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Results for “Double Effect Principle”

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At least 217 records · Page 12Linked to original sources
PubMed1996

The problem of inadequately relieved suffering.

A request for euthanasia or assistance in suicide usually derives from severe patient distress and indicates significant suffering. Although the Hippocratic purview of medicine requires that suffering be acknowledged, its causes be identified, and that steps be taken to provide adequate relief, an appreciation of the diversity of factors that may contribute to suffering underscores the need for methodical assessment and familiarity with a range of therapeutic strategies. It may be argued that when other options to effectively relieve suffering are available, euthanasia and assisted suicide fall outside of the purview of Hippocratic medicine. Given the existence of other options, the capacity for human maleficence, and the lack of resources currently allocated to the relief of suffering, this paper presents a number of reservations regarding the legalization of euthanasia and assisted suicide. In addition, it is suggested that the current community focus on the issue of inadequately relieved suffering should be harnessed to work toward the provision of care that would diminish the impression that elective death is necessary to ensure adequate relief.

Caregivers↗
PubMed1996

Community attitudes on the family of issues surrounding the death of terminal patients.

In two studies, respondents made recommendations for the medical treatment of a terminally ill elderly woman. The woman was or was not experiencing intractable pain, and had requested either heroic medical efforts or euthanasia. Respondents' recommendations were influenced by both the specific wishes of the patient and the pain the person was experiencing. However, participants were not completely swayed by the patient's wishes: only about half of the sample recommended euthanasia even when the patient was in intractable pain and had requested death; also, many subjects would not resuscitate the patient whose heart or lungs failed, even though she had requested heroic measures. Respondent attitudes toward euthanasia predicted recommendations in the expected directions. We suggest that there is less dissent on the issues that arise for medical treatments at the end of life than has been widely assumed.

Advance Directives↗
PubMed2003

Understanding and responding to patients' requests for assistance in dying.

PURPOSE: To explore how nurses experience and respond to patients' requests for assistance in dying (AID). DESIGN AND METHODS: A phenomenological study of 10 self-selected nurses. FINDINGS: Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context-driven rather than rule-mandated, and they drew a distinction between secondarily hastening and directly causing death. CONCLUSIONS: Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress.

Attitude of Health Personnel↗
PubMed2002

Sanctity of life--are some lives more sacred than others?

Court decisions concerning the life and death of patients become more and more frequent in the context of medical practice. One of the most controversial decisions in this area in recent years has been the decision of the Court of Appeal in Re A (Conjoined Twins: Medical Treatment), authorising the separation of conjoined twins. This paper will argue that the decision was flawed both on legal and moral grounds and that its potential implications for future cases are more far-reaching than the judgment itself suggests.

Criminal Law↗
PubMed1998

In search of a new ethic for treating patients with chronic pain: what can medical boards do?

Author argues that a complex "ethic of underprescribing" underlies the continued reluctance of physicians to use opioids to treat chronic pain. She contends that state medical boards are uniquely positioned to promote a new ethic for pain management, but stresses the difficulties for boards in attaining this goal. She thinks success may hinge on whether boards can change their approach to pain management and persuade a skeptical medical community that adopting a risk for underprescribing will serve the long-term interests of patients and the profession.

Analgesics, Opioid↗
PubMed1998

Killing and allowing to die: another look.

Author offers an analytic defense of the coherence of the distinction between "killing" and "allowing to die," based on contemporary philosophy of action and intention.

Decision Making↗
PubMed2000

Relieving pain and foreseeing death: a paradox about accountability and blame.

The authors look closely at the often cited Rule of Double Effect and argue that, in some cases, a physician can legitimately claim to have acted within the Rule's parameters. In other cases, however, physicians can abuse the notion of unintended consequences. The test case they offer concerns palliative care that causes foreseeable death.

Analgesics, Opioid↗
PubMed1994

Euthanasia in The Netherlands.

The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the "Dutch experiment" need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life.

Advance Directives↗