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Between “Aid in Dying” and “Assisted Suicide”
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
Bioethical debates about end-of-life decision making have largely focused on one topic: the so-called “right to die.” Most broadly, the “right to die” refers to the ability of incurably sick and/or disabled people to end their lives with the assistance of a medical provider. Defined as such, practically every bioethicist accepts some articulation of this right. Bioethical debates focus, rather, on its appropriate scope. These debates fall along—and at the intersection of—two axes: procedure and population.
The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
Approximately 10,000 patients live in a vegetative state in the United States. The complexities created by life-sustaining technologies have given rise to the “right-to-die” movement across the country. Proponents of the right to die assert that individuals have a right to die with dignity and to determine when to end their lives. They argue that passive, as well as active, euthanasia is justified. They also argue that the right to die, like the right to give informed consent, reflects a triumph of patient autonomy. Opposition to the right-to-die movement has come from many sources, including the right-to-life movement. These opponents argue that suicide is wrong on religious and theological grounds, as well as being harmful to the community and the common good and that it produces harmful consequences for other individuals in society. Others have argued that no human being has a right to decide, for himself/herself or for others, when life is no longer worth living. They posit that there is a danger that such decisions may be based on wrong or ulterior motives. An example would be an agreement to end the life of a patient whose continual stay in the hospital was a financial burden to the family, or of a patient whose family members stood to benefit financially by inheritance. It can be argued that, once a society agrees that at some stage a life is not worth sustaining, society is on a “slippery slope.” Once passive euthanasia becomes acceptable, the next step will be active euthanasia, which in turn can easily lead to forced or involuntary euthanasia.
Artificial Nutrition, Advance Directives and End of Life in Long-Term Care
Published in Victor R. Preedy, Handbook of Nutrition and Diet in Palliative Care, 2019
Literature focused on advance care planning and specifically ADs in the United States originated from legal mandates and the right-to-die movement in the latter part of the twentieth century, unlike the previous focus on do-not-resuscitate orders and a less autonomous environment. The first right-to-die case was that of Karen Ann Quinlan, a young nursing home resident in a persistent vegetative state supported on a respirator. Although the case involved discontinuation of a respirator, removal of AN was also an option, but one that was not acceptable to her family at that time. Quinlan died nine years later of pneumonia while still receiving AN.
From Courtroom to Clinic: Legal Cases that Changed Mental Health Treatment
Published in Journal of Legal Medicine, 2020
What is missing from the book is analysis that connects the cases. For example, how did litigation that sought to establish a right to treatment for the involuntarily committed mentally ill end up protecting only a more narrow liberty interest? What is the relationship between the right to informed consent to medical treatment articulated in Canterbury v Spence (1972), the “right to die” sought on behalf of Nancy Cruzan (1990), and the right to refuse treatment sought in Rogers v. Okin (1979) and Rennie v. Klein (1978)? What is the relationship between the right to refuse treatment and the right to treatment? Similarly, in the chapter addressing the landmark Tarasoff (1976) case, the author fails to draw connections between a psychotherapist’s duty to protect a reasonably foreseeable victim of her patient and the appropriate dimensions of the psychotherapist-patient privilege addressed in the previous chapter, which discussed Jaffe v Redmond (1996).
Why Dax’s Case Still Matters
Published in The American Journal of Bioethics, 2019
Kayhan Parsi, William J. Winslade
It would be a misreading of Dax’s case as simply an indictment of the culture of the burn unit. Nor is it simply a “right to die” case. Rather, at its heart, Dax’s case is about respecting patients as persons. Dax held strong views. But it’s essential to appreciate the evolution of Dax’s views as evidenced by the several documentaries and news programs made about his case. For instance, some of Dax’s early views toward his disabilities would strike us as ableist today (e.g., he was initially concerned that he would have to sell pencils on a street corner). Although Dax is known primarily as someone who is a champion of autonomy, he is also someone who worked toward living a full and productive live with his disabilities. An anti-ableist approach would empower patients to live with their disabilities in as rich and fulfilling a manner as possible.
Developments in euthanasia practice in the Netherlands: Balancing professional responsibility and the patient’s autonomy
Published in European Journal of General Practice, 2019
Pauline S. C. Kouwenhoven, Ghislaine J. M. W. van Thiel, Agnes van der Heide, Judith A. C. Rietjens, Johannes J. M. van Delden
In 2012, the ‘Dutch Right to Die Society’ (NVVE) founded the ‘End-of-Life Clinic.’ The Society’s key objective is to enhance freedom of choice at the end of life. It believes that the room the law offers for people who are suffering and want to end their life is not utilized sufficiently by physicians [8]. The aim of the End-of-Life Clinic, therefore, is to offer euthanasia—within the limits of the law—to people whose treating physician rejects their request for euthanasia or assisted suicide [9]. It has ambulant teams of physicians and nurses for this purpose. Their physicians are known to be less reticent regarding euthanasia in case of mental suffering than other Dutch physicians [10]. The End-of-Life Clinic seems to support and enhance the emphasis on the autonomous wish of the patient in euthanasia practice, because its essential aim is to grant a euthanasia request in case of unbearable suffering without the prospect of improvement, just as the euthanasia law permits [2]. However, if care is considered in a broader context than just fulfilling the patient’s autonomous wish to die, what fits into the law may not necessarily be the best possible care.