Between Euthanasia and Dysthanasia: The Ethical Issue of Sedation in the Terminal Phase of Illness

Background: Deep sedation, euthanasia and therapeutic relentlessness lead us today to rethink the paradigm of life and the contingency of human existence. Between therapeutic relentlessness, the unreasonable care which uses heavy therapeutic means which are often disproportionate to the expected benefit, namely keeping alive a patient whose condition is considered medically hopeless;and euthanasia which would precipitate the process of death would be sedation in the terminal phase of the illness. Should doctors and families of comatose patients decide the “life” and “death” of their patients? For anti-euthanasia associations, doctors, relatives of terminally ill patients and the State itself, if they accept the principle of euthanasia, they are “murderers”, while for pro-euthanasists, the dignity of the human being would recommend that the days of patients in situations considered critical be shortened, to avoid unnecessary suffering and humiliation. Methods: A systematic review of the literature was carried out to identify relevant articles relating to euthanasia, dysthanasia and sedation in the terminal phase of illness. The search was conducted in French or English in three databases: PubMed, Google Scholar and Science Direct. Objectives: The objectives of this article are: 1) define the terminologies and concepts of palliative sedation, deep sedation, deep and continuous sedation until death, euthanasia and dysthanasia;2) present aspects of the meaning of life and the human person in African cultures;and 3) propose an ethical reflection on the value of life. Results: After precisely defining the concepts of euthanasia, dysthanasia and sedation, this research presented the African anthropological and ethical approach to the mysteries of life and death. Conclusion: With this in mind, the golden rule of medicine always remains as such “Primum non nocere”.

Application of Presumptive Consent in Passive Euthanasia

In the criminological system, passive euthanasia is an act that meets the constitutive elements. We should discard the traditional view of distinguishing between acts and omissions, but use genuine consent or presumptive consent under the patient’s right to self-determination as the basis for its justification. In general, the patient’s genuine consent takes precedence, but in case of the unavail-ability of the patient’s genuine consent, his or her presumptive consent should be applied as a substitute. The judgment of presumptive con-sent should follow the subsequence, with the living will of the patient applied first and then the substitute decision-making. If the patient’s personal will cannot be inferred after exhausting all available possi-bilities, the principle of prioritizing the interests of life should prevail, and the ongoing life-sustaining medical care should not be interrupted or terminated.

Euthanasia controversy in China:do we have the right to die?

This research examines the contentious issue of euthanasia and physician-assisted suicide in the context of China's unique conditions.Historically,the debate over euthanasia has been influenced by moral philosophy and ethics,and euthanasia is illegal in China at present.The research explores the difficulty in making euthanasia legalized across five key dimensions:financial,medical,social,legal,and psychological factors.We conclude that while there is a desire among some terminally ill patients for euthanasia,the current situation in China makes it unsuitable for legalization.The profound question of one's right to die remains a significant moral and judicial challenge,indicating the need for continued dialogue and nuanced understanding of this complex issue.

Palliative care with adequate pain relief challenges the need for euthanasia legislation

Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management.

Unbearable suffering obviates euthanasia:definitionally derived set of propositions comprising euthanasia’s purpose,claim,and benefit lead to contradiction establishing the paradox of euthanasia

Relying on euthanasia’s definitionally derived set of propositions to provide its purpose,claims,and benefit,we obtain the core concept.Nonetheless,given its core concept,euthanasia is demonstrated to provide no benefit to the animal to justify its use.Euthanasia 1)cannot possibly,and therefore does not,end unbearable suffering,2)it fails to hasten death,and 3)it,therefore,provides no perceptible relief to the patient.These findings are significant because the argument’s validity does not permit euthanasia to satisfy its definitionally derived purpose,claims,or benefit on logical grounds.In other words,the argument is that as a form of legalized assisted suicide,euthanasia is wrong but not in the way principled arguments would suggest.Additionally,irrespective of euthanasia actually doing what it claims,if it is allowed to be provisioned,then euthanasia will affect vulnerable populations exactly like nonprincipled arguments claim.Therefore,despite sharing aspects with each type of argument in the extant literature,my argument against euthanasia can be categorized as neither principled nor nonprincipled,which makes it significant because it may be the first of a new category of argument against the concept and practice to enter the discourse on euthanasia.As a corollary,since we prove that unbearable suffering logically entails death,when it is authentic signifying that death is imminent,because euthanasia’s only purpose is to end unbearable suffering by inducing death,euthanasia is completely obviated.

