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Abortion and neonaticide: ethics, practice, and policy in four nations.

https://arctichealth.org/en/permalink/ahliterature58480
Source
Bioethics. 2002 Jun;16(3):202-30
Publication Type
Article
Date
Jun-2002
Author
Michael L Gross
Author Affiliation
Department of Political Science, The University of Haifa, Mt. Carmel, Haifa, Israel. mgross@poli.haifa.ac.il
Source
Bioethics. 2002 Jun;16(3):202-30
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Abnormalities
Abortion, Eugenic
Abortion, Legal
Adult
Comparative Study
Decision Making
Denmark
Developed Countries
Ethical Analysis
Euthanasia, Passive
Female
Fetus
Great Britain
Health Care Rationing
Homicide
Humans
Infant, Newborn
Infant, Premature
Internationality
Israel
Parents
Personhood
Pregnancy
Pregnancy Trimester, Third
Public Policy
Quality of Life
Resuscitation
Social Values
United States
Value of Life
Withholding Treatment
Abstract
Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform.
PubMed ID
12211246 View in PubMed
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Source
Wien Med Wochenschr. 1995;145(6):143-7
Publication Type
Article
Date
1995
Author
K H Beine
Author Affiliation
Hans-Prinzhorn-Klinik, Hemer.
Source
Wien Med Wochenschr. 1995;145(6):143-7
Date
1995
Language
German
Publication Type
Article
Keywords
Austria
Cause of Death
English Abstract
Euthanasia - legislation & jurisprudence
Female
Homicide - legislation & jurisprudence
Humans
Liability, Legal
Male
Nursing Staff, Hospital - legislation & jurisprudence
Patient Care Team - legislation & jurisprudence
Professional Impairment - legislation & jurisprudence
Abstract
The phenomenon of patient homicides committed by health service employees has, in the previous years, repeatedly aroused much attention. The cases made known in Germany, the USA, Holland, Norway, and Austria appear to provide evidence to the effect that we are not only dealing with unique incidents. The scientific investigation of this especially sensitive taboo-topic is, to date, missing. The judicial trials carried out emphatically indicate that culprit motives, colleague behavior, but also to a large extent decisions made by superiors remain unclear. It remains controversial, what effect working conditions, strain of employees, their level of education and personal viewpoints over such criminal acts they possess. Finally, the long latency period between the first internal suspicions and the responsible parties' appropriate reactions requires duplicatable explanation. The following paper presents a German single-case study of patient homicide by a female nurse. The focus on causality rests on the presentation of developments up to the point where the long-fermenting suspicion could no longer be dismissed, and appropriate consequences took place. The account largely avoids the "definite" findings required during the judicial process. It concerns rather above all an open, uncertain, and possibly without external influence course of development which in stages each colleague in the health professions can trace, to the point where the uncertain and horrifying suspicion became a certainty. With this single-case study in hand it is made understandable in which ways personal circumstances and professional conditions at the worksituation can intertwine in such a way that the original motivation to help turns into its abysmal opposite. It is the author's intention to make preventive learning possible through this single case study. Every employee in the health professions should proceed on the assumption that such occurrences could also in his own field of work come to pass. In this respect, it is of considerable importance to differentiate between hasty and untenable incriminations and original increasing early-warning signs.
PubMed ID
7785282 View in PubMed
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[A contribution to the euthanasia debate: the law and the self-chosen death]

https://arctichealth.org/en/permalink/ahliterature68471
Source
Lakartidningen. 1996 Aug 28;93(35):2915-7
Publication Type
Article
Date
Aug-28-1996
Author
M K Nielsen
Author Affiliation
Socialrätt vid Lunds universitet.
Source
Lakartidningen. 1996 Aug 28;93(35):2915-7
Date
Aug-28-1996
Language
Swedish
Publication Type
Article
Keywords
Euthanasia - legislation & jurisprudence
Humans
Physician's Role
Right to Die
Suicide, Assisted - legislation & jurisprudence
Sweden
PubMed ID
8815343 View in PubMed
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Acting on a living will: a physician's dilemma.

