WorldWideScience

Sample records for voluntary active euthanasia

  1. Suicide and voluntary active euthanasia: why the difference in attitude?

    Science.gov (United States)

    Beech, I

    1995-06-01

    It appears that the attitudes of health professionals differ towards suicide and voluntary active euthanasia. An acceptance of, if not an agreement with, voluntary active euthanasia exists, while there is a general consensus that suicide should be prevented. This paper searches for a working definition of suicide, to discover ethical reasons for the negative value that suicide assumes, and also to provide a term of reference when comparing suicide with euthanasia. On arriving at a working definition of suicide, it is compared with voluntary active euthanasia. An analysis of utilitarian and deontological considerations is provided and proves to be inconclusive with respect to the ethical principles informing the attitudes of professionals. Therefore, a search for other influences is attempted; this indicates that psychological influences inform attitudes to a greater degree than ethical principles.

  2. Is there a place for voluntary active euthanasia in modern-day medicine?

    National Research Council Canada - National Science Library

    Ogunbanjo, GA; Knapp van Bogaert, D

    2013-01-01

    This article discusses various ethical and legal concepts regarding euthanasia and includes notions such as physician-assisted suicide, assisted suicide, voluntary active euthanasia, killing versus...

  3. The dead donor rule, voluntary active euthanasia, and capital punishment.

    Science.gov (United States)

    Coons, Christian; Levin, Noah

    2011-06-01

    We argue that the dead donor rule, which states that multiple vital organs should only be taken from dead patients, is justified neither in principle nor in practice. We use a thought experiment and a guiding assumption in the literature about the justification of moral principles to undermine the theoretical justification for the rule. We then offer two real world analogues to this thought experiment, voluntary active euthanasia and capital punishment, and argue that the moral permissibility of terminating any patient through the removal of vital organs cannot turn on whether or not the practice violates the dead donor rule. Next, we consider practical justifications for the dead donor rule. Specifically, we consider whether there are compelling reasons to promulgate the rule even though its corresponding moral principle is not theoretically justified. We argue that there are no such reasons. In fact, we argue that promulgating the rule may actually decrease public trust in organ procurement procedures and medical institutions generally - even in states that do not permit capital punishment or voluntary active euthanasia. Finally, we examine our case against the dead donor rule in the light of common arguments for it. We find that these arguments are often misplaced - they do not support the dead donor rule. Instead, they support the quite different rule that patients should not be killed for their vital organs.

  4. Rethinking voluntary euthanasia.

    Science.gov (United States)

    Stoyles, Byron J; Costreie, Sorin

    2013-12-01

    Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

  5. U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

    2002-01-01

    A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

  6. Human dignity and the future of the voluntary active euthanasia debate in South Africa

    Directory of Open Access Journals (Sweden)

    Donrich W Jordaan

    2017-05-01

    Full Text Available The issue of voluntary active euthanasia was thrust into the public policy arena by the Stransham-Ford lawsuit. The High Court legalised voluntary active euthanasia – however, ostensibly only in the specific case of Mr Stransham-Ford. The Supreme Court of Appeal overturned the High Court judgment on technical grounds, not on the merits. This means that in future the courts can be approached again to consider the legalisation of voluntary active euthanasia. As such, Stransham-Ford presents a learning opportunity for both sides of the legalisation divide. In particular, conceptual errors pertaining to human dignity were made in Stransham-Ford, and can be avoided in future. In this article, I identify these errors and propose the following three corrective principles to inform future debate on the subject: (i human dignity is violable; (ii human suffering violates human dignity; and (iii the ‘natural’ causes of suffering due to terminal illness do not exclude the application of human dignity.

  7. Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion.

    Science.gov (United States)

    Amaraskekara, Kumar; Bagaric, Mirko

    2004-09-01

    The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia.

  8. Voluntary euthanasia: a utilitarian perspective.

    Science.gov (United States)

    Singer, Peter

    2003-10-01

    Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

  9. Guilty but good: defending voluntary active euthanasia from a virtue perspective.

    Science.gov (United States)

    Begley, Ann Marie

    2008-07-01

    This article is presented as a defence of voluntary active euthanasia from a virtue perspective and it is written with the objective of generating debate and challenging the assumption that killing is necessarily vicious in all circumstances. Practitioners are often torn between acting from virtue and acting from duty. In the case presented the physician was governed by compassion and this illustrates how good people may have the courage to sacrifice their own security in the interests of virtue. The doctor's action created huge tensions for the nurse, who was governed by the code of conduct and relevant laws. Appraising active euthanasia from a virtue perspective can offer a more compassionate approach to the predicament of practitioners and clients. The tensions arising from the virtue versus rules debate generates irreconcilable difficulties for nurses. A shift towards virtue would help to resolve this problem and support the call for a change in the law. The controversial nature of this position is acknowledged. The argument is put forward on the understanding that many practitioners will not agree with the conclusions reached.

  10. Voluntary euthanasia under control? Further empirical evidence from The Netherlands.

    Science.gov (United States)

    Jochemsen, H; Keown, J

    1999-01-01

    Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control. PMID:10070633

  11. Raping and making love are different concepts: so are killing and voluntary euthanasia.

    OpenAIRE

    Davies, J.

    1988-01-01

    The distinction between 'kill' and 'help to die' is argued by analogy with the distinction between 'rape' and 'make love to'. The difference is the consent of the receiver of the act, therefore 'kill' is the wrong word for an act of active voluntary euthanasia. The argument that doctors must not be allowed by law to perform active voluntary euthanasia because this would recognise an infringement of the sanctity of life ('the red light principle') is countered by comparing such doctors with th...

  12. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    Science.gov (United States)

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

  13. Non-voluntary passive euthanasia: the social consequences of euphemisms.

    Science.gov (United States)

    Sayers, Gwen M

    2007-11-01

    Non-voluntary passive euthanasia, the commonest form of euthanasia, is seldom mentioned in the UK. This article illustrates how the legal reasoning in Airedale NHS Trust v Bland contributed towards this conceptual deletion. By upholding the impermissibility of euthanasia, whilst at the same time permitting 'euthanasia' under the guise of 'withdrawing futile treatment', it is argued that the court (logically) allowed (withdrawing futile treatment and euthanasia). The Bland reasoning was incorporated into professional guidance, which extended the court's ruling to encompass patients who, unlike Anthony Bland, were sentient. But since the lawfulness of (withdrawing futile treatment and euthanasia) hinges on the futility of treatment, and since the guidance provides advice about withdrawing treatment from patients who differ from those considered in court, the lawfulness of such 'treatment decisions' is unclear. Legislation is proposed in order to redress the ambiguity that arose when moral decisions about 'euthanasia' were translated into medical decisions about 'treatment'.

  14. Raping and making love are different concepts: so are killing and voluntary euthanasia.

    Science.gov (United States)

    Davies, J

    1988-01-01

    The distinction between 'kill' and 'help to die' is argued by analogy with the distinction between 'rape' and 'make love to'. The difference is the consent of the receiver of the act, therefore 'kill' is the wrong word for an act of active voluntary euthanasia. The argument that doctors must not be allowed by law to perform active voluntary euthanasia because this would recognise an infringement of the sanctity of life ('the red light principle') is countered by comparing such doctors with the drivers of emergency vehicles, who are allowed to drive through red lights. PMID:3184136

  15. Active and passive euthanasia.

    Science.gov (United States)

    Rachels, J

    1975-01-09

    The traditional distinction between active and passive euthanasia requires critical analysis. The conventional doctrine is that there is such an important moral difference between the two that, although the latter is sometimes permissible, the former is always forbidden. This doctrine may be challenged for several reasons. First of all, active euthanasia is in many cases more humane than passive euthanasia, Secondly, the conventional doctrine leads to decisions concerning life and death on irrelevant grounds. Thirdly, the doctrine rests on a distinction between killing and letting die that itself has no moral importance. Fourthly, the most common arguments in favor of the doctrine are invalid. I therefore suggest that the American Medical Association policy statement that endorses this doctrine is unsound.

  16. Voluntary euthanasia in Northern Ireland: general practitioners' beliefs, experiences, and actions.

    Science.gov (United States)

    McGlade, K J; Slaney, L; Bunting, B P; Gallagher, A G

    2000-01-01

    BACKGROUND: There has been much recent interest in the press and among the profession on the subject of euthanasia and physician-assisted suicide. The BMA recently conducted a 'consensus conference' over the internet to collect views on physician-assisted suicide. Any surveys to date have addressed a variety of specialties; however, no recent surveys have looked at general practitioner (GP) attitudes and experiences. AIM: To explore the attitudes of GPs in Northern Ireland towards the issue of patient requests for euthanasia, their nature, and doctors' experiences of such requests. METHOD: An anonymous, confidential postal survey of all (1053) GP principals in Northern Ireland. RESULTS: Seventy per cent of responders believe that passive euthanasia is both morally and ethically acceptable. Fewer (49%) would be prepared to take part in passive euthanasia. However, over 70% of physicians responding consider physician-assisted suicide and voluntary active euthanasia to be wrong. Thirty per cent of responders have received requests from patients for euthanasia in the past five years. One hundred and seven doctors gave information about these requests. Thirty-nine out of 54 patient requests for passive euthanasia had been complied with, as had one of 19 requests for physician-assisted suicide and four out of 38 patient requests for active euthanasia. Doctors perceived the main reasons why patients sought euthanasia was because of fear of loss of dignity and fear of being a burden to others. CONCLUSIONS: While the majority of GPs support passive euthanasia, they, in common with those who approve of assisted suicide and active euthanasia, often express a reluctance to take part in such actions. This may reflect the moral, legal, and emotional dilemmas doctors encounter when facing end-of-life decisions. PMID:11127168

  17. [Active euthanasia, or assisted suicide?

    Science.gov (United States)

    Julesz, Máté

    2016-10-01

    Both active euthanasia and assisted suicide are legal in The Netherlands, Belgium, Luxemburg and, most recently, in Canada. Examination of national legislations of countries where both active euthanasia and assisted suicide are legal. The number of accomplished active euthanasia cases and that of assisted suicide cases. Analysis of national statistical data. Comparison of statistical data before and after 2010. Comparison of the related practices in the surveyed countries. The number of active euthanasia cases markedly predominates over the number of assisted suicide cases. Cancer is a main reason for active euthanasia, or assisted suicide. In countries with a larger population, the number of active euthanasia cases is higher than that in countries with a smaller population. Regarding the fact that the applicants for active euthanasia withdraw their requests in a smaller number than the applicants for assisted suicide, patients prefer the choice of active euthanasia. Since the related legislative product is too recent in Canada at present, it may be only presumed that a certain preference will also develop in the related practices in Canada. Orv. Hetil., 2016, 157(40), 1595-1600.

  18. Euthanasia: A National Survey of Attitudes toward Voluntary Termination of Life.

    Science.gov (United States)

    Jorgenson, David E.; Neubecker, Ron C.

    1980-01-01

    A study on the attitudes of adults related to the voluntary termination of life showed that those persons with favorable attitudes toward suicide were also favorable toward euthanasia. Religiosity was negatively associated with pro-euthanasia attitudes. Whites and males were more favorable toward euthanasia than Blacks and females. (Author)

  19. Euthanasia: A National Survey of Attitudes toward Voluntary Termination of Life.

    Science.gov (United States)

    Jorgenson, David E.; Neubecker, Ron C.

    1980-01-01

    A study on the attitudes of adults related to the voluntary termination of life showed that those persons with favorable attitudes toward suicide were also favorable toward euthanasia. Religiosity was negatively associated with pro-euthanasia attitudes. Whites and males were more favorable toward euthanasia than Blacks and females. (Author)

  20. Assisted suicide and assisted voluntary euthanasia: Stransham-Ford High Court case overruled by the Appeal Court – but the door is left open

    National Research Council Canada - National Science Library

    David J McQuoid-Mason

    2017-01-01

    Whether persons wishing to have doctor-assisted suicide or voluntary active euthanasia may make a court application based on their rights in the Constitution has not been answered by the Appeal Court...

  1. [Euthanasia].

    Science.gov (United States)

    Julesz, Máté

    2013-04-28

    The problem of euthanasia emerges again and again in today's Europe. The Dutch type of regulation of euthanasia could be introduced into the Hungarian legal system. Today, in Hungary, the ethical guidelines of the chamber of medicine, the criminal law and the administrative health law also forbid active euthanasia. In Hungary, the criminal code reform of 2012 missed to liberalise the regulation of euthanasia. Such liberalisation awaits bottom-up support from the part of the society. In Europe, active euthanasia is legal only in the Netherlands, Belgium, Luxemburg and Switzerland. In Hungary, a passive form of euthanasia is legal, i.e. a dying patient may, under strict procedural circumstances, refuse medical treatment. The patient is not allowed to refuse medical treatment, if she is pregnant and foreseeably capable to give birth to her child.

  2. Non-voluntary and involuntary euthanasia in The Netherlands: Dutch perspectives.

    Science.gov (United States)

    Cohen-Almagor, Raphael

    2003-01-01

    During the summer of 1999, twenty-eight interviews with some of the leading authorities on euthanasia policy were conducted in the Netherlands. They were asked about cases of non-voluntary (when patients are incompetent) and involuntary euthanasia (when patients are competent and made no request to die). This study reports the main findings, showing that most respondents are quite complacent with regard to breaches of the guideline that require the patient's consent as a prerequisite to performance of euthanasia.

  3. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    Science.gov (United States)

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia.

  4. Motivations of physicians and nurses to practice voluntary euthanasia: a systematic review

    Science.gov (United States)

    2014-01-01

    Background While a number of reviews have explored the attitude of health professionals toward euthanasia, none of them documented their motivations to practice euthanasia. The objective of the present systematic review was to identify physicians’ and nurses’ motives for having the intention or for performing an act of voluntary euthanasia and compare findings from countries where the practice is legalized to those where it is not. Methods The following databases were investigated: MEDLINE/PubMed (1950+), PsycINFO (1806+), CINAHL (1982+), EMBASE (1974+) and FRANCIS (1984+). Proquest Dissertations and Theses (1861+) was also investigated for gray literature. Additional studies were included by checking the references of the articles included in the systematic review as well as by looking at our personal collection of articles on euthanasia. Results This paper reviews a total of 27 empirical quantitative studies out of the 1 703 articles identified at the beginning. Five studies were in countries where euthanasia is legal and 22 in countries where it is not. Seventeen studies were targeting physicians, 9 targeted nurses and 1 both health professionals. Six studies identified the motivations underlying the intention to practice euthanasia, 16 the behavior itself and 5 both intention and behavior. The category of variables most consistently associated with euthanasia is psychological variables. All categories collapsed, the four variables most frequently associated with euthanasia are past behavior, medical specialty, whether the patient is depressed and the patient’s life expectancy. Conclusions The present review suggests that physicians and nurses are motivated to practice voluntary euthanasia especially when they are familiar with the act of euthanasia, when the patient does not have depressive symptoms and has a short life expectancy and their motivation varies according to their medical specialty. Additional studies among nurses and in countries where

  5. Assisted suicide and voluntary euthanasia: role contradictions for physicians.

    Science.gov (United States)

    Randall, Fiona; Downie, Robin

    2010-08-01

    It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were legalised doctors must be essentially involved in the whole process including prescribing the medication and (in euthanasia) administering it. This paper explores some reasons for this assumption and argues that it flatly contradicts what it means to be a doctor. The paper is thus not mainly concerned with the ethics of AS/VE but rather with the concept of a doctor that has evolved since the time of Hippocrates to current professional guidance reflected in healthcare law. The paper argues that the most common recent argument for AS/VE--that patients have a right to control when and how they die--in fact points to the involvement not of doctors but of legal agencies as decision makers plus technicians as agents.

  6. Euthanasia: a summary of the law in England and Wales.

    Science.gov (United States)

    Simillis, Constantinos

    2008-07-01

    When medical treatment becomes futile, or the patient's suffering is intractable, doctors face the agonising dilemma of whether to proceed with euthanasia. It is important for a doctor to be familiar with the law surrounding euthanasia, in order to avoid prosecution. This paper explores the law in England and Wales regarding the different categories of euthanasia: voluntary euthanasia, nonvoluntary euthanasia, passive euthanasia, and active euthanasia.

  7. Is there a logical slippery slope from voluntary to nonvoluntary euthanasia?

    Science.gov (United States)

    Jones, David Albert

    2011-12-01

    John Keown has constructed a logical slippery slope argument from voluntary euthanasia (VAE) to nonvoluntary euthanasia (NVAE). VAE if justified implies that death can be of overall benefit, in which case it should also be facilitated in those who cannot consent (NVAE). Hallvard Lillehammer asserts that Keown's argument rests on a fallacy. However, pace Lillehammer, it can be restated to escape this fallacy. Its validity is confirmed by applying to VAE some well-established general principles of medical decision making. Thus, either VAE and NVAE must be accepted together or, if NVAE is regarded as unacceptable, VAE should also be rejected.

  8. Support for voluntary and nonvoluntary euthanasia: what roles do conditions of suffering and the identity of the terminally ill play?

    Science.gov (United States)

    Ho, Robert; Chantagul, Natalie

    2015-01-01

    This study investigated the level of support for voluntary and nonvoluntary euthanasia under three conditions of suffering (pain; debilitated nature of the body; burden on the family) experienced by oneself, a significant other, and a person in general. The sample consisted of 1,897 Thai adults (719 males, 1,178 females) who voluntarily filled in the study's questionnaire. Initial multivariate analysis of variance indicated significant group (oneself, significant other, person in general) differences in level of support for voluntary and nonvoluntary euthanasia and under the three conditions of suffering. Multigroup path analysis conducted on the posited euthanasia model showed that the three conditions of suffering exerted differential direct and indirect influences on the support of voluntary and nonvoluntary euthanasia as a function of the identity of the person for whom euthanasia was being considered. The implications of these findings are discussed.

  9. Euthanasia and the active-passive distinction.

    Science.gov (United States)

    Reichenbach, Bruce R

    1987-01-01

    The author examines various claimed differences between active and passive euthanasia and, if there are differences, whether they are morally significant. He refutes arguments based on acting vs. not acting, intention, double effect, cause of death, and natural law theory. Reichenbach proposes that the most helpful distinction is the one between intentional killing (active euthanasia) and appropriate treatment for the dying or terminally ill (passive euthanasia). Significant moral difference, however, rests on the contention that intentional killing is always wrong and that, all else being equal, dying by natural means is intrinsically good, whereas dying by unnatural means is not.

  10. Doctors can kill--active euthanasia in South Africa.

    Science.gov (United States)

    Oosthuizen, Hennie

    2003-01-01

    Medical practitioners in South Africa will be given the legal right to end the lives of terminally ill patients. This is the practice of active euthanasia, the procedure whereby a medical doctor or a professional nurse can end the life of a terminally ill patient at the patient's request, by providing or administering a lethal dosage of a drug. Voluntary active euthanasia is included in a Draft Bill--The End of Life Decisions Act--which form part of a report of the South African Law Commission, wherein regulations regarding the end-of-life decisions are formulated. Specifically, it provides that a medical practitioner may under certain conditions stop the treatment of a patient whose life functions are being maintained artificially. Further, that a competent person may refuse life-sustaining treatment if he chooses to die. A medical practitioner may also give effect to a patient's living will in which the patient has requested the cessation of treatment. The Act also provides for the options of active voluntary euthanasia or physician-assisted suicide.

  11. Pandemic preparedness planning: will provisions for involuntary termination of life support invite active euthanasia?

    Science.gov (United States)

    Berger, Jeffrey T

    2010-01-01

    A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients' claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally different and morally superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe.

  12. Difficult Decisions: Euthanasia.

    Science.gov (United States)

    Parakh, Jal S.; Slesnick, Irwin L.

    1992-01-01

    Focuses on the moral arguments for and against the controversial topic of voluntary active euthanasia. Discusses the question of legalization and decriminalization of the practice. Provides a student worksheet with questions to stimulate discussion on the issue. (MDH)

  13. Difficult Decisions: Euthanasia.

    Science.gov (United States)

    Parakh, Jal S.; Slesnick, Irwin L.

    1992-01-01

    Focuses on the moral arguments for and against the controversial topic of voluntary active euthanasia. Discusses the question of legalization and decriminalization of the practice. Provides a student worksheet with questions to stimulate discussion on the issue. (MDH)

  14. Euthanasia.

    Science.gov (United States)

    Sanchez-Sweatman, L

    1994-01-01

    Nurses are often involved in situations associated with euthanasia. Examples may include removal of life-supporting devices, "do-not-resuscitate" orders and the prescribing of large potentially lethal doses of narcotics or sedatives. The result of such situations is that physicians order "euthanasia-like" procedures that nurses comply with. Thus nurses must confront euthanasia issues and related implications for nursing practice from a legal and ethical perspective.

  15. Alberta euthanasia survey: 1. Physicians' opinions about the morality and legalization of active euthanasia.

    Science.gov (United States)

    Kinsella, T D; Verhoef, M J

    1993-01-01

    OBJECTIVE: To ascertain the opinions of a sample of Alberta physicians about the morality and legalization of active euthanasia, the determinants of these opinions and the frequency and sources of requests for assistance in active euthanasia. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Of the respondents 44% did believe that it is sometimes right to practice active euthanasia; 46% did not. Moral acceptance of active euthanasia correlated with type of practice and religious affiliation and activity. In all, 28% of the physicians stated that they would practice active euthanasia if it were legalized, and 51% indicated that they would not. These opinions were significantly related to sex, religious affiliation and activity, and country of graduation. Just over half (51%) of the respondents stated that the law should be changed to permit patients to request active euthanasia. Requests (usually from patients) were reportedly received by 19% of the physicians, 78% of whom received fewer than five. CONCLUSIONS: This survey revealed severely disparate opinions among Alberta physicians about the morality of active euthanasia. In particular, religious affiliation and activity were associated with the polarized opinions. The desire for active euthanasia, as inferred from requests by patients, was not frequent. Overall, there was no strong support expressed by the physicians for the personal practice of legalized active euthanasia. These data will be vital to those involved in health education and public policy formation about active euthanasia in Alberta and the rest of Canada. PMID:8500029

  16. Death Anxiety and Voluntary Passive Euthanasia: Influences of Proximity to Death and Experiences with Death in Important Other Persons.

    Science.gov (United States)

    Devins, Gerald M.

    1979-01-01

    Identified five sources of death anxiety. Significant relationships were observed between each source and experimental factors. The relationship between death anxiety and attitude toward voluntary passive euthanasia was explored, and a significant correlation was noted among elderly persons. Results were consistent with an idiographic orientation…

  17. Death Anxiety and Voluntary Passive Euthanasia: Influences of Proximity to Death and Experiences with Death in Important Other Persons.

    Science.gov (United States)

    Devins, Gerald M.

    1979-01-01

    Identified five sources of death anxiety. Significant relationships were observed between each source and experimental factors. The relationship between death anxiety and attitude toward voluntary passive euthanasia was explored, and a significant correlation was noted among elderly persons. Results were consistent with an idiographic orientation…

  18. [Euthanasia].

    Science.gov (United States)

    Gherardi, Carlos R

    2003-01-01

    Technological progress in medicine regarding the application of life-sustaining treatment in the critical patient and the cultural changes that have taken place in contemporary society with respect to the patients' right to decide over the end of their lives, demand the existence of a definition of euthanasia that will acknowledge this new scenario. The concept of euthanasia would be very specifically limited by the exclusion of so-called passive forms of euthanasia and of omission as a possible procedure to cause death and the need for the explicit request of the patient involved. Likewise, the definition of euthanasia should include a specific reference to the means through which death is to be achieved. Euthanasia would thus be defined basically as causing the death of a patient suffering from a mortal disease, upon his or her request and for his or her own benefit, by administering a toxic or poisonous substance in mortal doses. This restrictive definition would differentiate euthanasia from cases of refusal to receive treatment, even if death is the consequence of such refusal, and also from cases in which life-sustaining treatment is withheld or withdrawn to enable the occurrence of death.

  19. The compatibility between Shiite and Kantian approach to passive voluntary euthanasia.

    Science.gov (United States)

    Dabbagh, Soroush; Aramesh, Kiarash

    2009-01-01

    Euthanasia is one of the controversial topics in current medical ethics. Among the six well-known types of euthanasia, passive voluntary euthanasia (PVE) seems to be more plausible in comparison with other types, from the moral point of view. According to the Kantian framework, ethical features come from 'reason'. Maxims are formulated as categorical imperative which has three different versions. Moreover, the second version of categorical imperative which is dubbed 'principle of ends' is associated with human dignity. It follows from this that human dignity has an indisputable role in the Kantian story. ON THE OTHER HAND, THERE ARE TWO MAIN THEOLOGICAL SCHOOLS IN ISLAMIC TRADITION WHICH ARE CALLED: Ash'arite and Mu'tazilite. Moreover, there are two main Islamic branches: Shiite and Sunni. From the theological point of view, Shiite's theoretical framework is similar to the Mu'tazilite one. According to Shiite and Mu'tazilite perspectives, moral goodness and badness can be discovered by reason, on its own. Accordingly, bioethical judgments can be made based on the very concept of human dignity rather than merely resorting to the Holy Scripture or religious jurisprudential deliberations. As far as PVE is concerned, the majority of Shiite scholars do not recognize a person's right to die voluntarily. Similarly, on the basis of Kantian ethical themes, PVE is immoral, categorically speaking. According to Shiite framework, however, PVE could be moral in some ethical contexts. In other words, in such contexts, the way in which Shiite scholars deal with PVE is more similar to Rossian ethics rather than the Kantian one.

  20. The compatibility between Shiite and Kantian approach to passive voluntary euthanasia

    Science.gov (United States)

    Dabbagh, Soroush; Aramesh, Kiarash

    2009-01-01

    Euthanasia is one of the controversial topics in current medical ethics. Among the six well-known types of euthanasia, passive voluntary euthanasia (PVE) seems to be more plausible in comparison with other types, from the moral point of view. According to the Kantian framework, ethical features come from ‘reason’. Maxims are formulated as categorical imperative which has three different versions. Moreover, the second version of categorical imperative which is dubbed ‘principle of ends’ is associated with human dignity. It follows from this that human dignity has an indisputable role in the Kantian story. On the other hand, there are two main theological schools in Islamic tradition which are called: Ash’arite and Mu’tazilite. Moreover, there are two main Islamic branches: Shiite and Sunni. From the theological point of view, Shiite’s theoretical framework is similar to the Mu’tazilite one. According to Shiite and Mu’tazilite perspectives, moral goodness and badness can be discovered by reason, on its own. Accordingly, bioethical judgments can be made based on the very concept of human dignity rather than merely resorting to the Holy Scripture or religious jurisprudential deliberations. As far as PVE is concerned, the majority of Shiite scholars do not recognize a person’s right to die voluntarily. Similarly, on the basis of Kantian ethical themes, PVE is immoral, categorically speaking. According to Shiite framework, however, PVE could be moral in some ethical contexts. In other words, in such contexts, the way in which Shiite scholars deal with PVE is more similar to Rossian ethics rather than the Kantian one. PMID:23908735

  1. Voluntary euthanasia, physician-assisted suicide, and the right to do wrong.

    Science.gov (United States)

    Varelius, Jukka

    2013-09-01

    It has been argued that voluntary euthanasia (VE) and physician-assisted suicide (PAS) are morally wrong. Yet, a gravely suffering patient might insist that he has a moral right to the procedures even if they were morally wrong. There are also philosophers who maintain that an agent can have a moral right to do something that is morally wrong. In this article, I assess the view that a suffering patient can have a moral right to VE and PAS despite the moral wrongness of the procedures in light of the main argument for a moral right to do wrong found in recent philosophical literature. I maintain that the argument does not provide adequate support for such a right to VE and PAS.

  2. Alberta euthanasia survey: 1. Physicians' opinions about the morality and legalization of active euthanasia.

    OpenAIRE

    Kinsella, T D; Verhoef, M.J.

    1993-01-01

    OBJECTIVE: To ascertain the opinions of a sample of Alberta physicians about the morality and legalization of active euthanasia, the determinants of these opinions and the frequency and sources of requests for assistance in active euthanasia. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through ...

  3. The dangers of euthanasia and dementia: how Kantian thinking might be used to support non-voluntary euthanasia in cases of extreme dementia.

    Science.gov (United States)

    Sharp, Robert

    2012-06-01

    Some writers have argued that a Kantian approach to ethics can be used to justify suicide in cases of extreme dementia, where a patient lacks the rationality required of Kantian moral agents. I worry that this line of thinking may lead to the more extreme claim that euthanasia is a proper Kantian response to severe dementia (and similar afflictions). Such morally treacherous thinking seems to be directly implied by the arguments that lead Dennis Cooley and similar writers to claim that Kant might support suicide. If rationality is the only factor in valuing a human life, then the loss of that rationality (however such loss might be defined) would allow us to use essentially utilitarian thinking in order to support non-voluntary euthanasia, since the patients themselves would no longer be moral agents that demand respect.

  4. [Effects of care experience to the attitude of active euthanasia among the Austrian population–a cross sectional study].

    Science.gov (United States)

    Sohar, Birgit; Großschädl, Franziska; Meier, Isabella Maria; Stronegger, Willibald Julius

    2015-12-01

    Attitudes towards active euthanasia by request of competent patients who are seriously or incurable ill people are common in public debates. There is still a lack of knowledge on how people with care experience differ in their attitudes towards active euthanasia from those without. The aim of this study is to find out if and how care experience has an effect on the attitude toward voluntary active euthanasia. In spring 2014 a cross-sectional survey was conducted among the Austrian population by a self-developed questionnaire (on basis of a qualitative pilot study). An online-survey was distributed among persons aged 16 to 65 years and a postal survey among those aged 65 years and older (n=725). Descriptive data was analysed with IBM SPSS Version 2.0. Ethical approval has been provided by the Medical University Graz. 48% of the respondents have experience with care, 8.6% as physicians or nurses, 43.7% as family caregiver and 50% as not caring relatives. Multiple answers were possible. People with caring experience–as nurses or family caregiver–show a significantly lower approval of voluntary active euthanasia (p=0.04). Care experiences have an impact on the attitude towards voluntary active euthanasia. Thus, experiences of caring should be better included in end-of-life debates.

  5. After the Slippery Slope: Dutch Experiences on Regulating Active Euthanasia

    NARCIS (Netherlands)

    Boer, Th.A.

    2003-01-01

    “When a country legalizes active euthanasia, it puts itself on a slippery slope from where it may well go further downward.” If true, this is a forceful argument in the battle of those who try to prevent euthanasia from becoming legal. The force of any slippery-slope argument, however, is by

  6. After the Slippery Slope: Dutch Experiences on Regulating Active Euthanasia

    NARCIS (Netherlands)

    Boer, Th.A.

    2003-01-01

    “When a country legalizes active euthanasia, it puts itself on a slippery slope from where it may well go further downward.” If true, this is a forceful argument in the battle of those who try to prevent euthanasia from becoming legal. The force of any slippery-slope argument, however, is by definit

  7. After the Slippery Slope: Dutch Experiences on Regulating Active Euthanasia

    NARCIS (Netherlands)

    Boer, Th.A.

    2003-01-01

    “When a country legalizes active euthanasia, it puts itself on a slippery slope from where it may well go further downward.” If true, this is a forceful argument in the battle of those who try to prevent euthanasia from becoming legal. The force of any slippery-slope argument, however, is by definit

  8. Living in the hands of God. English Sunni e-fatwas on (non-)voluntary euthanasia and assisted suicide.

    Science.gov (United States)

    Van den Branden, Stef; Broeckaert, Bert

    2011-02-01

    Ever since the start of the twentieth century, a growing interest and importance of studying fatwas can be noted, with a focus on Arabic printed fatwas (Wokoeck 2009). The scholarly study of end-of-life ethics in these fatwas is a very recent feature, taking a first start in the 1980s (Anees 1984; Rispler-Chaim 1993). Since the past two decades, we have witnessed the emergence of a multitude of English fatwas that can easily be consulted through the Internet ('e-fatwas'), providing Muslims worldwide with a form of Islamic normative guidance on a huge variety of topics. Although English online fatwas do provide guidance for Muslims and Muslim minorities worldwide on a myriad of topics including end-of-life issues, they have hardly been studied. This study analyses Islamic views on (non-)voluntary euthanasia and assisted suicide as expressed in English Sunni fatwas published on independent--i.e. not created by established organisations--Islamic websites. We use Tyan's definition of a fatwa to distinguish between fatwas and other types of texts offering Islamic guidance through the Internet. The study of e-fatwas is framed in the context of Bunt's typology of Cyber Islamic Environments (Bunt 2009) and in the framework of Roy's view on the virtual umma (Roy 2002). '(Non-)voluntary euthanasia and assisted suicide' are defined using Broeckaert's conceptual framework on treatment decisions at the end of life (Broeckaert 2008). We analysed 32 English Sunni e-fatwas. All of the e-fatwas discussed here firmly speak out against every form of active termination of life. They often bear the same structure, basing themselves solely on Quranic verses and prophetic traditions, leaving aside classical jurisprudential discussions on the subject. In this respect they share the characteristics central in Roy's typology of the fatwa in the virtual umma. On the level of content, they are in line with the international literature on Islamic end-of-life ethics. English Sunni e-fatwas make

  9. [Active euthanasia in Colombia and assisted suicide in California].

    Science.gov (United States)

    Julesz, Máté

    2016-01-31

    The institution of active euthanasia has been legal in Colombia since 2015. In California, the regulation on physician-assisted suicide will come into effect on January 1, 2016. The legal institution of active euthanasia is not accepted under the law of the United States of America, however, physician-assisted suicide is accepted in an increasing number of member states. The related regulation in Oregon is imitated in other member states. In South America, Colombia is not the first country to legalize active euthanasia: active euthanasia has been legal in Uruguay since 1932. The North American legal tradition markedly differs from the South American one and both are incompatible with the Central European rule of law. In Hungary and in most European Union countries, solely the passive form of euthanasia is legal. In the Benelux countries, the active form of euthanasia is legal because the supranational law of the European Union does not prohibit it. Notwithstanding, European Union law does not prescribe legalization of either the active form of euthanasia, or the physician-assisted suicide.