Exploring euthanasia in Malta: an intersectional analysis of medical, legal, and ethical perspectives

This paper provides a comprehensive examination of euthanasia from various perspectives,including medical,legal,religious,philosophical,and moral.The study also explores the public perceptions and trends in Malta.The medical perspective analyses the benefits and risks of euthanasia and its impact on the healthcare system.The legal perspective discusses the legality of euthanasia in Malta and the potential legal implications of legalizing the practice.The religious perspective explores the beliefs of various religious groups in Malta,particularly Catholicism,on euthanasia.The philosophical perspective discusses the ethical and moral considerations of euthanasia.The paper also analyses the results of surveys conducted in Malta,examining the public’s attitudes towards euthanasia.Overall,the study provides a thorough analysis of euthanasia from various angles,shedding light on the complex and controversial nature of the topic.

Culturally sanctioned suicide:Euthanasia,seppuku,and terrorist martyrdom

Suicide is one of the greatest concerns in psychiatric practice, with considerable efforts devoted to prevention. The psychiatric view of suicide tends to equate it with depression or other forms of mental illness. However, some forms of suicide occur independently of mental illness and within a framework of cultural sanctioning such that they aren't regarded as suicide at all. Despitepersistent taboos against suicide, euthanasia and physician-assisted suicide in the context of terminal illness is increasingly accepted as a way to preserve autonomy and dignity in the West. Seppuku, the ancient samurai ritual of suicide by self-stabbing, was long considered an honorable act of self-resolve such that despite the removal of cultural sanctioning, the rate of suicide in Japan remains high with suicide masquerading as seppuku still carried out both there and abroad. Suicide as an act of murder and terrorism is a practice currently popular with Islamic militants who regard it as martyrdom in the context of war. The absence of mental illness and the presence of cultural sanctioning do not mean that suicide should not be prevented. Culturally sanctioned suicide must be understood in terms of the specific motivations that underlie the choice of death over life. Efforts to prevent culturally sanctioned suicide must focus on alternatives to achieve similar ends and must ultimately be implemented within cultures to remove the sanctioning of self-destructive acts.

The Euthanasia Debate:Importance of Spiritual Care in End of Life

Euthanasia is presented by its advocates as the panacea for all pain and suffering.The terminally ill who struggle with multiple symptoms of their illness were assured of relief,but what that relief translates into is the termination of life in what is known as mercy killing.So,there would be an end to pain and suffering.But,could we conclude there is an end(i.e.,termination)to pain and suffering with the advocates of euthanasia when all that are done is taking out the individual who is the subject of that experiential reality and goes beyond that one individual to affecting countless lives?Besides,there are terminally ill people who decide to end their lives but would not have made that choice except for the offer put before them by the euthanasia advocates.However,that very reality is responsible for pain and suffering,either terminal illness or loss persists.It is for this reason that this paper adopts a contrary view from the above.I argue that terminally ill individuals grappling with symptoms of their condition do not need termination of life,but an intervention that strongly underscores being present to the individual in need.In other words,a care-giver must be present before there can be any meaningful care given to the patient.And I am using the pastoral care model in elaborating the notion of presence,as I equally elaborate the notion of healing presence that stresses the spiritual element of the human person whereby through our presence to the other,we thrive in times of adversity and illness by drawing strengths and courage from our connectedness,which is what the presence of pastoral care offers and equally assures the terminally ill in those moments of need.

