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  1. The Significance of the Distinction Between “Having a Life” Vs. “Being Alive” in End-of-Life Care.Gavin G. Enck - 2022 - Medicine, Health Care and Philosophy 25 (2):251-258.
    In end-of-life care discussions, I contend that the distinction between “having a life” vs. “being alive” is an underutilized distinction. This distinction is significant in separating different states of existence conflated by patients, families, and clinicians. In the clinical setting, applying this distinction in end-of-life care discussions aids patients’ and family members’ decision-making by helping them understand that being alive can differ from having a life. Moreover, this distinction helps them decide which state may be the most important to them. (...)
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  • The Ethical Obligation of the Dead Donor Rule.Anne L. Dalle Ave, Daniel P. Sulmasy & James L. Bernat - 2020 - Medicine, Health Care and Philosophy 23 (1):43-50.
    The dead donor rule originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We hold that (...)
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  • Physician–Patient Relationship, Assisted Suicide and the Italian Constitutional Court.E. Turillazzi, A. Maiese, P. Frati, M. Scopetti & M. Di Paolo - 2021 - Journal of Bioethical Inquiry 18 (4):671-681.
    In 2017, Italy passed a law that provides for a systematic discipline on informed consent, advance directives, and advance care planning. It ranges from decisions contextual to clinical necessity through the tool of consent/refusal to decisions anticipating future events through the tools of shared care planning and advance directives. Nothing is said in the law regarding the issue of physician assisted suicide. Following the DJ Fabo case, the Italian Constitutional Court declared the constitutional illegitimacy of article 580 of the criminal (...)
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  • Mental Illness, Lack of Autonomy, and Physician-Assisted Death.Jukka Varelius - 1st ed. 2015 - In Jukka Varelius & Michael Cholbi (eds.), New Directions in the Ethics of Assisted Suicide and Euthanasia. Springer Verlag. pp. 59-77.
    In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...)
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  • Normativity Unbound: Liminality in Palliative Care Ethics.Hillel Braude - 2012 - Theoretical Medicine and Bioethics 33 (2):107-122.
    This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that (...)
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  • The Dead Donor Rule: Can It Withstand Critical Scrutiny?F. G. Miller, R. D. Truog & D. W. Brock - 2010 - Journal of Medicine and Philosophy 35 (3):299-312.
    Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...)
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  • Obtaining Consent for Organ Donation From a Competent ICU Patient Who Does Not Want to Live Anymore and Who is Dependent on Life-Sustaining Treatment; Ethically Feasible?Jelle L. Epker, Yorick J. De Groot & Erwin J. O. Kompanje - 2013 - Clinical Ethics 8 (1):29-33.
    We anticipate a further decline of patients who eventually will become brain dead. The intensive care unit (ICU) is considered a last resort for patients with severe and multiple organ dysfunction. Patients with primary central nervous system failure constitute the largest group of patients in which life-sustaining treatment is withdrawn. Almost all these patients are unconscious at the moment physicians decide to withhold and withdraw life-sustaining measures. Sometimes, however competent ICU patients state that they do not want to live anymore (...)
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  • Getting Real About Killing and Allowing to Die: A Critical Discussion of the Literature.Andrew Stumpf & Dominic Rogalski - 2021 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 4 (2).
    The moral significance of the distinction between killing and allowing to die has played a key role in debates about euthanasia and physician assisted suicide. Since the withdrawal of life-sustaining treatment is held as morally permissible in the medical community, it follows that if there is no morally significant difference between killing and allowing to die, then there is no morally significant difference between withdrawing life-sustaining treatment or administering a lethal injection to end a patient’s life. Consistency then requires that (...)
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  • Death, Devices, and Double Effect.Stuart G. Finder & Michael Nurok - 2019 - HEC Forum 31 (1):63-73.
    Along with the growing utilization of the total artificial heart comes a new set of ethical issues that have, surprisingly, received little attention in the literature: How does one apply the criteria of irreversible cessation of circulatory function given that a TAH rarely stops functioning on its own? Can one appeal to the doctrine of double effect as an ethical rationale for turning off a TAH given that this action directly results in death? And, On what ethical grounds can a (...)
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  • Mental Illness, Natural Death, and Non-Voluntary Passive Euthanasia.Jukka Varelius - 2015 - Ethical Theory and Moral Practice:1-14.
    When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers treating her are obligated (...)
