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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 In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn.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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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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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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Age and life-sustaining treatment. Attitudes of intensive care unit professionals.

https://arctichealth.org/en/permalink/ahliterature211159
Source
Acta Anaesthesiol Scand. 1996 Sep;40(8 Pt 1):904-8
Publication Type
Article
Date
Sep-1996
Author
G. Melltorp
T. Nilstun
Author Affiliation
Department of Anaesthesiology, University Hospital MAS, Malmö, Sweden.
Source
Acta Anaesthesiol Scand. 1996 Sep;40(8 Pt 1):904-8
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Advance Directives
Age Factors
Attitude of Health Personnel
Euthanasia, Passive - psychology
Humans
Intensive Care Units
Life Support Care - psychology
Medical Staff, Hospital - psychology
Questionnaires
Sweden
Abstract
In Sweden, the official policy is that life-sustaining treatment should not be denied because of chronological age. This policy is also emphasised in a recent official report on priority setting in health care. But is this policy accepted among health care professionals? Do they consider chronological age relevant when decisions to forgo life-sustaining treatment are to be made?
Questionnaire survey to physicians, registered nurses and enrolled nurses at the Intensive Care Unit, University Hospital MAS, Malmö, Sweden.
More than 65% of the respondents were of the opinion that chronological age per se influenced decisions about life-sustaining treatment. Fewer, a little more than 40%, answered that it would make a difference to their own judgment about life-sustaining treatment whether the patient is 25 or 75 years old. The respondents were also confronted with 10 different factors characterising patients in need of life-sustaining treatment. According to a majority, advance directive, decision-making capacity, and chronological age should be taken into consideration in these situations.
The results indicate that chronological age is used as a criterion when decisions to forgo life-sustaining treatment are to be made in the ICU. Many health care professionals also believe that chronological age should be used as a criterion. This is clearly discordant with the official policy in Sweden and other countries, which is that age-based rationing is never justified.
PubMed ID
8908226 View in PubMed
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[A medical controversy on treatment withdrawal. Does the physician risk to be charged for killing? Only if he deviates from the medical society consensus].

https://arctichealth.org/en/permalink/ahliterature226515
Source
Lakartidningen. 1991 Apr 10;88(15):1417-20
Publication Type
Article
Date
Apr-10-1991

An old woman, prepared to die: what should the ER doctors do?

https://arctichealth.org/en/permalink/ahliterature230236
Source
CMAJ. 1989 Sep 1;141(5):456-7
Publication Type
Article
Date
Sep-1-1989
Author
B. Trent
Source
CMAJ. 1989 Sep 1;141(5):456-7
Date
Sep-1-1989
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Decision Making
Emergency Service, Hospital
Euthanasia, Passive
Female
Humans
Male
Right to Die
Notes
Comment In: CMAJ. 1989 Nov 15;141(10):10282804817
Erratum In: Can Med Assoc J 1989 Oct 15;141(8):770
PubMed ID
2766187 View in PubMed
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219 records – page 1 of 22.