Ethical, Religious, and Psychological Aspects of Euthanasia： Qualitative Study of Japanese Roman Catholics

The main aim of this qualitative work is to explore the scope, nature of existing doubts, concerns, and objections, which arose in the mentality of selected groups of Japanese Roman Catholics, and to provide the typology of these findings. The method used in this research was based on specially devised questionnaires. This method aimed to collect qualitative data. The results obtained from questionnaires delivered in selected groups of Japanese Roman Catholics （Hokkaido prefecture） inform that there is a very deep gap between understanding of the concept of euthanasia and its acceptance/rejection. This investigation also reveals the hierarchy of values in the mentioned context. In conclusion, the concept of euthanasia is very often confused with so called ＂death with dignity＂ （Songenshi） and because of this fact it is not clear, what action is consistent with the religious doctrine and what is against. This confusion might be a crucial factor which determines the attitude towards rejection/acceptance/withdrawal from the decision concerning euthanasia in the group of Japanese Roman Catholics.

The Right to Life, Voluntary Euthanasia, and Termination of Life on Request

In this article, the logical implications of a right to life are examined. It is first argued that the prohibition of Termination of life on request confers an inalienable right to life. A fight is inalienable if it cannot legitimately be waived or transferred. Since voluntary euthanasia entails waiver of the right to life, the inalienability yields that it cannot be justified. Therefore, any ethical position that is in favor of voluntary euthanasia has to argue that the right to life is an inalienable right and accept the conclusion that killing on request is justified.

“Euthanasia” in China:Yes or No?——First patient fails to die an easy death

In China, the definition ofeuthanasia given byChinese scholars is: thewhole process of allowingpatients on the verge ofdeath with incurabledisease and sustainextreme pains spirituallyand bodily to tide over thedeath stage and end lifeby artificial means uponthe request of thepatients or their familiesand with theconsent of doctors.But in China, euthanasiahas not been legalized.

Termination of life! reflections on abortion and euthanasia

The article follows an analysis critical of the human rights convention from the perspective of abortion and euthanasia,bringing arguments for and against the right to life,starting at conception and to the final phase of a human being.

Theory-laden model of ethical applications and ethics of euthanasia

The primary aim of this paper is to critically evaluate the deductive model of ethical applications,which is based on normative ethical theories like deontology and consequentialism,and to show why a number of models have failed to furnish appropriate resolutions to practical moral problems.Here,for the deductive model,I want to call it a“Linear Mechanical Model”because the basic assumption of this model is that if a normative theory is sacrosanct,then the case is as it is.The conclusion derived from the case will also be correct,true and acceptable.However,traditional ethicists used to apply their ethical theories,but they did not know which moral theory was effective on the ground level of reality.The study will show readers how ethical theories are in conflict with each other in the case of euthanasia.In more precise words,“which ethical theories are said to be applied,meta-ethical or normative,or both for the resolution of ethical problems?If normative theories are said to be applied,how the application can take place when it is contrary to our experience,that(then)in a situation of moral crises,no one really applies a theory?”For that,my argument is the linear model has failed because it is rigid,often ignores the agents’intrinsic values,and has no space to amend it,no matter how bizarre the consequence is.Its alternative is the Inductive model.For that,the paper will take three moral principles(autonomy,beneficence including maleficence,and justice)of Beauchamp&Childress.This suggests us for resolving value-laden moral problems,we should consider some steps such as a)recognising moral issues to start with;b)developing the moral imagination;c)sharpening analytical/critical skills;d)testing out disagreements;e)effecting decisions and behavior;and f)implementation,closure,and process are of vital importance,in other words,it starts with the free and informed consensus of all interested parties,but this model also has been failed because the model could not give a systematic organization to their way of resolution.Here,my argument is that the inductive model provides resolution of the practical problem but ignores what is ethically obligatory,permissible,or wrong in that situation,and there are no appropriate suggestions in the case of a moral crisis.

Euthanasia in a Welfare State:Experiences from the Review Procedure in the Netherlands

This paper is based on an ethical analysis of 1,200 reports submitted to one of the five Regional Review Committees on Euthanasia in the Netherlands in the years 2005-09. Despite legal and professional safeguards with regard to euthanasia, and despite the overall high quality of care, the Dutch euthanasia practice is still not unproblematic. This paper identifies some important ethical issues： the sometimes obscure meaning of ＂patient autonomy＂; inferior quality of care or refusal to accept care, which aggravates a patient＇s suffering; insufficient spiritual, social, and psychological care; fears for a terrible death on the basis of outdated experiences in the past; and undue pressure from the side of relatives. Despite these concerns, and despite the fact that euthanasia remains a morally problematic death, however, the Dutch euthanasia practice can be described as morally solid.

