicians have to defend their actions and sometimes physicians have been prosecuted in the courts. There is no official regulation or register and euthanasia is performed within the framework of an existing doctor-patient relationship, with the additional involvement of the patient’s relatives. Generally, the patients are in hospital for treatment of end-stage disease and the end-of-life question comes up in this context. If a patient is unable to provide informed consent because he or she is comatose, an advance directive, if available, can help with the decision-making. Otherwise, reconstructing the patient’s potential will in such a situation, with the assistance of the closest relatives, can provide a basis on which to make a reasonable decision. However, for several reasons, e.g., biases and intentions of the relatives, this is a slippery slope and often not an adequate solution.
Christiaan Barnard's views on euthanasia
Published in Baylor University Medical Center Proceedings, 2018
Although he recognized that the concept of medical euthanasia—that is, the termination of a life as an extension of the medical treatment of a dying patient—had never had much public support, he put forward his reasons for believing that there is a place for it in medical practice. He differentiated active euthanasia, “in which life is ended by direct intervention, such as giving a patient a lethal dose of a drug,” from passive euthanasia, in which death results “from withdrawal of life-support systems or life-sustaining medications.” But he suggested that there was little “moral” distinction between a deliberate act of omission, when death is the goal or purpose, and a deliberate act of commission.
When can Muslims withdraw or withhold life support? A narrative review of Islamic juridical rulings
Published in Global Bioethics, 2020
Afshan Mohiuddin, Mehrunisha Suleman, Shoaib Rasheed, Aasim I. Padela
Our literature search involved three stages. The first stage of the search was the review of Islamic bioethics manuscripts/texts and conference proceedings that were available to the authors to uncover cited juridical rulings on the topic. The second stage involved Google searches for fatwā online (performed on 09/19/2014). The opinions of physicians or other scholars (non-jurists) were not considered to be fatwās. Juridical rulings related to end-of-life care within these sources were identified and obtained. The third stage of the search used Pubmed, Scopus, ATLA Religion Database, and Index Islamicus databases. These databases were chosen in order to have a comprehensive search spanning the fields of medicine, social sciences and religion. The search string for the literature databases included the following terms: “passive euthanasia” or “life support care” or “life support” or “life sustaining treatment” or “critical care” or “withholding treatment” or “withdrawing treatment” or “withholding care” or “withdrawing care” or “end of life” or “terminal care” or “ethics” as mesh terms/main subject headings or text words in all fields. These were linked to “Islam(ic)” or “Muslim(s)” as main subject headings (exploded) or text words in all fields. Articles in the English language that expressed views on the issue of withholding and/or withdrawing medical treatment or life support were included. Importantly, fatwās were included only if they were ascribed to trained muftīs or faqīhs, or to national and international Muslim fiqh councils. Figure 1 illustrates the search strategy. Each fatwā was analysed for the exact medical intervention in question, whether or not they made a distinction between withholding and withdrawing, and any justifying conditions that were cited.