  10. Assisted suicide and assisted voluntary euthanasia: Stransham-Ford High Court case overruled by the Appeal Court – but the door is left open

    Directory of Open Access Journals (Sweden)

    David J McQuoid-Mason

    2017-05-01

    Full Text Available Whether persons wishing to have doctor-assisted suicide or voluntary active euthanasia may make a court application based on their rights in the Constitution has not been answered by the Appeal Court. Therefore, if Parliament does not intervene beforehand, such applications can be made – provided the applicants have legal standing, full arguments are presented regarding local and foreign law, and the application evidence is comprehensive and accurate. The Appeal Court indicated that the question should be answered by Parliament because ‘issues engaging profound moral questions beyond the remit of judges to determine, should be decided by the representatives of the people of the country as a whole’. However, the Government has not implemented any recommendations on doctor-assisted suicide and voluntary active euthanasia made by the South African Law Commission 20 years ago. The courts may still develop the law on doctor-assisted death, which may take into account developments in medical practice. Furthermore, ‘the possibility of a special defence for medical practitioners or carers would arise and have to be explored’.

  11. Passive and active euthanasia: what is the difference?

    Science.gov (United States)

    Gesang, Bernward

    2008-06-01

    In order to discuss the normative aspects of euthanasia one has to clarify what is meant by active and passive euthanasia. Many philosophers deny the possibility of distinguishing the two by purely descriptive means, e.g. on the basis of theories of action or the differences between acting and omitting to act. Against this, such a purely descriptive distinction will be defended in this paper by discussing and refining the theory developed by Dieter Birnbacher in his "Tun und Unterlassen". On this basis I will suggest a new definition of active and passive euthanasia.

  12. After the slippery slope: Dutch experiences on regulating active euthanasia.

    Science.gov (United States)

    Boer, Theo A

    2003-01-01

    "When a country legalizes active euthanasia, it puts itself on a slippery slope from where it may well go further downward." If true, this is a forceful argument in the battle of those who try to prevent euthanasia from becoming legal. The force of any slippery slope argument, however, is by definition limited by its reference to future developments which cannot empirically be sustained. Experience in the Netherlands--where a law regulating active euthanasia was accepted in April 2001--may shed light on the strengths as well as the weaknesses of the slippery slope argument in the context of the euthanasia debate. This paper consists of three parts. First, it clarifies the Dutch legislation on euthanasia and explains the cultural context in which it originated. Second, it looks at the argument of the slippery slope. A logical and an empirical version are distinguished, and the latter, though philosophically less interesting, proves to be most relevant in the discussion on euthanasia. Thirdly, it addresses the question whether Dutch experiences in the process of legalizing euthanasia justify the fear of the slippery slope. The conclusion is that Dutch experiences justify some caution.

  13. The new regulation of voluntary euthanasia and medically assisted suicide in the Netherlands.

    Science.gov (United States)

    Janssen, Andre

    2002-08-01

    On 1 April 2002 the Dutch Bill 'Termination of Life on Request and Assisted Suicide (Review Procedures) Act' (Wet toetsing levensbeeindiging op verzoek en hulp bij zelfdoding) came into force. This article starts with an outline of the former legal position in The Netherlands regarding euthanasia and medically assisted suicide, followed by an explanation of the new Act. The main focus of this contribution lays on the requirements of due care, the obligation to notify euthanasia to the coroner and the revised legal position of the so-called Regional Review Commissions. Furthermore, the article considers the termination of life in the case of minors and the function and requirements of written statements of euthanasia by patients no longer capable of communication. Finally, the article gives an overview of the problems [that] may come in the future concerning the approach to euthanasia in The Netherlands.

  14. Active euthanasia and physician-assisted suicide: the German discussion.

    Science.gov (United States)

    Oehmichen, Manfred; Meissner, Christoph

    2003-03-01

    The debate on legalization of active euthanasia in the Netherlands and Belgium and the refused legal right to choose the circumstances of Diana Pretty's own death are the last actual reasons for reconsidering the situation in Germany. Around the world heated debates have broken out on the topic of active euthanasia. Specialists in the field of 'forensic medicine' have taken full part in these discussions. The present survey from the point of view of forensic medicine begins with a look at current terminology and at the laws pertaining to euthanasia in Germany. These laws are then contrasted with actual practice, including a description of the increasing acceptance of active euthanasia by the German population. The main argument against legalization of active euthanasia is that its formal acceptance in law would cause the dam of restraint to burst, culminating in widespread misuse, as already seen in recent serial killings by nurses in hospitals and homes for the elderly around the world. Contrasted with this are the arguments for taking active steps at the end of life, including emotional considerations such as the revulsion against mechanized medicine and the fear of pain and rational arguments such as the necessity to end a 'life unworthy of life', to save medical costs, and obtaining prior consent in 'living wills'. Such considerations have put in jeopardy the moral integrity of the medical profession - and thus the layperson's trust in physicians--around the world. In Germany especially the history of mass killing during the Nazi era constitutes a fundamental argument against active euthanasia. As a consequence, in Germany active euthanasia will not receive legal sanction, although recommendations on rendering dying more bearable are permitted.

  15. [The controversy about so-called "active euthanasia"].

    Science.gov (United States)

    Karbowski, K

    1996-09-17

    In the past few years, the discussion about the right to kill severely ill patients for humanitarian reasons--once called euthanasia and after World War II in the German speaking countries as euphemism called 'aktive Sterbehilfe' (active help to die)--has become more intensive. Actually, only the Netherlands do officially practice euthanasia. But the variant that consists in putting a pharmaceutical at the patient's disposal in order to kill himself is very well known in other countries, e.g. in Switzerland, where the pressure on the legislator to also legalize euthanasia grows. Taking into account medico-ethical reasons, historical experiences, alarming euthanasia ideas in bioethics and social philosophy, the danger due to the impossibility to control the development in this field, and the insidious extension of euthanasia indications, the author rejects firmly the idea of legalized euthanasia. These problems are related to those that occur in fixing the moment of death of potential organ donors. A lack of organs in transplantation medicine should not lead physicians to explant organs from donors in a dying condition. For physicians who take care of potential organ donors and who have to look after their interests towards transplantation teams, it is often too difficult to cope with this task. Local ethical commissions should support them.

  16. [Requests for active euthanasia: which reality in an oncology center.].

    Science.gov (United States)

    Chvetzoff, G; Perret, M; Thevenet, G; Arbiol, E; Gobet, S; Saltel, P

    2009-09-01

    Euthanasia is a controversial issue in today's society. In countries where euthanasia is legal, it is mainly associated with people with cancer. We retrospectively studied the frequency and basis of patients' requests for active euthanasia in the oncology setting.MethodsRecurrent requests for euthanasia made by the patients of Leon-Berard cancer center (Lyon, France) between 2001 and 2003 were recorded by questioning the physicians and nurse supervisors in charge or by collecting information from the minutes of multidisciplinary palliative care meetings. We also collected information on the general health status of the patients, their motives and their evolution over time, as well as responses from caregivers.ResultsWe identified 16 requests for euthanasia. These involved 8 men, 7 women and 1 child (median age, 56 years), corresponding to 1% of the total deaths recorded during the period. In 2 cases, the request had come from the family only. The most frequent motives were psychological distress (38%), desire for self-autonomy (31%) and pain (31%). Half of the patients, particularly those striving for autonomy, persisted with their request until death, whereas 2 of 3 requests motivated by physical or psychological distress were not maintained. Sedation was administered to 3 patients in response to recurrent requests.ConclusionRequests for euthanasia in cancer patients are rare but may occur. Sometimes suffering is not relieved by palliative care and the request is maintained. Dealing with these patients puts caregivers in a difficult situation.

  17. Attitudes toward Euthanasia in Hong Kong--A Comparison between Physicians and the General Public

    Science.gov (United States)

    Chong, Alice Ming-lin; Fok, Shiu-yeu

    2005-01-01

    This article reports the findings of a cross-sectional study that compared the attitudes of 618 respondents of a general household survey and a random sample of 1,197 physicians toward different types of euthanasia in Hong Kong. The general public was found to agree with active euthanasia and non-voluntary euthanasia and was neutral about passive…

  18. Attitudes toward Euthanasia in Hong Kong--A Comparison between Physicians and the General Public

    Science.gov (United States)

    Chong, Alice Ming-lin; Fok, Shiu-yeu

    2005-01-01

    This article reports the findings of a cross-sectional study that compared the attitudes of 618 respondents of a general household survey and a random sample of 1,197 physicians toward different types of euthanasia in Hong Kong. The general public was found to agree with active euthanasia and non-voluntary euthanasia and was neutral about passive…

  19. Euthanasia and related practices worldwide.

    Science.gov (United States)

    Kelleher, M J; Chambers, D; Corcoran, P; Keeley, H S; Williamson, E

    1998-01-01

    The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The "slippery slope" argument is briefly considered.

  20. Attitudes toward euthanasia: implications for social work practice.

    Science.gov (United States)

    Chong, Alice Ming-Lin; Fok, Shiu-Yeu

    2009-01-01

    This article reports the findings of a randomized general household survey that examined the attitudes of 618 Chinese respondents toward different types of euthanasia. The general public is found to agree with active euthanasia and non-voluntary euthanasia, but is neutral about passive euthanasia. Support for euthanasia is predicted by decreasing importance of religious belief, higher family income, experiences in taking care of terminally ill family members, being non-Protestants, and increasing age. Patients were perceived as the chief decision makers in euthanasian decisions. Finally, suggestions on social work practice and professional training are made.

  1. Voluntary euthanasia in Northern Ireland: general practitioners' beliefs, experiences, and actions.

    OpenAIRE

    McGlade, K. J.; Slaney, L; Bunting, B. P.; Gallagher, A G

    2000-01-01

    BACKGROUND: There has been much recent interest in the press and among the profession on the subject of euthanasia and physician-assisted suicide. The BMA recently conducted a 'consensus conference' over the internet to collect views on physician-assisted suicide. Any surveys to date have addressed a variety of specialties; however, no recent surveys have looked at general practitioner (GP) attitudes and experiences. AIM: To explore the attitudes of GPs in Northern Ireland towards the issue o...

  2. The euthanasia debate.

    Science.gov (United States)

    Harris, N M

    2001-10-01

    Debates about the moral dilemmas of euthanasia date back to ancient times. Many of the historical arguments used for and against the practice remain valid today. Indeed, any form of discussion on the subject often provokes emotive responses, both from members of the medical profession and the general public. For this reason alone, the issue will continue to be debated at all levels of society. There are, however, other factors that ensure euthanasia will remain a subject of major controversy within medical, legal and governmental bodies. Firstly, the act of euthanasia itself is illegal, yet in its passive form occurs on a daily basis in many of our hospitals (1). Secondly, medical advances have made it possible to artificially prolong the life of an increasing number of patients far beyond what was possible only a few years ago. Furthermore, we must all contend with the reality that financial constraints are an important consideration in modern health care provision. Finally, there is an ethical difficulty in interpreting the concept of a patient's right, or autonomy, versus the rights and duty of a doctor. Before attempting to answer the questions posed by these issues, it is important to have some accurate definitions of both euthanasia and of the concept of morality. According to the House of Lords Select Committee on Medical Ethics, the precise definition of euthanasia is "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering" (2). The term can be further divided into voluntary and involuntary euthanasia. The former is said to occur if a competent patient makes an informed request for a life terminating event and the latter can be used if a patient does not give informed and specific consent for such treatment. It is the occurrence of involuntary euthanasia which forms one of the main arguments against legalisation. This is discussed in greater detail below. Euthanasia is frequently separated into

  3. A Right to Die?: Ethical Dilemmas of Euthanasia.

    Science.gov (United States)

    Albright, Dianne E.; Hazler, Richard J.

    1992-01-01

    Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…

  4. A Right to Die?: Ethical Dilemmas of Euthanasia.

    Science.gov (United States)

    Albright, Dianne E.; Hazler, Richard J.

    1992-01-01

    Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…

  5. Euthanasia: agreeing to disagree?

    Science.gov (United States)

    2010-01-01

    In discussions about the legalisation of active, voluntary euthanasia it is sometimes claimed that what should happen in a liberal society is that the two sides in the debate “agree to disagree”. This paper explores what is entailed by agreeing to disagree and shows that this is considerably more complicated than what is usually believed to be the case. Agreeing to disagree is philosophically problematic and will often lead to an unstable compromise. PMID:20676776

  6. Euthanasia--again. "Letting die" is not in the patient's best interests: a case for active euthanasia.

    Science.gov (United States)

    Kuhse, H

    1985-05-27

    Recent discussions in the Journal on the subject of euthanasia have relied on intuitive appeals to distinctions traditionally considered to be morally relevant, such as the distinction between acts and omissions (or killing and letting die), or ordinary and extraordinary means of treatment. These discussions remained inconclusive. However, the question of euthanasia no longer remains inconclusive if one adopts the perspective suggested by the United States President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and by the World Medical Assembly--that a doctor should act in his or her patient's best interests. From this vantage point, it is argued, there will be instances when active euthanasia is the proper cause of action.

  7. [Euthanasia in history and the present - in the spectrum between euthanasia and terminal care].

    Science.gov (United States)

    von Engelhardt, Dietrich

    2010-01-01

    Euthanasia signifies in antiquity an easy and happy death and not at all an active termination of life, which was forbidden in the Hippocratic oath, but justified by philosophers. In the Christian middle ages active euthanasia and abortion are explicitly refused. At the beginnings of modern times MORE (1516) and BACON (1623) plead for euthanasia and differentiate for the first time between "euthanasia interior" as a mental preparation and "euthanasia exterior" as a physical and direct termination of life. Around 1900 a change takes place--in medicine as well as in the humanities and arts. The lawyer Karl BINDING and the psychiatrist Alfred HOCHE (1920) support active euthanasia in the case of mental deficiency; similar views are taken by the population. Under the "Third Reich" euthanasia unlawfully is carried out as termination of life without or even against consent. Today oaths, declarations and laws are intended to prevent such a "medicine without humanity" (MITSCHERLICH and MIELKE 1947). Active voluntary euthanasia is under certain conditions allowed by the legislation in some countries (Netherlands, Belgium, Luxembourg). Essential seem the consideration of different types of euthanasia and above all a psychical-mental assistance in the process of dying. The height of culture is measured by dealing with death and dying.

  8. [Euthanasia through history and religion].

    Science.gov (United States)

    Gajić, Vladimir

    2012-01-01

    INTRODUCTION Euthanasia represents an ethical, social, legal and medical issue, which is being disputed more and more frequently worldwide. In Serbia, it is illegal and punishable by law and subject to a prison sentence. Euthanasia verbatim, meaning "good death", refers to the practice of ending a life in order to relieve pain and suffering. It can be voluntary, when a person knowingly declares the wish to end life, and involuntary, when relatives and family make decisions on behalf of patients in coma. It can be active, when a person applies a medical procedure to end life and passive, when medical procedures which can extend a patient's life are not applied. EUTHANASIA THROUGH HISTORY: The term was known in old Greece, and Hippocrates mentioned it in his oath, which is now taken by all doctors in the world, by which they pledge not to apply a medicine which can lead to death of the patients, nor to give such counsel. Euthanasia had its most vigorous impetus in the mid-20th century when it was being carried out deliberately in Nazi Germany. All leading religions from Christianity, over Buddhism, to Islam, are directly or indirectly against any kind of euthanasia. EUTHANASIA TODAY: At the beginning of the 21st century, euthanasia was legalized in several most developed countries in the world, among them the Netherlands, Belgium, Germany, Switzerland, Japan, India and some American and Mexican federal states. The World Medical Association from 82 countries has condemned euthanasia, and called all medical workers who practice euthanasia to reconsider their attitudes and to stop this practice.

  9. [Legal issues of physician-assisted euthanasia. Part II--Help in the dying process, direct and indirect active euthanasia].

    Science.gov (United States)

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2013-01-01

    In Germany, physician-assisted euthanasia involves numerous risks for the attending physician under criminal and professional law. In the absence of clear legal provisions, four different categories of euthanasia have been developed in legal practice and the relevant literature: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. The so-called "help during the dying process" by administering medically indicated analgesic drugs without a life-shortening effect is exempt from punishment if it corresponds to the will of the patient. If the physician omits to give such analgesic drugs although the patient demands them, this is deemed a punishable act of bodily injury. The same applies if the physician administers analgesics against the will of the patient. Medically indicated pain treatment which has a potential or certain life-shortening effect (indirect active euthanasia) is permitted under certain conditions: if there are no alternative and equally suitable treatment options without the risk of shortening the patient's life, if the patient has given his consent to the treatment and if the physician does not act with the intention to kill. The deliberate killing of a dying or terminally ill patient for the purpose of ending his suffering (direct active euthanasia) is prohibited. This includes both deliberately killing a patient against or without his will (by so-called "angels of death") and the killing of a patient who expressly and earnestly demands such an act from his physician (killing on request/on demand). Physician-assisted suicide is generally not liable to punishment in Germany. Nevertheless, the action may be subject to punishment if the physician omits to rescue the life of an unconscious suicide victim. "Palliative sedation" is regarded as a special case. It may become necessary if certain symptoms in the terminal stage of a fatal disease unbearable for the patient cannot be controlled by any other

  10. [Organ donation after active euthanasia in a patient with a neurodegenerative disease].

    Science.gov (United States)

    van Dijk, Gert; Giezeman, Ariane; Ultee, Fred; Hamers, Raoul

    2013-01-01

    In countries where active euthanasia by a physician is allowed under law - Belgium and the Netherlands - physicians are sometimes confronted with patients who want to donate organs after active euthanasia has been performed. This combination of procedures has been reported in Belgium, and this article is the first description of such a case in the Netherlands. It concerns a patient with a neurodegenerative disease who donated organs after euthanasia. The combination of two complex and controversial procedures - active euthanasia and organ donation - raises important ethical, legal and practical issues. It is suggested that with a thorough preparation and a strict separation of both procedures, organ donation after active euthanasia can strengthen patient autonomy and increase the number of donated organs.

  11. Voluntary control of electrogastric activity.

    Science.gov (United States)

    Walker, B B; Lawton, C A; Sandman, C A

    1978-12-01

    The tonic component of the electrogastrogram (EGG) has been shown to differentiate duodenal ulcer patients from healthy individuals (15). It has therefore been of considerable interest to investigate the possibility that individuals can learn to modify electrogastric activity. Using a discriminative conditioning paradigm with analogue feedback (Experiment I), subjects were generally unsuccessful at controlling tonic EGG activity. However, when the conditioning paradigm was altered (Experiment II) it was clear that subjects were able to modify specific electrogastric changes. In addition to EGG, heart rate, respiration, abdominal muscle activity, and digital blood flow were measured in order to assess the physiological concomitants of learned control of gastrointestinal activity. Subjects who evidenced discriminative control also showed the least amount of abdominal muscle activity and reported being the most relaxed. The results of these studies suggest that exploration of the physiological processes underlying the electrical activity of the gastrointestinal system and the ability of individuals to modify this activity may lead to significant clinical and theoretical advances.

  12. [Euthanasia and the doctrine of double effect].

    Science.gov (United States)

    Klein, Martin

    2005-01-01

    Direct active euthanasia is prohibited in most countries while passive and indirect is not. However, many arguments against the legalization of voluntary active euthanasia are flawed. Ethical differences between active and passive or indirect euthanasia are difficult to maintain especially when the passivity of the actor causes death. The crucial point is not activity or passivity but respect for the autonomy of individual human beings. In particular there appears to be little ethical difference between active and indirect euthanasia. Indirect euthanasia has often been justified by the principle of double effect, which traces back to Thomas Aquinas. But resorting to this rule contains a logical fallacy. The principle of double effect does not allow foreseen and unwanted adverse effects of an action to occur when they are avoidable. In terminal sedation, an example for indirect euthanasia, hypoxemia and dehydration can easily be prevented by respirator therapy and fluid administration. Therefore the rule of double effect is not applicable. Indirect and direct active euthanasia cannot be ethically distinguished by resorting to the principle of double effect.

  13. Relational responsibility, and not only stewardship, a Roman Catholic view on voluntary euthanasia for dying and non-dying patients.

    Science.gov (United States)

    Schotsmans, Paul T

    2003-01-01

    The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called "stewardship argument": Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist--and even secular--debate on the legitimacy of euthanasia.

  14. Alberta euthanasia survey: 2. Physicians' opinions about the acceptance of active euthanasia as a medical act and the reporting of such practice.

    Science.gov (United States)

    Verhoef, M J; Kinsella, T D

    1993-01-01

    OBJECTIVE: To ascertain the opinions of Alberta physicians about the acceptance of active euthanasia as a medical act (the "medicalization" of active euthanasia) and the reporting of colleagues practising active euthanasia, as well as the sociodemographic correlates. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Although only 44% of the respondents considered active euthanasia morally "right" at least 70% opted to medicalize the practice if it were legal by restricting it to be performed by physicians and to be taught at medical sites. Even though active euthanasia is criminal homicide in Canada, 33% of the physicians stated that they would not report a colleague participating in the act of anyone, and 40% and 60% stated that they would not report a colleague to medical or legal authorities respectively. Acceptance or rejection of active euthanasia as a medical act was strongly related to religious affiliation and activity (p euthanasia revealed profound incongruities in the opinions of the sample of Alberta physicians concerning their ethical and social duties in the practice of medicine. These data highlight the need for relevant modifications of health education policies concerning biomedical ethics and physicians' obligations to society. PMID:8500030

  15. Euthanasia, virtue ethics and the law.

    Science.gov (United States)

    van Zyl, Liezl

    2002-02-01

    Following the recent revival of virtue ethics, a number of ethicists have discussed the moral problems surrounding euthanasia by drawing on concepts such as compassion, benevolence, death with dignity, mercy, and by inquiring whether euthanasia is compatible with human flourishing. Most of these writers assert, or simply assume, that their arguments concerning the morality of euthanasia also support their views with regard to legislation. I argue, against these writers, that legislation cannot and should not be based on our moral and religious beliefs concerning whether euthanasia allows a person to die a good death. I then outline an Aristotelian approach to the role of law and government in a good society, according to which the task of the legislator is not to ensure that people actually act virtuously, but is instead to make it possible for them to choose to live (and die) well by ensuring that they have access to the goods that are necessary for flourishing. In the second half of the paper I apply this approach to the question of whether voluntary active euthanasia should be legalised by asking (1) whether euthanasia always deprives people of the necessary conditions for flourishing, and (2) whether the option to request euthanasia is ever necessary for flourishing.

  16. The notion of "killing". Causality, intention, and motivation in active and passive euthanasia.

    Science.gov (United States)

    Fuchs, T

    1998-01-01

    As a new approach to the still unsettled problem of a morally significant difference between active and passive euthanasia, the meanings of the notion of killing are distinguished on the levels of causality, intention, and motivation. This distinction allows a thorough analysis and refutation of arguments for the equality of killing and letting die which are often put forward in the euthanasia debate. Moreover, an investigation into the structure of the physician's action on those three levels yields substantial differences between the two ways of acting. As can be demonstrated, only a teleological notion of the organism is able to grasp the characteristic feature of active euthanasia. On this basis it is argued that an action against the organism as a whole must, on the interpersonal level, be at once directed against the patient as a person himself.

  17. Assessing voluntary muscle activation with the twitch interpolation technique.

    Science.gov (United States)

    Shield, Anthony; Zhou, Shi

    2004-01-01

    The twitch interpolation technique is commonly employed to assess the completeness of skeletal muscle activation during voluntary contractions. Early applications of twitch interpolation suggested that healthy human subjects could fully activate most of the skeletal muscles to which the technique had been applied. More recently, however, highly sensitive twitch interpolation has revealed that even healthy adults routinely fail to fully activate a number of skeletal muscles despite apparently maximal effort. Unfortunately, some disagreement exists as to how the results of twitch interpolation should be employed to quantify voluntary activation. The negative linear relationship between evoked twitch force and voluntary force that has been observed by some researchers implies that voluntary activation can be quantified by scaling a single interpolated twitch to a control twitch evoked in relaxed muscle. Observations of non-linear evoked-voluntary force relationships have lead to the suggestion that the single interpolated twitch ratio can not accurately estimate voluntary activation. Instead, it has been proposed that muscle activation is better determined by extrapolating the relationship between evoked and voluntary force to provide an estimate of true maximum force. However, criticism of the single interpolated twitch ratio typically fails to take into account the reasons for the non-linearity of the evoked-voluntary force relationship. When these reasons are examined, it appears that most are even more challenging to the validity of extrapolation than they are to the linear equation. Furthermore, several factors that contribute to the observed non-linearity can be minimised or even eliminated with appropriate experimental technique. The detection of small activation deficits requires high resolution measurement of force and careful consideration of numerous experimental details such as the site of stimulation, stimulation intensity and the number of interpolated

  18. Euthanasia: the Dutch experience.

    Science.gov (United States)

    olde Scheper, T M; Duursma, S A

    1994-01-01

    Although rules about euthanasia have been developed in the Netherlands, euthanasia has not been legalized. We review the historical aspects of euthanasia, its definition and why no distinction is now made between active and passive euthanasia in the Netherlands. The guidelines for euthanasia, in use in the Utrecht University Hospital, are presented and the result of some studies on euthanasia is discussed. Non-treatment decisions were taken in 17.5% of all deaths in 1990 but only 1.8% of all deaths were the result of euthanasia. Life-terminating acts without explicit and persistent request of the patients occurred in 0.8% of all deaths. The most common reasons for requests for euthanasia were loss of dignity in 57%, pain in 46%, distressing mode of dying in 46% and being dependent on others in 33%. Of all medical decisions concerning the end of life 79% related to patients older than 65 years. The guidelines for euthanasia developed in the Netherlands support both patient and physician in the request for euthanasia.

  19. Finnish physicians' attitudes towards active euthanasia have become more positive over the last 10 years.

    Science.gov (United States)

    Louhiala, Pekka; Enkovaara, Heta; Halila, Hannu; Pälve, Heikki; Vänskä, Jukka

    2015-04-01

    Most physicians are against active euthanasia. Very little is known about the possible changes in the attitudes of physicians. A questionnaire was sent to a random sample of 1003 Finnish physicians of working age. A similar questionnaire had been sent to a random sample of Finnish physicians also in 1993 and 2003. The questionnaire consisted of statements about euthanasia, for which the participants were asked to express their agreement or disagreement on a 5-point Likert scale. In general, Finnish physicians' attitudes towards active euthanasia have become considerably more positive. In 2003, 61% of the respondents were against the legalisation of euthanasia and 29% supported it. In 2013, both groups were of equal size (46%). The willingness to perform active euthanasia has not, however, increased significantly, even in a legalised setting. The attitudes of Finnish physicians towards active euthanasia became considerably more positive between 2003 and 2013. There was no significant change, however, in the willingness to practice euthanasia if it became legal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. [Care at the end of life or active euthanasia?].

    Science.gov (United States)

    Husebø, Stein; Husebø, Bettina Sandgathe

    2005-06-30

    Estimates for the next 50 years indicate that the number of European citizens above 65 will increase from today's 15 - 20 % to 30 - 40 %. In the same period the number of patients suffering from dementia wills more than double. Norway has the largest percentage of beds in nursing facilities per capita in Europe, more than twice that of most European countries. The dramatic decrease in birth rates in most European countries, with women seeking education and employment, will make proper care for the majority of the weakest elderly a major European challenge. Painful and unnecessary treatments violating basic human rights for weak elderly people suffering from dementia are widespread. The unnecessary life-prolonging medical treatment of the dying in acute wards incurs enormous costs. Options for euthanasia or palliative care are much debated poles regarding the terminally ill in Europe. If a European aim is to guarantee the frail old, that means us, dignity in their last years of life, several needs must be met. Resources now used on acute medicine must be shared with long-term care. These necessary changes will require strong medical and ethical involvement from all physicians.

  1. Against euthanasia for children: a response to Bovens.

    Science.gov (United States)

    Kaczor, Christopher

    2016-01-01

    If we accept euthanasia for adults, should we also accept voluntary euthanasia for children? In 'Child Euthanasia: Should We Just Not Talk about It?', Luc Bovens answers this question affirmatively. Bovens examines five arguments against extending euthanasia to minors, the arguments being weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care. He rejects each of these arguments. In this paper, I provide a rejoinder for each of his responses. I also critique his view that opponents of euthanasia have extra responsibility to promote palliative care. On the contrary, if euthanasia is legalised, advocates of euthanasia have a special obligation to promote improvements in palliative care.

  2. Euthanasia. Definitions and debate.

    Science.gov (United States)

    Martin, J

    This paper looks at the origins and history of euthanasia and describes active and passive intervention. The author also describes the development of the various organisations advocating euthanasia or supporting those who wish to use it. Public opinion on the subject is explored, as well as the rights of patients and practitioners.

  3. The ethics of killing and letting die: active and passive euthanasia.

    Science.gov (United States)

    McLachlan, H V

    2008-08-01

    In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try (or to continue to try) to prevent each and everyone from dying. In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations.

  4. 77 FR 55487 - Agency Information Collection Activities; Voluntary Customer Survey

    Science.gov (United States)

    2012-09-10

    ... U.S. Customs and Border Protection, Department of Homeland Security, and sent via electronic mail to... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities; Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: 30-Day...

  5. A cardiorespiratory classifier of voluntary and involuntary electrodermal activity

    Directory of Open Access Journals (Sweden)

    Sejdic Ervin

    2010-02-01

    Full Text Available Abstract Background Electrodermal reactions (EDRs can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations. Methods Eight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1 an EDR detector, 2 a respiratory filter and 3 a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary. Results Detected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%. Conclusions The proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

  6. Voluntary activation of trapezius measured with twitch interpolation

    DEFF Research Database (Denmark)

    Taylor, Janet L; Olsen, Henrik Baare; Sjøgaard, Gisela

    2009-01-01

    This study investigated the feasibility of measuring voluntary activation of the trapezius muscle with twitch interpolation. Subjects (n=8) lifted the right shoulder or both shoulders against fixed force transducers. Stimulation of the accessory nerve in the neck was used to evoke maximal twitche...

  7. [Euthanasia in Chile].

    Science.gov (United States)

    Carrasco M, Víctor Hugo; Crispi, Francisca

    2016-12-01

    Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chile’s history in euthanasia and the population’s opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation. In order to have an open discussion in our population about the issue, the debate has to be opened to the citizens, accompanied by clear medical information about the procedure.

  8. EUTHANASIA DALAM PERSPEKTIF HUKUM ISLAM

    Directory of Open Access Journals (Sweden)

    Arifin Rada

    2013-05-01

    Full Text Available Euthanasia is an attempt to end someone life when he/she has an uncurable illness, euthanasia will be done in order to release his/her from suffering his/her illness. In Indonesia, euthanasia can not be done and it is classified as an illegal act. Both in the positive law and the ethics code regulate that performing an euthanasia is not allowed. Regarded to the perspective of Islamic law, also regulated that an active euthanasia is an act that is forbidden and punishable by God with a punishment of hell for those who did.

  9. EUTHANASIA DALAM PERSPEKTIF HUKUM ISLAM

    OpenAIRE

    Arifin Rada

    2013-01-01

    Euthanasia is an attempt to end someone life when he/she has an uncurable illness, euthanasia will be done in order to release his/her from suffering his/her illness. In Indonesia, euthanasia can not be done and it is classified as an illegal act. Both in the positive law and the ethics code regulate that performing an euthanasia is not allowed. Regarded to the perspective of Islamic law, also regulated that an active euthanasia is an act that is forbidden and punishable by God with a punish...

  10. [Euthanasia and the paradox in delegation of life assessment].

    Science.gov (United States)

    Moeschl, Peter

    2002-11-30

    Active euthanasia, a question of individual existence, fundamentally concerns the concept of human society. Although legalizing voluntary euthanasia seems to be consequent in liberal democracy, delegation of the act of homicide leads to a paradox in liberalism: Generalization in the assessment of individual life--as it is necessary in such a context--undermines the fundamental right of the individual for social existence irrespective of any assessment whatsoever. This is reflected by the humanistic principle of human dignity as it has been described by Kant. Conventional jurisdiction, which permits passive and indirect euthanasia but prosecutes active homicide, avoids this fundamental problem. Nevertheless it facilitates a humane demise within the framework of adequate hospice care.

  11. Implications of legalising euthanasia in The Netherlands: greater regulatory control?

    Science.gov (United States)

    Thynne, Kelisiana

    2002-11-01

    Euthanasia has been decriminalised in The Netherlands for the last 30 years, but it was only in April 2001 that the Dutch Parliament legalised voluntary physician-assisted suicide. The legislation incorporates developments in case law, including scope for peer review, and provides common ethical principles for a clear system of control over doctors' actions in regard to patients who request euthanasia. The legalised regulatory system may prove more effective in controlling voluntary and non-voluntary euthanasia in The Netherlands than in countries where euthanasia remains illegal.

  12. The problem of euthanasia and dysthanasia in burns.

    Science.gov (United States)

    Pondĕlicek, I; Königova, R

    1983-09-01

    The authors discuss basic approaches to the problem of defining euthanasia. The definition should maintain the distinction between active and passive and between voluntary and involuntary euthanasia. Some of the recent views of the ethical and moral aspects are mentioned, as well as the reasons for terminating resuscitation in persons who suffer 'brain death' (permanent central nervous system) dysfunction. This problem is a matter of great urgency particularly in the burn centres, dealing with old patients. The authors base the discussion on their clinical experience showing that it is sometimes better that a person should die than continue living in certain desperate states, such as unbearable suffering, severe debilitation, permanent coma etc. However, the problem of euthanasia is in conclusion considered as an open system of question, where the answers are not unanimous. They are complicated with respect to the ethical, forensic aspects and also to the peculiarities of psychology.

  13. Passive euthanasia

    Science.gov (United States)

    Garrard, E; Wilkinson, S

    2005-01-01

    The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an "Ethics Task Force" established by the European Association of Palliative Care (EAPC) in February 2001. It claims that the expression "passive euthanasia" is a contradiction in terms and hence that there can be no such thing. This paper critically assesses the main arguments for the Task Force's view. Three arguments are considered. Firstly, an argument based on the (supposed) wrongness of euthanasia and the (supposed) permissibility of what is often called passive euthanasia. Secondly, the claim that passive euthanasia (so-called) cannot really be euthanasia because it does not cause death. And finally, a consequence based argument which appeals to the (alleged) bad consequences of accepting the category of passive euthanasia. We conclude that although healthcare professionals' nervousness about the concept of passive euthanasia is understandable, there is really no reason to abandon the category provided that it is properly and narrowly understand and provided that "euthanasia reasons" for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons. PMID:15681666

  14. Euthanasia revisited.

    Science.gov (United States)

    Chao, D V K; Chan, N Y; Chan, W Y

    2002-04-01

    Euthanasia is a debatable issue. It is illegal all over the world. The Netherlands is the only country where euthanasia and physician-assisted suicide are openly practised since the physician performing these acts will not be prosecuted under certain circumstances. There were several court cases and court decisions that affected the development of euthanasia and physician-assisted suicide in individual countries. When a patient asked for euthanasia, it was very important to find out the underlying reasons and make all legal means available to relieve the pain and other distressing symptoms.