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  • Beyond the Equivalence Thesis: How to Think About the Ethics of Withdrawing and Withholding Life-Saving Medical Treatment.Nathan Emmerich & Bert Gordijn - 2019 - Theoretical Medicine and Bioethics 40 (1):21-41.
    With few exceptions, the literature on withdrawing and withholding life-saving treatment considers the bare fact of withdrawing or withholding to lack any ethical significance. If anything, the professional guidelines on this matter are even more uniform. However, while no small degree of progress has been made toward persuading healthcare professionals to withhold treatments that are unlikely to provide significant benefit, it is clear that a certain level of ambivalence remains with regard to withdrawing treatment. Given that the absence of clinical (...)
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  • Moral Evaluations of Organ Transplantation Influence Judgments of Death and Causation.Michael Nair-Collins & Mary A. Gerend - 2015 - Neuroethics 8 (3):283-297.
    Two experiments investigated whether moral evaluations of organ transplantation influence judgments of death and causation. Participants’ beliefs about whether an unconscious organ donor was dead and whether organ removal caused death in a hypothetical vignette varied depending on the moral valence of the vignette. Those who were randomly assigned to the good condition were more likely to believe that the donor was dead prior to organ removal and that organ removal did not cause death. Furthermore, attitudes toward euthanasia and organ (...)
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  • The Final Act: An Ethical Analysis of Pia Dijkstra’s Euthanasia for a Completed Life.T. J. Holzman - 2021 - Journal of Bioethical Inquiry 18 (1):165-175.
    Amongst other countries, the Netherlands currently allows euthanasia, provided the physician performing the procedure adheres to a strict set of requirements. In 2016, Second Chamber member Pia Dijkstra submitted a law proposal which would also allow euthanasia without the reason necessarily having any medical foundation; euthanasia on the basis of a completed life. The debate on this topic has been ongoing for over two decades, but this law proposal has made the discussion much more immediate and concrete. This paper considers (...)
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  • Intending, Hastening and Causing Death in Non-Treatment Decisions: A Physician Interview Study.Morten Magelssen, Sophia Kaushal & Kalala Ariel Nyembwe - 2016 - Journal of Medical Ethics 42 (9):592-596.
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  • Good Medical Ethics: Table 1.Dan W. Brock - 2015 - Journal of Medical Ethics 41 (1):34-36.
  • The Dead Donor Rule: A Defense.Samuel C. M. Birch - 2013 - Journal of Medicine and Philosophy 38 (4):426-440.
    Miller, Truog, and Brock have recently argued that the “dead donor rule,” the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are (...)
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  • Two Ways to Kill a Patient.Ben Bronner - 2018 - Journal of Medicine and Philosophy 43 (1):44-63.
    According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die—an important distinction, according to some. I argue that killing can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.
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  • Pacemaker Deactivation: Withdrawal of Support or Active Ending of Life?Thomas S. Huddle & F. Amos Bailey - 2012 - Theoretical Medicine and Bioethics 33 (6):421-433.
    In spite of ethical analyses assimilating the palliative deactivation of pacemakers to commonly accepted withdrawings of life-sustaining therapy, many clinicians remain ethically uncomfortable with pacemaker deactivation at the end of life. Various reasons have been posited for this discomfort. Some cardiologists have suggested that reluctance to deactivate pacemakers may stem from a sense that the pacemaker has become part of the patient’s “self.” The authors suggest that Daniel Sulmasy is correct to contend that any such identification of the pacemaker is (...)
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  • Palliative Sedation, Foregoing Life-Sustaining Treatment, and Aid-in-Dying: What is the Difference?Patrick Daly - 2015 - Theoretical Medicine and Bioethics 36 (3):197-213.
    After a review of terminology, I identify—in addition to Margaret Battin’s list of five primary arguments for and against aid-in-dying—the argument from functional equivalence as another primary argument. I introduce a novel way to approach this argument based on Bernard Lonergan’s generalized empirical method. Then I proceed on the basis of GEM to distinguish palliative sedation, palliative sedation to unconsciousness when prognosis is less than two weeks, and foregoing life-sustaining treatment from aid-in-dying. I conclude that aid-in-dying must be justified on (...)
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  • Mental Illness, Natural Death, and Non-Voluntary Passive Euthanasia.Jukka Varelius - 2016 - Ethical Theory and Moral Practice 19 (3):635-648.
    When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers treating her are obligated (...)
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  • Clinical and Ethical Perspectives on Brain Death.Michael Nair-Collins - 2015 - Medicolegal and Bioethics 5:69-80.
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