不给予或撤除生命维持干预与安乐死、消极安乐死的概念辨析

不给予或撤除生命维持干预是临床实践中常见且棘手的伦理学问题。该问题的讨论应建立在清晰的概念之上,但不给予或撤除生命维持干预常与安乐死、消极安乐死和尊严死等概念混淆,引发误解。重新定义安乐死和消极安乐死具有理论和现实的紧迫性。基于汤姆•比彻姆和阿诺德•戴维森提出的安乐死定义,提出消极安乐死的定义。基于该定义,认为不给予或撤除生命维持干预与消极安乐死为交叉关系。鉴于安乐死概念的争议及其富含的感情色彩,强调讨论生命维持干预的使用时应区分事实与价值,并建议慎用或弃用安乐死与消极安乐死。

安乐死合法性的存在主义哲学辩护

安乐死根据执行方式可分为消极安乐死和积极安乐死,根据病人同意方式分为自愿安乐死和非自愿安乐死。存在主义的生命哲学精髓可概括为“存在的超越性和选择的价值性、死亡的自由性和生命的创造性”。从存在主义哲学视角来审视安乐死的合法性问题:消极安乐死基于存在的超越性,让生命有尊严、自然地离开;积极安乐死基于选择的价值性,让生命走向本真的存在;自愿安乐死尊重死亡的自由性,让生命死得其时、获得一个圆满的结局;非自愿安乐死从反面论证了生命的创造性,让生命成就社会幸福、实现完美的谐和。

安乐死的有限出罪研究

消极安乐死在实务中有被界定为故意杀人罪的风险,对此,可参考德国判例,引入自我决定权作为消极安乐死的权利基础,并借助被害人承诺进行出罪。原则上,实施积极安乐死的行为不阻却违法性,应以故意杀人罪论处,但在量刑时可借助期待可能性理论,根据具体案情进行有限宽宥。在特定情形下,可通过规范适用但书条款,对积极安乐死做出无罪宣告的决定。

生前预嘱的合法化与适用问题研究

生前预嘱不同于安乐死、协助自杀,契合保护预嘱人医疗自主权、死亡尊严的现实需求,其合法化具有充足的法理依据;其订立主体应当为完全民事行为能力人,且其文本内容系预嘱人的真实意思表示,不违反法律、行政法规的强制性规定或者公序良俗;其适用情形不宜限制过严,应予扩大解释--一是预嘱人罹患阿尔茨海默症或处于永久性植物状态时,均应认定其符合生前预嘱的适用情形;二是不应对孕妇的生前预嘱设置排除或部分排除条款,而应尊重孕妇的医疗自主权,且胎儿利益不得绝对优先于孕妇的自主权。

善终理念下我国尊严死立法的现实阻碍与价值分析

尊严死是近年来备受社会关注的热点问题之一,在缓解临终患者的身心痛苦、提高死亡质量、减少医患冲突和医疗资源浪费等方面起着重要作用。无意义的治疗不仅不能挽救患者的生命,而且还会加重患者所遭受的折磨,让患者无法有尊严地迎接死亡。我国作为世界上老年人口最多的国家,尊严死的立法顺应了时代和人民的需求,体现了善终理念的要求,能够有效提高老年人及临终患者的生存质量。尊严死是对生命权及人格尊严的保护,彰显了患者意思自治等民法的精神和原则,是对我国伦理道德的传承和发展。

基于3R原则探讨动物实验中人道终点的判定与应用

实验动物人道终点作为3R原则中优化原则的主要体现和应用,已被国际社会所认可并形成了完善的法律法规体系,伴随着我国在实验动物福利伦理方面所取得的巨大进步,实验动物人道终点的实践也得到了较大的应用和发展。通过对动物人道终点的判定原则和方法进行探讨,在最大程度保障动物福利的前提下,有效保证了动物实验数据的真实性、准确性和完整性,为从事动物实验的研究人员提供了一定的参考。