https://arctichealth.org/en/permalink/ahliterature211004
Source
CMAJ. 1996 Oct 1;155(7):893-5
Publication Type
Article
Date
Oct-1-1996
Author
M. Gordon
D. Levitt
Author Affiliation
Baycrest Centre for Geriatric Care, North York, Ont.
Source
CMAJ. 1996 Oct 1;155(7):893-5
Date
Oct-1-1996
Language
English
Publication Type
Article
Keywords
Aged
Canada
Chronic Disease
Combined Modality Therapy
Dissent and Disputes
Ethics Committees
Ethics Committees, Clinical
Ethics, Medical
Euthanasia, Passive - psychology
Fatal Outcome
Group Processes
Humans
Living Wills - psychology
Male
Moral Obligations
Personal Autonomy
Quadriplegia - complications - psychology - therapy
Social Values
Withholding Treatment
Abstract
The implementation of a living will can give rise to ethical dilemmas for the patient's family and the health care professionals involved. The case reported here raises questions about the right of patients to self-determination, the importance of quality-of-life considerations in treatment decisions and physicians' obligations with respect to the implementation of living wills. Physicians should ensure in advance that the instructions set out in a living will are unambiguous and should bring to the patient's attention any ethical difficulties that they foresee in carrying out those instructions.
Notes
Cites: Lancet. 1972 Apr 1;1(7753):734-74111204
Cites: J Am Geriatr Soc. 1995 Jun;43(6):716-77775737
Cites: JAMA. 1990 Oct 10;264(14):1846-532402044
Cites: N Engl J Med. 1991 Mar 28;324(13):882-82000110
Cites: CMAJ. 1992 Jun 1;146(11):1937-441596842
Cites: Ann Intern Med. 1992 Aug 1;117(3):254-61616221
Cites: Med J Aust. 1993 Apr 5;158(7):460-48469195
Cites: Br J Hosp Med. 1993 Apr 21-May 4;49(8):576-88508244
Cites: Arch Intern Med. 1994 Jan 24;154(2):209-178285816
Cites: J Am Geriatr Soc. 1994 Mar;42(3):303-78120316
Cites: CMAJ. 1994 Aug 1;151(3):285-98039081
Cites: J Am Geriatr Soc. 1994 Sep;42(9):997-10037503822
Cites: Ann Intern Med. 1995 Mar 1;122(5):368-747847649
Cites: Ann Intern Med. 1995 Mar 1;122(5):377-87847651
Cites: Arch Intern Med. 1995 Apr 24;155(8):793-67717786
Cites: J Am Geriatr Soc. 1995 Jun;43(6):696-7017775732
Cites: JAMA. 1989 Nov 3;262(17):2415-92795827
PubMed ID
8837536 View in PubMed
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Active and passive euthanasia: the cases of Drs. Claudio Alberto de la Rocha and Nancy Morrison.

https://arctichealth.org/en/permalink/ahliterature202519
Source
CMAJ. 1999 Mar 23;160(6):857-60
Publication Type
Article
Date
Mar-23-1999
Author
D. Gorman
Author Affiliation
University of Toronto.
Source
CMAJ. 1999 Mar 23;160(6):857-60
Date
Mar-23-1999
Language
English
Publication Type
Article
Keywords
Canada
Ethics, Medical
Euthanasia - legislation & jurisprudence
Euthanasia, Passive - legislation & jurisprudence
Humans
Malpractice - legislation & jurisprudence
Medical Futility
Patient Advocacy - legislation & jurisprudence
Suicide, Assisted - legislation & jurisprudence
Notes
Cites: Int J Antimicrob Agents. 2000 Mar;14(2):157-6010720807
Cites: Philos Public Aff. 1977 Winter;6(2):85-11211663015
Cites: N Engl J Med. 1975 Jan 9;292(2):78-801109443
Comment In: CMAJ. 1999 Sep 21;161(6):68510513269
Comment In: CMAJ. 1999 Jul 13;161(1):18, 2010420857
PubMed ID
10189436 View in PubMed
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Source
Ugeskr Laeger. 1995 Feb 20;157(8):1024-7
Publication Type
Article
Date
Feb-20-1995
Author
A P Folker
N. Hvidt
Source
Ugeskr Laeger. 1995 Feb 20;157(8):1024-7
Date
Feb-20-1995
Language
Danish
Publication Type
Article
Keywords
Denmark
Euthanasia - legislation & jurisprudence
Humans
Patient Advocacy
Physician's Role
Quality of Life
Abstract
The growing interest in the subject of active euthanasia in connection with the debate regarding legalization of such practices in Denmark necessitates taking a definite standpoint. The difference in concept between active and passive euthanasia is stressed, and the Dutch guidelines are reviewed. The article discusses how far the patient's autonomy should go, as it regards the consideration of self-determination as being too narrow a criterion in itself. The discussion on the quality of life is included, and the consequences of the process of expulsion as a sociological concept are considered--the risk of a patient feeling guilty for being alive and therefore feeling compelled to request active euthanasia. The changed function of the physician is underlined, and it is discussed whether active euthansia will cause a breach of confidence between the physician and his patient. In connection with the debate the following tendencies in society are emphasized: lack of clarity, increasing medicalization and utilitarian priorities.
PubMed ID
7879300 View in PubMed
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Active euthanasia: should polls be action guides?