  15. Attitudes toward active euthanasia among medical students at two German universities.

    Science.gov (United States)

    Clemens, Katri Elina; Klein, Eva; Jaspers, Birgit; Klaschik, Eberhard

    2008-06-01

    There has been an ongoing debate about a legalisation of active euthanasia (AE) in Germany. Palliative care education in German medical schools seeks to foster and cultivate a negative attitude toward AE, but little is known about its effectiveness in this respect. The aim of this study was to assess attitudes toward AE among students with and without palliative medicine tuition (PMT). The link to an anonymised online questionnaire was sent out to 1,092 third, fifth and sixth year medical students (YMS) in August-November 2006 at two German universities: university one (U1) with compulsory and additional optional PMT and university two (U2) without any PMT. Thirteen questions addressed active, passive or indirect euthanasia and physician-assisted suicide (statistic: mean +/- SD (range), Wilcoxon, Whitney U Test, significance p circumstances that lack dignity'. Of all students, 21.1% at U1 and 37.2% at U2 could imagine to perform AE in patients, even though 72.6% at U1 and 78.2% at U2 think its legalisation would promote misuse. The high proportion of pro-AE attitudes gives reason to reconsider both 'standard' and palliative medicine tuition for medical students.

  16. Drugs used for euthanasia in Flanders, Belgium.

    Science.gov (United States)

    Vander Stichele, R H; Bilsen, J J R; Bernheim, J L; Mortier, F; Deliens, L

    2004-02-01

    Our aim was to describe and assess the medicinal products and doses used for euthanasia in a series of cases, identified within an epidemiological death certificate study in Belgium, where euthanasia was until recently legally forbidden and where guidelines for euthanasia are not available. In a random sample of the deaths in 1998 in Belgium, the physicians who signed the death certificates were identified and sent an anonymous mail questionnaire. The questionnaires of the deaths classified as euthanasia cases were reviewed by a multi-disciplinary panel. A total of 22 among 1925 questionnaires pertained to voluntary euthanasia. In 17 cases, detailed information on the euthanatics (medicinal substances used for euthanasia) used was provided. Opioids were used in 13 cases (in 7 as a single drug). Time between last dose and expiry ranged from 4 to 900 min. The panel judged that only in 4 cases effective euthanatics were used. In the end-of-life decision cases perceived by Belgian physicians as euthanasia, pharmacological practices were disparate, although dominated by the use of morphine, in the very late phase of dying, in doses which were unlikely to be lethal. Most physicians clandestinely engaging in euthanasia in Belgium seemed unaware of procedures for guaranteeing a quick, mild and certain death. Information on the pharmacological aspects of euthanasia should be included in the medical curriculum and continuing medical education, at least in countries with a legal framework permitting euthanasia under specified conditions.

  17. [Euthanasia outside Europe].

    Science.gov (United States)

    Julesz, Máté

    2014-08-10

    The passive form of euthanasia is legalized almost in every civilized country. Its active form is not a generally accepted legal institution. In Europe, active euthanasia is legalized only in The Netherlands, Belgium, Luxembourg and Switzerland. In Australia, the Act on the Rights of the Terminally Ill of 1995 legalized the institution of assisted suicide, which is not identical to active euthanasia. The difference lies in the fact that legalized active euthanasia means that the author of a murder is not punishable (under certain circumstances), whilst assisted suicide is not about murder, rather about suicide. In the first case, the patient is killed on his or her request by someone else. In the second case, the patient himself or herself executes the act of self-killing (by the assistance of a healthcare worker). In Australia, the institution of assisted suicide was repealed in 1997. Assisted suicide is legal in four USA member states: in Vermont, Washington, Montana and Oregon. In Uruguay, the active form of euthanasia has been legal since 1932.

  18. Passive Euthanasia

    National Research Council Canada - National Science Library

    E. Garrard; S. Wilkinson

    2005-01-01

    The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an "Ethics Task Force" established by the European Association of Palliative Care (EAPC) in February 2001...

  19. Involuntary euthanasia of severely ill newborns: is the Groningen Protocol really dangerous?

    Science.gov (United States)

    Voultsos, P; Chatzinikolaou, F

    2014-01-01

    Advances in medicine can reduce active euthanasia of newborns with severe anomalies or unusual prematurity, but they cannot eliminate it. In the Netherlands, voluntary active euthanasia among adults and adolescents has been allowed since 2002, when the so-called Groningen Protocol (GP) was formulated as an extension of the law on extremely premature and severely ill newborns. It is maintained that, at bioethical level, it serves the principle of beneficence. Other European countries do not accept the GP, including Belgium. Admissibility of active euthanasia is a necessary, though inadequate, condition for acceptance of the GP. Greece generally prohibits euthanasia, although the legal doctrine considers some of the forms of euthanasia permissible, but not active or involuntary euthanasia. The wide acceptance of passive newborns euthanasia, especially when the gestational age of the newborns is 22-25 weeks ("grey zone"), admissibility of practices within the limits between active and passive euthanasia (e.g., withholding/withdrawing), of "indirect active euthanasia" and abortion of the late fetus, the tendency to accept after-birth-abortion (infanticide) in the bioethical theory, the lower threshold for application of withdrawing in neonatal intensive care units compared with pediatric intensive care units, all the above advocate wider acceptance of the GP. However, the GP paves the way for a wide application of involuntary (or pseudo-voluntary) euthanasia (slippery slope) and contains some ambiguous concepts and requirements (e.g., "unbearable suffering"). It is suggested that the approach to the sensitive and controversial ethical dilemmas concerning the severely ill newborns is done not through the GP, but rather, through a combination of virtue bioethics (especially in the countries of the so-called "Mediterranean bioethical zone") and of the principles of principlism which is enriched, however, with the "principle of mutuality" (enhancement of all values and

  20. Involuntary euthanasia of severely ill newborns: is the Groningen Protocol really dangerous?

    Science.gov (United States)

    Voultsos, P; Chatzinikolaou, F

    2014-01-01

    Advances in medicine can reduce active euthanasia of newborns with severe anomalies or unusual prematurity, but they cannot eliminate it. In the Netherlands, voluntary active euthanasia among adults and adolescents has been allowed since 2002, when the so-called Groningen Protocol (GP) was formulated as an extension of the law on extremely premature and severely ill newborns. It is maintained that, at bioethical level, it serves the principle of beneficence. Other European countries do not accept the GP, including Belgium. Admissibility of active euthanasia is a necessary, though inadequate, condition for acceptance of the GP. Greece generally prohibits euthanasia, although the legal doctrine considers some of the forms of euthanasia permissible, but not active or involuntary euthanasia. The wide acceptance of passive newborns euthanasia, especially when the gestational age of the newborns is 22-25 weeks ("grey zone"), admissibility of practices within the limits between active and passive euthanasia (e.g., withholding/withdrawing), of "indirect active euthanasia" and abortion of the late fetus, the tendency to accept after-birth-abortion (infanticide) in the bioethical theory, the lower threshold for application of withdrawing in neonatal intensive care units compared with pediatric intensive care units, all the above advocate wider acceptance of the GP. However, the GP paves the way for a wide application of involuntary (or pseudo-voluntary) euthanasia (slippery slope) and contains some ambiguous concepts and requirements (e.g., "unbearable suffering"). It is suggested that the approach to the sensitive and controversial ethical dilemmas concerning the severely ill newborns is done not through the GP, but rather, through a combination of virtue bioethics (especially in the countries of the so-called "Mediterranean bioethical zone") and of the principles of principlism which is enriched, however, with the "principle of mutuality" (enhancement of all values and

  1. Maximal force, voluntary activation and muscle soreness after eccentric damage to human elbow flexor muscles

    Science.gov (United States)

    Prasartwuth, O; Taylor, JL; Gandevia, SC

    2005-01-01

    Muscle damage reduces voluntary force after eccentric exercise but impaired neural drive to the muscle may also contribute. To determine whether the delayed-onset muscle soreness, which develops ∼1 day after exercise, reduces voluntary activation and to identify the possible site for any reduction, voluntary activation of elbow flexor muscles was examined with both motor cortex and motor nerve stimulation. We measured maximal voluntary isometric torque (MVC), twitch torque, muscle soreness and voluntary activation in eight subjects before, immediately after, 2 h after, 1, 2, 4 and 8 days after eccentric exercise. Motor nerve stimulation and motor cortex stimulation were used to derive twitch torques and measures of voluntary activation. Eccentric exercise immediately reduced the MVC by 38 ± 3% (mean ±s.d., n = 8). The resting twitch produced by motor nerve stimulation fell by 82 ± 6%, and the estimated resting twitch by cortical stimulation fell by 47 ± 15%. While voluntary torque recovered after 8 days, both measures of the resting twitch remained depressed. Muscle tenderness occurred 1–2 days after exercise, and pain during contractions on days 1–4, but changes in voluntary activation did not follow this time course. Voluntary activation assessed with nerve stimulation fell 19 ± 6% immediately after exercise but was not different from control values after 2 days. Voluntary activation assessed by motor cortex stimulation was unchanged by eccentric exercise. During MVCs, absolute increments in torque evoked by nerve and cortical stimulation behaved differently. Those to cortical stimulation decreased whereas those to nerve stimulation tended to increase. These findings suggest that reduced voluntary activation contributes to the early force loss after eccentric exercise, but that it is not due to muscle soreness. The impairment of voluntary activation to nerve stimulation but not motor cortical stimulation suggests that the activation deficit lies in the

  2. Voluntary activation of human knee extensors measured using transcranial magnetic stimulation.

    Science.gov (United States)

    Goodall, S; Romer, L M; Ross, E Z

    2009-09-01

    The aim of this study was to determine the applicability and reliability of a transcranial magnetic stimulation twitch interpolation technique for measuring voluntary activation of a lower limb muscle group. Cortical voluntary activation of the knee extensors was determined in nine healthy men on two separate visits by measuring superimposed twitch torques evoked by transcranial magnetic stimulation during isometric knee extensions of varying intensity. Superimposed twitch amplitude decreased linearly with increasing voluntary torque between 50 and 100% of mean maximal torque, allowing estimation of resting twitch amplitude and subsequent calculation of voluntary activation. There were no systematic differences for maximal voluntary activation within day (mean +/- s.d. 90.9 +/- 6.2 versus 90.7 +/- 5.9%; P = 0.98) or between days (90.8 +/- 6.0 versus 91.2 +/- 5.7%; P = 0.92). Systematic bias and random error components of the 95% limits of agreement were 0.23 and 9.3% within day versus 0.38 and 7.5% between days. Voluntary activation was also determined immediately after a 2 min maximal voluntary isometric contraction; in four of these subjects, voluntary activation was determined 30 min after the sustained contraction. Immediately after the sustained isometric contraction, maximal voluntary activation was reduced from 91.2 +/- 5.7 to 74.2 +/- 12.0% (P knee extensors.

  3. The theologic ethics of euthanasia.

    Science.gov (United States)

    Vaux, Kenneth L

    1989-01-01

    The implications of a system of theological ethics are explored in relation to passive euthanasia, "double effect euthanasia," and active euthanasia. A religio-moral ethos anchored in beliefs of radical ethical freedom; the sacred origin and destiny of the human soul; persistent sin; and the drama of suffering, death, and transfiguration as a paradigm for difficult choices condones passive euthanasia and counsels the compassionate offer of relief from pain, even with the "double-edged intention" that the analgesia might end the patient's life. Active euthanasia must be proscribed in principle, but the technological advances that have postponed death also create the need for greater physician participation in offering a point of release in the barricade against death that we have erected.

  4. [Limits to euthanasia].

    Science.gov (United States)

    de Kort, Susanne J

    2015-01-01

    A recent survey showed that less than half of Dutch physicians would find it conceivable to grant a request for euthanasia from a patient suffering from psychiatric disease or dementia, or who is tired of life. Because of a broader interpretation by the Regional Review Committees of the official criteria for due care, all recent cases of euthanasia in these specific groups of patients had been accepted. In this commentary it is argued that, following recent social developments in the Netherlands (including cuts in provision of care for the elderly and of mental health care, and a narrowed view about end-of-life issues), the official euthanasia criteria for due care are no longer suitable if we are to avoid a 'slippery slope' effect in cases such as those mentioned above. The criteria of a) a voluntary and well-considered request and b) absence of reasonable treatment alternatives are particularly under pressure. A plea is hold for a return to stricter interpretation of the criteria.

  5. Attitude of doctors toward euthanasia in Delhi, India

    Directory of Open Access Journals (Sweden)

    Sheetal Singh

    2015-01-01

    among the study population to assess the clarity and adequacy of the questions. Reliability and content validity of the questionnaire were established. Reliability was calculated by "Cronbach Alpha" and the value computed was 0.839 the pilot study was conducted in a subset of 30 persons from the same study universe. Data were analyzed using Stata 11.2 and all the P < 0.05 were considered as statistically significant. Association of categorical variables among the groups was compared by using Chi-square/Fisher′s exact test. Student′s t-test was used to compare mean values in the two independent groups, and one-way ANOVA was used for more than two groups. A total of 200 questionnaires were returned out of 400, giving a response rate of 50%. Analysis and Results: Our study provided the evidence that all doctors who responded to the questionnaire knew term euthanasia. This could be due to the fact that these professionals are in close association with issues pertaining to euthanasia in their day to day work. No significant difference seen in the attitude of doctors of different age group toward euthanasia, although younger doctors endorse robustly for euthanasia. This may be because younger doctors are open for addressing these debatable issues proactively. We found no association between gender and attitude toward euthanasia in our study. Conclusion: It is evident from our study that oncologists, hematologists, psychiatrist, and intensivists do not support active euthanasia at all. There is a strong voice in support of voluntary passive euthanasia among psychiatrists and intensivists in our study. However, oncologists and hematologists are not in favor of passive euthanasia.

  6. Euthanasia: India's position in the global scenario.

    Science.gov (United States)

    Shekhar, Skand; Goel, Ashish

    2013-11-01

    Euthanasia requests have increased as the number of debilitated patients rises in both developed and developing countries such as India due to medical, psychosocial-emotional, socioenvironmental, and existential issues amid fears of potential misuse. WORLD'S POSITION: Albania, Colombia, the Netherlands, and Switzerland permit euthanasia conditionally. Australia's legalization of euthanasia has been withdrawn. The United States permits withdrawal of life support. Mexico and Norway permit active euthanasia. INDIA'S POSITION: Following the Aruna Shanbaug case the Supreme Court granted legal sanction to passive, but not active, euthanasia that is valid till the Parliament legislates on euthanasia. HANDLING EUTHANASIA REQUESTS: Acknowledging the complexity of the problem; individualizing the palliative approach; and accepting the 'There is no alternative' or 'There is no answer' (TINA) factor.

  7. Comparison of body-powered voluntary opening and voluntary closing prehensor for activities of daily life

    Directory of Open Access Journals (Sweden)

    Kelsey Berning

    2014-05-01

    Full Text Available Persons with an upper-limb amputation who use a body-powered prosthesis typically control the prehensor through contralateral shoulder movement, which is transmitted through a Bowden cable. Increased cable tension either opens or closes the prehensor; when tension is released, some passive element, such as a spring, returns the prehensor to the default state (closed or open. In this study, we used the Southampton Hand Assessment Procedure to examine functional differences between these two types of prehensors in 29 nondisabled subjects (who used a body-powered bypass prosthesis and 2 persons with unilateral transradial amputations (who used a conventional body-powered device. We also administered a survey to determine whether subjects preferred one prehensor or the other for specific tasks, with a long-term goal of assessing whether a prehensor that could switch between both modes would be advantageous. We found that using the voluntary closing prehensor was 1.3 s faster (p = 0.02 than using the voluntary opening prehensor, across tasks, and that there was consensus among subjects on which types of tasks they preferred to do with each prehensor type. Twenty-five subjects wanted a device that could switch between the two modes in order to perform particular tasks.

  8. Comparison of body-powered voluntary opening and voluntary closing prehensor for activities of daily life.

    Science.gov (United States)

    Berning, Kelsey; Cohick, Sarah; Johnson, Reva; Miller, Laura Ann; Sensinger, Jonathon W

    2014-01-01

    Persons with an upper-limb amputation who use a body-powered prosthesis typically control the prehensor through contralateral shoulder movement, which is transmitted through a Bowden cable. Increased cable tension either opens or closes the prehensor; when tension is released, some passive element, such as a spring, returns the prehensor to the default state (closed or open). In this study, we used the Southampton Hand Assessment Procedure to examine functional differences between these two types of prehensors in 29 nondisabled subjects (who used a body-powered bypass prosthesis) and 2 persons with unilateral transradial amputations (who used a conventional body-powered device). We also administered a survey to determine whether subjects preferred one prehensor or the other for specific tasks, with a long-term goal of assessing whether a prehensor that could switch between both modes would be advantageous. We found that using the voluntary closing prehensor was 1.3 s faster (p = 0.02) than using the voluntary opening prehensor, across tasks, and that there was consensus among subjects on which types of tasks they preferred to do with each prehensor type. Twenty-five subjects wanted a device that could switch between the two modes in order to perform particular tasks.

  9. Euthanasia: is there a case for changing the law?

    Science.gov (United States)

    Griffith, Richard

    2007-06-01

    Calls for a change in the law to allow strictly controlled forms of voluntary euthanasia and assisted dying in the United Kingdom continue following two recent cases. In this article Richard Griffith reviews the current stance of the law on euthanasia and assisted dying and discusses attempts at reform made by Lord Joffe in the Assisted Dying for the Terminally Ill Bill 2005 (HL).

  10. Euthanasia in Belgium, the Netherlands and Luxembourg.

    Science.gov (United States)

    2013-11-01

    Each of the Benelux countries (Belgium, Luxembourg, Netherlands) has enacted legislation that partially decriminalises euthanasia, defined as an act that intentionally terminates someone's life at their request. In the Netherlands and Luxembourg, but not in Belgium, the legislation partially decriminalised assisted suicide at the same time. In all three countries, euthanasia can only be performed by a doctor, in response to the patient's voluntary and well-considered request, and for patients who have an incurable disease that causes unbearable suffering, without any prospect of relief. In the Netherlands, minors can request euthanasia as of the age of 12 years. In 2011, reported euthanasia accounted for about 1% of deaths in Belgium and 3% in the Netherlands. In 75% of cases, cancer was the disease leading to a request for euthanasia. In the Netherlands, the number of cases of euthanasia reported by doctors in surveys matches the number that is officially declared. In Belgium, it is thought that there are as many unreported as reported cases of euthanasia. Since the enactment of euthanasia legislation, fewer deaths involve the intentional administration of lethal drugs without an explicit request from the patient.

  11. A right to die? Euthanasia and the law in Australia.

    Science.gov (United States)

    Bartels, Lorana; Otlowski, Margaret

    2010-02-01

    This article examines the legal regulation of active voluntary euthanasia and assisted suicide in Australia. The Dying with Dignity Bill 2009 (Tas), which was recently defeated by the Tasmanian Parliament, is discussed, as well as other jurisdictions' past and present legislative developments in this context. The recent case law is also considered to ascertain how "mercy killing" or assisted suicide cases are dealt with by the criminal justice system, with particular reference to the case of R v Justins [2008] NSWSC 1194. This is followed by a critical evaluation of the key arguments for and against euthanasia. The article concludes by examining the significance of the Tasmanian Bill and the implications of such legislation.

  12. 16 CFR 1031.5 - Criteria for Commission involvement in voluntary standards activities.

    Science.gov (United States)

    2010-01-01

    ... Commission involvement in the development of voluntary safety standards for consumer products: (a) The... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Criteria for Commission involvement in voluntary standards activities. 1031.5 Section 1031.5 Commercial Practices CONSUMER PRODUCT...

  13. Time-dependent cortical activation in voluntary muscle contraction.

    Science.gov (United States)

    Yang, Qi; Wang, Xiaofeng; Fang, Yin; Siemionow, Vlodek; Yao, Wanxiang; Yue, Guang H

    2011-01-01

    This study was to characterize dynamic source strength changes estimated from high-density scalp electroencephalogram (EEG) at different phases of a submaximal voluntary muscle contraction. Eight healthy volunteers performed isometric handgrip contractions of the right arm at 20% maximal intensity. Signals of the handgrip force, electromyography (EMG) from the finger flexor and extensor muscles and 64-channel EEG were acquired simultaneously. Sources of the EEG were analyzed at 19 time points across preparation, execution and sustaining phases of the handgrip. A 3-layer boundary element model (BEM) based on the MNI (Montréal Neurological Institute) brain MRI was used to overlay the sources. A distributed current density model, LORETA L1 norm method was applied to the data that had been processed by independent component analysis (ICA). Statistical analysis based on a mixed-effects polynomial regression model showed a significant and consistent time-dependent non-linear source strength change pattern in different phases of the handgrip. The source strength increased at the preparation phase, peaked at the force onset time and decreased in the sustaining phase. There was no significant difference in the changing pattern of the source strength among Brodmann's areas 1, 2, 3, 4, and 6. These results show, for the first time, a high time resolution increasing-and-decreasing pattern of activation among the sensorimotor regions with the highest activity occurs at the muscle activity onset. The similarity in the source strength time courses among the cortical centers examined suggests a synchronized parallel function in controlling the motor activity.

  14. Euthanasia: a need for reform.

    Science.gov (United States)

    Moody, Janis

    Recent high profile right-to-die cases have served to heighten the confusion surrounding euthanasia, particularly in relation to active and passive euthanasia. It is apparent that the underlying philosophical basis of the active-passive distinction has led to distortions in the law surrounding this issue, which further compounds the confusion. It is time for a more honest approach to assistance in dying. In the long-term, reform is inevitable and may involve reclassifying passive and active euthanasia as life-terminating acts. Nurses need to have an understanding of the ethical and legal basis of euthanasia to acknowledge and define their possible future role in relation to the provision of life-terminating acts.

  15. Startle activation is additive with voluntary cortical activation irrespective of stimulus modality.

    Science.gov (United States)

    Maslovat, Dana; Drummond, Neil M; Carter, Michael J; Carlsen, Anthony N

    2015-10-01

    When a startling acoustic stimulus (SAS) is presented during a simple reaction time (RT) task, it can trigger the prepared response through an involuntary initiation pathway. Previous research modelling the effects of presenting a SAS at various intervals following a non-startling auditory imperative signal (IS) suggested that involuntary initiation-related neural activation is additive with the voluntary initiation processes. The current study tested the predictions of this additive model when the SAS and IS are of different modalities by using a visual rather than auditory go-signal. Because voluntary RT latencies are delayed for visual stimuli compared to acoustic stimuli, it was hypothesised that the time course of additive activation would be similarly delayed. Participants performed 150 RT trials requiring a targeted 20° wrist extension task with a SAS presented 0-125 ms following a visual go-signal. Results were not different to those predicted by an additive model (p=0.979), yet were significantly different to those predicted by a horse-race model (p=0.037), indicating a joint contribution of voluntary and involuntary activation, even when the IS and SAS are of different modalities. Furthermore, the results indicated that voluntary RT differences due to stimulus modality are attributable to processes that occur prior to the increase in initiation-related activation.

  16. [Notes on euthanasia].

    Science.gov (United States)

    Goic, Alejandro

    2005-03-01

    In the Judeo-Christian tradition, human life is held to be sacred, a semblance of the divine and a gift from God which the individual cannot dispose of at his or her own will. Hence, these monotheistic religions have made of the crime of murder a transgression of God's own commandment not to kill and have extended the applicability of this commandment to the practice of euthanasia and suicide. On the other hand, some non-religious traditions offer plausible reasons favoring euthanasia. This is a delicate matter for physicians, since the Hippocratic tradition forbids euthanasia and because as care-givers they must also bear the psychological, moral and emotional burden of carrying it out. Physicians are trained to preserve life but not to bring it to an end. As human beings, they must always respect the principle of nonmaleficence, and as physicians they must always respect as well the principle of beneficence. It is difficult to accept the fact that ending a human life can be an act of beneficence. In order to differentiate between passive and active euthanasia, the concept of proportionality of medical acts must be brought into consideration. For instance, using high doses of opiates to alleviate pain or withholding the use of an extraordinary method of treatment are not passive acts aimed at ending the life of a terminally ill patient, but medical acts that are reasonable, judicious and proportionate to the condition and irreversibility of a patient's illness. Therefore, so-called passive euthanasia cannot be considered the same as euthanasia. On the other hand, medically assisted suicide is a deceitful form of active euthanasia. The aim of this act is to cause death and the physician is morally responsible for such a death, since he is providing the means for bringing a human life to an end. Many times the desire to die expressed by terminally ill elderly and helpless patients is a request for help and an expression of reproach against a society that allows for

  17. The body as unwarranted life support: a new perspective on euthanasia.

    Science.gov (United States)

    Shaw, David

    2007-09-01

    It is widely accepted in clinical ethics that removing a patient from a ventilator at the patient's request is ethically permissible. This constitutes voluntary passive euthanasia. However, voluntary active euthanasia, such as giving a patient a lethal overdose with the intention of ending that patient's life, is ethically proscribed, as is assisted suicide, such as providing a patient with lethal pills or a lethal infusion. Proponents of voluntary active euthanasia and assisted suicide have argued that the distinction between killing and letting die is flawed and that there is no real difference between actively ending someone's life and "merely" allowing them to die. This paper shows that, although this view is correct, there is even less of a distinction than is commonly acknowledged in the literature. It does so by suggesting a new perspective that more accurately reflects the moral features of end-of-life situations: if a patient is mentally competent and wants to die, his body itself constitutes unwarranted life support unfairly prolonging his or her mental life.

  18. Assisted suicide and euthanasia.

    Science.gov (United States)

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases.

  19. Euthanasia: An Indian perspective.

    Science.gov (United States)

    Sinha, Vinod K; Basu, S; Sarkhel, S

    2012-04-01

    In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or "mercy -killing" of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession. Moreover, undiagnosed depression and possibility of social 'coercion' in people asking for euthanasia put a further question mark on the ethical principles underlying such an act. These concerns have led to strict guidelines for implementing PAS. Assessment of the mental state of the person consenting to PAS becomes mandatory and here, the role of the psychiatrist becomes pivotal. Although considered illegal in our country, PAS has several advocates in the form of voluntary organizations like "death with dignity" foundation. This has got a fillip in the recent Honourable Supreme Court Judgment in the Aruna Shaunbag case. What remains to be seen is how long it takes before this sensitive issue rattles the Indian legislature.

  20. 78 FR 57818 - Commission Participation and Commission Employee Involvement in Voluntary Standards Activities

    Science.gov (United States)

    2013-09-20

    ... From the Federal Register Online via the Government Publishing Office CONSUMER PRODUCT SAFETY COMMISSION 16 CFR Part 1031 Commission Participation and Commission Employee Involvement in Voluntary Standards Activities AGENCY: Consumer Product Safety Commission. ACTION: Notice of proposed...

  1. 75 FR 78257 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Science.gov (United States)

    2010-12-15

    ... in evaluating reports of alleged injuries and adverse reactions from the use of cosmetics. The... HUMAN SERVICES Food and Drug Administration Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary Cosmetic Registration Program AGENCY: Food and Drug...

  2. Dementia and assisted suicide and euthanasia

    NARCIS (Netherlands)

    I.D. de Beaufort (Inez); S. van de Vathorst (Suzanne)

    2016-01-01

    textabstractAbstract : The number of dementia patients requesting euthanasia in the Netherlands has increased over the past five years. The issue is highly controversial. In this contribution we discuss some of the main arguments: the nature of suffering, the voluntariness of the request and the rol

  3. Dementia and assisted suicide and euthanasia

    NARCIS (Netherlands)

    I.D. de Beaufort (Inez); S. van de Vathorst (Suzanne)

    2016-01-01

    textabstractAbstract : The number of dementia patients requesting euthanasia in the Netherlands has increased over the past five years. The issue is highly controversial. In this contribution we discuss some of the main arguments: the nature of suffering, the voluntariness of the request and the

  4. Attitudes of oncologists toward euthanasia in Turkey.

    Science.gov (United States)

    Mayda, Atilla Senih; Ozkara, Erdem; Corapçioğlu, Funda

    2005-09-01

    There have been intensive debates about euthanasia and attempts to change laws on euthanasia in all countries. What doctors and particularly oncologists think about euthanasia must be taken into consideration, as their voices are crucial in this dialogue. The aim of this study was to find out how Turkish doctors approach euthanasia in the context of cancer. A questionnaire was used to collect data from 85 oncologists out of a total 800 in active oncology practice. Of the oncologists surveyed, 43.8% did not object to euthanasia. Some 33.7% had been asked to perform euthanasia and 41.5% believed that euthanasia was performed secretly although it is against the law in Turkey. Forty-two doctors (50.6%) noted that they had withdrawn treatment in patients. Doctors who encounter terminally ill patients with cancer should update their knowledge about patients' rights and euthanasia. Doctors, who are often asked to perform euthanasia, especially in the cancer setting, can help to illuminate the debates about euthanasia.

  5. Physician-assisted suicide, euthanasia, and Christian bioethics: moral controversy in Germany.

    Science.gov (United States)

    May, Arnd T

    2003-01-01

    Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients' wishes, be made in light of commonly shared values, unless these violate the principle of "in dubio pro vita". The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life.

  6. Physiological alterations of maximal voluntary quadriceps activation by changes of knee joint angle.

    Science.gov (United States)

    Becker, R; Awiszus, F

    2001-05-01

    The purpose of this study was to investigate the influence of different angles of the knee joint on voluntary activation of the quadriceps muscle, estimating the ability of a subject to activate a muscle maximally by means of voluntary contraction. Isometric torque measurement was performed on 6 healthy subjects in 5 degrees intervals between 30 degrees and 90 degrees of knee joint flexion. Superimposed twitches at maximal voluntary contraction (MVC) and at a level of 60% and 40% of the MVC were applied and the voluntary activation estimated. At between 30 degrees and 75 degrees of knee flexion, the maximal extension torque increased at an average rate of 2.67 +/- 0.6 Nm/degree, followed by a decline with further flexion. However, throughout the joint-angle range tested, voluntary activation increased on average by 0.37%/degree with a maximum at 90 degrees of flexion. Due to the influence of joint position it is not possible to generalize results obtained at the knee joint angle of 90 degrees of flexion, which is usually used for the quadriceps twitch-interpolation technique. Consequently, it is useful to investigate voluntary activation deficits in knee joint disorders at a range of knee joint angles that includes, in particular, the more extended joint angles used frequently during daily activity.

  7. Eutanasia Euthanasia

    Directory of Open Access Journals (Sweden)

    C. R. Gherardi

    2003-01-01

    Full Text Available Los avances de la medicina en el área tecnológica respecto de la aplicación de métodos de soporte vital en el paciente crítico y las modificaciones culturales que se han operado en la sociedad contemporánea con relación al derecho de los pacientes a decidir sobre el final de sus vidas, hacen imprescindible disponer de una definición de eutanasia que atienda la vigencia de este nuevo escenario. La exclusión de las llamadas formas pasivas y en general de la omisión como procedimiento o conducta posible para la provocación de la muerte y la necesidad de la voluntariedad explícita del paciente delimitarían muy concretamente el concepto de eutanasia. Del mismo modo, una referencia concreta sobre el modo de provocar la muerte debería integrar obligatoriamente su definición. Así, la eutanasia significaría básicamente provocar la muerte de un paciente portador de una enfermedad mortal, a su requerimiento y en su propio beneficio, por medio de la administración de un tóxico o veneno en dosis mortal. Esta definición muy restrictiva separaría la eutanasia de los casos de rechazo de tratamiento, aunque se produjera la muerte como resultado del mismo, y también de las situaciones en que la abstención o el retiro de un soporte vital en el paciente crítico permite la llegada de la muerte.Technological progress in medicine regarding the application of life-sustaining treatment in the critical patient and the cultural changes that have taken place in contemporary society with respect to the patients' right to decide over the end of their lives, demand the existence of a definition of euthanasia that will acknowledge this new scenario. The concept of euthanasia would be very specifically limited by the exclusion of so-called passive forms of euthanasia and of omission as a possible procedure to cause death and the need for the explicit request of the patient involved. Likewise, the definition of euthanasia should include a specific

  8. Percent voluntary inactivation and peak force predictions with the interpolated twitch technique in individuals with high ability of voluntary activation.

    Science.gov (United States)

    Herda, Trent J; Walter, Ashley A; Costa, Pablo B; Ryan, Eric D; Hoge, Katherine M; Stout, Jeffrey R; Cramer, Joel T

    2011-10-01

    The purpose of this study was to examine the sensitivity and peak force prediction capability of the interpolated twitch technique (ITT) performed during submaximal and maximal voluntary contractions (MVCs) in subjects with the ability to maximally activate their plantar flexors. Twelve subjects performed two MVCs and nine submaximal contractions with the ITT method to calculate percent voluntary inactivation (%VI). Additionally, two MVCs were performed without the ITT. Polynomial models (linear, quadratic and cubic) were applied to the 10-90% VI and 40-90% VI versus force relationships to predict force. Peak force from the ITT MVC was 6.7% less than peak force from the MVC without the ITT. Fifty-eight percent of the 10-90% VI versus force relationships were best fit with nonlinear models; however, all 40-90% VI versus force relationships were best fit with linear models. Regardless of the polynomial model or the contraction intensities used to predict force, all models underestimated the actual force from 22% to 28%. There was low sensitivity of the ITT method at high contraction intensities and the predicted force from polynomial models significantly underestimated the actual force. Caution is warranted when interpreting the % VI at high contraction intensities and predicted peak force from submaximal contractions.

  9. Neural activation during submaximal contractions seems more reflective of neuromuscular ageing than maximal voluntary activation

    Directory of Open Access Journals (Sweden)

    Gil eScaglioni

    2016-02-01

    Full Text Available This study aimed at testing the hypothesis that differences in neural activation strategy during submaximal but not maximal plantarflexions exist between young and older men. Eleven young men (YM, 26±4 yr and 13 OM (76±3 yr volunteered for the investigation. Maximal voluntary torque (MVT was 38.2%, lower (P<0.001 in OM than in YM, while voluntary activation was equivalent (~97%. The relationship between the interpolated twitch-torque and the voluntary torque (IT-VT relationship was composite (curvilinear+exponential for both age-groups. However, the OM showed accentuated concavity, as attested by the occurrence of the deviation from linearity at a lower contraction intensity (OM: 54.9 vs. YM: 71.9% MVT. In conclusion, ageing does not affect the capacity to fully activate the plantar flexors during maximal performances, but it alters the activation pattern for submaximal levels of effort. The greater age-related concavity of the IT-VT relationship suggests that, during submaximal contractions, OM need to reach a level of activation higher than YM to develop an equivalent relative torque.

