After having been acquainted with the historical development of euthanasia, the following steps for assitance in dying, called passive euthanasia are being discussed. a) Assistance during dying without speeding up death is the self-evident duty of a doctor. b) Assistance during death and speeding up the same as an unavoidable result of therapeutical treatment, more or less desired or more or less unavoidable. c) Assistance through letting the patient die by abandoning all therapeutical means, when these would only lead to a short extension of life time. No doctor is compelled to take measures to extend life if it is against the will of the patient. He is not even entitled to do so. A special problem is the abandoning of extended operative treatment, this borders on the so called active enthanasia. The dying patient always has the same right of treatment by a docter as well as nursing like all other suffering human beings. The decision to let a patient die should not result in leaving him by himself and to abandon all nursing as well. Such steps would include letting him lie in dirty linen, not sucking off the mucous secretion from the trachea, refusal to assist during mealtimes, non-assistance during cathetering, and the removal of the dying person to the bathroom, or any other remote orner of the hospital. No dying person should stay without help Loneliness especially is the greatest pain of a dying patient.

Ethics, Medical↗

PubMedDate not supplied

The death of children following negligence: social aspects.

Although the figure of unreported cases of neglected children is much higher than that of physical ill-treatment of children, neglect has rarely received attention, in most cases only when traces of physical ill-treatment were proven at the same time. Symptomatic are in the first place intense emaciation as well as dry puckered, scaly and extremely dirty skin, lack of subcutaneous fatty tissue and of Bichat's fat pad, matted hair, aged face, sunken eyes, and eczema from urine with ulcerations in the buttock and thigh regions. In addition one finds signs of localized hypothermia or rickets. My own observations cover 54 cases in which neglect and malnutrition have caused the death of the children involved. All the children had been living in extremely bad social conditions. The backgrounds of the children's mothers were also socially poor. Most of the mothers were too young to fulfill their duties. The fathers, where known, were alcoholics, unwilling to work and seldom cared for their family. They too were often too young to cope with their role as father. In this day and age, which has provided us with a much better understanding of the importance of the early development of the child for its later social attitude, mothers with all their problems and difficulties should not be left on their own. Motherlike behaviour is not necessarily programmed with the birth of a child. Mother duties must be learned as early as possible. This process should begin during pregnancy at the latest. A few proposals will be made.

Child Welfare↗

PubMedDate not supplied

Enteral bacterial infection as a possible cause of cot death.

At post mortems performed in cases of cot death, the cause of death has been established as due to a variety of pathological changes. In connection with the anamnesis data, inflammation in the region of the respiratory system, especially of the lungs, infections of the gastrointestinal tract, otitis media and electrolyte shifts can in many cases be traced back to a common origin, if we assume a bacterioenterotoxin poisoning (which takes a different course in infants than in older children or adults). Extensive inquiries prior to the post mortem, autopsies performed always by the same method, as well as all the ensuing examinations, are indispensable in order to explain the cause of the sudden death and to make sure that the results of the post mortem are not influenced by the importance the pathologist attributes to a certain method of examination.

Autopsy↗

PubMedDate not supplied

[Legal medicine problems in the terminal care of the aged].

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Aged↗