https://arctichealth.org/en/permalink/ahliterature220935
Source
CMAJ. 1993 Jun 1;148(11):1889-90
Publication Type
Article
Date
Jun-1-1993
Author
J S Senn
Source
CMAJ. 1993 Jun 1;148(11):1889-90
Date
Jun-1-1993
Language
English
Publication Type
Article
Keywords
Alberta
Attitude of Health Personnel
Ethics, Medical
Euthanasia
Humans
Questionnaires
Notes
Cites: JAMA. 1988 Apr 8;259(14):2139-403346989
Cites: Arch Intern Med. 1992 Oct;152(10):1973-61417370
Cites: J Med Ethics. 1992 Sep;18 Suppl:1-231357177
Cites: Lancet. 1991 Sep 14;338(8768):669-741715962
Cites: Science. 1981 Jan 30;211(4481):453-87455683
Comment On: CMAJ. 1993 Jun 1;148(11):1921-68500029
Comment On: CMAJ. 1993 Jun 1;148(11):1929-338500030
PubMed ID
8500025 View in PubMed
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Advance directives for resuscitation and other life-saving or sustaining measures.

https://arctichealth.org/en/permalink/ahliterature224132
Source
CMAJ. 1992 Mar 15;146(6):1072A-B
Publication Type
Article
Date
Mar-15-1992

Advance directives: patient preferences in family practice.

https://arctichealth.org/en/permalink/ahliterature229101
Source
Can Fam Physician. 1990 May;36:876-8
Publication Type
Article
Date
May-1990
Author
John P Sloan
Source
Can Fam Physician. 1990 May;36:876-8
Date
May-1990
Language
English
Publication Type
Article
Keywords
Advance Directives
Aged
Attitude
Canada
Data Collection
Decision Making
Euthanasia, Passive
Family
Family Practice
Humans
Life Support Care
Patient Care
Patients
Terminal Care
Third-Party Consent
Abstract
The author reports on six months' experience of obtaining advance directives from patients for care in a family practice. Patients were questioned about their preferences for comfort or prolonging life and then were asked to delegate a substitute decision maker. Of 20 patients, all who responded chose comfort over prolonging life. Delegated substitute decision makers included spouses, children, and professionals or friends. In this population, patients overwhelmingly favoured comfort over prolonging life in the event that they might be irreversibly disabled, and they tended to choose spouses or other first-degree relatives as substitute decision makers.
Notes
Cites: J Am Geriatr Soc. 1975 Oct;23(10):433-411159263
Cites: Ann Intern Med. 1986 May;104(5):711-53963666
Cites: J Fam Pract. 1986 May;22(5):439-423701283
Cites: Clin Geriatr Med. 1986 Aug;2(3):511-203742442
Cites: J Am Geriatr Soc. 1987 Aug;35(8):814-203611572
Cites: Med Law. 1989;7(5):457-652493552
PubMed ID
11653912 View in PubMed
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583 records – page 1 of 59.