  10. Intensive care unit nurses' opinions about euthanasia.

    Science.gov (United States)

    Kumaş, Gülşah; Oztunç, Gürsel; Nazan Alparslan, Z

    2007-09-01

    This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011).

  11. Attitudes of Catholic and Protestant clergy on euthanasia and abortion.

    Science.gov (United States)

    Nagi, M H; Pugh, M D; Lazerine, N G

    1981-01-01

    The attitudes of a random sample of 614 Catholic and Protestant clergymen from the Cleveland area were analyzed in relation to the following: 1) acceptance of euthanasia; 2) the establishment of legal guidelines; and 3) the similarity between euthanasia and abortion. In general the clergy were not opposed to all forms of euthanasia. They tended to make strong distinctions between passive and active euthanasia. Active euthanasia was highly unacceptable to the clergy, but they viewed passive euthanasia more favorably. There was a definite ranking in priority of the different circumstances under which the termination of life-supporting techniques would be acceptable to the clergy. Also significant was the fact that they did not tend to evaluate the issues surrounding euthanasia completely from a spiritual, or sacred perspective. Both Protestants and Catholics tended to approve of passive euthanasia, but they highly disapproved of active euthanasia. Catholics were significantly more opposed to both forms of euthanasia. In general conservative Protestants were more opposed to passive euthanasia on most dimensions than were Catholics. Both Catholic and Protestant clergy showed fear that official approval of types of euthanasia would spread into abuses. Although spiritually oriented clergy tended to show somewhat less unfavorable views on euthanasia when compared with abortion, generally, appreciable differences or role types on this particular sub-dimension was lacking.

  12. Pavlov's conceptualization of voluntary movements within the framework of the theory of higher nervous activity.

    Science.gov (United States)

    Windholz, G

    1998-01-01

    Pavlov became interested in the nature of voluntary movements after receiving Konorski and Miller's letter in 1928 describing their experiments on conditioning of motor movements in dogs. Their paradigmatic experiment involved presenting an indifferent stimulus, followed by passive raising of the dog's leg and then reinforcement. If the same stimulus was provided during a number of trials, the animal lifted its corresponding leg. In 1928 Pavlov asked his students to condition motor movements in his laboratory. Although their findings were equivocal, Pavlov incorporated the so-called voluntary movements into his theory of higher nervous activity. Voluntary movements were responses to external environmental contingencies. On the cortical level, the motor analyzer's cells had both afferent and efferent functions. In Pavlov's view, the motor analyzer's cells established connections with the afferent cells of other sensory analyzers. Pavlov held that motor movements, as responses to external and internal environments, give humans the illusion of voluntary behavior.

  13. Trainability of muscular activity level during maximal voluntary co-contraction: comparison between bodybuilders and nonathletes.

    Directory of Open Access Journals (Sweden)

    Sumiaki Maeo

    Full Text Available Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE. Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes. The electromyograms (EMGs of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE. The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (P<0.01 than those for nonathletes (biceps brachii: 66±14% in bodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%. There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03. Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction.

  14. [Euthanasia - an attempt to organize issue].

    Science.gov (United States)

    Kirmes, Tomasz; Wilk, Mateusz; Chowaniec, Czesław

    This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide. Any form of euthanasia is illegal in Poland according to both the Penal Code and Code of Medical Ethics. Range of possible penal consequences perpetrator is very wide from waiver of punishment to life imprisonment and it comes from different penal qualification of the euthanasia. Qualification of the euthanasia is based on terms of intent of perpetrator's act, request of patient, strong empathy for suffering if the patient and decision based on up-to-date medical knowledge. It is valuable to mention "do-not-resuscitate" DNR procedure, which in case of medical futility is legally accepted in Poland, but in other form may be qualified as passive euthanasia.

  15. Voluntary activation during maximal contraction with advancing age: a brief review.

    Science.gov (United States)

    Klass, Malgorzata; Baudry, Stéphane; Duchateau, Jacques

    2007-07-01

    It is well established that the loss of muscle mass (i.e. sarcopenia) is the primary factor contributing to the reduction in muscle force with ageing. Based on the observation that force declines at a faster rate than muscle mass, neural alterations are also thought to contribute to muscle weakness by reducing central drive to the agonist muscles and by increasing coactivation of the antagonist muscles. Researchers have attempted to quantify the contribution of impaired voluntary drive to the decline in muscle force using superimposed electrical stimulation during maximal voluntary contractions (MVCs) and by recording surface electromyographic (EMG) activity. Although reduced voluntary activation of agonist muscles and increased coactivation of antagonist muscles during a MVC have been reported with advancing age, such changes are not supported by all studies. These discrepancies may be explained by differences in sensitivity between the methods used to assess voluntary activation, as well as differences between the characteristics of the study population, the muscle group that is tested, and the type of contraction that is performed. The objective of this review is to summarize current knowledge regarding the activation of agonist and antagonist muscles during MVC in elderly and to try to clarify the disparities in literature concerning the influence of a possible deficit in voluntary activation on the maximal force capacity of muscles in elderly adults.

  16. The Legitimacy of Prohibiting Euthanasia

    Directory of Open Access Journals (Sweden)

    Gildenhuys, Peter

    2015-10-01

    Full Text Available ohn Arras argues against the legalization of physician- assisted suicide and active euthanasia on the basis of social costs that he anticipates will result from legalization. Arras believes that the legalization of highly restricted physician-assisted suicide will result in the legalization of active euthanasia without special restrictions, a prediction I grant for the sake of argument. Arras further anticipates that the practices of physician-assisted suicide and euthanasia will be abused, so that many patients who engage in these practices will lose out as a result. He refers to these losses as social costs to legalization. But the social costs at play in typical public policy debates are borne by individuals other than the agent who engages in the controversial activity, specifically by people who cannot be held responsible for enduring those costs. Even if plausible interpretations of Arras’ predictions about the abuse of the practice are granted, legalization of physician-assisted suicide or euthanasia brings no social costs of this latter sort. For this reason, and also because a ban on euthanasia is unfair to those who would profit from it, the losses in utility brought about by legalization would have to be very great to justify a ban.

  17. Motivation and benefits of voluntary activities. Case study: EYOF 2013 Braşov

    Directory of Open Access Journals (Sweden)

    Codruţa Adina BĂLTESCU

    2016-07-01

    Full Text Available Voluntary activities have become natural concerns among an increasing number of European citizens. Romania, as a member state of the EU, has a low number of participations in voluntary activities, situation partly justified by the lack of presence of our country on the map of large scale events organization which is based to a high extent, on volunteers’ involvement. The present paper presents the results of a quantitative marketing research organized among volunteers who participated at EYOF 2013 Braşov and highlights the participation’s motivations and benefits felt by volunteers at the end of the event. The authors of the article highlight the differences reported between volunteers’ expectations and their opinions after the event, the results obtained being considered useful for planning the voluntary activities in organizing future events hosted in our country.

  18. Voluntary stand-up physical activity enhances endurance exercise capacity in rats

    Science.gov (United States)

    Seo, Dae Yun; Lee, Sung Ryul; Kwak, Hyo-Bum; Seo, Kyo Won; McGregor, Robin A; Yeo, Ji Young; Ko, Tae Hee; Bolorerdene, Saranhuu; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo

    2016-01-01

    Involuntary physical activity induced by the avoidance of electrical shock leads to improved endurance exercise capacity in animals. However, it remains unknown whether voluntary stand-up physical activity (SPA) without forced simulating factors improves endurance exercise capacity in animals. We examined the eff ects of SPA on body weight, cardiac function, and endurance exercise capacity for 12 weeks. Twelve male Sprague-Dawley rats (aged 8 weeks, n=6 per group) were randomly assigned to a control group (CON) or a voluntary SPA group. The rats were induced to perform voluntary SPA (lifting a load equal to their body weight), while the food height (18.0 cm) in cages was increased progressively by 3.5 every 4 weeks until it reached 28.5 cm for 12 weeks. The SPA group showed a lower body weight compared to the CON group, but voluntary SPA did not affect the skeletal muscle and heart weights, food intake, and echocardiography results. Although the SPA group showed higher grip strength, running time, and distance compared to the CON group, the level of irisin, corticosterone, genetic expression of mitochondrial biogenesis, and nuclei numbers were not affected. These findings show that voluntary SPA without any forced stimuli in rats can eff ectively reduce body weight and enhance endurance exercise capacity, suggesting that it may be an important alternative strategy to enhance endurance exercise capacity. PMID:27162483

  19. Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb.

    Science.gov (United States)

    Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2014-02-15

    With fatiguing exercise, firing of group III/IV muscle afferents reduces voluntary activation and force of the exercised muscles. These afferents can also act across agonist/antagonist pairs, reducing voluntary activation and force in nonfatigued muscles. We hypothesized that maintained firing of group III/IV muscle afferents after a fatiguing adductor pollicis (AP) contraction would decrease voluntary activation and force of AP and ipsilateral elbow flexors. In two experiments (n = 10) we examined voluntary activation of AP and elbow flexors by measuring changes in superimposed twitches evoked by ulnar nerve stimulation and transcranial magnetic stimulation of the motor cortex, respectively. Inflation of a sphygmomanometer cuff after a 2-min AP maximal voluntary contraction (MVC) blocked circulation of the hand for 2 min and maintained firing of group III/IV muscle afferents. After a 2-min AP MVC, maximal AP voluntary activation was lower with than without ischemia (56.2 ± 17.7% vs. 76.3 ± 14.6%; mean ± SD; P muscle afferents from the hand decreased voluntary drive and force of AP. Moreover, this effect decreased voluntary drive and torque of proximal unfatigued muscles, the elbow flexors. Fatigue-sensitive group III/IV muscle nociceptors act to limit voluntary drive not only to fatigued muscles but also to unfatigued muscles within the same limb.

  20. The repeated bout effect of eccentric exercise is not associated with changes in voluntary activation.

    Science.gov (United States)

    Kamandulis, Sigitas; Skurvydas, Albertas; Brazaitis, Marius; Skikas, Laimutis; Duchateau, Jacques

    2010-04-01

    The aim of this study was to compare the possible changes in muscle activation level between a first and second bout of damaging eccentric exercise performed at 2 weeks interval (i.e. repeated bout effect). To that purpose, ten physically active males took part in this study. The eccentric exercise consisted of 10 sets of 12 maximal voluntary contractions (MVC) produced by the knee extensors during movements performed at a constant speed of 160 degrees s(-1). Changes in voluntary and electrically evoked torque in concentric and/or isometric conditions were assessed at the following time points: pre-exercise, and 2 min, 1 and 24 h after each eccentric exercise. At the same time points, voluntary activation was quantified by the superimposed electrical stimulation technique. Muscle soreness and plasma CK activity were measured within 48 h after the eccentric exercise. The results showed that the decrease in eccentric peak torque was linear throughout the exercise protocol. At the end of bouts 1 and 2, torque was significantly reduced by 27.7 +/- 9.1 and 23.4 +/- 11.2, respectively, with no difference between bouts (P > 0.05). At 24 h post-exercise, a lower reduction (P eccentric exercise appears to reduce muscle damage, but does not influence the level of voluntary activation.

  1. Intrinsic muscle strength and voluntary activation of both lower limbs and functional performance after stroke.

    Science.gov (United States)

    Horstman, Astrid M; Beltman, Marijke J; Gerrits, Karin H; Koppe, Peter; Janssen, Thomas W; Elich, Peter; de Haan, Arnold

    2008-07-01

    The objective of this study was to assess the nature of muscle weakness in both legs after stroke compared with able-bodied control individuals and to examine whether there is a relationship between the degree of muscle weakness and coactivation of knee extensors and flexors as well as voluntary activation capacity of knee extensors of both paretic and non-paretic legs and indices of functional performance. Maximal voluntary isometric torques of knee extensors (MVCe) and flexors (MVCf) were determined in 14 patients (bilaterally) and 12 able-bodied controls. Simultaneous measurements were made of torque and surface EMG from agonist and antagonist muscles. Coactivation was calculated. Supramaximal triplets were evoked with electrical stimulation to estimate maximal torque capacity and degree of voluntary activation of knee extensors. MVCs, activation and coactivation parameters were correlated to scores of seven functional performance tests. MVCe, MVCf and voluntary activation were lower in paretic lower limb (PL) compared with both non-paretic lower limb (NL) and control. Besides, all these parameters of NL were also lower than control. Electrically evoked torque capacity of knee extensors of PL was about 60% of both NL and control, which were not significantly different from each other. Strong significant correlations between strength, as well as voluntary activation, and functional performance were found. Coactivation did not correlate well with functional performance. Thus, whereas for NL activation failure can explain weakness, for PL both activation failure and reduced intrinsic torque capacity are responsible for the severe weakness. Activation capacity and muscle strength correlated strongly to functional performance, while coactivation did not.

  2. Measurement of voluntary activation based on transcranial magnetic stimulation over the motor cortex.

    Science.gov (United States)

    Todd, Gabrielle; Taylor, Janet L; Gandevia, Simon C

    2016-09-01

    This article reviews the use of transcranial magnetic stimulation (TMS) over the motor cortex to make estimates of the level of voluntary drive to muscles. The method, described in 2003 (Todd et al. J Physiol 551: 661-671, 2003), uses a TMS pulse to produce descending corticospinal volleys that synaptically activate motoneurons, resulting in a muscle twitch. Linear regression of the superimposed twitch amplitude and voluntary force (or torque) can generate an "estimated" resting twitch for muscles involved in a task. This procedure has most commonly been applied to elbow flexors but also to knee extensors and other muscle groups. Data from 44 papers using the method were tabulated. We identify and discuss five major technical challenges, and the frequency with which they are addressed. The technical challenges include inadvertent activation of the cortical representation of antagonist muscles, the role of antagonist torques at the studied joint, uncertainty about the effectiveness of the TMS pulse in activating the motoneuron pool, the linearity of the voluntary force (or torque) and superimposed twitch relationship, and variability in the TMS-evoked EMG and force/torque responses. The ideal situation in which the descending corticospinal volleys recruit all of the agonist motoneurons and none of the antagonist motoneurons is unlikely to ever occur, and hence results must be carefully examined to assess the authenticity of the voluntary activation estimates in the context of the experimental design. A partial compromise lies in the choice of stimulus intensity. We also identify aspects of the procedure that require further investigation.

  3. Voluntary Activity of Polish People and Its Motives in Recent Years: New Volunteering

    Science.gov (United States)

    Kosewska, Bernadetta

    2015-01-01

    This article covers an issue or the phenomenon of volunteering. The introduction is a recall of a definition of volunteering. Then it shows the distribution of voluntary activity in different countries of the European Union in order to look at some aspects of the phenomenon in the microscale of one country--Poland. It shows the percentage of…

  4. Voluntary access to a warm plate reduces hyperactivity in activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; de Rijke, Corine E; Brakkee, Jan H; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa. In ABA, scheduled feeding in combination with voluntary wheel running leads to hyperactivity, reduced food intake, severe body weight loss and hypothermia. In this study it was investigated whether hyperactivity in ABA

  5. Deficiencies of regulation of euthanasia in legal acts of foreign countries

    Directory of Open Access Journals (Sweden)

    Polaks R.

    2014-01-01

    Full Text Available Today in most countries the practising of euthanasia is not permissible and as in any case of a criminal offence, which endangers the life of a person, criminal liability applies here. However, the analysis of legal norms in foreign criminal codes reveals several deficiencies, ranging from – the absence of legal regulation which leads to a paradoxical situation, when ignoring the motive and aim of the offence, euthanasia is qualified according to the article of the criminal code which provides for liability for murder with no mitigating circumstances, but assisted suicide liability does not apply at all, – to including special legal norms pertaining to this problematic issue, in the structure of criminal codes, in the disposition of which there is an absence of several mandatory constituent elements of these particular criminal offences, thus unduly extending the provision of these norms in practice also in the cases not related to “easy death”. The deficiencies of legal acts are observed also in those few countries which allow a definite form of euthanasia and its practising by means of special laws. And most importantly, foreign legislators ignore such forms of terminating the lives of incurably ill persons as active and passive non-voluntary euthanasia, which depending on the nature of the offence requires an appropriate legal framework, which so far has not been observed.

  6. Alberta Euthanasia Survey: 3-year follow-up.

    Science.gov (United States)

    Verhoef, M J; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 to 1146 physicians who could be traced through the 1994 Medical Directory of the provincial college of physicians and surgeons; 25 questionnaires were returned because they could not be delivered. OUTCOME MEASURES: Physicians' opinions about (a) the morality of active euthanasia, (b) changes in the law to permit active euthanasia and (c) the practice of legalized euthanasia. RESULTS: Of the 1121 physicians sent a follow-up questionnaire 866 (77%) returned it completed. The responses of these same 866 physicians in 1991 provided a basis for comparison. Of the 866, 360 (42%) stated in the 1994 survey that it is sometimes right to practise active euthanasia; a similar proportion (384 [44%]) gave this response in 1991. However, other opinions changed significantly. In 1991, 250 of the respondents (29%) indicated that they would practise active euthanasia if it were legalized, as compared with 128 (15%) in 1994 (p euthanasia, as compared with 316 (37%) in 1994 (p euthanasia between 1991 and 1994, in both surveys at least 70% of those who responded to this question indicated that active euthanasia, if it were legalized, should be performed only by physicians and should be taught at medical sites. CONCLUSION: Alberta physicians' support for the practice and legalization of active euthanasia decreased considerably between 1991 and 1994. However, most physicians remain in favour of restricting active euthanasia, if it were legalized, to the medical profession. These results suggest a

  7. [Attitudes towards euthanasia: The impact of experiencing end-of-life care].

    Science.gov (United States)

    Köhler, Norbert; Brähler, Elmar; Götze, Heide

    2014-01-01

    It is a matter of debate whether euthanasia should be part of medical practice. The current study investigates the attitudes of bereaved family members of cancer patients towards euthanasia. We conducted a survey with 211 people who had recently lost a close relative to cancer. Participants were asked whether euthanasia should be part of medical practice.Two logistic regression models were calculated in order to determine the factors influencing the attitude towards active euthanasia and assisted suicide. About 70% and 75% of the respondents approved active euthanasia and assisted suicide, respectively. Religious denomination and psychological distress had a significant impact on the attitude towards active euthanasia. About 10%of the deceased patients had asked for active euthanasia. There was no difference between bereaved family members and the general population regarding the acceptance of euthanasia. Attitudes towards active euthanasia are associated with psychological distress and shaped by cultural values rather than by the experience of end-of-life care.

  8. Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls

    DEFF Research Database (Denmark)

    Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela

    2017-01-01

    Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of...

  9. [Passive euthanasia and living will].

    Science.gov (United States)

    Julesz, Máté

    2014-07-06

    This article deals with the intentional distinction between murder of first degree and passive euthanasia. In Hungary, active euthanasia is considered to be a murder of first degree, whilst the Netherlands, Belgium, Luxemburg and Switzerland have legalized the active form of mercy killing in Europe. The palliative terminal care, when e.g. giving pain-killer morphine to the patient, might result in decreasing the patient's life-span, and thus causing indirect euthanasia. However, the legal institution of living will exists in several counter-euthanasia countries. The living will allows future patients to express their decision in advance to refuse a life-sustaining treatment, e.g. in case of irreversible coma. The institution of living will exists in Germany and in Hungary too. Nevertheless, the formal criteria of living will make it hardly applicable. The patient ought to express his/her will before a notary public in advance, and he/she should hand it over when being hospitalized. If the patient is not able to present his/her living will to his/her doctor in the hospital, then his/her only hope remains that he/she has given a copy of the living will to the family doctor previously, and the family doctor will notify the hospital.

  10. Professed religious affiliation and the practice of euthanasia.

    Science.gov (United States)

    Baume, P; O'Malley, E; Bauman, A

    1995-01-01

    Attitudes towards active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) among 1,238 doctors on the medical register of New South Wales varied significantly with self-identified religious affiliation. More doctors without formal religious affiliation ('non-theists') were sympathetic to AVE, and acknowledged that they had practised AVE, than were doctors who gave any religious affiliation ('theists'). Of those identifying with a religion, those who reported a Protestant affiliation were intermediate in their attitudes and practices between the agnostic/atheist and the Catholic groups. Catholics recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic medical respondents who had been so requested, recorded that they had taken active steps to bring about the death of patients. PMID:7776349

  11. Euthanasia: moral paradoxes.

    Science.gov (United States)

    ten Have, H A

    2001-11-01

    Over the past 30 years, euthanasia has been under continuous debate in The Netherlands. This contribution aims to provide a moral assessment of this debate. It is argued that euthanasia should be understood within a historical context, as a protest against medical power and as a way to bring about good death. Within the euthanasia debate, two paradoxes are identified which make the issue inherently complex and hard to regulate. The first paradox results from the dialectical relation between individual autonomy and relief of suffering as the major justifications of euthanasia. Although euthanasia represents an ultimate effort to give the individual patient control over his dying, the result of the debate is an increase of medical power. The second paradox is that although euthanasia emerged from a commitment to good death, it is resulting in a reduced range of options to bring about good death.

  12. Euthanasia: the legal issues.

    Science.gov (United States)

    Chaloner, C; Sanders, K

    The legal status of euthanasia is frequently deliberated. It remains unlawful in Britain and advocates for a change in the law are vigorously opposed by those who argue that it should remain unchanged. An objective account, in which current law and arguments for and against change are exposed, is essential to inform the euthanasia debate. In this article the legal issues concerning euthanasia are examined and arguments raised by proposed changes in the law are considered.

  13. The relationships among sprint performance, voluntary swimming activity, and social dominance in juvenile rainbow trout.

    Science.gov (United States)

    McDonald, D G; Keeler, R A; McFarlane, W J

    2007-01-01

    The specific objectives of this study were to determine whether sprint performance in juvenile rainbow trout is correlated with either voluntary swimming activity or aggressive behaviors and to determine the reciprocal: the effect of swimming activity and aggression on sprint performance. Sprint performance was assessed by rapidly accelerating trout (5-7-cm fork length) to a fixed velocity (40, 42, or 45 cm s(-1)) and then holding them at that velocity until fatigue. There was considerable interindividual variation in sprint performance not explained by variations in body size, but intraindividual performance was highly repeatable over at least 2 mo. Voluntary swimming was measured as the frequency of transits (voluntary transit activity, VTA) between two identical tanks via a connecting channel with two different flow regimes: zero or minimum velocity (0 or 2.5 cm s(-1)) and high velocity (84 cm s(-1)). There was a strong correlation between sprint performance and VTA in minimal current but no correlation in high current. Furthermore, sprint performance did not predict the outcome of dominance encounters. Experience with rapid acceleration, especially when voluntary, led to a pronounced improvement in sprint performance in proportion to the number of acceleration events. Social dominance encounters had a more complex effect: a significant reduction in sprint performance in previously high-performance sprinters and the reverse for low performers. We propose that there are four independent axes of interindividual variation in juvenile rainbow trout: spontaneous and rheotaxis-stimulated locomotor activity, aggressive activity, and the trainability of sprint performance. The independence of these axes has the potential to produce a much larger diversity in behavioral and ultimately physiological phenotypes than would be produced if the axes were linked.

  14. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    2006-01-01

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated" contractio

  15. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    2006-01-01

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated"

  16. Euthanasia: Some Legal Considerations

    Science.gov (United States)

    Koza, Pamela

    1976-01-01

    Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)

  17. Euthanasia: Some Legal Considerations

    Science.gov (United States)

    Koza, Pamela

    1976-01-01

    Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)

  18. Battlefield euthanasia - courageous compassion or war crime?

    Science.gov (United States)

    Neuhaus, Susan J

    2011-03-21

    Issues relating to voluntary euthanasia that are currently being debated by Australian society are distinctly different from those encountered by battlefield doctors. Doctors in war undertake to treat those affected by conflict; their participation in euthanasia challenges the profession's definition of "duty of care". Euthanasia must be distinguished from "triage" and medical withdrawal of care (which are decided within a medical facility where, although resources may be limited, comfort care can be provided in the face of treatment futility). Battlefield euthanasia is a decision made, often immediately after hostile action, in the face of apparently overwhelming injuries; there is often limited availability of pain relief, support systems or palliation that would be available in a civilian environment. The battlefield situation is further complicated by issues of personal danger, the immediacy of decision making and difficulties with distinguishing civilians from combatants. Regardless of the circumstances on a battlefield, doctors, whether they are civilians or members of a defence force, are subject to the laws of armed conflict, the special provisions of the Geneva Conventions and the ethical codes of the medical profession.

  19. Changes in voluntary quadriceps activation predict changes in muscle strength and gait biomechanics following knee joint effusion.

    Science.gov (United States)

    Pietrosimone, Brian; Lepley, Adam S; Murray, Amanda M; Thomas, Abbey C; Bahhur, Nael O; Schwartz, Todd A

    2014-09-01

    It has been hypothesized that arthrogenic muscle inhibition is responsible for altering physical function following knee injury. The association between the onset of arthrogenic muscle inhibition, measured using voluntary quadriceps activation, and changes in muscle strength and gait biomechanics are unknown. Outcomes were collected before and following a 60 ml experimental knee effusion in eighteen healthy participants. Voluntary quadriceps activation was the predictor variable, while the criterion variable included, maximal voluntary isometric strength, peak knee flexion angle, peak internal knee extension moment, and peak vertical ground reaction forces during the first half of stance phase upon stair descent. Percent change scores (Δ) were imputed into linear regression equations to determine associations between predictor and criterion variables. The variance in Δ voluntary quadriceps activation significantly predicted 87% the variance in the Δ strength (R(2)=0.87, Pknee flexion angle, Δ voluntary quadriceps activation predicted an additional 29% (Δ R(2)=0.29, P=0.007) of the variance in the Δ knee extension moment (R(2)=0.54, P=0.003, Δ knee extension moment=-10.79+0.74Δ knee flexion angle+1.64Δ voluntary quadriceps activation) following knee effusion. Immediate quadriceps activation deficits following joint effusion result in immediate alterations in muscle strength, knee extensor moment and vertical ground reaction force during gait. Published by Elsevier Ltd.

  20. Maximal intermittent contractions of the first dorsal interosseous inhibits voluntary activation of the contralateral homologous muscle.

    Science.gov (United States)

    Kavanagh, Justin J; Feldman, Matthew R; Simmonds, Michael J

    2016-09-07

    The aim of this study was to investigate how maximal intermittent contractions for a hand muscle influence cortical and reflex activity, as well as the ability to voluntarily activate, the homologous muscle in the opposite limb. Twelve healthy subjects (age: 24 ± 3 years, all right hand dominant) performed maximal contractions of the dominant limb first dorsal interosseous (FDI), and activity of the contralateral FDI was examined in a series of experiments. Index finger abduction force, FDI EMG, motor evoked potentials and heteronomous reflexes were obtained from the contralateral limb during brief non-fatiguing contractions. The same measures, as well as the ability to voluntarily activate the contralateral FDI, were then assessed in an extended intermittent contraction protocol that elicited fatigue. Brief contractions under non-fatigued conditions increased index finger abduction force, FDI EMG, and motor evoked potential amplitude of the contralateral limb. However, when intermittent maximal contractions were continued until fatigue, there was an inability to produce maximal force with the contralateral limb (~30%) which was coupled to a decrease in the level of voluntary activation (~20%). These declines were present without changes in reflex activity, and regardless of whether cortical or motor point stimulation was used to assess voluntary activation. It is concluded that performing maximal intermittent contractions with a single limb causes an inability of the CNS to maximally drive the homologous muscle of the contralateral limb. This was, in part, mediated by mechanisms that involve the motor cortex ipsilateral to the contracting limb.

  1. Legal euthanasia in Belgium: characteristics of all reported euthanasia cases.

    Science.gov (United States)

    Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; Deliens, Luc

    2010-02-01

    To study the reported medical practice of euthanasia in Belgium since implementation of the euthanasia law. Analysis of the anonymous database of all euthanasia cases reported to the Federal Control and Evaluation Committee Euthanasia. All euthanasia cases reported by physicians for review between implementation of the euthanasia law on September 22nd, 2002 and December 31, 2007 (n = 1917). Frequency of reported euthanasia cases, characteristics of patients and the decision for euthanasia, drugs used in euthanasia cases, and trends in reported cases over time. The number of reported euthanasia cases increased every year from 0.23% of all deaths in 2002 to 0.49% in 2007. Compared with all deaths in the population, patients who died by euthanasia were more often younger (82.1% of patients who received euthanasia compared with 49.8% of all deaths were younger than 80, P Euthanasia was most often performed with a barbiturate, sometimes in combination with neuromuscular relaxants (92.4%) and seldom with morphine (0.9%). In almost all patients, unbearable physical (95.6%) and/or psychological suffering (68%) were reported. A small minority of cases (6.6%) concerned nonterminal patients, mainly suffering from neuromuscular diseases. The frequency of reported euthanasia cases has increased every year since legalization. Euthanasia is most often chosen as a last resort at the end of life by younger patients, patients with cancer, and seldom by nonterminal patients.

  2. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    Science.gov (United States)

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents.

  3. On-farm Euthanasia of Broiler Chickens: Effects of Different Gas Mixtures on behavior and brain activity

    NARCIS (Netherlands)

    Gerritzen, M.A.; Lambooij, E.; Reimert, H.G.M.; Stegeman, J.A.; Spruijt, B.M.

    2004-01-01

    The purpose of this study was to investigate the suitability of gas mixtures for euthanasia of groups of broilers in their housing by increasing the percentage of CO2. The suitability was assessed by the level of discomfort before loss of consciousness, and the killing rate. The gas mixtures injecte

  4. [Dementia, end of life and euthanasia].

    Science.gov (United States)

    Bier, J C; Salmon, E; Ivanoiu, A

    2014-09-01

    Among legislative criteria granting the right to practice euthanasia or assisted suicide, there are systematically four major elements. Precisely, any request must be voluntary, persistent, to be well thought and well informed. Such euthanasia raises numerous difficult questions in case of dementia. It also justifies thinking about possibilities that can offer specific arrangements of anticipated demands in such peculiar cases. Empirical experiences show us that it applies with difficulties in practice. Finally, to avoid that a big majority of these demands would find themselves not applied in practice, it would certainly be necessary to add to it structural valuation of advance care planning, and assure its recognition and development. These should not be limited to a single pathological target but would address all of us to increase advance care planning initiation, which remains the most limiting factor of such any early but continuous procedure.

  5. The risks of using continuous deep palliative sedation within the context of euthanasia

    Directory of Open Access Journals (Sweden)

    Polaks R.

    2016-01-01

    Full Text Available Although palliative care is one of the main arguments among the opponents of euthanasia, the individual medical activities implemented within it are not always evaluated unequivocally. Considering that patient in such care centres arrives mainly at the last stages of the disease when intensive treatments are no longer able to help, to reduce discomfort and relieve pain caused by the disease, analgesic means can be used that can shorten the patient's life expectancy and cause death. Such undesirable consequences can be seen in the deep and continuous palliative sedation, which not only is the last resort for pain prevention process, but also is still quite debatable medical and legal doctrine, seeing in it a similarity to the so-called “easy death”, resulting in an unofficial name - “slow euthanasia”. It is therefore important to emphasize that deep and continuous palliative sedation is considered medically correct action only if its application is justified by the need to relieve the incurably ill person from the grievous pain and sufferings caused by the disease, not to cause death, and only when in certain clinical circumstances, it cannot be achieved by other means and methods. In all other cases, depending on the state fact matters, activities of a physician constitute either an active voluntary or non-voluntary euthanasia, which in most countries of the world is a subject to criminal sanctions.

  6. Effects of early-onset voluntary exercise on adult physical activity and associated phenotypes in mice.

    Science.gov (United States)

    Acosta, Wendy; Meek, Thomas H; Schutz, Heidi; Dlugosz, Elizabeth M; Vu, Kim T; Garland, Theodore

    2015-10-01

    The purpose of this study was to evaluate the effects of early-life exercise on adult physical activity (wheel running, home-cage activity), body mass, food consumption, and circulating leptin levels in males from four replicate lines of mice selectively bred for high voluntary wheel running (High Runner or HR) and their four non-selected control (C) lines. Half of the mice were given wheel access shortly after weaning for three consecutive weeks. Wheel access was then removed for 52 days, followed by two weeks of adult wheel access for all mice. A blood sample taken prior to adult wheel testing was analyzed for circulating leptin concentration. Early-life wheel access significantly increased adult voluntary exercise on wheels during the first week of the second period of wheel access, for both HR and C mice, and HR ran more than C mice. During this same time period, activity in the home cages was not affected by early-age wheel access, and did not differ statistically between HR and C mice. Throughout the study, all mice with early wheel access had lower body masses than their sedentary counterparts, and HR mice had lower body masses than C mice. With wheel access, HR mice also ate significantly more than C mice. Early-life wheel access increased plasma leptin levels (adjusted statistically for fat-pad mass as a covariate) in C mice, but decreased them in HR mice. At sacrifice, early-life exercise had no statistically significant effects on visceral fat pad, heart (ventricle), liver or spleen masses (all adjusted statistically for variation in body mass). Results support the hypothesis that early-age exercise in mice can have at least transitory positive effects on adult levels of voluntary exercise, in addition to reducing body mass, and may be relevant for the public policy debates concerning the importance of physical education for children. Copyright © 2015. Published by Elsevier Inc.

  7. Youth Voluntary Activities in Non-governmental Organizations and Perception of Volunteerism: Example of Educational Volunteers Foundation of Turkey (TEGV

    Directory of Open Access Journals (Sweden)

    Aslı Yönten Balaban

    2015-12-01

    Full Text Available AbstractVolunteer activities, which can be described as activities without demanding any recompense, has an important role in strengthening the social structure. Youth participation into voluntary activities makes them active in the field of social integration while contributing their personal development. In this study, youth voluntary activities with regards to non-governmental organizations in Turkey will be discussed. It is also aimed to evaluate perception of volunteerism and the contribution of young volunteers’ activities to themselves in specific and to society in general.Keywords: Participation, Volunteerism, Educational Volunteers Foundation of Turkey (TEGVJEL Classification Codes: I29, L31

  8. Voluntary Exercise Preconditioning Activates Multiple Antiapoptotic Mechanisms and Improves Neurological Recovery after Experimental Traumatic Brain Injury.

