End-Of-Life Decisions in Medical Care

Principles and Policies for Regulating the Dying Process

By: Stephen W. Smith

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Hardcover | 23 February 2012

At a Glance

Hardcover
368 Pages

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22.86 x 15.24 x 2.06

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Those involved in end-of-life decision making must take into account both legal and ethical issues. This book starts with a critical reflection of ethical principles including ideas such as moral status, the value of life, acts and omissions, harm, autonomy, dignity and paternalism. It then explores the practical difficulties of regulating end-of-life decisions, focusing on patients, healthcare professionals, the wider community and issues surrounding 'slippery slope' arguments. By evaluating the available empirical evidence, the author identifies preferred ways to regulate decisions and minimise abuses at the end of life, and outlines an ethical theory which can provide practical guidance for those engaged in end-of-life decisions.

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You Can Find This Book In

Non-Fiction Philosophy Ethics & Moral Philosophy Medicine Medicine in General Medical Profession Medical Ethics & Professional Conduct Nursing & Ancillary Services Nursing Nursing Specialities Terminal Care Nursing Law

Laws of Specific Jurisdictions Social Law Medical & Healthcare Law Society & Culture Ethical Issues & Debates Ethical Issues of Euthanasia & Right To Die Religion & Beliefs

Table of cases	p. xiii
Acknowledgements	p. xv
Introduction	p. 1
Introduction	p. 1
Some definitional concerns	p. 11

Moral status	p. 17
Introduction	p. 17
Some initial thoughts	p. 19
Species and speciesism	p. 22
Preference based on characteristics	p. 23
Central cases	p. 30
A multi-criterial system for moral status	p. 38
Conclusion	p. 47
The value of life	p. 49
Introduction	p. 49
The sanctity versus quality of life debate	p. 50
The fund a menial problem	p. 55
Returning to basics	p. 58
A new way of valuing life	p. 62
Benefits of the new approach	p. 66
Conclusion	p. 72
Killing versus letting die and moral responsibility	p. 74
Introduction	p. 74
The act/omission distinction	p. 75
Intention and foresight	p. 78
Keeping the distinction between killing and letting die	p. 84
Moral responsibility	p. 85
A final criticism	p. 91
Conclusion	p. 92
Autonomy and paternalism	p. 94
Introduction	p. 94
The concept of autonomy	p. 95
Regulating autonomy	p. 110
Conclusion	p. 115
Beneficence, non-maleficence and harm	p. 116
Introduction	p. 116
The concept of harm and the principle of non-maleficence	p. 117
The principle of beneficence	p. 122
Death as a harm or a benefit	p. 125
Conclusion	p. 126
Dignity	p. 128
Introduction	p. 128
Category/definitional issues	p. 129
Philosophical justifications for dignity	p. 133
An alternative justification for dignity	p. 138
Two possible problems	p. 142
Conclusion	p. 143
A comprehensive ethical approach	p. 145
Introduction	p. 145
Moral status	p. 145
Autonomy	p. 148
Harm and benefit	p. 152
The value of life	p. 154
Dignity	p. 155
Moral responsibility	p. 157
Specific practices	p. 160
Conclusions	p. 163

Introduction to Part II	p. 167
Introduction	p. 167
Important differences between law and ethics	p. 168
Issues specific to law	p. 170
General evidentiary sources	p. 171
The Netherlands surveys	p. 171
Annual governmental reports	p. 176
The Angels of Death study	p. 178
The types of regulatory mechanisms	p. 180
Conclusion	p. 181
Protection of patients	p. 182
Introduction	p. 182
The prevention of suicide	p. 182
Rational suicide	p. 184
Preventing suicide in practice	p. 187
Conclusions about the prevention of suicide	p. 194
The protection of vulnerable groups	p. 195
How end-of-life decisions may adversely impact vulnerable groups	p. 196
Available evidence	p. 198
Argument in favour of assisted dying practices	p. 201
Conclusions about the protection of vulnerable groups	p. 202
Conclusions about the protection of patients	p. 203
The impact on health-care practitioners	p. 205
Introduction	p. 205
Direct impact upon health-care practitioners	p. 206
'Playing God'	p. 206
The distrust of health-care professionals	p. 211
Psychological effects	p. 213
The psychological effect of taking part	p. 213
The pressure to take part	p. 216
Professionalism of the euthanasia underground	p. 218
Professional codes of conduct	p. 223
Conclusion	p. 226
Greater societal issues	p. 228
Introduction	p. 228
The wider community	p. 228
Introduction	p. 228
Immediate groups	p. 230
Regional or national societal groups	p. 236
Conclusions about the wider community	p. 240
Investigation and prevention of illegal conduct	p. 240
Reporting systems	p. 242
Description of current reporting systems in the Netherlands and Oregon	p. 243
Evaluation of reporting systems	p. 245
The Dutch reporting rate	p. 245
The usefulness of the Oregon reports	p. 248
Other problems with reporting systems	p. 252
Prosecution and conviction of illegal activity	p. 253
Conclusion	p. 259
Slippery slope arguments	p. 261
Introduction	p. 261
Slippery slope arguments	p. 261
The logical 'slippery slope' argument	p. 265
The empirical slippery slope argument	p. 269
Conclusion	p. 289
Necessary procedural protections	p. 290
Introduction	p. 290
The request	p. 291
Procedures leading to death	p. 298
Reporting, investigation and judgment	p. 307
Conclusion	p. 313
Conclusions	p. 314
Introduction	p. 314
Summary of arguments	p. 316
A model for going forward	p. 325
Final conclusions	p. 332
Bibliography	p. 334
Index	p. 342
Table of Contents provided by Ingram. All Rights Reserved.

End-Of-Life Decisions in Medical Care

Principles and Policies for Regulating the Dying Process

At a Glance

Hardcover

Shipping

How to return your order

Defective items

You Can Find This Book In

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