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Euthanasia, the ultimate abandonment.
In this issue we are pleased to publish the address given recently by Mrs Rita Marker of the Anti-euthanasia Task Force (USA) at a press conference in the House of Commons in London. It offers a most informative update on the development of euthanasia discussion in the United States. We must be grateful that the situation elsewhere is different. In Germany, as a recent correspondent told the Editor, the memory of euthanasia under the Nazis is still too fresh for there to be such a development. Even in Holland there are moves to develop a hospice programme, to offer a radically alternative approach to terminal care. Yet in Britain the idea of the living will is beginning to catch on, and we do well to take note of how it is being used in the United States as a gateway to euthanasia.
Physicians' attitudes toward assisted suicide in AIDS.
We investigated factors influencing attitudes and practices among San Francisco physicians toward physician-assisted suicide in the context of AIDS. To explore this topic a questionnaire was developed for use in comparing two physician groups. This self-administered instrument was completed by 69 physician members of the San Francisco County Community Consortium (CCC), a community-based clinical research organization whose members care for persons with human immunodeficiency virus (HIV) disease. A comparison group consisted of 86 randomly sampled San Francisco physicians recruited from the California Medical Association mailing list. Anonymity of respondents was maintained. Chi-squares and t-tests were conducted to compare physician groups with regard to demographics and experiences with AIDS. Factor analytic techniques and correlational analyses were used to identify attitudinal and behavioral predictors of willingness to assist in a patient suicide. Twenty-three percent of the total sample would be likely to grant the patient's initial request for assistance in committing suicide. When faced with an adamant request, CCC members would be more likely to assist than comparison group physicians. Ethical beliefs were the strongest predictor of physicians' intention to assist. Identification with the AIDS patient also had significant predictive value.
A patient's request to change GPs.
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Active voluntary euthanasia: a needless Pandora's box.
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Conflicts of conscience. Hospice and assisted suicide.
Proposals to legalize assisted suicide challenge hospice's identity and integrity. In the wake of Measure 16, Oregon hospice programs must develop practical policies to balance traditional commitments not to hasten death and not to abandon patients with dying patients' legal right to request lethal prescriptions.
Derek Humphry discusses death with dignity with Thomasine Kushner.
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Legalizing physician-assisted suicide: some thoughts and concerns.
Surveys show that most Americans favor the decriminalization of physician-assisted suicide in certain circumstances. Several states are now considering legislation to bring this about and make the United States the first place in the civilized world where physician aid in dying is sanctioned. In the Netherlands, where physician-assisted suicide is practiced but officially remains illegal, 85% of assisted suicides occur in the elderly, and most involve the help of general practitioners. In the United States, family physicians provide health care to many older adults with chronic or terminal illness whose numbers will increase as the elderly population expands. The legalization of physician-assisted suicide would affect the way American physicians practice medicine in unpredictable ways, yet physicians are participating relatively little in deliberations concerning this issue. The problem of suffering in persons with chronic and terminal illness cannot be ignored. Compassionate, effective, and ethical solutions must be found. As a former family physician and now geriatric psychiatrist, I review the pros and cons of physician-assisted suicide (emphasizing arguments against legalization) and encourage family physicians to debate this matter.
Rational suicide: no longer 'crazy'?
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Assisted suicide: where do nurses draw the line?
If a terminally or chronically ill patient chooses death, where does one draw the line between allowing suicide, encouraging suicide, assisting with suicide, or directly killing? How does one differentiate between injecting a consenting patient with a lethal injection for the purpose of causing death, from inserting the needle so that the patient may inject the lethal dose his or herself? Clearly there are differences between action, facilitation, encouragement, and mere information.
Terrible death of Socrates: some medical and classical reflections.
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Mercy killing: a position statement regarding David Rodriguez.
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Rhabdomyolysis in antiquity. From ancient descriptions to scientific explication.
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