    Science.gov (United States)

    Zhao, Zaorui; Sabirzhanov, Boris; Wu, Junfang; Faden, Alan I; Stoica, Bogdan A

    2015-09-01

    Physical activity can attenuate neuronal loss, reduce neuroinflammation, and facilitate recovery after brain injury. However, little is known about the mechanisms of exercise-induced neuroprotection after traumatic brain injury (TBI) or its modulation of post-traumatic neuronal cell death. Voluntary exercise, using a running wheel, was conducted for 4 weeks immediately preceding (preconditioning) moderate-level controlled cortical impact (CCI), a well-established experimental TBI model in mice. Compared to nonexercised controls, exercise preconditioning (pre-exercise) improved recovery of sensorimotor performance in the beam walk task, as well as cognitive/affective functions in the Morris water maze, novel object recognition, and tail-suspension tests. Further, pre-exercise reduced lesion size, attenuated neuronal loss in the hippocampus, cortex, and thalamus, and decreased microglial activation in the cortex. In addition, exercise preconditioning activated the brain-derived neurotrophic factor pathway before trauma and amplified the injury-dependent increase in heat shock protein 70 expression, thus attenuating key apoptotic pathways. The latter include reduction in CCI-induced up-regulation of proapoptotic B-cell lymphoma 2 (Bcl-2)-homology 3-only Bcl-2 family molecules (Bid, Puma), decreased mitochondria permeabilization with attenuated release of cytochrome c and apoptosis-inducing factor (AIF), reduced AIF translocation to the nucleus, and attenuated caspase activation. Given these neuroprotective actions, voluntary physical exercise may serve to limit the consequences of TBI.

  9. Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions.

    Science.gov (United States)

    Behrens, Martin; Mau-Moeller, Anett; Mueller, Karoline; Heise, Sandra; Gube, Martin; Beuster, Nico; Herlyn, Philipp K E; Fischer, Dagmar-C; Bruhn, Sven

    2016-02-01

    This study investigated effects of plyometric training (6 weeks, 3 sessions/week) on maximum voluntary contraction (MVC) strength and neural activation of the knee extensors during isometric, concentric and eccentric contractions. Twenty-seven participants were randomly assigned to the intervention or control group. Maximum voluntary torques (MVT) during the different types of contraction were measured at 110° knee flexion (180°=full extension). The interpolated twitch technique was applied at the same knee joint angle during isometric, concentric and eccentric contractions to measure voluntary activation. In addition, normalized root mean square of the EMG signal at MVT was calculated. The twitch torque signal induced by electrical nerve stimulation at rest was used to evaluate training-related changes at the muscle level. In addition, jump height in countermovement jump was measured. After training, MVT increased by 20Nm (95% CI: 5-36Nm, P=0.012), 24Nm (95% CI: 9-40Nm, P=0.004) and 27Nm (95% CI: 7-48Nm, P=0.013) for isometric, concentric and eccentric MVCs compared to controls, respectively. The strength enhancements were associated with increases in voluntary activation during isometric, concentric and eccentric MVCs by 7.8% (95% CI: 1.8-13.9%, P=0.013), 7.0% (95% CI: 0.4-13.5%, P=0.039) and 8.6% (95% CI: 3.0-14.2%, P=0.005), respectively. Changes in the twitch torque signal of the resting muscle, induced by supramaximal electrical stimulation of the femoral nerve, were not observed, indicating no alterations at the muscle level, whereas jump height was increased. Given the fact that the training exercises consisted of eccentric muscle actions followed by concentric contractions, it is in particular relevant that the plyometric training increased MVC strength and neural activation of the quadriceps muscle regardless of the contraction mode. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Voluntary Activity of Polish People and its Motives in Recent Years: New Volunteering

    Directory of Open Access Journals (Sweden)

    Kosewska Bernadetta

    2015-12-01

    Full Text Available This article covers an issue or the phenomenon of volunteering. The introduction is a recall of a definition of volunteering. Then it shows the distribution of voluntary activity in different countries of the European Union in order to look at some aspects of the phenomenon in the microscale of one country - Poland. It shows the percentage of involvement of Polish women and men in volunteering, their age, their motives to work for others. It makes the reader to think about an innovative definition of volunteering.

  11. Temporal muscle activation assessment by ultrasound imaging during flexor withdrawal reflex and voluntary contraction.

    Science.gov (United States)

    Jose, Gomez-Tames; Shuto, Nakamura; Jose, Gonzalez; Wenwei, Yu

    2013-01-01

    Activating flexor reflexes by electrical stimulation has been used as a mechanism to initiate the swing phase or to enhance it for spinal cord injured patients. However, it is necessary to know their contraction dynamics in order to artificially induce them at the right moment of a walking cycle. This requires understanding the temporal activation pattern of both surface and deep muscles simultaneously. This study aimed at developing a system to measure and analyze the temporal activation of both surface and deep muscles during voluntary contraction and flexor reflexes (also called withdrawal reflexes) using ultrasound imaging. A set of experiments were done to verify the validity of the system, while exploring the temporal pattern of muscle activation during flexor reflexes. As a result, we were able to quantify the surface and deep muscle activity by measuring the muscle thickness, pennation angle and long-axis displacement, from the ultrasound images.

  12. May Christians request medically assisted suicide and euthanasia?

    Directory of Open Access Journals (Sweden)

    D. Etienne de Villiers

    2016-05-01

    Full Text Available The article deals with the question: ‘Is it morally acceptable for terminally ill Christians to voluntarily request medically assisted suicide or euthanasia?’ After a brief discussion of relevant changes in the moral landscape over the last century, two influential, but opposite views on the normative basis for the Christian ethical assessment of medically assisted suicide and voluntary euthanasia are critically discussed. The inadequacy of both the view that the biblical message entails an absolute prohibition against these two practices, and the view that Christians have to decide on them on the basis of their own autonomy, is argued. An effort is made to demonstrate that although the biblical message does not entail an absolute prohibition it does have normative ethical implications for deciding on medically assisted suicide and voluntary euthanasia. Certain Christian beliefs encourage terminally ill Christians to live a morally responsible life until their death and cultivate a moral prejudice against taking the life of any human being. This moral prejudice can, however, in exceptional cases be outweighed by moral considerations in favour of medically assisted suicide or voluntary euthanasia.

  13. Activation of rectus capitis posterior major muscles during voluntary retraction of the head in asymptomatic subjects.

    Science.gov (United States)

    Hallgren, Richard C; Rowan, Jacob J; Bai, Peng; Pierce, Steven J; Shafer-Crane, Gail A; Prokop, Lawrence L

    2014-01-01

    The purpose of this study was to assess levels of electromyographic activity measured from rectus capitis posterior major (RCPM) muscles of asymptomatic subjects as their heads moved from a self-defined neutral position to a retracted position. A 2 × 2 within-subjects factorial research design was used. Disposable, intramuscular electrodes were used to collect electromyographic data from asymptomatic subjects between the ages of 20 and 40 years old. Data analysis was performed using mixed effects β regression models. Activation of RCPM muscles was found to significantly increase (P < .0001) as the head moved from a self-defined neutral position to a retracted position. Rectus capitis posterior major muscle activation levels, measured as a function of head position, have not been previously reported. The findings from this study showed that RCPM muscle activation significantly increases during voluntary retraction of the head. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  14. Voluntary activation level and muscle fiber recruitment of human quadriceps during lengthening contractions.

    Science.gov (United States)

    Beltman, J G M; Sargeant, A J; van Mechelen, W; de Haan, A

    2004-08-01

    Voluntary activation levels during lengthening, isometric, and shortening contractions (angular velocity 60 degrees/s) were investigated by using electrical stimulation of the femoral nerve (triplet, 300 Hz) superimposed on maximal efforts. Recruitment of fiber populations was investigated by using the phosphocreatine-to-creatine ratio (PCr/Cr) of single characterized muscle fibers obtained from needle biopsies at rest and immediately after a series of 10 lengthening, isometric, and shortening contractions (1 s on/1 s off). Maximal voluntary torque was significantly higher during lengthening (270 +/- 55 N.m) compared with shortening contractions (199 +/- 47 N.m, P < 0.05) but was not different from isometric contractions (252 +/- 47 N.m). Isometric torque was higher than torque during shortening (P < 0.05). Voluntary activation level during maximal attempted lengthening contractions (79 +/- 8%) was significantly lower compared with isometric (93 +/- 5%) and shortening contractions (92 +/- 3%, P < 0.05). Mean PCr/Cr values of all fibers from all subjects at rest were 2.5 +/- 0.6, 2.0 +/- 0.7, and 2.0 +/- 0.7, respectively, for type I, IIa, and IIax fibers. After 10 contractions, the mean PCr/Cr values for grouped fiber populations (regardless of fiber type) were all significantly different from rest (1.3 +/- 0.2, 0.7 +/- 0.3, and 0.8 +/- 0.6 for lengthening, isometric, and shortening contractions, respectively; P < 0.05). The cumulative distributions of individual fiber populations after either contraction mode were significantly different from rest (P < 0.05). Curves after lengthening contractions were less shifted compared with curves from isometric and shortening contractions (P < 0.05), with a smaller shift for the type IIax compared with type I fibers in the lengthening contractions. The results indicate a reduced voluntary drive during lengthening contractions. PCr/Cr values of single fibers indicated a hierarchical order of recruitment of all fiber

  15. Dementia and assisted suicide and euthanasia.

    Science.gov (United States)

    de Beaufort, Inez D; van de Vathorst, Suzanne

    2016-07-01

    The number of dementia patients requesting euthanasia in the Netherlands has increased over the past five years. The issue is highly controversial. In this contribution we discuss some of the main arguments: the nature of suffering, the voluntariness of the request and the role of the physician. We argue that society has a duty to care for patients who suffer from dementia and to make their lives as good and comfortable as possible. We also argue that it can be morally acceptable for those who do not want to continue their life with dementia to choose to die. The choice can be based on good reasons.

  16. On euthanasia: exploring psychological meaning and attitudes in a sample of Mexican physicians and medical students.

    Science.gov (United States)

    del Río, Asunción Álvarez; Marván, Ma Luisa

    2011-12-01

    Euthanasia has become the subject of ethical and political debate in many countries including Mexico. Since many physicians are deeply concerned about euthanasia, due to their crucial participation in its decision and implementation, it is important to know the psychological meaning that the term 'euthanasia' has for them, as well as their attitudes toward this practice. This study explores psychological meaning and attitudes toward euthanasia in 546 Mexican subjects, either medical students or physicians, who were divided into three groups: a) beginning students, b) advanced students, and c) physicians. We used the semantic networks technique, which analyzed the words the participants associated with the term 'euthanasia'. Positive psychological meaning, as well as positive attitudes, prevailed among advanced students and physicians when defining euthanasia, whereas both positive and negative psychological meaning together with more ambivalent attitudes toward euthanasia predominated in beginning students. The findings are discussed in the context of a current debate on a bill proposing active euthanasia in Mexico City.

  17. 75 A CRITICAL APPRAISAL OF EUTHANASIA UNDER NIGERIAN ...

    African Journals Online (AJOL)

    Fr. Ikenga

    physician-assisted suicide and active euthanasia and the U.S states of Oregon and Washington ... A Omipidan “Euthanasia: The 21st Century Culture of Death” vol.7 ..... People Support Physician-Assisted Suicide and Why These Reasons Are ...

  18. Palliative treatment alternatives and euthanasia consultations: a qualitative interview study.

    Science.gov (United States)

    Buiting, Hilde M; Willems, Dick L; Pasman, H Roeline W; Rurup, Mette L; Onwuteaka-Philipsen, Bregje D

    2011-07-01

    There is much debate about euthanasia within the context of palliative care. The six criteria of careful practice for lawful euthanasia in The Netherlands aim to safeguard the euthanasia practice against abuse and a disregard of palliative treatment alternatives. Those criteria need to be evaluated by the treating physician as well as an independent euthanasia consultant. To investigate 1) whether and how palliative treatment alternatives come up during or preceding euthanasia consultations and 2) how the availability of possible palliative treatment alternatives are assessed by the independent consultant. We interviewed 14 euthanasia consultants and 12 physicians who had requested a euthanasia consultation. We transcribed and analyzed the interviews and held consensus meetings about the interpretation. Treating physicians generally discuss the whole range of treatment options with the patient before the euthanasia consultation. Consultants actively start thinking about and proposing palliative treatment alternatives after consultations, when they have concluded that the criteria for careful practice have not been met. During the consultation, they take into account various aspects while assessing the criterion concerning the availability of reasonable alternatives, and they clearly distinguish between euthanasia and continuous deep sedation. Most consultants said that it was necessary to verify which forms of palliative care had previously been discussed. Advice concerning palliative care seemed to be related to the timing of the consultation ("early" or "late"). Euthanasia consultants were sometimes unsure whether or not to advise about palliative care, considering it not their task or inappropriate in view of the previous discussions. Two different roles of a euthanasia consultant were identified: a limited one, restricted to the evaluation of the criteria for careful practice, and a broad one, extended to actively providing advice about palliative care. Further

  19. Finnish nurses' attitudes towards their role in the euthanasia process.

    Science.gov (United States)

    Terkamo-Moisio, Anja; Gastmans, Chris; Ryynänen, Olli-Pekka; Pietilä, Anna-Maija

    2017-01-01

    Nurses' voices remain unheard in most debates about euthanasia, although their crucial role in the euthanasia process is widely acknowledged. Moreover, in Canadian euthanasia law, nurses have a more active role, which further highlights the need for knowledge about nurses' attitudes towards their role in the euthanasia process. What are Finnish nurses' attitudes towards their potential role in the euthanasia process? Which characteristics are associated with those attitudes? Cross-sectional web-based survey. Participants and research context: 1003 nurses, recruited via social media and the members' bulletin of the Finnish Nurses Association. Ethical considerations: Ethical approval was obtained from the Committee on Research Ethics of the university to which the first author was affiliated. The great majority (85.2%) of nurses felt that their perspective should be considered in decision-making related to euthanasia. Furthermore, most of the participants (74.7%) reported willingness to participate in the euthanasia process if it were legal, and 88.6% agreed that a nurse should be present when euthanasia is performed if the patient wishes so. Furthermore, over half agreed that some of the preparatory tasks were part of their job description. However, a minority (32.9%) agreed with a possible obligation to participate based on their profession. Nurses' age, religiosity and educational level influenced their attitudes in the current results. Despite the strong agreement on decision-making concerning euthanasia and participation in the euthanasia process, obligation to participate based on the profession was rejected by most participants. Nurses regarded themselves as consultants in the decision-making process, which may indicate their unwillingness to share the responsibility for the decision itself. Specific safety mechanisms should be considered to protect nurses who refuse to be involved in the euthanasia process due to harm that involuntary participation might

  20. Euthanasia--a moral choice?

    National Research Council Canada - National Science Library

    Sveinsson, Olafur Arni

    2007-01-01

    Euthanasia has been heatedly discussed in Western countries over the last years. Only a few nations have legalized euthanasia or physician assisted suicide with the Dutch at the forefront of that field...

  1. Euthanasia: another face of murder.

    Science.gov (United States)

    Bamgbose, Oluyemisi

    2004-02-01

    Debate over euthanasia is not a recent phenomenon. Over the years, public opinion, decisions of courts, and legal and medical approaches to the issue of euthanasia has been conflicting. The connection between murder and euthanasia has been attempted in a few debates. Although it is widely accepted that murder is a crime, a clearly defined stand has not been taken on euthanasia. This article considers euthanasia from the medical, legal, and global perspectives and discusses the crime of murder in relation to euthanasia, taking into consideration the issue of consent in the law of crime. This article concludes that in the midst of this debate on euthanasia and murder, the important thing is that different countries need to find their own solution to the issue of euthanasia rather than trying to import solutions from other countries.

  2. Euthanasia: the role of good care.

    Science.gov (United States)

    Seale, C; Addington-Hall, J

    1995-03-01

    The results from two surveys in England of relatives and others who knew people in samples drawn from death certificates are reported. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. The argument that good care and, in particular, hospice care is effective in reducing the desire for euthanasia has been proposed as an argument against the legalization of voluntary euthanasia. The findings suggest that the picture is in fact more complex. People who received hospice care were, if anything, more likely to have respondents who felt that it would have been better if they had died earlier. The latter held when controlling for other variables found to influence respondents' views, such as the level of distress and dependency experienced by the dying person. It appears possible that the same may apply to the dying peoples' own wishes, although here the time order of events could not be controlled for in the data. It is suggested that this may be due to hospice care being geared to helping patients express their fears and exercise choice. The wish for euthanasia may then be an assertion of personal control, rather than an act of surrender. Alternatively, people (and their relatives) who accept hospice care may be predisposed to consider the benefits of an earlier death.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. [Euthanasia in Belgium].

    Science.gov (United States)

    Simón Lorda, Pablo; Barrio Cantalejo, Inés M

    2012-01-01

    The experience of the Netherlands in relation with the legalization and practice of euthanasia is better known in Spain than the Belgian experience in this matter. But the historical process of social debate in Belgium has many specific details which should be known by Spanish healthcare professionals, bioethicists, politicians and lawyers. This paper begins with a comparative analysis of both countries: Spain and Belgium and follows with a description of the milestones of the historical process of debating and, finally, passing the Belgian Law on Euthanasia in 2002. The next chapter consists of a description of the main contents of this important Law. The paper continues then with an approach to the epidemiology of the practice of euthanasia in Belgium and finishes with a description of the different positions of the actors of the process. Two positions are described more in depth: the opinion of the specialists in palliative care, and the opinion of the Catholic Church. The paper ends underlining the reason for the incorporation of the Belgian experience on euthanasia to the debate about the possibility of legalizing euthanasia in Spain.

  4. Intention, procedure, outcome and personhood in palliative sedation and euthanasia.

    Science.gov (United States)

    Materstvedt, Lars Johan

    2012-03-01

    Palliative sedation at the end of life has become an important last-resort treatment strategy for managing refractory symptoms as well as a topic of controversy within palliative care. Furthermore, palliative sedation is prominent in the public debate about the possible legalisation of voluntary assisted dying (physician-assisted suicide and euthanasia). This article attempts to demonstrate that palliative sedation is fundamentally different from euthanasia when it comes to intention, procedure, outcome and the status of the person. Nonetheless, palliative sedation in its most radical form of terminal deep sedation parallels euthanasia in one respect: both end the experience of suffering. However, only the latter intentionally ends life and also has this as its goal. There is the danger that deep sedation could bring death forward in time due to particular side effects of the treatment. Still that would, if it happens, not be intended, and accordingly is defensible in view of the doctrine of double effect.

  5. Feeding frequency, but not dietary water content, affects voluntary physical activity in young lean adult female cats.

    Science.gov (United States)

    de Godoy, M R C; Ochi, K; de Oliveira Mateus, L F; de Justino, A C C; Swanson, K S

    2015-05-01

    The objective of this study was to investigate whether increased dietary water content and feeding frequency increased voluntary physical activity of young, lean adult female cats. A replicated 4 × 4 Latin square design with a 2 × 2 factorial treatment arrangement (feeding frequency and water content) was used. The 4 treatments consisted of 1 meal daily dry pet food without added water (1D; 12% moisture as is), 1 meal daily dry pet food with added water (1W; 70% total water content), 4 meals daily dry pet food without added water (4D; 12% moisture as is), and 4 meals daily dry pet food with added water (4W; 70% total water content). Eight healthy adult, lean, intact, young, female domestic shorthair cats were used in this experiment. Voluntary physical activity was evaluated using Actical activity monitors placed on collars and worn around the cats' necks for the last 7 d of each experimental period of 14 d. Food anticipatory activity (FAA) was calculated based on 2 h prior to feeding periods and expressed as a percentage of total daily voluntary physical activity. Increased feeding frequency (4 vs. 1 meal daily) resulted in greater average daily activity (P = 0.0147), activity during the light period (P = 0.0023), and light:dark activity ratio (P = 0.0002). In contrast, physical activity during the dark period was not altered by feeding frequency (P > 0.05). Cats fed 4 meals daily had increased afternoon FAA (P= 0.0029) compared with cats fed once daily. Dietary water content did not affect any measure of voluntary physical activity. Increased feeding frequency is an effective strategy to increase the voluntary physical activity of cats. Thus, it may assist in the prevention and management of obesity.

  6. Attitudinal and motivational antecedents of participation in voluntary employee development activities.

    Science.gov (United States)

    Hurtz, Gregory M; Williams, Kevin J

    2009-05-01

    This study investigated factors influencing ongoing participation in employee development activities. A multiple-indicator structural equation model building on the theory of planned behavior and prior employee development literature was tested with a survey across 4 organizations on 2 occasions. The model uses reactions to past participation and past supportiveness of the social and organizational environment as indirect antecedents of participation, filtered through their impact on attitudes and behavioral intentions toward future participation. Learning goal orientation also influenced attitudes toward participation. Whereas personal control over participation and higher levels of voluntariness were negatively related to participation, intentions to participate and availability of opportunities arose as strong predictors of higher participation rates. Many significant hypothesized paths were found, and 85% of the variance in participation was explained by the model variables. Increasing employee awareness of opportunities and managing positive attitudes toward those opportunities are recommended as key factors for increasing participation rates.

  7. 'Setting a principled boundary'? Euthanasia as a response to 'life fatigue'.

    Science.gov (United States)

    Huxtable, Richard; Möller, Maaike

    2007-03-01

    The Dutch case of Brongersma presents novel challenges to the definition and evaluation of voluntary euthanasia since it involved a doctor assisting the suicide of an individual who was (merely?) 'tired of life'. Legal officials had called on the courts to 'set a principled boundary', excluding such cases from the scope of permissible voluntary euthanasia, but they arguably failed. This failure is explicable, however, since the case seems justifiable by reference to the two major principles in favour of that practice, respect for autonomy and beneficence. Ultimately, it will be argued that those proponents of voluntary euthanasia who are wary of its use in such circumstances may need to draw upon 'practical' objections, in order to erect an otherwise arbitrary perimeter. Furthermore, it will be suggested that the issues raised by the case are not peculiarly Dutch in nature and that, therefore, there are lessons here for other jurisdictions too.

  8. [Euthanasia in Muslim law].

    Science.gov (United States)

    Abbasi, Mahmoud

    2007-09-01

    If a physician accepts to conduct an act of euthanasia or assisted suicide, would it be possible for him to be charged with homicide or even, is patient consent or motivation of the physician, susceptible to change the nature of the criminal act? Since the 1990s, a transformation has occurred in the way of dealing with these questions and figures from the world of philosophy, ethics and law can now be found in favor of euthanasia and assisted suicide. In certain countries, legislation has even been modified to follow this pattern. In consequence, besides the philosophical and ethical dimensions of this issue, it has become necessary to reexamine, even to revise, the notion of responsibility concerning euthanasia in Muslim law from new bases constituted by the doctrine of the Ulemas.

  9. [Euthanasia and medical act].

    Science.gov (United States)

    2011-05-01

    Right to life -as the prohibition of intentionally and arbitrarily taking life, even with authorization of the concerned one- is an internationally recognized right. In many countries, debate regarding euthanasia is more centered in its convenience, social acceptability and how it is regulated, than in its substantial legitimacy. Some argue that euthanasia should be included as part of clinical practice of health professionals, grounded on individual's autonomy claims-everyone having the liberty to choose how to live and how to die. Against this, others sustain that life has a higher value than autonomy, exercising autonomy without respecting the right to life would become a serious moral and social problem. Likewise, euthanasia supporters some-times claim a 'right to live with dignity', which must be understood as a personal obligation, referred more to the ethical than to the strictly legal sphere. In countries where it is already legalized, euthanasia practice has extended to cases where it is not the patient who requests this but the family or some healthcare professional, or even the legal system-when they think that the patient is living in a condition which is not worthy to live. Generalization of euthanasia possibly will end in affecting those who need more care, such as elder, chronically ill or dying people, damaging severely personal basic rights. Nature, purpose and tradition of medicine rule out the practice of euthanasia, which ought not be considered a medical act or legitimately compulsory for physicians. Today's medicine counts with effective treatments for pain and suffering, such as palliative care, including sedative therapy, which best preserves persons dignity and keeps safe the ethos of the medical profession.

  10. They shoot horses, don't they? How valid are the arguments of opponents against euthanasia?

    Science.gov (United States)

    Martens, Willem H J

    2009-12-01

    In this article the arguments against euthanasia are examined. One of the weightiest arguments of mental health professionals against the practice of euthanasia is that a doctor's active commitment to euthanasia can be interpreted as causing harm. It is investigated whether this statement can be ethically justified on the basis of the text of the medical oath or medical declaration. Furthermore, it will be discussed whether it is ethically acceptable when doctors refuse a) to help candidates of euthanasia who (would likely) meet the legal standards of euthanasia, or b) to refer them to a colleague.

  11. Euthanasia and common sense: a reply to Garcia.

    Science.gov (United States)

    Seay, Gary

    2011-06-01

    J. L. A. Garcia holds that my defense of voluntary euthanasia in an earlier paper amounts to an "assault on traditional common sense" about what medical ethics permits physicians to do, particularly insofar as I hold that a physician's duty to abstain from intentionally killing is only a defeasible duty, not an unconditional one. But I argue here that it is Garcia's views that are more at odds with common sense, and that voluntary euthanasia is in fact a humane alternative that respects patient autonomy and is consistent with the most fundamental moral duties of physicians. Among these is a duty to relieve suffering, which can sometimes outweigh the fundamental duty to conserve life.

  12. Asymmetrical Brain Activity Induced by Voluntary Spatial Attention Depends on the Visual Hemifield: A Functional Near-Infrared Spectroscopy Study

    Science.gov (United States)

    Harasawa, Masamitsu; Shioiri, Satoshi

    2011-01-01

    The effect of the visual hemifield to which spatial attention was oriented on the activities of the posterior parietal and occipital visual cortices was examined using functional near-infrared spectroscopy in order to investigate the neural substrates of voluntary visuospatial attention. Our brain imaging data support the theory put forth in a…

  13. Asymmetrical Brain Activity Induced by Voluntary Spatial Attention Depends on the Visual Hemifield: A Functional Near-Infrared Spectroscopy Study

    Science.gov (United States)

    Harasawa, Masamitsu; Shioiri, Satoshi

    2011-01-01

    The effect of the visual hemifield to which spatial attention was oriented on the activities of the posterior parietal and occipital visual cortices was examined using functional near-infrared spectroscopy in order to investigate the neural substrates of voluntary visuospatial attention. Our brain imaging data support the theory put forth in a…

  14. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults

    DEFF Research Database (Denmark)

    Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias

    2016-01-01

    Incomplete voluntary muscle activation may contribute to impaired muscle mechanical function and physical function in older adults. Exercise interventions have been shown to increase voluntary muscle activation, although the evidence is sparse for mobility-limited older adults, particularly in as...

  15. [Qualitative research about euthanasia concept, between Spanish doctors].

    Science.gov (United States)

    Cuervo Pinna, M Á; Rubio, M; Altisent Trota, R; Rocafort Gil, J; Gómez Sancho, M

    2016-01-01

    The decriminalisation of euthanasia and assisted medical suicide has generated a continuous debate. The terminological confusion is one of the main difficulties in obtaining medical practice consensus. The objective of this study was to determine whether the terms of Euthanasia and physician assisted suicide are used with the same meaning by doctors in Extremadura (Spain). A qualitative study was conducted using two focus groups in which doctors from different specialties who attended a large number of terminal patients participated. No other focus group was required due to saturation. The sessions were tape recorded and transcribed by two experts in qualitative methodology. Atlas.ti software was used for the analysis. We were advised by the "Health Care at the end of life" Group of the Organizacion Médica Colegial of Spain. Terminological confusion was verified in: 1) The mixture of etymological, functional and social concepts, 2) the term Passive Euthanasia, 3) the association between euthanasia and physician assisted suicide, 4) the confusion with the equivalent "wish to hasten death", and 5) the difficulty of differentiating sedation with Euthanasia. There was consensus on some aspects: a) Full voluntariness, b) the condition of terminal illness, and c) the condition of unbearable symptoms. Conceptual variability persists in relation to the concept of Euthanasia, and is particularly noticeable in the persistence of the concept of passive euthanasia. It would be desirable to achieve a common language to assign a precise meaning to these words to help doctors in their professional practice. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  16. Euthanasia in Albania

    Directory of Open Access Journals (Sweden)

    Beslinda Rrugia

    2016-03-01

    Full Text Available The right to live is a right guaranteed by the constitution as well as international legal acts in force in a country, and is based on the moral of a society. But does the right to live imply a parallel individual right to die? Or should the state protect the right to life of a person who does not want to live anymore, going like this against the will of that person? Albanian anthropology, as a post-communist society lacks the tradition of freedom, as in this case of the freedom that belongs to a man affected by an incurable disease. For this reason, in Albania not only we do not have a law on euthanasia, but the issue of euthanasia is not raised as an issue nor by the legislator nor by civil society. The purpose of this paper is to give an overview of euthanasia in Albania, as well as on some specific problems facing the Albanian reality. The methodology used in the paper consists with the combination of comparing legal provisions of euthanasia (or the lack of them in a vertical historical continuity.

  17. [Euthanasia--a moral choice?].

    Science.gov (United States)

    Sveinsson, Olafur Arni

    2007-01-01

    Euthanasia has been heatedly discussed in Western countries over the last years. Only a few nations have legalized euthanasia or physician assisted suicide with the Dutch at the forefront of that field. Proponents of euthanasia mostly argue for euthanasia on two grounds. Firstly, that the patient has a right to die and secondly, that there is no substantial difference between euthanasia and palliative care. In this paper I will argue against both of the above. I discuss the arguments against euthanasia which are in principle four. Firstly, it is held by many that taking a human life is wrong under all circumstances. Secondly, that it is an unjustifiable demand to ask a person to take another person's life. In relation to that argument, euthanasia is not in accordance with the basic principles of medicine and nursing as they have evolved over the years and could therefore easily disrupt the therapeutic relationship. Thirdly, as shown from Holland there is empirical evidence that euthanasia is not under good enough surveillance and therefore invites misuse. Fourthly, even though euthanasia might possibly be justifiable under certain circumstances, legalisation might well invite abuse because of the message and pressure that the option places on both patients and professionals in terminal care. My answer to the euthanasia demand is palliative care, where dialogue between the patient and doctor is central. But the dialogue cannot be effective, unless both partners are willing and able to engage in sincere and frank conversations.

  18. 16 CFR 1031.7 - Commission support of voluntary standards activities.

    Science.gov (United States)

    2010-01-01

    ... or subsidizing technical assistance, including research, health science data, and engineering support.... (5) Providing assistance on methods of disseminating information and education about the voluntary... conflicting State and local regulations. (8) Monitoring the number and market share of products conforming...

  19. Attitudes of medical students towards euthanasia in a multicultural setting.

    Science.gov (United States)

    Adchalingam, K; Kong, W H; Zakiah, M A; Zaini, M; Wong, Y L; Lang, C C

    2005-03-01

    A cross-sectional survey of 400 medical students of multicultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes, and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease while 48% of them were against it. Seventy-one percent of the students involved in the study were against the idea of active euthanasia i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. Thirty-two percent of the respondents favoured the legalization of euthanasia in Malaysia while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities.

  20. Within- and between-session reliability of the maximal voluntary knee extension torque and activation.

    Science.gov (United States)

    Park, Jihong; Hopkins, J Ty

    2013-01-01

    A ratio between the torque generated by maximal voluntary isometric contraction (MVIC) and exogenous electrical stimulus, central activation ratio (CAR), has been widely used to assess quadriceps function. To date, no data exist regarding between-session reliability of this measurement. Thirteen neurologically sound volunteers underwent three testing sessions (three trials per session) with 48 hours between-session. Subjects performed MVICs of the quadriceps with the knee locked at 90° flexion and the hip at 85°. Once the MVIC reached a plateau, an electrical stimulation from superimposed burst technique (SIB: 125 V with peak output current 450 mA) was manually delivered and transmitted directly to the quadriceps via stimulating electrodes. CAR was calculated by using the following equation: CAR = MVIC torque/MVIC + SIB torque. Intraclass correlation coefficients (ICC) were calculated within- (ICC((2,1))) and between-session (ICC((2,k))) for MVIC torques and CAR values. Our data show that quadriceps MVIC and CAR are very reliable both within- (ICC((2,1)) = 0.99 for MVIC; 0.94 for CAR) and between-measurement sessions (ICC((2,k)) = 0.92 for MVIC; 0.86 for CAR) in healthy young adults. For clinical research, more data of the patients with pathological conditions are required to ensure reproducibility of calculation of CAR.

  1. Time course of human motoneuron recovery after sustained low-level voluntary activity.

    Science.gov (United States)

    Héroux, Martin E; Butler, Annie A; Gandevia, Simon C; Taylor, Janet L; Butler, Jane E

    2016-02-01

    Motoneurons often fire repetitively and for long periods. In sustained voluntary contractions the excitability of motoneurons declines. We provide the first detailed description of the time course of human motoneuron recovery after sustained activity at a constant discharge rate. We recorded the discharge of single motor units (MUs, n = 30) with intramuscular wire electrodes inserted in triceps brachii during weak isometric contractions. Subjects (n = 15) discharged single MUs at a constant frequency (∼10 Hz) with visual feedback for prolonged durations (3-7 min) until rectified surface electromyogram (sEMG) of triceps brachii increased by ∼100%. After a rest of 1-2, 15, 30, 60, 120, or 240 s, subjects briefly resumed the contraction with the target MU at the same discharge rate. Each MU was tested with three to four rest periods. The magnitude of sEMG was increased when contractions were resumed, and the target motoneuron discharged at the test frequency following rest intervals of 2-60 s (P = 0.001-0.038). The increased sEMG indicates that greater excitatory drive was needed to discharge the motoneuron at the test rate. The increase in EMG recovered exponentially with a time constant of 28 s but did not return to baseline even after a rest period of ∼240 s. Thus the decline in motoneuron excitability from a weak contraction takes several minutes to recover fully.

