The concept of death Criteria of death: refers to the evidence that indicates th
Gadson, Rickey, Contributing Editor has reference to this Academic Journal, PHwiki organized this Journal The concept of death Criteria of death: refers to the evidence that indicates that someone is dead Cardiopulmonary criterion: irreversible cessation of cardiopulmonary functions Brain-death criterion Physician-assisted suicide: when a patient ingests a lethal substance provided by the physician as long as that purpose Voluntary euthanasia: the physician administering the lethal substance Is there a moral difference between the two Does, in the as long as mer case, the physician kill the patient, while in the latter, the patient kills herself
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Has its origins in Roman Catholic moral theology, where it is employed to distinguish between obligatory careordinary in addition to care that may be permissibly as long as goneextraordinary. has been criticized as being unclear in addition to resulting in confusion in addition to controversy about how it should be applied (U.S. President’s Commission). The distinction used to mark the difference between statistically usual in addition to statistically unusual care, between noninvasive in addition to highly invasive treatments, in addition to between treatments that employ low- in addition to high-technology interventions The correct underst in addition to ing of the traditional distinction is the difference between treatment that is beneficial in addition to treatment that is unduly burdensome (or without benefit) to a patient. Public opinion Medicine: American Medical Associations ethical guidelines the physician should not intentionally cause death. Religion Law
Four Kinds of End-of-Life Treatment Pain in addition to suffering Pain management Competency Persistent Vegetative State Whole-Brain-Death Four as long as ms of treatment of patients near death that have received special attention are: resuscitation, artificial nutrition in addition to hydration, terminal sedation, futile treatment 70-90% of advanced cancer patients have sever pain that requires the use of opioid drugs 90 – 95% of patients can have their pain controlled 5% have excruciating in addition to intractable pain at the end of life Options: Continue to offer morphine (ineffective) Kill patient (illegal in addition to immoral) Offer palliative sedation
The larger question in many of these situations is: how do we respond to suffering Hospice in addition to palliative care Aggressive pain-killing medications Sitting with the dying Euthanasia Brain death is defined as the irreversible cessation of all the functions of the entire brain, including the brainstem. If the brain can be viewed simplistically as consisting of two partsthe cerebral hemispheres (higher centers) in addition to the brainstem (lower centers)brain death is defined as the destruction of the entire brain, both the cerebral hemispheres in addition to the brainstem. In contrast, in the permanent vegetative state (PVS) the cerebral hemispheres are damaged extensively in addition to permanently but the brainstem is relatively intact The vegetative state is characterized by the loss of all higher brain functions, with relative sparing of brainstem functions. Because brainstem functions are still present, the arousal mechanisms contained in the brainstem are relatively intact in addition to the patient there as long as e is not in a coma. The patient has sleep/wake cycles but at no time manifests any signs of consciousness, awareness, voluntary interaction with the environment, or purposeful movements. Thus, the patient can be awake but is always unaware: a mindless wakefulness.
The vegetative state is considered persistent when it is present longer than one month in the acute as long as m in addition to permanent when the condition becomes irreversible. The exact prevalence is unknown, but it is estimated that in the United States there are approximately 10,000 to 25,000 adults in addition to 4,000 to 10,000 children in a vegetative state (Multi-Society Task Force on PVS). Lawrence M. Hinman http://ethics.s in addition to iego.edu The Terri Schiavo case is, so far, the most famous in addition to notorious end-of-life case of the twenty-first century. Lawrence M. Hinman http://ethics.s in addition to iego.edu The Schiavo autopsy, released June 15 2005, showed severe in addition to irreversible brain damage Brain half its usual size Damaged in almost all regions, including that region which controls vision
ethical in addition to legal doctrine of in as long as med consent The doctrine of in as long as med consent requires that treatment not be administered without the in as long as med in addition to voluntary consent of a competent patient promotes the well-being of patients while respecting their self-determination or autonomy provides especially strong support as long as patients deciding about life-sustaining treatment another person must decide as long as them about life support treatment turning to a close family member of the patient, when one is available How should a surrogate make life-sustaining-treatment decisions as long as an incompetent patient There are three st in addition to ards as long as a surrogate’s decisions: advance directive (e.g., a “living will” or a “durable power of attorney as long as healthcare”) the “substituted judgment” st in addition to ard the “best-interest” st in addition to ard
Physician gives a lethal injection to the patient Physician assists a patient with suicide Physician gives a dying patient medication needed as long as pain relief although the drugs will hasten death Physician withdraws nutrition in addition to hydration through tubes or lines Physician withdraws needed life-sustaining treatment Physician withholds nutrition or life-suistaining treatment Various degrees of causing death: Active euthanasia Assisted suicide Pain medication so heavy it shortens life Withdrawal of needed life-sustaining treatment Withdrawal of medical nutrition in addition to hydration Moral conceptions regarding taking life in addition to killing may be divided into: goal-based, duty-based, in addition to rights-based
A goal-based position (utilitarianism) prohibits taking life when doing so fails to maximize the goals or consequences the position holds to be valuable, as long as example, human happiness or the satisfaction of people’s desires This position not only permits but requires taking an innocent person’s life when doing so will produce the greatest balance of benefits over harms Taking life is wrong because it violates a fundamental moral duty not to take innocent human life intentionally. This view looks not to the consequences produced by a particular killing but to the action itself, which is prohibited by the duty not to kill. Taking human life is morally wrong because it violates a basic moral right not to be killed. killing harms its victims because it denies them their future, together with all that they wanted to pursue or achieve in that future. It wrongs its victims by taking from them without their consent what is rightfully theirstheir lives.
the distinction is central to the Roman Catholic doctrine of double effect Double effect refers to actions that may have two effects, one that is directly intended in addition to the other one only indirectly intended or as long as eseen. In treating a dying cancer patient’s pain, it may seem clear that the physician’s primary or direct intention is to treat the pain The earlier death from respiratory depression caused by the morphine the physician prescribes to treat the pain is, at most, a secondary or indirect intention, or more accurately, a as long as e-seen but unintended consequence. Killing is usually distinguished from allowing to die by establishing whether something was done, or not done, that resulted in death. A person who kills per as long as ms an action that causes a person to die in a way in addition to at a time that the person would not otherwise have died. The claim is that the mere fact that one doing is a killing, while the other is an allowing to die, does not make one morally better or worse than the other, or make one morally justified or permissible when the other is not. This is compatible with saying that a particular killing, all things considered, is morally worse than, or not as bad as, a particular allowing to die because of other differences between the two, such as the motives of the agents or the presence or absence of the consent of the victim.
When a decision is made not to initiate some as long as m of life-sustaining treatment, such as kidney dialysis or support, in addition to the patient dies as a result, this is commonly understood to be an omission in addition to so an allowing to die But what of stopping life support as long as example, stopping respirator support at the persistent, voluntary request of a clearly competent in addition to respirator-dependent patient who is terminally ill in addition to undergoing suffering that cannot be adequately relieved If such action is taken by the physician with the intent of respecting the patient’s right to decide about his or her treatment, most people would consider it a morally justified instance of allowing the patient to die. If only killing, but not allowing to die, is prohibited, then stopping life support in addition to not starting it are both allowing to die in addition to morally permitted.
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