  2. ANALISIS TERHADAP PELAKSANAAN EUTHANASIA PASIF

    Directory of Open Access Journals (Sweden)

    Umi Enggarsasi

    1997-07-01

    Full Text Available Dalam KUHP tidak satu pasal pun yang menjelaskan batasan atau pengertian euthanasia. Namun demikian, pengenaan terhadap euthanasia dianalogikan dengan delik-delik yang tercantum dalam pasal 338, 340, 344 KUHP. Dengan dasar itulah maka pelaksanaan euthanasia dilarang. Larangan euthanasia pasif tidak pernah efektif karena kematian sebagai akibat ketidakmampuan ilmu dan teknologi kedokteran, dipandang sebagai kematian alamiah, sedangkan terhadap kematian alamiah tentu saja tidak ditahan-tahan atau dilarang hukum pidana maupun kode etik kedokteran. Hukum pidana dan kode etik kedokteran, tidak mewajibkan dokter untuk mengobati pasien di Iuar batas kemampuan ilmu dan teknologi kedokteran. berdasarkan penerapan karakteristik delik omisionis terbukti bahwa, larangan euthanasia pasif tidak memenuhi kriteria untuk diterapkan sebagai perbuatan pidana. Dalam hal terjadinya euthanasia pasif, walaupun dokter melakukan perbuatan positif, secara logika, kematian pasien tidak dapat dihindari. Dengan demikian sulit untuk dibuktikan adanya hubungan kausal antara akibat yang dilarang timbulnya dengan kelakuan negatif dokter.

  3. Euthanasia is not medical treatment.

    Science.gov (United States)

    Boudreau, J Donald; Somerville, Margaret A

    2013-01-01

    The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence. Both proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate. Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited. Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians. The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.

  4. From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance.

    Science.gov (United States)

    Enke, Martin; Meyer, Patric; Flor, Herta

    2016-01-01

    Numerous questionnaire studies on attitudes towards euthanasia produced conflicting results, precluding any general conclusion. This might be due to the fact that human behavior can be influenced by automatically triggered attitudes, which represent ingrained associations in memory and cannot be assessed by standard questionnaires, but require indirect measures such as reaction times (RT) or electroencephalographic recording (EEG). Event related potentials (ERPs) of the EEG and RT during an affective priming task were assessed to investigate the impact of automatically triggered attitudes and were compared to results of an explicit questionnaire. Explicit attitudes were ambivalent. Reaction time data showed neither positive nor negative associations towards euthanasia. ERP analyses revealed an N400 priming effect with lower mean amplitudes when euthanasia was associated with negative words. The euthanasia-related modulation of the N400 component shows an integration of the euthanasia object in negatively valenced associative neural networks. The integration of all measures suggests a bottom-up process of attitude activation, where automatically triggered negative euthanasia-relevant associations can become more ambiguous with increasing time in order to regulate the bias arising from automatic processes. These data suggest that implicit measures may make an important contribution to the understanding of euthanasia-related attitudes.

  5. From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance.

    Directory of Open Access Journals (Sweden)

    Martin Enke

    Full Text Available Numerous questionnaire studies on attitudes towards euthanasia produced conflicting results, precluding any general conclusion. This might be due to the fact that human behavior can be influenced by automatically triggered attitudes, which represent ingrained associations in memory and cannot be assessed by standard questionnaires, but require indirect measures such as reaction times (RT or electroencephalographic recording (EEG. Event related potentials (ERPs of the EEG and RT during an affective priming task were assessed to investigate the impact of automatically triggered attitudes and were compared to results of an explicit questionnaire. Explicit attitudes were ambivalent. Reaction time data showed neither positive nor negative associations towards euthanasia. ERP analyses revealed an N400 priming effect with lower mean amplitudes when euthanasia was associated with negative words. The euthanasia-related modulation of the N400 component shows an integration of the euthanasia object in negatively valenced associative neural networks. The integration of all measures suggests a bottom-up process of attitude activation, where automatically triggered negative euthanasia-relevant associations can become more ambiguous with increasing time in order to regulate the bias arising from automatic processes. These data suggest that implicit measures may make an important contribution to the understanding of euthanasia-related attitudes.

  6. Attitudes of acutely ill patients towards euthanasia in Hong Kong.

    Science.gov (United States)

    Lam, R C S; Chien, Wai-Tong

    2007-01-01

    The global euthanasia debate by health care professionals has raised important ethical issues concerning the professional duties and responsibilities of nurses caring for terminal patients. The purpose of this study was to examine the attitudes of acutely ill patients towards the practice of euthanasia in Hong Kong. A modified form of the 23-item Questionnaire for General Household Survey scale was used. This cross-sectional survey study was conducted with a stratified sample of in-patients recruited from a wide variety of departments in a regional, acute general hospital. Seventy-seven out of 129 patients responded (59.7%) and a high proportion of patients agreed with the use of euthanasia in the following circumstances: 'where they were a third party', if 'someone they loved' was affected, or if 'they themselves were the patient'. Of the 77 patients, 54 agreed with active euthanasia (70.1%) and 65 with passive (84.4%). The results also indicated that a few socio-demographic characteristics (such as age, gender and household income) statistically significantly correlated with patients' attitudes towards euthanasia. These findings highlight that Chinese patients with acute illness generally accept the use of euthanasia. Further research on the attitudes and perceptions of patients towards the use of euthanasia is recommended, particularly in diverse groups of Chinese and Asian patients with acute or terminal illness.

  7. An Ethical Review of Euthanasia and Physician-assisted Suicide

    OpenAIRE

    BANOVI?, Bo?idar; TURANJANIN, Veljko; MILORADOVI?, An?ela

    2017-01-01

    Background: In the majority of countries, active direct euthanasia is a forbidden way of the deprivation of the patients? life, while its passive form is commonly accepted. This distinction between active and passive euthanasia has no justification, viewed through the prism of morality and ethics. Therefore, we focused on attention on the moral and ethical implications of the aforementioned medical procedures. Methods: Data were obtained from the Clinical Hospital Center in Kragujevac, collec...

  8. GPi Oscillatory Activity Differentiates Tics from the Resting State, Voluntary Movements, and the Unmedicated Parkinsonian State

    Science.gov (United States)

    Jimenez-Shahed, Joohi; Telkes, Ilknur; Viswanathan, Ashwin; Ince, Nuri F.

    2016-01-01

    Background: Deep brain stimulation (DBS) is an emerging treatment strategy for severe, medication-refractory Tourette syndrome (TS). Thalamic (Cm-Pf) and pallidal (including globus pallidus interna, GPi) targets have been the most investigated. While the neurophysiological correlates of Parkinson's disease (PD) in the GPi and subthalamic nucleus (STN) are increasingly recognized, these patterns are not well characterized in other disease states. Recent findings indicate that the cross-frequency coupling (CFC) between beta band and high frequency oscillations (HFOs) within the STN in PD patients is pathologic. Methods: We recorded intraoperative local field potentials (LFPs) from the postero-ventrolateral GPi in three adult patients with TS at rest, during voluntary movements, and during tic activity and compared them to the intraoperative GPi-LFP activity recorded from four unmedicated PD patients at rest. Results: In all PD patients, we noted excessive beta band activity (13–30 Hz) at rest which consistently modulated the amplitude of the co-existent HFOs observed between 200 and 400 Hz, indicating the presence of beta-HFO CFC. In all 3TS patients at rest, we observed theta band activity (4–7 Hz) and HFOs. Two patients had beta band activity, though at lower power than theta oscillations. Tic activity was associated with increased high frequency (200–400 Hz) and gamma band (35–200 Hz) activity. There was no beta-HFO CFC in TS patients at rest. However, CFC between the phase of 5–10 Hz band activity and the amplitude of HFOs was found in two TS patients. During tics, this shifted to CFC between the phase of beta band activity and the amplitude of HFOs in all subjects. Conclusions: To our knowledge this is the first study that shows that beta-HFO CFC exists in the GPi of TS patients during tics and at rest in PD patients, and suggests that this pattern might be specific to pathologic/involuntary movements. Furthermore, our findings suggest that during tics

  9. GPi oscillatory activity differentiates tics from the resting state, voluntary movements, and the unmedicated parkinsonian state

    Directory of Open Access Journals (Sweden)

    Joohi Jimenez-Shahed

    2016-09-01

    Full Text Available Background: Deep brain stimulation (DBS is an emerging treatment strategy for severe, medication-refractory Tourette syndrome (TS. Thalamic (Cm-Pf and pallidal (including globus pallidus interna, GPi targets have been the most investigated. While the neurophysiological correlates of Parkinson’s disease (PD in the GPi and subthalamic nucleus (STN are increasingly recognized, these patterns are not well characterized in other disease states. Recent findings indicate that the cross-frequency coupling (CFC between beta band and high frequency oscillations (HFOs within the STN in PD patients is pathologic. Methods: We recorded intraoperative local field potentials (LFPs from the postero-ventrolateral GPi in three adult patients with TS at rest, during voluntary movements, and during tic activity and compared them to the intraoperative GPi-LFP activity recorded from four unmedicated PD patients at rest. Results: In all PD patients, we noted excessive beta band activity (13-30Hz at rest which consistently modulated the amplitude of the co-existent HFOs observed between 200-400Hz, indicating the presence of beta-HFO CFC. In all 3 TS patients at rest, we observed theta band activity (4-7Hz and HFOs. Two patients had beta band activity, though at lower power than theta oscillations. Tic activity was associated with increased high frequency (200-400Hz and gamma band (35-200Hz activity. There was no beta-HFO CFC in TS patients at rest. However, CFC between the phase of 5-10Hz band activity and the amplitude of HFOs was found in two TS patients. During tics, this shifted to CFC between the phase of beta band activity and the amplitude of HFOs in all subjects. Conclusions: To our knowledge this is the first study that shows that beta-HFO CFC exists in the GPi of TS patients during tics and at rest in PD patients, and suggests that this pattern might be specific to pathologic/involuntary movements. Furthermore, our findings suggest that during tics, resting

  10. Euthanasia and the Criminal Law

    OpenAIRE

    Trnka, Pavel

    2016-01-01

    1 Abstract Euthanasia is a highly controversial issue that is becoming an increasingly hot topic almost all over the world. Etymologically, the word "euthanasia" has its origins in the Greek word "euthanatos", meaning "good death" (from eu- "good, pleasant" + thanatos "death"). Later, however, in the wake of an interpretative shift, euthanasia generally came to be used, alongside its meaning of good death (merciful, good, beautiful, easy death), as the term of choice in connection with killin...

  11. Nursing students' approaches toward euthanasia.

    Science.gov (United States)

    Ozcelik, Hanife; Tekir, Ozlem; Samancioglu, Sevgin; Fadiloglu, Cicek; Ozkara, Erdem

    2014-01-01

    In Turkey, which is a secular, democratic nation with a majority Muslim population, euthanasia is illegal and regarded as murder. Nurses and students can be faced with ethical dilemmas and a lack of a legal basis, with a conflict of religious beliefs and social and cultural values concerning euthanasia. The aim of this study was to investigate undergraduate nursing students' attitudes towards euthanasia. The study, which had a descriptive design, was conducted with 600 students. The 1st, 2nd, 3rd, and 4th year nursing students at a school of nursing were contacted in May 2009, and 383 students (63.8% of the study population of a total of 600 students) gave informed consent. Two tools were used in accordance with questionnaire preparation rules. The majority of students were female and single (96.9%), and their mean age was 21.3 ± 1.5 years. A majority (78.9%) stated they had received no training course/education on the concept of euthanasia. Nearly one-third (32.4%) of the students were against euthanasia; 14.3% of the students in the study agreed that if their relatives had an irreversible, lethal condition, passive euthanasia could be performed. In addition, 24.8% of the students agreed that if they themselves had an irreversible, lethal condition, passive euthanasia could be performed. Less than half (42.5%) of the students thought that discussions about euthanasia could be useful. There was a significant relation between the study year and being against euthanasia (p euthanasia could be abused (p euthanasia was unethical (p euthanasia.

  12. Euthanasia in The Netherlands.

    Science.gov (United States)

    van der Wal, G.; Dillmann, R. J.

    1994-01-01

    The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the "Dutch experiment" need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life. PMID:8019226

  13. Euthanasia--definition, dangers and alternatives.

    Science.gov (United States)

    Saunders, C

    1994-03-01

    There is as yet (1992) no law specifically allowing euthanasia, the active intervention to end a patient's life. The discussion has so far been restricted to such action as taking place at a patient's request, but evidence from the Netherlands appears to show that the move to involuntary euthanasia is a real danger. Palliative medicine offers appropriate treatment for relief and support where limits are set on interventions that would no longer be in a patient's best interests. It is possible to relieve distress by using the increasing knowledge in this field. It is important to distinguish this from euthanasia and the term "passive euthanasia" is confusing and unfortunate. Those with extensive experience in the treatment of advanced cancer have much to share with practitioners in other specialties, not least in the possible achievements of both patient and family at the end of life. Society has the responsibility for including them in its concern to the end of life and for supporting those who find it difficult to believe in any meaning in their existence.

  14. Nursing Student Attitudes toward Euthanasia: A Cross-Sectional Study.

    Science.gov (United States)

    Hosseinzadeh, Kazem; Rafiei, Hossein

    2017-01-01

    Euthanasia is among the most common and controversial end-of-life care issues. Examining the attitudes of nursing students to this issue is important because they may well encounter these issues during the course of their clinical placements. Research aims: This study aims to examine the attitudes of a sample of Iranian nursing students towards euthanasia. This is a descriptive cross-sectional study. Participants and research context: Using convenience sampling, 382 Muslim nursing students were enrolled in this study. Data were collected using a demographic variables checklist and a self-administered questionnaire that included a definition of euthanasia and 11 closed questions that sought to record participants' level of agreement with euthanasia based on a Likert scale. Ethical consideration: Consent for participation was implicit, indicated by the participants having returned the completed questionnaires. Participants were assured that their data would remain anonymous, be kept confidential and be stored safely. Of the 382 participants, 61.5% were female, and the remainder were male. The mean age was 62.6 ± 14.1 years (range: 32-91 years). In total, 34.2%, 41.6% and 24% of students reported a negative, neutral and positive attitude to euthanasia, respectively. Most students with clinical experience, and 38.5% of students with no clinical experience, indicated their agreement with active euthanasia. There are a number of misconceptions among Iranian Muslim nursing students regarding the definition of euthanasia. Nonetheless, most students exhibit positive attitudes to euthanasia consistent with their clinical experiences. It is recommended to explore the factors that induced nursing students' tendency to euthanasia.

  15. [EUTHANASIA AND ASSISTED SUICIDE].

    Science.gov (United States)

    Lantero, Caroline

    2015-07-01

    Euthanasia and assisted suicide are not part of French laws of bioethics and lack, for the time being, definition and normative framework other than their criminal prosecution. To transform them into a right, these concepts certainly call for an ethical and legal debate. This paper aims to question the ideas to be considered, the conceptual bases and normative tools that may be useful to the discussion.

  16. Euthanasia: An Indian perspective

    OpenAIRE

    Sinha, Vinod K.; Basu, S; Sarkhel, S.

    2012-01-01

    In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or “mercy –killing” of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the ...

  17. Alberta Euthanasia Survey: 3-year follow-up.

    OpenAIRE

    Verhoef, M.J.; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 ...

  18. Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review.

    LENUS (Irish Health Repository)

    McCormack, Ruaidhri

    2012-01-01

    To review studies over a 20-year period that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS), assess efforts to minimise bias in included studies, determine the effect of subgroup variables (e.g. age, gender) on doctors\\' attitudes, and make recommendations for future research. Data sources: Three electronic databases, four pertinent journals, reference lists of included studies. Review methods: Literature search of English articles between January 1990 and April 2010. Studies were excluded if they did not present independent data (e.g. commentaries) or if they related to doctors outside the UK, patients younger than 18 years old, terminal sedation, withdrawing or withholding treatment, or double-effect. Quantitative and qualitative data were extracted.

  19. Sensory modulation of voluntary and TMS-induced activation in hand muscles.

    Science.gov (United States)

    Kofler, Markus; Valls-Solé, Josep; Fuhr, Peter; Schindler, Christian; Zaccaria, Barbara R; Saltuari, Leopold

    2008-07-01

    Nociceptive suppression of tonic voluntary electromyographic (EMG) activity in human hand muscles (cutaneous silent period, CSP) is in its functional organization consistent with a spinal protective reflex. Motoneuronal excitability and its modulation may also be investigated by conditioned motor evoked potentials (MEPs). To date, effects of exteroceptive stimuli on tonic EMG and on MEPs have been compared mainly using innocuous stimuli, while noxious stimuli have not been studied in great detail. In ten subjects, we recorded CSPs induced in volitionally activated flexor pollicis brevis muscle (FPB) by noxious digit II (D2) stimulation, and in first dorsal interosseous muscle (FDI) following noxious D2 and digit V (D5) stimulation. Then, transcranial magnetic stimulation (TMS) was used to evoke MEPs in the same hand muscles at rest--conditioned by equal noxious D2 or D5 stimulation and individually delayed--so that the MEPs occurred at times corresponding to immediately before, during, and immediately after the CSP in each subject. Immediately before the CSP, there was no significant difference between nociceptive MEP modulation and tonic EMG modulation in any muscle-finger-combination. In the middle of the CSP, noxious finger stimulation exerted suppression of TMS-induced MEPs in all the three muscle-finger-combinations, but less so as compared to corresponding tonic EMG levels. After the CSP, MEPs remained suppressed when corresponding tonic EMG levels were significantly enhanced. Notably, MEPs were also suppressed in cases when occurring at times corresponding to the excitatory long-loop reflex. Incomplete MEP suppression during the CSP may allow for an "emergency grip" even during noxious stimulation. MEP suppression outlasting the CSP is compatible with a "passive" re-synchronization of volitionally activated motor units rather than an "active" reflex involving recruitment of corticospinal motoneurons. The differences in tonic EMG and MEP modulation favors an

  20. Physiologic, Behavioral, and Histologic Responses to Various Euthanasia Methods in C57BL/6NTac Male Mice

    Science.gov (United States)

    Boivin, Gregory P; Bottomley, Michael A; Schiml, Patricia A; Goss, Lori; Grobe, Nadja

    2017-01-01

    Rodent euthanasia using exposure to increasing concentrations of CO2 has come under scrutiny due to concerns of potential pain during the euthanasia process. Alternatives to CO2, such as isoflurane and barbiturates, have been proposed as more humane methods of euthanasia. In this study, we examined 3 commonly used euthanasia methods in mice: intraperitoneal injection of pentobarbital–phenytoin solution, CO2 inhalation, and isoflurane anesthesia followed by CO2 inhalation. We hypothesized that pentobarbital–phenytoin euthanasia would cause fewer alterations in cardiovascular response, result in less behavioral evidence of pain or stress, and produce lower elevations in ACTH than would the isoflurane and CO2 methods, which we hypothesized would not differ in regard to these parameters. ACTH data suggested that pentobarbital–phenytoin euthanasia may be less stressful to mice than are isoflurane and CO2 euthanasia. Cardiovascular, behavioral, and activity data did not consistently or significantly support isoflurane or pentobarbital–phenytoin euthanasia as less stressful methods than CO2. Euthanasia with CO2 was the fastest method of the 3 techniques. Therefore, we conclude that using CO2 with or without isoflurane is an acceptable euthanasia method. Pathologic alterations in the lungs were most severe with CO2 euthanasia, and alternative euthanasia techniques likely are better suited for studies that rely on analysis of the lungs. PMID:28905718

  1. Euthanasia and assisted suicide in selected European countries and US states: systematic literature review.

    Science.gov (United States)

    Steck, Nicole; Egger, Matthias; Maessen, Maud; Reisch, Thomas; Zwahlen, Marcel

    2013-10-01

    Legal in some European countries and US states, physician-assisted suicide and voluntary active euthanasia remain under debate in these and other countries. The aim of the study was to examine numbers, characteristics, and trends over time for assisted dying in regions where these practices are legal: Belgium, Luxembourg, the Netherlands, Switzerland, Oregon, Washington, and Montana. This was a systematic review of journal articles and official reports. Medline and Embase databases were searched for relevant studies, from inception to end of 2012. We searched the websites of the health authorities of all eligible countries and states for reports on physician-assisted suicide or euthanasia and included publications that reported on cases of physician-assisted suicide or euthanasia. We extracted information on the total number of assisted deaths, its proportion in relation to all deaths, and socio-demographic and clinical characteristics of individuals assisted to die. A total of 1043 publications were identified; 25 articles and reports were retained, including series of reported cases, physician surveys, and reviews of death certificates. The percentage of physician-assisted deaths among all deaths ranged from 0.1%-0.2% in the US states and Luxembourg to 1.8%-2.9% in the Netherlands. Percentages of cases reported to the authorities increased in most countries over time. The typical person who died with assistance was a well-educated male cancer patient, aged 60-85 years. Despite some common characteristics between countries, we found wide variation in the extent and specific characteristics of those who died an assisted death.

  2. Euthanasia and relief of suffering: attitudes of medical students.

    Science.gov (United States)

    Ramírez-Rivera, J; Ramos, O

    1995-01-01

    Medical students, from the first, second and third year classes of the University of Puerto Rico School of Medicine, answered a questionnaire which included testing knowledge and attitudes about euthanasia and the relief of suffering. More than 60% of each class participated, a total of two hundred. Ninety three percent of the students knew the definition of euthanasia but 50 percent could not tell the difference between active and passive euthanasia. Students in the first year were better oriented than their counterparts in the third year (58 percent versus 44 percent). Seventy percent of the 100 students who could differentiate between active and passive euthanasia thought that active euthanasia should not be considered murder, but 69 percent were cognizant it was so considered in Puerto Rico. Eighty-three percent of first year students but only 61 percent of third year students thought that physicians should alleviate suffering of terminally ill patients. Medical schools should provide a serious, unprejudiced and complete discussion of euthanasia and other life and death issues in their curricula. A humane orientation of medical students should be given as much emphasis as other aspects of professional training.

  3. Age and Acceptance of Euthanasia.

    Science.gov (United States)

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  4. Age and Acceptance of Euthanasia.

    Science.gov (United States)

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  5. Physician assisted suicide: the great Canadian euthanasia debate.

    Science.gov (United States)

    Schafer, Arthur

    2013-01-01

    A substantial majority of Canadians favours a change to the Criminal Code which would make it legally permissible, subject to careful regulation, for patients suffering from incurable physical illness to opt for either physician assisted suicide (PAS) or voluntary active euthanasia (VAE). This discussion will focus primarily on the arguments for and against decriminalizing physician assisted suicide, with special reference to the British Columbia case of Lee Carter vs. Attorney General of Canada. The aim is to critique the arguments and at the same time to describe the contours of the current Canadian debate. Both ethical and legal issues raised by PAS are clarified. Empirical evidence available from jurisdictions which have followed the regulatory route is presented and its relevance to the slippery slope argument is considered. The arguments presented by both sides are critically assessed. The conclusion suggested is that evidence of harms to vulnerable individuals or to society, consequent upon legalization, is insufficient to support continued denial of freedom to those competent adults who seek physician assistance in hastening their death. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Euthanasia for Detainees in Belgium.

    Science.gov (United States)

    Devolder, Katrien

    2016-07-01

    In 2011, Frank Van Den Bleeken became the first detainee to request euthanasia under Belgium's Euthanasia Act of 2002. This article investigates whether it would be lawful and morally permissible for a doctor to accede to this request. Though Van Den Bleeken has not been held accountable for the crimes he committed, he has been detained in an ordinary prison, without appropriate psychiatric care, for more than 30 years. It is first established that Van Den Bleeken's euthanasia request plausibly meets the relevant conditions of the Euthanasia Act and that, consequently, a doctor could lawfully fulfill it. Next, it is argued that autonomy-based reasons for euthanizing him outweigh complicity-based reasons against doing so, and that, therefore, it is also morally permissible for a doctor to carry out the euthanasia request.

  7. To end life or not to prolong life: the effect of message framing on attitudes toward euthanasia.

    Science.gov (United States)

    Gamliel, Eyal

    2013-05-01

    People ascribe "euthanasia" different values and view it differently. This study hypothesized that a different framing of objectively the same euthanasia situations would affect people's attitudes toward it. Indeed, "positive" framing of euthanasia as not prolonging life resulted in more support for both passive and active euthanasia relative to "negative" framing of the objectively same situations as ending life. Two experiments replicated this pattern using either continuous measures of attitude or dichotomous measures of choice. The article offers two theoretical explanations for the effect of message framing on attitudes toward euthanasia, discusses implications of this effect, and suggests future research.

  8. Voluntary activities and online education for digital heritage inventory development after the Great East Japan Earthquake

    OpenAIRE

    近藤康久; Yasuhisa Kondo; 魚津知克; Tomokatsu Uozu; 清野陽一; Yoichi Seino; 阿児雄之; Takayuki Ako; 合田美子; Yoshiko Goda; 藤本悠; Yu Fujimoto; 山口欧志; Hiroshi Yamaguchi

    2013-01-01

    Consortium for Earthquake-Damaged Cultural Heritage (CEDACH) is a voluntary initiative launched just after the Great East Japan Earthquake on 11 March 2011. The consortium is developing a social network between local cultural resource managers restoring disaster-damaged cultural heritage on one side and remote researchers including historians, archaeologists and specialists of cultural information studies on the other side, in order to facilitate collaborative projects. This paper presents th...

  9. VOLUNTARY ACTIVITIES AND ONLINE EDUCATION FOR DIGITAL HERITAGE INVENTORY DEVELOPMENT AFTER THE GREAT EAST JAPAN EARTHQUAKE

    OpenAIRE

    Kondo, Y.; Uozu, T.; Seino, Y.; Ako, T.; Goda, Y; Fujimoto, Y.; Yamaguchi, H

    2013-01-01

    Consortium for Earthquake-Damaged Cultural Heritage (CEDACH) is a voluntary initiative launched just after the Great East Japan Earthquake on 11 March 2011. The consortium is developing a social network between local cultural resource managers restoring disaster-damaged cultural heritage on one side and remote researchers including historians, archaeologists and specialists of cultural information studies on the other side, in order to facilitate collaborative projects. This paper pr...

  10. Determinants of favourable opinions about euthanasia in a sample of French physicians.

    Science.gov (United States)

    Dany, Lionel; Baumstarck, Karine; Dudoit, Eric; Duffaud, Florence; Auquier, Pascal; Salas, Sébastien

    2015-11-05

    The question whether euthanasia should be legalised has led to substantial public debate in France. The objective of this study in a sample of French physicians was to establish the potential determinants of a favourable opinion about euthanasia in general and when faced with a specific situation as embodied in the Humbert affair. The study was a cross-sectional survey investigating two different samples of medical doctors: (1) those specialised in palliative care and affiliated to the French Society for Patient Accompaniment and Palliative Care; (2) medical interns (medical doctors in training course) in a French medical university (Marseille). A questionnaire was sent (email) to each voluntary participant including sociodemographics, professional status, mention of believing in God, and opinion about euthanasia (the question was designed to assess the general opinion about euthanasia and the opinion about a specific case, the Vincent Humbert' case (a man who was rendered quadriplegic, blind, and mute after an accident and has requested euthanasia). A total of 413 physicians participated in the research (participation rate: 48.5%). Less than half of the population were favourable to euthanasia in general and almost two-thirds of the population were favourable to Vincent Humbert's request for euthanasia. Based on the multivariate analysis, individuals believing in God and being a medical intern were significant independent factors linked to having a favourable opinion about euthanasia in general and about the Vincent Humbert's request. There is still no study in France on the development of opinion about euthanasia and its impact. The issue goes beyond the strictly professional sphere and involves broader socio-political stakes. These stakes do not necessarily take into account medical practices and experiences or the desires of end-of-life patients. The professional upheaval that the future French legal framework will doubtlessly trigger will require further

  11. A minimalist legislative solution to the problem of euthanasia.

    Science.gov (United States)

    Komesaroff, Paul A; Charles, Stephen

    2015-05-18

    Intense debate has continued for many years about whether voluntary euthanasia or assisted suicide should be permitted by law. The community is bitterly divided and there has been vigorous opposition from medical practitioners and the Australian Medical Association. Despite differences of religious and philosophical convictions and ethical values, there is widespread community agreement that people with terminal illnesses are entitled to adequate treatment, and should also be allowed to make basic choices about when and how they die. A problem with the current law is that doctors who follow current best practice cannot be confident that they will be protected from criminal prosecution. We propose simple changes to Commonwealth and state legislation that recognise community concerns and protect doctors acting in accordance with best current practice. This minimalist solution should be widely acceptable to the community, including both the medical profession and those who object to euthanasia for religious reasons. Important areas of disagreement will persist that can be addressed in future debates.

  12. Sex-dependent effects of developmental exposure to bisphenol A and ethinyl estradiol on metabolic parameters and voluntary physical activity.

    Science.gov (United States)

    Johnson, S A; Painter, M S; Javurek, A B; Ellersieck, M R; Wiedmeyer, C E; Thyfault, J P; Rosenfeld, C S

    2015-12-01

    Endocrine disrupting chemicals (EDC) have received considerable attention as potential obesogens. Past studies examining obesogenic potential of one widespread EDC, bisphenol A (BPA), have generally focused on metabolic and adipose tissue effects. However, physical inactivity has been proposed to be a leading cause of obesity. A paucity of studies has considered whether EDC, including BPA, affects this behavior. To test whether early exposure to BPA and ethinyl estradiol (EE, estrogen present in birth control pills) results in metabolic and such behavioral disruptions, California mice developmentally exposed to BPA and EE were tested as adults for energy expenditure (indirect calorimetry), body composition (echoMRI) and physical activity (measured by beam breaks and voluntary wheel running). Serum glucose and metabolic hormones were measured. No differences in body weight or food consumption were detected. BPA-exposed females exhibited greater variation in weight than females in control and EE groups. During the dark and light cycles, BPA females exhibited a higher average respiratory quotient than control females, indicative of metabolizing carbohydrates rather than fats. Various assessments of voluntary physical activity in the home cage confirmed that during the dark cycle, BPA and EE-exposed females were significantly less active in this setting than control females. Similar effects were not observed in BPA or EE-exposed males. No significant differences were detected in serum glucose, insulin, adiponectin and leptin concentrations. Results suggest that females developmentally exposed to BPA exhibit decreased motivation to engage in voluntary physical activity and altered metabolism of carbohydrates v. fats, which could have important health implications.

  13. Stockperson attitudes toward pig euthanasia.

    Science.gov (United States)

    Rault, J-L; Holyoake, T; Coleman, G

    2017-02-01

    Euthanasia is a necessary act for any facility keeping live animals. Nevertheless, the crucial role and responsibility of the stockperson in deciding and conducting on-farm euthanasia has been overlooked. Stockperson characteristics and knowledge that lead to appropriate decision-making and the skills to competently perform the procedure remain to be identified. An important component of the stockperson's characteristics that predict behavior is the stockperson's attitudes. This preliminary study investigated the factors that influence stockperson attitudes toward the practice of on-farm euthanasia in the pork industry. A total of 120 stockpeople from 10 Australian pig farms (ranging in size from 50 to 4,754 sows and from 2 to 32 employees) completed a questionnaire based on focus group input to assess their attitudes toward euthanasia and decision processes. Factors identified included stockperson attitudes and attributes (empathy affect, empathy attribution, feeling bad about euthanizing, and negative attitudes to pigs), beliefs about the working environment (perceived time constraints and relying on others), and factors related to decision-making (comfortable with euthanasia, trouble deciding and avoid if possible, confidence, insufficient knowledge, seeking knowledge, and using sources to get advice). Numerous significant correlations were found between these variables. Furthermore, regression analyses showed confidence as the only significant predictor of being comfortable with euthanasia (12.5% of the variance; euthanasia ( euthanasia, which comprises both a decision-making process and the act itself, can adversely affect stockpeople. This preliminary study offers insights for implementation of successful practical and humane pig euthanasia protocols on farm. This will benefit stockperson well-being and animal well-being alike.

  14. Augmentation of Voluntary Locomotor Activity by Transcutaneous Spinal Cord Stimulation in Motor-Incomplete Spinal Cord-Injured Individuals.

    Science.gov (United States)

    Hofstoetter, Ursula S; Krenn, Matthias; Danner, Simon M; Hofer, Christian; Kern, Helmut; McKay, William B; Mayr, Winfried; Minassian, Karen

    2015-10-01

    The level of sustainable excitability within lumbar spinal cord circuitries is one of the factors determining the functional outcome of locomotor therapy after motor-incomplete spinal cord injury. Here, we present initial data using noninvasive transcutaneous lumbar spinal cord stimulation (tSCS) to modulate this central state of excitability during voluntary treadmill stepping in three motor-incomplete spinal cord-injured individuals. Stimulation was applied at 30 Hz with an intensity that generated tingling sensations in the lower limb dermatomes, yet without producing muscle reflex activity. This stimulation changed muscle activation, gait kinematics, and the amount of manual assistance required from the therapists to maintain stepping with some interindividual differences. The effect on motor outputs during treadmill-stepping was essentially augmentative and step-phase dependent despite the invariant tonic stimulation. The most consistent modification was found in the gait kinematics, with the hip flexion during swing increased by 11.3° ± 5.6° across all subjects. This preliminary work suggests that tSCS provides for a background increase in activation of the lumbar spinal locomotor circuitry that has partially lost its descending drive. Voluntary inputs and step-related feedback build upon the stimulation-induced increased state of excitability in the generation of locomotor activity. Thus, tSCS essentially works as an electrical neuroprosthesis augmenting remaining motor control.

  15. Voluntary Exercise Promotes Glymphatic Clearance of Amyloid Beta and Reduces the Activation of Astrocytes and Microglia in Aged Mice

    Directory of Open Access Journals (Sweden)

    Xiao-fei He

    2017-05-01

    Full Text Available Age is characterized by chronic inflammation, leading to synaptic dysfunction and dementia because the clearance of protein waste is reduced. The clearance of proteins depends partly on the permeation of the blood–brain barrier (BBB or on the exchange of water and soluble contents between the cerebrospinal fluid (CSF and the interstitial fluid (ISF. A wealth of evidence indicates that physical exercise improves memory and cognition in neurodegenerative diseases during aging, such as Alzheimer’s disease (AD, but the influence of physical training on glymphatic clearance, BBB permeability and neuroinflammation remains unclear. In this study, glymphatic clearance and BBB permeability were evaluated in aged mice using in vivo two-photon imaging. The mice performed voluntary wheel running exercise and their water-maze cognition was assessed; the expression of the astrocytic water channel aquaporin 4 (AQP4, astrocyte and microglial activation, and the accumulation of amyloid beta (Aβ were evaluated with immunofluorescence or an enzyme-linked immunosorbent assay (ELISA; synaptic function was investigated with Thy1–green fluorescent protein (GFP transgenic mice and immunofluorescent staining. Voluntary wheel running significantly improved water-maze cognition in the aged mice, accelerated the efficiency of glymphatic clearance, but which did not affect BBB permeability. The numbers of activated astrocytes and microglia decreased, AQP4 expression increased, and the distribution of astrocytic AQP4 was rearranged. Aβ accumulation decreased, whereas dendrites, dendritic spines and postsynaptic density protein (PSD95 increased. Our study suggests that voluntary wheel running accelerated glymphatic clearance but not BBB permeation, improved astrocytic AQP4 expression and polarization, attenuated the accumulation of amyloid plaques and neuroinflammation, and ultimately protected mice against synaptic dysfunction and a decline in spatial cognition

  16. Role of the Dorsal Medial Habenula in the Regulation of Voluntary Activity, Motor Function, Hedonic State, and Primary Reinforcement

    Science.gov (United States)

    Hsu, Yun-Wei A.; Wang, Si D.; Wang, Shirong; Morton, Glenn; Zariwala, Hatim A.; de la Iglesia, Horacio O.

    2014-01-01

    The habenular complex in the epithalamus consists of distinct regions with diverse neuronal populations. Past studies have suggested a role for the habenula in voluntary exercise motivation and reinforcement of intracranial self-stimulation but have not assigned these effects to specific habenula subnuclei. Here, we have developed a genetic model in which neurons of the dorsal medial habenula (dMHb) are developmentally eliminated, via tissue-specific deletion of the transcription factor Pou4f1 (Brn3a). Mice with dMHb lesions perform poorly in motivation-based locomotor behaviors, such as voluntary wheel running and the accelerating rotarod, but show only minor abnormalities in gait and balance and exhibit normal levels of basal locomotion. These mice also show deficits in sucrose preference, but not in the forced swim test, two measures of depression-related phenotypes in rodents. We have also used Cre recombinase-mediated expression of channelrhodopsin-2 and halorhodopsin to activate dMHb neurons or silence their output in freely moving mice, respectively. Optical activation of the dMHb in vivo supports intracranial self-stimulation, showing that dMHb activity is intrinsically reinforcing, whereas optical silencing of dMHb outputs is aversive. Together, our findings demonstrate that the dMHb is involved in exercise motivation and the regulation of hedonic state, and is part of an intrinsic reinforcement circuit. PMID:25143617

  17. Role of the dorsal medial habenula in the regulation of voluntary activity, motor function, hedonic state, and primary reinforcement.

    Science.gov (United States)

    Hsu, Yun-Wei A; Wang, Si D; Wang, Shirong; Morton, Glenn; Zariwala, Hatim A; de la Iglesia, Horacio O; Turner, Eric E

    2014-08-20

    The habenular complex in the epithalamus consists of distinct regions with diverse neuronal populations. Past studies have suggested a role for the habenula in voluntary exercise motivation and reinforcement of intracranial self-stimulation but have not assigned these effects to specific habenula subnuclei. Here, we have developed a genetic model in which neurons of the dorsal medial habenula (dMHb) are developmentally eliminated, via tissue-specific deletion of the transcription factor Pou4f1 (Brn3a). Mice with dMHb lesions perform poorly in motivation-based locomotor behaviors, such as voluntary wheel running and the accelerating rotarod, but show only minor abnormalities in gait and balance and exhibit normal levels of basal locomotion. These mice also show deficits in sucrose preference, but not in the forced swim test, two measures of depression-related phenotypes in rodents. We have also used Cre recombinase-mediated expression of channelrhodopsin-2 and halorhodopsin to activate dMHb neurons or silence their output in freely moving mice, respectively. Optical activation of the dMHb in vivo supports intracranial self-stimulation, showing that dMHb activity is intrinsically reinforcing, whereas optical silencing of dMHb outputs is aversive. Together, our findings demonstrate that the dMHb is involved in exercise motivation and the regulation of hedonic state, and is part of an intrinsic reinforcement circuit.

  18. Voluntary Slavery

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2014-06-01

    Full Text Available The permissibility of actions depends upon facts about the flourishing and separateness of persons. Persons differ from other creatures in having the task of discovering for themselves, by conjecture and refutation, what sort of life will fulfil them. Compulsory slavery impermissibly prevents some persons from pursuing this task. However, many people may conjecture that they are natural slaves. Some of these conjectures may turn out to be correct. In consequence, voluntary slavery, in which one person welcomes the duty to fulfil all the commands of another, is permissible. Life-long voluntary slavery contracts are impermissible because of human fallibility; but fixed-term slavery contracts should be legally enforceable. Each person has the temporarily alienable moral right to direct her own life.

  19. Voluntary Slavery

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2014-06-01

    Full Text Available The permissibility of actions depends upon facts about the flourishing and separateness of persons. Persons differ from other creatures in having the task of discovering for themselves, by conjecture and refutation, what sort of life will fulfil them. Compulsory slavery impermissibly prevents some persons from pursuing this task. However, many people may conjecture that they are natural slaves. Some of these conjectures may turn out to be correct. In consequence, voluntary slavery, in which one person welcomes the duty to fulfil all the commands of another, is permissible. Life-long voluntary slavery contracts are impermissible because of human fallibility; but fixed-term slavery contracts should be legally enforceable. Each person has the temporarily alienable moral right to direct her own life.

  20. What people close to death say about euthanasia and assisted suicide: a qualitative study

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-01-01

    Objective To explore the experiences of people with a “terminal illness”, focusing on the patients' perspective of euthanasia and assisted suicide. Method A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non‐malignant. Results That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Conclusion Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. PMID:17145910

  1. What people close to death say about euthanasia and assisted suicide: a qualitative study.

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-12-01

    To explore the experiences of people with a "terminal illness", focusing on the patients' perspective of euthanasia and assisted suicide. A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a "terminal" illness, malignant or non-malignant. That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death.

  2. [Euthanasia: medications and medical procedures].

    Science.gov (United States)

    Lossignol, D

    2008-09-01

    The Belgian law relative to euthanasia has been published in 2002. A physician is allowed to help a patient with intractable suffering (physical or psychological). Legal conditions are clear. However, nothing is said about medical procedures or medications to be used. The present paper will present specific clinical situations at the end of life, practical procedures and medications. A special focus is made on psychological impact of euthanasia.

  3. [Euthanasia and the physician].

    Science.gov (United States)

    Martins, A G

    1991-01-01

    The problem of Euthanasia is approached in the light of the Hippocratic principles, which have not changed with time but have only been adapted to new scientific and social developments. The definition of what constitutes Euthanasia is clarified and the need to avoid that semantic mutations may manipulate ideas is stressed, so that what is certainly wrong does not seem to appear as right. The uniqueness and individuality of the human being is emphasized as well as the commitment of doctors to their patients wellbeing, although at times a balance may be needed in relation to some apparently conflicting interests of society as a whole. The importance of the doctor/patient relationship is stressed, particularly in the final stages of terminal disease. Decisions concerning life and death, although preferably to be shared, still rest most times upon the doctor's shoulders alone. The respect for the wishes of the patients, their right to know the truth and its limits, the use of the living will, the right to die in dignity, the use of ordinary or extraordinary means of treatment, the concept of brain death and the rules for resuscitation, are commented upon. In all cases, the need for a global and individualized approach is mandatory before any final decision is made. Total respect for human life, from its beginning to its end is emphasized, intentional killing, for whatever reason or motivation, is firmly rejected. Reference is made to national and international codes of ethics as well as to declarations and statements of the World Medical Association.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Attitude toward euthanasia scale: psychometric properties and relations with religious orientation, personality, and life satisfaction.

    Science.gov (United States)

    Aghababaei, Naser; Wasserman, Jason Adam

    2013-12-01

    End-of-life decisions (ELDs) represent a controversial subject, with ethical dilemmas and empirical ambiguities that stand at the intersection of ethics and medicine. In a non-Western population, we examined individual differences in perceiving ELDs that end the life of a patient as acceptable and found that an attitude toward euthanasia (ATE) scale consists of 2 factors representing voluntary and nonvoluntary euthanasia. Also, acceptance of ELDs that end the life of a patient negatively correlated with life satisfaction, honesty-humility, conscientiousness, and intrinsic and extrinsic personal motivation toward religion. These findings provided additional construct validity of the ATE scale.

  5. Strength Training to Contraction Failure Increases Voluntary Activation of the Quadriceps Muscle Shortly After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Mikkelsen, Elin Karin; Jakobsen, Thomas Linding; Holsgaard-Larsen, Anders;

    2016-01-01

    OBJECTIVE: The objective of this study was to investigate voluntary activation of the quadriceps muscle during one set of knee extensions performed until contraction failure in patients shortly after total knee arthroplasty. DESIGN: This was a cross-sectional study of 24 patients with total knee...... arthroplasty. One set of knee extensions was performed until contraction failure, using a predetermined 10 repetition maximum loading. In the operated leg, electromyographic (EMG) activity of the lateral and medial vastus, semitendinosus, and biceps femoris muscles was recorded during the set. Muscle activity...... (%EMGmax) and median power frequency of the EMG power spectrum were calculated for each repetition decile (10%-100% contraction failure). RESULTS: Muscle activity increased significantly over contractions from a mean of 90.0 and 93.6 %EMGmax (lateral vastus and medial vastus, respectively) at 10...

  6. Ethical And Religious Analysis On Euthanasia

    Directory of Open Access Journals (Sweden)

    Abdi Omar Shuriye

    2012-01-01

    Full Text Available This paper is an analysis on euthanasia from ethical and religious perspectives. Historically, the classical Greek thinkers including Aristotle had categorically accepted euthanasia with the main reason of minimizing pain. However, as science develops ethical and religious isuues related to the subject have increasingly created fervent debates on euthanesia. ABSTRAK: Kertas ini mengkaji euthanasia dari perspektif agama dan etika. Sejarah telah melihat para pemikir Greek termasuk Aristotle secara kategorinya menerima Euthanasia dengan sebab utama untuk mengurangkan kesakitan. Bagaimanapun, apabila sains berkembang, perbahasan mengenai isu-isu agama dan etika tentang Euthanasia telah meningkat dengan nyata.KEYWORDS: mercy killing; religion; ethics; morality; euthanasia

  7. Optimal Combinations of Isometric Normalization Tests for the Production of Maximum Voluntary Activation of the Shoulder Muscles.

    Science.gov (United States)

    Dal Maso, Fabien; Marion, Patrick; Begon, Mickaël

    2016-09-01

    To identify the smallest combinations of maximum voluntary isometric contraction (MVIC) tests that produce near-maximum voluntary activation (MVA) for a large proportion of participants for the shoulder girdle muscles. Cross-sectional study. Research center. Healthy participants (N=38). Not applicable. The electromyography of 12 shoulder muscles was recorded while participants performed 15 MVIC tests. The smallest combinations of MVIC tests that met our acceptance criterion (ie, produce 90% of MVA for 90% of participants) were identified. Optimal combinations were identified for each of the 12 muscles individually and for the 12 muscles simultaneously. Electromyographic activation levels of the 95th highest percentile obtained with our optimal combinations and with the Four Normalization Tests previously recommended were compared using paired t tests. Between 2 and 6 MVIC tests were required for each of the 12 muscles, and 12 MVIC tests were required for the 12 muscles to meet the acceptance criterion. These optimal combinations produced electromyographic activation levels of the 95th highest percentile comprised between 97% and 100% of MVA. These electromyographic activation levels were significantly higher than the electromyographic activation levels obtained with the Four Normalization Tests. Although the number of MVIC tests to normalize 12 shoulder muscles was increased compared with previous recommendations, the proposed method ensures that near-MVA (>90%) was obtained for a large proportion of participants (>90%). Moreover, because electromyographic activation levels of the 95th highest percentile were at least 97% of MVA, the identified combinations could reduce the interparticipant variability. The proposed combinations could help to improve electromyographic normalization and therefore reduce the misinterpretations regarding shoulder muscle activation levels. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All

  8. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

    Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

  9. [Euthanasia: the law, a few notions and the question of assisted suicide].

    Science.gov (United States)

    Herremans, J

    2008-09-01

    Conforming to the Belgian Law on Euthanasia of 28 May 2002, the definition of euthanasia is "an act practised by a third party intentionally, ending the life of a person at that person's request". Doctors who practise euthanasia commit no offence if they follow the prescribed conditions and procedures. The voluntary, well considered request for euthanasia must be initiated by an adult patient, complaining of unbearable physical or mental suffering caused by a serious and incurable medical condition, whether accidental or pathological. Consultation with a second doctor is required. If the death is not to be expected within a short period of time--in other words, for not terminally-ill patients--, the intervention of a third doctor is required, either a psychiatrist or a specialist of the patient's pathology. In that case, a delay of at least one month between the request and the euthanasia has to be respected. The doctor must declare the act of euthanasia to a Federal Commission composed of 8 doctors, 4 lawyers and 4 persons familiar with the problems of patients suffering from an incurable disease. This Commission has also to produce every other year a statistical and evaluation report for Parliament. The living will, called "advance declaration", is officially recognized but strictly limited to the state of irreversible unconsciousness of the patient. This law on the de-criminalization of euthanasia recognizes the right of personal autonomy for the patient and the principle of freedom of conscience for everyone. The law refers explicitly to the concept of euthanasia but does not specify the method to be used by the doctor. If it is the wish of the patient, and if the physical condition of the patient allows this solution, "assisted suicide" is permitted.

  10. Attitudes towards euthanasia among Greek intensive care unit physicians and nurses.

    Science.gov (United States)

    Kranidiotis, Georgios; Ropa, Julia; Mprianas, John; Kyprianou, Theodoros; Nanas, Serafim

    2015-01-01

    To investigate the attitudes of Greek intensive care unit (ICU) medical and nursing staff towards euthanasia. ICU physicians and nurses deal with end-of-life dilemmas on a daily basis. Therefore, the exploration of their stances on euthanasia is worthwhile. This was a descriptive quantitative study conducted in three ICUs in Athens. The convenience sample included 39 physicians and 107 nurses. Of respondents, 52% defined euthanasia inaccurately, as withholding or withdrawal of treatment, while 15% ranked limitation of life-support among the several forms of euthanasia, together with active shortening of the dying process and physician - assisted suicide. Only one third of participants defined euthanasia correctly. While 59% of doctors and 64% of nurses support the legalization of active euthanasia, just 28% and 26% of them, respectively, agree with it ethically. Confusion prevails among Greek ICU physicians and nurses regarding the definition of euthanasia. The majority of staff disagrees with active euthanasia, but upholds its legalization. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Ethical And Religious Analysis On Euthanasia

    National Research Council Canada - National Science Library

    Abdi Omar Shuriye

    2012-01-01

    This paper is an analysis on euthanasia from ethical and religious perspectives. Historically, the classical Greek thinkers including Aristotle had categorically accepted euthanasia with the main reason of minimizing pain...

  12. Voluntary exercise contributed to an amelioration of abnormal feeding behavior, locomotor activity and ghrelin production concomitantly with a weight reduction in high fat diet-induced obese rats.

    Science.gov (United States)

    Mifune, Hiroharu; Tajiri, Yuji; Nishi, Yoshihiro; Hara, Kento; Iwata, Shimpei; Tokubuchi, Ichiro; Mitsuzono, Ryouichi; Yamada, Kentaro; Kojima, Masayasu

    2015-09-01

    In the present study, effects of voluntary exercise in an obese animal model were investigated in relation to the rhythm of daily activity and ghrelin production. Male Sprague-Dawley rats were fed either a high fat diet (HFD) or a chow diet (CD) from four to 16 weeks old. They were further subdivided into either an exercise group (HFD-Ex, CD-Ex) with a running wheel for three days of every other week or sedentary group (HFD-Se, CD-Se). At 16 weeks old, marked increases in body weight and visceral fat were observed in the HFD-Se group, together with disrupted rhythms of feeding and locomotor activity. The induction of voluntary exercise brought about an effective reduction of weight and fat, and ameliorated abnormal rhythms of activity and feeding in the HFD-Ex rats. Wheel counts as voluntary exercise was greater in HFD-Ex rats than those in CD-Ex rats. The HFD-obese had exhibited a deterioration of ghrelin production, which was restored by the induction of voluntary exercise. These findings demonstrated that abnormal rhythms of feeding and locomotor activity in HFD-obese rats were restored by infrequent voluntary exercise with a concomitant amelioration of the ghrelin production and weight reduction. Because ghrelin is related to food anticipatory activity, it is plausible that ghrelin participates in the circadian rhythm of daily activity including eating behavior. A beneficial effect of voluntary exercise has now been confirmed in terms of the amelioration of the daily rhythms in eating behavior and physical activity in an animal model of obesity. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Effects of voluntary exercise on spontaneous physical activity and food consumption in mice: Results from an artificial selection experiment.

    Science.gov (United States)

    Copes, Lynn E; Schutz, Heidi; Dlugosz, Elizabeth M; Acosta, Wendy; Chappell, Mark A; Garland, Theodore

    2015-10-01

    We evaluated the effect of voluntary exercise on spontaneous physical activity (SPA) and food consumption in mice from 4 replicate lines bred for 57 generations for high voluntary wheel running (HR) and from 4 non-selected control (C) lines. Beginning at ~24 days of age, mice were housed in standard cages or in cages with attached wheels. Wheel activity and SPA were monitored in 1-min intervals. Data from the 8th week of the experiment were analyzed because mice were sexually mature and had plateaued in body mass, weekly wheel running distance, SPA, and food consumption. Body mass, length, and masses of the retroperitoneal fat pad, liver, and heart were recorded after the 13th week. SPA of both HR and C mice decreased with wheel access, due to reductions in both duration and average intensity of SPA. However, total activity duration (SPA+wheel running; min/day) was ~1/3 greater when mice were housed with wheels, and food consumption was significantly increased. Overall, food consumption in both HR and C mice was more strongly affected by wheel running than by SPA. Duration of wheel running had a stronger effect than average speed, but the opposite was true for SPA. With body mass as a covariate, chronic wheel access significantly reduced fat pad mass and increased heart mass in both HR and C mice. Given that both HR and C mice housed with wheels had increased food consumption, the energetic cost of wheel running was not fully compensated by concomitant reductions in SPA. The experiment demonstrates that both duration and intensity of both wheel running and SPA were significant predictors of food consumption. This sort of detailed analysis of the effects of different aspects of physical activity on food consumption has not previously been reported for a non-human animal, and it sets the stage for longitudinal examination of energy balance and its components in rodent models.

  14. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults - A randomized controlled trial.

    Science.gov (United States)

    Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias; Magnussen, Line V; Andersen, Marianne; Caserotti, Paolo

    2016-07-01

    Incomplete voluntary muscle activation may contribute to impaired muscle mechanical function and physical function in older adults. Exercise interventions have been shown to increase voluntary muscle activation, although the evidence is sparse for mobility-limited older adults, particularly in association with physical function. This study examined the effects of 12weeks of power training on outcomes of voluntary muscle activation and gait speed in mobility-limited older adults from the Healthy Ageing Network of Competence (HANC) study. We included 37 older men and women with a usual gait speed of analysis: n=16 in the training group (TG: 12weeks of progressive high-load power training, 2 sessions per week; age: 82.3±1.3years, 56% women) and n=21 in the control group (CG: no interventions; age: 81.6±1.1years, 67% women). Knee extensor muscle thickness (ultrasonography), strength (isokinetic dynamometry), voluntary activation (interpolated twitch technique), and gait speed (2-min maximal walking test) were assessed at baseline and post-intervention. At baseline, TG and CG were comparable for all measures. Post-intervention, significant between-group changes (TG vs. CG; pgait speed (+0.12m/s), whereas the between-group change in muscle thickness was non-significant (+0.08cm). Improvements in voluntary muscle activation were associated with improvements in gait speed in TG (r=0.67, ppower training, and is associated with improved maximal gait speed. Incomplete voluntary muscle activation should be considered one of the key mechanisms influencing muscle mechanical function and gait speed in older adults.

  15. Explaining the emergence of euthanasia law in the Netherlands : how the sociology of law can help the sociology of bioethics

    NARCIS (Netherlands)

    Weyers, Heleen

    The debate over the legalisation of voluntary euthanasia is most often seen to be the result of three changes in society: individualisation, diminished taboos concerning death and changes in the balance of power in medicine. The fact that these changes occurred in many western countries but led to

  16. Explaining the emergence of euthanasia law in the Netherlands : how the sociology of law can help the sociology of bioethics

    NARCIS (Netherlands)

    Weyers, Heleen

    2006-01-01

    The debate over the legalisation of voluntary euthanasia is most often seen to be the result of three changes in society: individualisation, diminished taboos concerning death and changes in the balance of power in medicine. The fact that these changes occurred in many western countries but led to l

  17. Explaining the emergence of euthanasia law in the Netherlands : how the sociology of law can help the sociology of bioethics

    NARCIS (Netherlands)

    Weyers, Heleen

    2006-01-01

    The debate over the legalisation of voluntary euthanasia is most often seen to be the result of three changes in society: individualisation, diminished taboos concerning death and changes in the balance of power in medicine. The fact that these changes occurred in many western countries but led to l

  18. Do the Physcians Defend Euthanasia

    Directory of Open Access Journals (Sweden)

    Tarık Gündüz

    1996-07-01

    Full Text Available In this study, after the definition and short historical development of Euthanasia, a questionnaire was given to 510 medical staff; 208 of whom are medical students who are in the 5th form and 302 of whom are physcians. In this questionnaire 6 multiple choice questions were asked about the knowledge level, social groups to comment and argue on the subject, the right of person to decide about his/her own life, opinions about current applications of euthanasia, whether he/she would agree on the application of the process and whether he would accept to get a responsibility in it or not. It was determined that among the people who attended the questionnaire, one third didn't have enough knowledge about the subject while 325 (63.72 % of them supported the application, still 351 (68.82 % of them refused to get a responsibility in the application of euthanasia, even if the process becomes legal. Opinions of the people who are with and against the idea were collected and summarized, it was determined that although passive euthanasia is not legal it is currently being applied when it is necessary and that physcians are biased to the legalization of the subject while they refuse to take a role in the application. Keywords : Euthanasia, Self Deliverance, Right to Life, Mercy Killing, Informed Consent

  19. Just how unlawful is "euthanasia"?

    Science.gov (United States)

    Tur, Richard H S

    2002-01-01

    Those who campaign for law reform to permit "euthanasia" may seek different things and at least some of what they seek may already be permissible under the criminal law of England and Wales. In this paper I examine one means whereby the criminal law delivers outcomes acceptable to the euthanasia lobby, that is the curious notion of "causation" deployed by the law, which adds a value override to the more usual notion of factual causation such that, for example, if medical treatment falls within the acceptable range as normal and proper, the pre-existing injury or illness is treated as exclusively the cause of death and the doctor escapes criminal liability, even where the medical treatment will shorten life to the certain knowledge, possibly even the wish, of the doctor. Thus the law may already be delivering a range of outcomes--euthanasia in a weak sense--acceptable to the euthanasia lobby. If so, it achieves this by stealth. That is inappropriate to the doctor-patient relationship, which is one of trust. So there is a strong case for greater transparency. Moreover, there are limits to the acceptable outcomes which an unreformed criminal law can deliver and in a range of cases the criminal law condemns the doctor to impotence and the patient to a prolonged, miserable and undignified death. So there is also a case for going beyond the current law and legalising euthanasia in a strong sense.

  20. Killing people: what Kant could have said about suicide and euthanasia but did not.

    Science.gov (United States)

    Brassington, I

    2006-10-01

    An agent who takes his own life acts in violation of the moral law, according to Kant; suicide, and, by extension, assisted suicide are therefore wrong. By a similar argument, and with a few important exceptions, killing is wrong; implicitly, then, voluntary euthanasia is also wrong. Kant's conclusions are uncompelling and his argument in these matters is undermined on considering other areas of his thought. Kant, in forbidding suicide and euthanasia, is conflating respect for persons and respect for people, and assuming that, in killing a person (either oneself or another), we are thereby undermining personhood. But an argument along these lines is faulty according to Kant's own standards. There is no reason why Kantians have to accept that self-killing and euthanasia are contrary to the moral law. Even if some Kantians adhere to this doctrine, others can reject it.

  1. Killing people: what Kant could have said about suicide and euthanasia but did not

    Science.gov (United States)

    Brassington, I

    2006-01-01

    An agent who takes his own life acts in violation of the moral law, according to Kant; suicide, and, by extension, assisted suicide are therefore wrong. By a similar argument, and with a few important exceptions, killing is wrong; implicitly, then, voluntary euthanasia is also wrong. Kant's conclusions are uncompelling and his argument in these matters is undermined on considering other areas of his thought. Kant, in forbidding suicide and euthanasia, is conflating respect for persons and respect for people, and assuming that, in killing a person (either oneself or another), we are thereby undermining personhood. But an argument along these lines is faulty according to Kant's own standards. There is no reason why Kantians have to accept that self‐killing and euthanasia are contrary to the moral law. Even if some Kantians adhere to this doctrine, others can reject it. PMID:17012496

  2. Belgian euthanasia law: a critical analysis.

    Science.gov (United States)

    Cohen-Almagor, R

    2009-07-01

    Some background information about the context of euthanasia in Belgium is presented, and Belgian law on euthanasia and concerns about the law are discussed. Suggestions as to how to improve the Belgian law and practice of euthanasia are made, and Belgian legislators and medical establishment are urged to reflect and ponder so as to prevent potential abuse.

  3. 21 CFR 522.900 - Euthanasia solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  4. An ethical review of euthanasia web sites.

    Science.gov (United States)

    Ravvaz, Kourosh; Patrick, Timothy B

    2007-10-11

    Euthanasia is an act of mercifully killing or letting die a sick or injured individual, and is an alternative to palliative care. As a healthcare related web site, a euthanasia site should satisfy standard ethical criteria such as the HONcode. In this paper, we report our preliminary review of euthanasia web sites for compliance with HONcode criteria.

  5. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Directory of Open Access Journals (Sweden)

    Erwin Stolz

    Full Text Available Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia.A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971. Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1 abstract description of euthanasia, (2 abstract description of physician-assisted suicide, (3 the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4 the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations including authoritarianism were tested via multiple logistic regression analyses.Rejection was highest in the case of the neonate (69% and lowest for the case of the older cancer patient (35%. A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate.Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  6. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Science.gov (United States)

    Stolz, Erwin; Burkert, Nathalie; Großschädl, Franziska; Rásky, Éva; Stronegger, Willibald J; Freidl, Wolfgang

    2015-01-01

    Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  7. Voluntary Activities and Online Education for Digital Heritage Inventory Development after the Great East Japan Earthquake

    Science.gov (United States)

    Kondo, Y.; Uozu, T.; Seino, Y.; Ako, T.; Goda, Y.; Fujimoto, Y.; Yamaguchi, H.

    2013-07-01

    Consortium for Earthquake-Damaged Cultural Heritage (CEDACH) is a voluntary initiative launched just after the Great East Japan Earthquake on 11 March 2011. The consortium is developing a social network between local cultural resource managers restoring disaster-damaged cultural heritage on one side and remote researchers including historians, archaeologists and specialists of cultural information studies on the other side, in order to facilitate collaborative projects. This paper presents three projects in which CEDACH contributed to the development of a digital inventory for disaster-damaged heritage management through web-based collaborations by self-motivated workers. The first project, CEDACH GIS, developed an online archaeological site inventory for the disaster area. Although a number of individuals voluntarily participated in the project at the beginning, it gradually stagnated due to limited need for local rescue archaeology. However, the experience of online-based collaborations worked well for the second project proposed by local specialists, in which CEDACH restored the book catalogue of a tsunami-devastated research library. This experience highlighted the need for online education to improve information and communication technologies (ICT) skills of data builders. Therefore, in the third project called CEDACHeLi, an e-Learning management system was developed to facilitate learning the fundamental knowledge and techniques required for information processing in rescue operations of disaster-damaged cultural heritage. This system will contribute to improved skills and motivation of potential workers for further developments in digital heritage inventory.

  8. Analgesic Activity of Tramadol and Buprenorphine after Voluntary Ingestion by Rats (Rattus norvegicus).

    Science.gov (United States)

    Taylor, Bryan F; Ramirez, Harvey E; Battles, August H; Andrutis, Karl A; Neubert, John K

    2016-01-01

    Effective pain management for rats and mice is crucial due to the continuing increase in the use of these species in biomedical research. Here we used a recently validated operant orofacial pain assay to determine dose-response curves for buprenorphine and tramadol when mixed in nut paste and administered to male and female rats. Statistically significant analgesic doses of tramadol in nut paste included doses of 20, 30, and 40 mg/kg for female rats but only 40 mg/kg for male rats. For male rats receiving buprenorphine mixed in nut paste, a significant analgesic response was observed at 0.5 and 0.6 mg/kg. None of the doses tested produced a significant analgesic response in female rats. Our results indicate that at the doses tested, tramadol and buprenorphine produced an analgesic response in male rats. In female rats, tramadol shows a higher analgesic effect than buprenorphine. The analgesic effects observed 60 min after administration of the statistically significant oral doses of both drugs were similar to the analgesic effects of 0.03 mg/kg subcutaneous buprenorphine 30 min after administration. The method of voluntary ingestion could be effective, is easy to use, and would minimize stress to the rats during the immediate postoperative period.

  9. Attitudes towards euthanasia and assisted suicide: a comparison between psychiatrists and other physicians.

    Science.gov (United States)

    Levy, Tal Bergman; Azar, Shlomi; Huberfeld, Ronen; Siegel, Andrew M; Strous, Rael D

    2013-09-01

    Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or when the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables.

  10. EUTHANASIA - A STUDY OF LAW, POLICY AND ETHICS

    Directory of Open Access Journals (Sweden)

    Zachariah

    2015-08-01

    Full Text Available Physician assisted suicide (PAS and Euthanasia as it is now known, is essentially the doctrine that when, owing to disease, senility or the like, a person’s life has permanently ceased to be either agreeable or useful , the sufferer should be painlessly killed either by himself or by another. The intentional termination of patient’s life in such a situation by an act or omission of medical care is called euthanasia or mercy killing. This is the most active area of research in contemporary bio ethics. The present article is aimed to have a global overview regarding legalization of euthanasia and the current Indian scenari o, legally and ethically regarding this issue

  11. Variation of magnitude and timing of wrist flexor stretch reflex across the full range of voluntary activation.

    Science.gov (United States)

    Cathers, I; O'Dwyer, N; Neilson, P

    2004-08-01

    This paper reports an investigation of the magnitude and timing of the stretch reflex over the full range of activation of flexor carpi radialis. While it is well established that the magnitude of the reflex increases with the level of muscle activation, there have been few studies of reflex magnitude above 50% of maximum voluntary contraction (MVC) and virtually no study of the timing of the response in relation to activation level. Continuous small amplitude (approximately 2 degrees) perturbations were applied to the wrist of 12 normal subjects while they maintained contraction levels between 2.5-95% MVC, monitored via surface electromyography (EMG). Both narrow band (4-5 Hz) and broad band (0-10 Hz) stretch perturbations were employed. The gain (EMG output/stretch input) and phase advance of the reflex varied with the level of muscle activation in a similar manner for both types of stretch, but there were significant differences in the patterns of change due to stretch bandwidth. Consistent with previous studies, the group average reflex gain initially increased with muscle activation level and then saturated. Inspection of individual data, however, revealed that the gain reached a peak at about 60% MVC and then decreased at higher contraction levels, the pattern across the full range of activation being well described by quadratic functions (mean r2=0.82). This quadratic pattern has not been reported previously for the neural reflex response in any muscle but is consistent with the pattern that has been reliably observed in studies of the mechanical reflex response in lower limb muscles. In contrast to the pattern for reflex gain, the phase advance of the reflex (at a stretch frequency of 4.5 Hz) decreased linearly from approximately 130 degrees at the lowest contraction levels to approximately 50 degrees as maximum voluntary contraction was reached (mean r2=0.69). This decrease corresponds to a delay of 49 ms introduced centrally in reflex pathways. All

  12. Euthanasia in Iranian Criminal System

    Directory of Open Access Journals (Sweden)

    Fatemeh Noori

    2014-03-01

    Full Text Available Mercy killing, euthanasia or killing a person who is terminally ill is not an allowable murder and all kinds of direct killings are in a sense of willful murder. Indirect mercy killing is considered as assisted suicide. According to Iranian criminal system, mercy killing is not allowable because human is a creature superior to an animal and will experience the result of their acts in the eternal world. A lot of efforts are done in many countries for the legalization of euthanasia or mercy killing.

  13. Attitudes of young neurosurgeons and neurosurgical residents towards euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Broekman, M L D; Verlooy, J S A

    2013-11-01

    Euthanasia and physician assisted suicide (PAS) are two controversial topics in neurosurgical practice. Personal attitudes and opinions on these important issues may vary between professionals, and may also depend on their location since current legislation differs between European countries. As these issues may have significant impact on clinical practice, the goal of the present study was to survey the opinions of neurosurgical residents and young neurosurgeons across Europe with respect to euthanasia and physician assisted suicide. We performed a survey among the participants of the European Association of Neurosurgical Societies (EANS) training courses (2011-2012), asking residents and young neurosurgeons nine questions on euthanasia and PAS. For the analysis of this survey, we divided all 295 participants into four European regions (North, South, East, West). We found that even though most residents are aware of regulations about euthanasia or PAS in their country or hospital, a substantial number were not aware of the regulations. We observed no significant differences in terms of their opinions on euthanasia and PAS among the four European regions. While most are actually in favor of euthanasia or PAS, if legally allowed, under appropriate circumstances, very few neurosurgeons would be willing to actively participate in these end-of-life practices. The results of this first survey on neurosurgical residents' attitudes towards euthanasia and PAS show that a significant number of residents is not familiar with national and/or local regulations regarding euthanasia and PAS. If legally allowed, most residents would be in favor of euthanasia and PAS, but only a minority would be willing to actively participate in these practices. We did not observe a difference in stances on euthanasia and PAS among residents from different regions in Europe.

  14. Testosterone and Voluntary Exercise, Alone or Together Increase Cardiac Activation of AKT and ERK1/2 in Diabetic Rats

    Science.gov (United States)

    Chodari, Leila; Mohammadi, Mustafa; Mohaddes, Gisou; Alipour, Mohammad Reza; Ghorbanzade, Vajiheh; Dariushnejad, Hassan; Mohammadi, Shima

    2016-01-01

    Background Impaired angiogenesis in cardiac tissue is a major complication of diabetes. Protein kinase B (AKT) and extracellular signal regulated kinase (ERK) signaling pathways play important role during capillary-like network formation in angiogenesis process. Objectives To determine the effects of testosterone and voluntary exercise on levels of vascularity, phosphorylated Akt (P- AKT) and phosphorylated ERK (P-ERK) in heart tissue of diabetic and castrated diabetic rats. Methods Type I diabetes was induced by i.p injection of 50 mg/kg of streptozotocin in animals. After 42 days of treatment with testosterone (2mg/kg/day) or voluntary exercise alone or in combination, heart tissue samples were collected and used for histological evaluation and determination of P-AKT and P-ERK levels by ELISA method. Results Our results showed that either testosterone or exercise increased capillarity, P-AKT, and P-ERK levels in the heart of diabetic rats. Treatment of diabetic rats with testosterone and exercise had a synergistic effect on capillarity, P-AKT, and P-ERK levels in heart. Furthermore, in the castrated diabetes group, capillarity, P-AKT, and P-ERK levels significantly decreased in the heart, whereas either testosterone treatment or exercise training reversed these effects. Also, simultaneous treatment of castrated diabetic rats with testosterone and exercise had an additive effect on P-AKT and P-ERK levels. Conclusion Our findings suggest that testosterone and exercise alone or together can increase angiogenesis in the heart of diabetic and castrated diabetic rats. The proangiogenesis effects of testosterone and exercise are associated with the enhanced activation of AKT and ERK1/2 in heart tissue.

  15. Direct-Active Euthanasia and Victim’s Consent as a Cause of Exempt Criminal Responsibility in Events of Non-Terminal but Incurable Diseases. An Interdisciplinary Approach from the Test of Proportionality in Strict Sense

    Directory of Open Access Journals (Sweden)

    Juan Carlos Cantillo Arcón

    2016-12-01

    Full Text Available This article is a research product about the legal implications of the direct-active euthanasia practiced by a doctor to a patient who has an incurable but non terminal disease which implies great suffering considering such by the current Colombian legal system, taking into account the victim’s consent as a cause of exempt criminal responsibility. Consequently, working from an interdisciplinary approach of criminal law as a science integrated to other legal and non-legal areas of knowledge, in order to develop a comprehensive analysis that contributes to academic discussions about the absence of criminal responsibility, constitutional study and medical activity practice. This product of research will show reflections and conclusions obtained from the analysis of the existent legal regulation about the availability of the protected legal right of life when practicing euthanasia (as described above. Additionally, we will see how the latter conduct constitutes a case of exempt criminal responsibility under the specified condition of “victim’s consent”, meaning that life is a disposable legal right when it competes, in the described factual circumstance, with the human dignity, applying the test of proportionality in strict sense.

  16. Voluntary exercise prevents colonic inflammation in high-fat diet-induced obese mice by up-regulating PPAR-γ activity

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Wei-Xin, E-mail: weixinliu@yahoo.com [Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning (China); Wang, Ting; Zhou, Feng; Wang, Ying; Xing, Jun-Wei; Zhang, Shen [Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning (China); Gu, Shou-Zhi [Department of Anatomy, Seirei Christopher College, Hamamatsu 433-8558 (Japan); Sang, Li-Xuan [Department of Cadre Ward II, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning (China); Dai, Cong [Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning (China); Wang, Hai-Lan [Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou 510300, Guangdong (China)

    2015-04-10

    Obesity is associated with increased colonic inflammation, which elevates the risk of colon cancer. Although exercise exerts anti-inflammatory actions in multiple chronic diseases associated with inflammation, it is unknown whether this strategy prevents colonic inflammation in obesity. We hypothesized that voluntary exercise would suppress colonic inflammation in high-fat diet (HFD)-induced obesity by modulation of peroxisome proliferator-activated receptor (PPAR)-γ. Male C57Bl/6J mice fed either a control diet (6.5% fat, CON) or a high-fat diet (24% fat, HFD) were divided into sedentary, voluntary exercise or voluntary exercise with PPAR-γ antagonist GW9662 (10 mg/kg/day). All interventions took place for 12 weeks. Compared with CON-sedentary group, HFD-sedentary mice gained significantly more body weight and exhibited metabolic disorders. Molecular studies revealed that HFD-sedentary mice had increased expression of inflammatory mediators and activation of nuclear factor (NF)-κB in the colons, which were associated with decreased expression and activity of PPAR-γ. Voluntary exercise markedly attenuated body weight gain, improved metabolic disorders, and normalized the expression of inflammatory mediators and activation of NF-κB in the colons in HFD-mice while having no effects in CON-animals. Moreover, voluntary exercise significantly increased expression and activity of PPAR-γ in the colons in both HFD- and CON-animals. However, all of these beneficial effects induced by voluntary exercise were abolished by GW9662, which inhibited expression and activity of PPAR-γ. The results suggest that decreased PPAR-γ activity in the colon of HFD-induced obesity may facilitate the inflammatory response and colon carcinogenesis. Voluntary exercise prevents colonic inflammation in HFD-induced obesity by up-regulating PPAR-γ activity. - Highlights: • Obesity down-regulates PPAR-γ in the colon. • Down-regulated colonic PPAR-γ may facilitate inflammatory

  17. Prevalence of depression in granted and refused requests for euthanasia and assisted suicide: a systematic review.

    Science.gov (United States)

    Levene, Ilana; Parker, Michael

    2011-04-01

    There is an established link between depression and interest in hastened death in patients who are seriously ill. Concern exists over the extent of depression in patients who actively request euthanasia/physician-assisted suicide (PAS) and those who have their requests granted. To estimate the prevalence of depression in refused and granted requests for euthanasia/PAS and discuss these findings. Methods A systematic review was performed in MEDLINE and PsycINFO in July 2010, identifying studies reporting rates of depression in requests for and cases of euthanasia/PAS. One author critically appraised the strength of the data using published criteria. 21 studies were included covering four countries. There was considerable heterogeneity in methods of assessing depression and selecting patients. In the highest quality studies, in the Netherlands and Oregon, 8-47% of patients requesting euthanasia/PAS had depressive symptoms and 2-17% of completed euthanasia/PAS cases had depressive symptoms. In the Netherlands, depression was significantly higher in refused than granted requests, and there was no significant difference in the rate of depression between euthanasia cases and similar patients who had not made a request for euthanasia. It is unclear whether depression increases the probability of making a request for euthanasia/PAS, but in the Netherlands most requests in depressed patients are rejected, leaving a depression rate in cases that is similar to the surrounding population. Less evidence is available elsewhere, but some level of depression has been identified in patients undergoing euthanasia/PAS in all the countries studied. Whether the presence of depression is ever compatible with an ethical decision on euthanasia/PAS is discussed.

  18. Co-Activity during Maximum Voluntary Contraction: A Study of Four Lower-Extremity Muscles in Children with and without Cerebral Palsy

    Science.gov (United States)

    Tedroff, Kristina; Knutson, Loretta M.; Soderberg, Gary L.

    2008-01-01

    This study was designed to determine whether children with cerebral palsy (CP) showed more co-activity than comparison children in non-prime mover muscles with regard to the prime mover during maximum voluntary isometric contraction (MVIC) of four lower-extremity muscles. Fourteen children with spastic diplegic CP (10 males, four females; age…

  19. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Science.gov (United States)

    2010-10-01

    ... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate data... 42 Public Health 1 2010-10-01 2010-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137...

  20. Legal Standards for Brain Death and Undue Influence in Euthanasia Laws.

    Science.gov (United States)

    Pope, Thaddeus Mason; Okninski, Michaela E

    2016-06-01

    A major appellate court decision from the United States seriously questions the legal sufficiency of prevailing medical criteria for the determination of death by neurological criteria. There may be a mismatch between legal and medical standards for brain death, requiring the amendment of either or both. In South Australia, a Bill seeks to establish a legal right for a defined category of persons suffering unbearably to request voluntary euthanasia. However, an essential criterion of a voluntary decision is that it is not tainted by undue influence, and this Bill falls short of providing adequate guidance to assess for undue influence.

  1. Euthanasia Acceptance: An Attitudinal Inquiry.

    Science.gov (United States)

    Klopfer, Fredrick J.; Price, William F.

    The study presented was conducted to examine potential relationships between attitudes regarding the dying process, including acceptance of euthanasia, and other attitudinal or demographic attributes. The data of the survey was comprised of responses given by 331 respondents to a door-to-door interview. Results are discussed in terms of preferred…

  2. Killing, letting die and euthanasia.

    Science.gov (United States)

    Husak, D N

    1979-12-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible.

  3. Beyond Baby Doe: Does Infant Transplantation Justify Euthanasia?

    Science.gov (United States)

    Coulter, David L.

    1988-01-01

    The paper examines ethical issues in the transplantation of organs from infants with anencephaly into infants with severe heart and kidney disease. It argues that active euthanasia of infants with anencephaly should be prohibited to safeguard the rights of all persons with severe neurological disabilities. (Author/DB)

  4. An Ethical Review of Euthanasia and Physician-assisted Suicide.

    Science.gov (United States)

    Banović, Božidar; Turanjanin, Veljko; Miloradović, Anđela

    2017-02-01

    In the majority of countries, active direct euthanasia is a forbidden way of the deprivation of the patients' life, while its passive form is commonly accepted. This distinction between active and passive euthanasia has no justification, viewed through the prism of morality and ethics. Therefore, we focused on attention on the moral and ethical implications of the aforementioned medical procedures. Data were obtained from the Clinical Hospital Center in Kragujevac, collected during the first half of the 2015. The research included 88 physicians: 57 male physicians (representing 77% of the sample) and 31 female physicians (23% of the sample). Due to the nature, subject and hypothesis of the research, the authors used descriptive method and the method of the theoretical content analysis. A slight majority of the physicians (56, 8%) believe that active euthanasia is ethically unacceptable, while 43, 2% is for another solution (35, 2% took a viewpoint that it is completely ethically acceptable, while the remaining 8% considered it ethically acceptable in certain cases). From the other side, 56, 8% of respondents answered negatively on the ethical acceptability of the physician-assisted suicide, while 33% of them opted for a completely ethic viewpoint of this procedure. Out of the remaining 10, 2% opted for the ethical acceptability in certain cases. Physicians in Serbia are divided on this issue, but a group that considers active euthanasia and physician-assisted suicide as ethically unacceptable is a bit more numerous.

  5. Beyond Baby Doe: Does Infant Transplantation Justify Euthanasia?

    Science.gov (United States)

    Coulter, David L.

    1988-01-01

    The paper examines ethical issues in the transplantation of organs from infants with anencephaly into infants with severe heart and kidney disease. It argues that active euthanasia of infants with anencephaly should be prohibited to safeguard the rights of all persons with severe neurological disabilities. (Author/DB)

  6. Physician-assisted suicide and euthanasia in Indian context: Sooner or later the need to ponder!

    Directory of Open Access Journals (Sweden)

    Farooq Khan

    2013-01-01

    Full Text Available Physician-assisted suicide (PAS is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder or at least under Section 304 (punishment for culpable homicide not amounting to murder. The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients′ wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time.

  7. Mental health and other clinical correlates of euthanasia attitudes in an Australian outpatient cancer population.

    Science.gov (United States)

    Carter, G L; Clover, K A; Parkinson, L; Rainbird, K; Kerridge, I; Ravenscroft, P; Cavenagh, J; McPhee, J

    2007-04-01

    A majority of patients with cancer have been reported to endorse euthanasia and physician assisted suicide (PAS) in general and a substantial proportion endorse these for themselves. However, the potential influence of mental health and other clinical variables on these decisions is not well understood. This study of 228 outpatients attending an oncology clinic in Newcastle, Australia used a cross-sectional design and logistic regression modelling to examine the relationship of demographic, disease status, mental health and quality of life variables to attitudes toward euthanasia and PAS. The majority reported support for euthanasia (79%, n=179), for PAS (69%, n=158) and personal support for euthanasia/PAS (68%, n=156). However, few reported having asked their doctor for euthanasia (2%, n=5) or PAS (2%, n=5). Three outcomes were modelled: support for euthanasia was associated with active religious belief (adjusted odds ratio (AOR) 0.21, 95% CI: 0.10-0.46); support for PAS was associated with active religious belief (AOR 0.35, 95% CI: 18-0.70) and recent pain (AOR 0.87, 95% CI: 0.0.76-0.99); and personal support for euthanasia/PAS was associated with active religious belief (AOR 0.26, 95% CI: 0.14-0.48). Depression, anxiety, recent suicidal ideation, and lifetime suicide attempt were not independently associated with any of the three outcomes modelled.

  8. Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

    Science.gov (United States)

    Khan, Farooq; Tadros, George

    2013-01-01

    Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients' wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time.

  9. Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

    Science.gov (United States)

    Khan, Farooq; Tadros, George

    2013-01-01

    Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients’ wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time. PMID:23833354

  10. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Science.gov (United States)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  11. Increased spinal reflex excitability is associated with enhanced central activation during voluntary lengthening contractions in human spinal cord injury

    Science.gov (United States)

    Kim, Hyosub E.; Corcos, Daniel M.

    2015-01-01

    This study of chronic incomplete spinal cord injury (SCI) subjects investigated patterns of central motor drive (i.e., central activation) of the plantar flexors using interpolated twitches, and modulation of soleus H-reflexes during lengthening, isometric, and shortening muscle actions. In a recent study of the knee extensors, SCI subjects demonstrated greater central activation ratio (CAR) values during lengthening (i.e., eccentric) maximal voluntary contractions (MVCs), compared with during isometric or shortening (i.e., concentric) MVCs. In contrast, healthy controls demonstrated lower lengthening CAR values compared with their isometric and shortening CARs. For the present investigation, we hypothesized SCI subjects would again produce their highest CAR values during lengthening MVCs, and that these increases in central activation were partially attributable to greater efficacy of Ia-α motoneuron transmission during muscle lengthening following SCI. Results show SCI subjects produced higher CAR values during lengthening vs. isometric or shortening MVCs (all P reflex testing revealed normalized H-reflexes (maximal SOL H-reflex-to-maximal M-wave ratios) were greater for SCI than controls during passive (P = 0.023) and active (i.e., 75% MVC; P = 0.017) lengthening, suggesting facilitation of Ia transmission post-SCI. Additionally, measures of spinal reflex excitability (passive lengthening maximal SOL H-reflex-to-maximal M-wave ratio) in SCI were positively correlated with soleus electromyographic activity and CAR values during lengthening MVCs (both P < 0.05). The present study presents evidence that patterns of dynamic muscle activation are altered following SCI, and that greater central activation during lengthening contractions is partly due to enhanced efficacy of Ia-α motoneuron transmission. PMID:25972590

  12. Responses of Male C57BL/6N Mice to Observing the Euthanasia of Other Mice.

    Science.gov (United States)

    Boivin, Gregory P; Bottomley, Michael A; Grobe, Nadja

    2016-01-01

    The AVMA Panel on Euthanasia recommends that sensitive animals should not be present during the euthanasia of others, especially of their own species, but does not provide guidelines on how to identify a sensitive species. To determine if mice are a sensitive species we reviewed literature on empathy in mice, and measured the cardiovascular and activity response of mice observing euthanasia of conspecifics. We studied male 16-wk-old C57BL/6N mice and found no increase in cardiovascular parameters or activity in the response of the mice to observing CO2 euthanasia. Mice observing decapitation had an increase in all values, but this was paralleled by a similar increase during mock decapitations in which no animals were handled or euthanized. We conclude that CO2 euthanasia of mice does not have an impact on other mice in the room, and that euthanasia by decapitation likely only has an effect due to the noise of the guillotine. We support the conceptual idea that mice are both a sensitive species and display empathy, but under the controlled circumstances of the euthanasia procedures used in this study there was no signaling of stress to witnessing inhabitants in the room.

  13. Responses of Male C57BL/6N Mice to Observing the Euthanasia of Other Mice

    Science.gov (United States)

    Boivin, Gregory P; Bottomley, Michael A; Grobe, Nadja

    2016-01-01

    The AVMA Panel on Euthanasia recommends that sensitive animals should not be present during the euthanasia of others, especially of their own species, but does not provide guidelines on how to identify a sensitive species. To determine if mice are a sensitive species we reviewed literature on empathy in mice, and measured the cardiovascular and activity response of mice observing euthanasia of conspecifics. We studied male 16-wk-old C57BL/6N mice and found no increase in cardiovascular parameters or activity in the response of the mice to observing CO2 euthanasia. Mice observing decapitation had an increase in all values, but this was paralleled by a similar increase during mock decapitations in which no animals were handled or euthanized. We conclude that CO2 euthanasia of mice does not have an impact on other mice in the room, and that euthanasia by decapitation likely only has an effect due to the noise of the guillotine. We support the conceptual idea that mice are both a sensitive species and display empathy, but under the controlled circumstances of the euthanasia procedures used in this study there was no signaling of stress to witnessing inhabitants in the room. PMID:27423146

  14. 'We are (not) the master of our body': elderly Jewish women's attitudes towards euthanasia and assisted suicide.

    Science.gov (United States)

    Baeke, Goedele; Wils, Jean-Pierre; Broeckaert, Bert

    2011-06-01

    In Belgium, dominant ideological traditions--Christianity and non-religious humanism--have the floor in debates on euthanasia and hardly any attention is paid to the practices and attitudes of ethnic and religious minorities, for instance, Jews. This article aims to meet this lacuna. Qualitative empirical research was performed in the Orthodox Jewish community of Antwerp (Belgium) with a purposive sample of elderly Jewish (non-)Hasidic and secularised Orthodox women. In-depth interviews were conducted to elicit their attitudes towards (non-)voluntary euthanasia and assisted suicide. The research reveals diverse views among women in the community on intentionally terminating a patient's life. Absolute rejection of every act which deliberately terminates life is found among the overwhelming majority of (religiously observant) Orthodox (Hasidic and non-Hasidic) women, as they have an unconditional faith and trust in God's sovereign power over the domain of life and death. On the other hand, the views of secularised Orthodox women--mostly irreligious women, who do not consider themselves Orthodox, thus not following Jewish law, yet say they belong to the Orthodox Jewish community--show an acceptance of voluntary euthanasia and assisted suicide but non-voluntary euthanasia is approached more negatively. As they perceive illness and death as merely profane facts, they stress a patient's absolute right towards self-determination, in particular with regard to one's end of life. Among non-Hasidic Orthodox respondents, more openness is found for cultivating a personal opinion which deviates from Jewish law and for the right of self-determination with regard to questions concerning life and death. In this study, these participants occupy an intermediate position. Our study reveals an interplay between ethical attitudes on euthanasia and religious convictions. The image one has of a transcendental reality, or of God, has a stronger effect on one's (dis)approval of euthanasia

  15. [Legal issues of physician-assisted euthanasia part I--terminology and historical overview].

    Science.gov (United States)

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2012-01-01

    Under German criminal law, euthanasia assisted by the attending physician involves the risk of criminal prosecution. However, in the absence of clear legal provisions, the law concerning euthanasia has been primarily developed by court rulings and jurisprudential literature in the last 30 years. According to a traditional classification there are four categories of euthanasia: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. However, there is still no generally accepted definition for the general term "euthanasia". The development of the law on the permissibility of euthanasia was strongly influenced by the conflict between the right of self-determination of every human being guaranteed by the Constitution and the constitutional mandate of the state to protect and maintain human life. The decisions of the German Federal Court of Justice on euthanasia in the criminal trials "Wittig" (1984), "Kempten" (1994) and "Putz" (2010) as well as the ruling of the 12th Division for Civil Matters of the Federal Court of Justice (2003) are of special importance. Some of these decisions were significantly influenced by the discussions in the jurisprudential literature. However, the German Bundestag became active for the first time as late as in 2009 when it adopted the 3rd Guardianship Amendment Act, which also contains provisions on the legal validity of a living will independent of the nature and stage of an illness. In spite of the new law, an analysis of the "Putz" case makes it especially clear that the criminal aspects of legal issues at the end of a person's life still remain controversial. It is to be expected that this issue will remain the subject of intensive discussion also in the next few years.

  16. Human Control Law and Brain Activity of Voluntary Motion by Utilizing a Balancing Task with an Inverted Pendulum

    Directory of Open Access Journals (Sweden)

    Satoshi Suzuki

    2010-01-01

    Full Text Available Human characteristics concerning voluntary motion control are investigated, because this motion is fundamental for the machine operation and human-computer system. Using a force feedback haptic device and a balancing task of a virtual inverted pendulum, participants were trained in the task, and hand motion/force was measured, and brain activity was monitored. First, through brain analysis by near-infrared spectroscopy (NIRS and motion analysis of the pendulum, we identified a participant who was the most expert. Next, control characteristics of the most expert were investigated by considering the operational force and delay factor of a human. As a result, it was found that predictive control based on velocity information was used predominantly although a perception feedback control against the pendulum posture worked. And it was shown that an on-off intermittency control, which was a strategy for the skilled balancing, can be described well by a liner model involving two types of time shifts for the position and velocity. In addition, it was confirmed that the cortex activity for observation in an ocular motor control area and visual processing area was strong to enhance above-mentioned control strategies.

  17. A Survey of Special Educators' Attitudes toward Euthanasia for Infants with Severe Handicaps.

    Science.gov (United States)

    Wood, Diane M.; May, Deborah C.

    1994-01-01

    This paper describes findings from a survey of the attitudes of 188 special education teachers toward ethical dilemmas surrounding surgery, active and passive euthanasia and the right to die. (Author/PB)

  18. [Acceptance or rejection of euthanasia. Survey of 3021 Federal Government employees].

    Science.gov (United States)

    García-Romero, H; González-González, A; Galicia, J

    1998-01-01

    A survey was conducted with 3021 employees of the Federal Government using self-administered questionnaires in order to collect data on the socioeconomic background of those surveyed (sex, age, civil status, number of children, religious, affiliation, educational level and monthly income), as well as their opinions about euthanasia. For the purposes of this study, three types of euthanasia were considered: 1) passive (the suspension of life support systems); 2) active (the application of immediate death causing means for people who suffer from incurable illnesses); and 3) active in the medium term (the application of substances which keep a patient sedated and comfortable while all food is withheld). Passive and medium-term active euthanasia were accepted by 40 percent of the population surveyed, while active euthanasia was accepted by 20 percent. These percentages were higher among young people, among those who were not heavily influenced by or did not practice religion, among professionals and among post-graduates.

  19. A Survey of Special Educators' Attitudes toward Euthanasia for Infants with Severe Handicaps.

    Science.gov (United States)

    Wood, Diane M.; May, Deborah C.

    1994-01-01

    This paper describes findings from a survey of the attitudes of 188 special education teachers toward ethical dilemmas surrounding surgery, active and passive euthanasia and the right to die. (Author/PB)

  20. Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder

    National Research Council Canada - National Science Library

    Khan, Farooq; Tadros, George

    2013-01-01

    .... Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups...

  1. Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

    Science.gov (United States)

    Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

    2015-01-28

    The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

  2. Pet Euthanasia: How Do I Know It Is Time?

    Science.gov (United States)

    ... veterinarian induce its death quietly and humanely through euthanasia. A decision concerning euthanasia may be one of the most difficult decisions ... sure it has a good quality of life, euthanasia may be the right decision. Quality of life ...

  3. Organ Donation After Euthanasia in the Netherlands: A Case Report.

    Science.gov (United States)

    van Wijngaarden, A K S; van Westerloo, D J; Ringers, J

    2016-11-01

    In 2014, there was still a shortage of available organs for transplantation, and 1044 patients were waiting for an organ in the Netherlands. Maximizing the pool of organ donors is part of the solution. In 2001, the Dutch Termination of Life on Request and Assisted Suicide Act was adopted, legalizing euthanasia under strict conditions. In 2010, 3136 reports were made of euthanasia and assisted suicide; in 2014, 5306 reports were made. Among them were patients with a desire to donate their organs after their deaths. Although a potential source of donor organs, only a few cases of organ donation after active euthanasia have been described. Since 2012, 16 combinations of these procedures have been performed in the Netherlands. The literature mentions 16 Belgian cases between 2005 and 2013. This limited number can be the result of lack of knowledge about this subject among healthcare professionals or because of practical, ethical, and/or legal considerations. Performing this combination has possible advantages, both in number as well as in transplantation outcomes. By describing a recent case in our center, we will try to outline the state of the art in the Netherlands and disseminate knowledge about the possibilities and limitations of organ donation after active euthanasia. Copyright © 2016. Published by Elsevier Inc.

  4. 76 FR 2124 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Science.gov (United States)

    2011-01-12

    ... an effective regulatory program for retail food establishments, establish basic quality control... illness and food defense preparedness and response, (6) compliance and enforcement, (7) industry and... HUMAN SERVICES Food and Drug Administration Agency Information Collection Activities;...

  5. Euthanasia: the perceptions of nurses in India.

    Science.gov (United States)

    Poreddi, Vijayalakshmi; Nagarajaiah; Konduru, Reddemma; Math, Suresh Bada

    2013-04-01

    Euthanasia provokes controversies in various domains, such as the moral, ethical, legal, religious, scientific, and economic. India legalised passive euthanasia (withdrawal of life support) for patients with brain death or who are in a permanent vegetative state in 2011, but research on perceptions of euthanasia among people in India is limited. This study aimed to examine nurses' perceptions of the practice of euthanasia as well as factors influencing those perceptions. A non-probability quantitative, cross-sectional design was adopted for a sample of 214 nurses working at a tertiary care centre. Data was collected through self-reported questionnaires at the nurses workplace.The findings revealed mixed opinions on euthanasia among the nurses. However, the majority of the participants did not agree with the practice of euthanasia. Nonetheless, further research is needed on this issue across the country among various health professionals in the context of current legislation.

  6. Cerebellar brain inhibition in the target and surround muscles during voluntary tonic activation.

    Science.gov (United States)

    Panyakaew, Pattamon; Cho, Hyun Joo; Srivanitchapoom, Prachaya; Popa, Traian; Wu, Tianxia; Hallett, Mark

    2016-04-01

    Motor surround inhibition is the neural mechanism that selectively favours the contraction of target muscles and inhibits nearby muscles to prevent unwanted movements. This inhibition was previously reported at the onset of a movement, but not during a tonic contraction. Cerebellar brain inhibition (CBI) is reduced in active muscles during tonic activation; however, it has not been studied in the surround muscles. CBI was evaluated in the first dorsal interosseus (FDI) muscle as the target muscle, and the abductor digiti minimi, flexor carpi radialis and extensor carpi radialis muscles as surround muscles, during rest and tonic activation of the FDI muscle in 21 subjects. Cerebellar stimulation was performed under magnetic resonance imaging-guided neuronavigation targeting lobule VIII of the cerebellar hemisphere. Stimulus intensities for cerebellar stimulation were based on the resting motor cortex threshold (RMT) and adjusted for the depth difference between the cerebellar and motor cortices. We used 90-120% of the adjusted RMT as the conditioning stimulus intensity during rest. The intensity that generated the best CBI at rest in the FDI muscle was selected for use during tonic activation. During selective tonic activation of the FDI muscle, CBI was significantly reduced only for the FDI muscle, and not for the surround muscles. Unconditioned motor evoked potential sizes were increased in all muscles during FDI muscle tonic activation as compared with rest, despite background electromyography activity increasing only for the FDI muscle. Our study suggests that the cerebellum may play an important role in selective tonic finger movement by reducing its inhibition in the motor cortex only for the relevant agonist muscle.

  7. Alleviation of Motor Impairments in Patients with Cerebral Palsy: Acute Effects of Whole-body Vibration on Stretch Reflex Response, Voluntary Muscle Activation and Mobility

    Directory of Open Access Journals (Sweden)

    Anne Krause

    2017-08-01

    Full Text Available IntroductionIndividuals suffering from cerebral palsy (CP often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP.Methods44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16–25 Hz, 1.5–3 mm. Assessment included (1 recordings of stretch reflex (SR activity of the triceps surae, (2 electromyography (EMG measurements of maximal voluntary muscle activation of lower limb muscles, and (3 neuromuscular activation during active range of motion (aROM. We recorded EMG of m. soleus (SOL, m. gastrocnemius medialis (GM, m. tibialis anterior, m. vastus medialis, m. rectus femoris, and m. biceps femoris. Angular excursion was recorded by goniometry of the ankle and knee joint.ResultsAfter WBV, (1 SOL SRs were decreased (p < 0.01 while (2 maximal voluntary activation (p < 0.05 and (3 angular excursion in the knee joint (p < 0.01 were significantly increased. No changes could be observed for GM SR amplitudes or ankle joint excursion. Neuromuscular coordination expressed by greater agonist–antagonist ratios during aROM was significantly enhanced (p < 0.05.DiscussionThe findings point toward acute neuromuscular and kinematic effects following one bout of WBV. Protocols demonstrate that pathological reflex responses are reduced (spinal level, while the execution of voluntary movement (supraspinal level is improved in regards to kinematic and neuromuscular control. This facilitation of muscle and joint control is probably due to a reduction of spasticity-associated spinal excitability in favor of giving access for greater supraspinal input during voluntary motor

  8. [Euthanasia/assisted suicide. Ethical and socio-religious aspects].

    Science.gov (United States)

    Chiriţă, V; Chiriţă, Roxana; Duică, Lavinia; Talau, Gh

    2009-01-01

    Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).

  9. [Motor unit activities of human masseter muscle during sustained voluntary contractions].

    Science.gov (United States)

    Shimizu, T

    1990-02-01

    The purpose of this paper is to investigate the motor unit activities of the human masseter muscle during sustained the bite force at a constant level. The electrical activities recorded with surface and inserted electrodes were studied, with the following results. 1. The masseter muscle had the changes of activities in two phases as a contraction progressed. 2. In the first phase, surface EMG activities decreased and discharge frequency of motor units also decreased. 3. In the second phase, surface EMG activities increased and discharge frequency of motor units also increased. 4. In the first phase, it was suggested that the bite force was maintained by an increase in the twitch tension produced by a motor unit and that there were no recruitment of additional motor units. 5. In the second phase, it was indicated that the bite force was maintained by the recruitment of new motor units and an increase in the discharge frequency of motor units to compensate a loss of force resulted from the contractile element fatigue.

  10. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act.

    NARCIS (Netherlands)

    Alphen, J.E. van; Donker, G.A.; Marquet, R.L.

    2010-01-01

    The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. AIM: To investigate changes in the number of, and reasons for, requests for euthanasi

  11. Induced Gamma-Band Activity During Voluntary Movement: EEG Analysis for Clinical Purposes.

    Science.gov (United States)

    Amo, Carlos; Del Castillo, Miguel Ortiz; Barea, Rafael; de Santiago, Luis; Martínez-Arribas, Alejandro; Amo-López, Pedro; Boquete, Luciano

    2016-10-01

    Propose a simplified method applicable in routine clinical practice that uses EEG to assess induced gamma-band activity (GBA) in the 30-90 Hz frequency range in cerebral motor areas. EEG recordings (25 healthy subjects) of cerebral activity (at rest, motor task). GBA was obtained as power spectral density (PSD). GBA - defined as the gamma index (Iγ) - was calculated using the basal GBA (γB) and motor GBA (γMOV) PSD values. The mean values of Iγ were (IγR (right hand) = 1.30, IγL (left hand) = 1.22). Manual laterality showed a correlation with Iγ. Iγ may provide a useful way of indirectly assessing operation of activated motor neuronal circuits. It could be applied to diagnosis of motor area pathologies and as follow up in rehabilitation processes. Likewise, Iγ could enable the assessment of motor capacity, physical training and manual laterality in sport medicine.

  12. Ethical And Religious Analysis On Euthanasia

    OpenAIRE

    Abdi Omar Shuriye

    2012-01-01

    This paper is an analysis on euthanasia from ethical and religious perspectives. Historically, the classical Greek thinkers including Aristotle had categorically accepted euthanasia with the main reason of minimizing pain. However, as science develops ethical and religious isuues related to the subject have increasingly created fervent debates on euthanesia. ABSTRAK: Kertas ini mengkaji euthanasia dari perspektif agama dan etika. Sejarah telah melihat para pemikir Greek termasuk Aristotle sec...

  13. Voluntary Participation in an Active Learning Exercise Leads to a Better Understanding of Physiology

    Science.gov (United States)

    Carvalho, Helena; West, Crystal A.

    2011-01-01

    Students learn best when they are focused and thinking about the subject at hand. To teach physiology, we must offer opportunities for students to actively participate in class. This approach aids in focusing their attention on the topic and thus generating genuine interest in the mechanisms involved. This study was conducted to determine if…

  14. Understanding Crowdsourcing: Effects of motivation and rewards on participation and performance in voluntary online activities

    NARCIS (Netherlands)

    W.A.M. Borst (Irma)

    2010-01-01

    textabstractCompanies increasingly outsource activities to volunteers that they approach via an open call on the internet. The phenomenon is called ‘crowdsourcing’. For an effective use of crowdsourcing it is important to understand what motivated these online volunteers and what is the influence of

  15. Understanding Crowdsourcing: Effects of motivation and rewards on participation and performance in voluntary online activities

    NARCIS (Netherlands)

    W.A.M. Borst (Irma)

    2010-01-01

    textabstractCompanies increasingly outsource activities to volunteers that they approach via an open call on the internet. The phenomenon is called ‘crowdsourcing’. For an effective use of crowdsourcing it is important to understand what motivated these online volunteers and what is the influence of

  16. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans

    NARCIS (Netherlands)

    Kox, M.; Eijk, L.T.G.J. van; Zwaag, J.; Wildenberg, J. van den; Sweep, F.C.; Hoeven, J.G. van der; Pickkers, P.

    2014-01-01

    Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot b

  17. Euthanasia, National and International Perspectives

    Directory of Open Access Journals (Sweden)

    Rustin-Petru Ciasc

    2013-08-01

    Full Text Available The topic of euthanasia can be defined and analyzed upon considering several perspectives, such as the legal, religious, historical, philosophical, medical or ethical ones. This article attempts to supply a brief presentation of these perspectives, indicating the existing trends and standpoints at world level in connection to perceptions regarding the phenomenon mentioned, exemplified by opinions described in the doctrine and relevant jurisprudence. At the same time, in this article I will try to indicate the weak spots of the Romanian legislation in the euthanasia area, upon supplying some proposals for legislative intervention. Concomitantly, it should appear the idea that not the right to die per se is to receive motivations and be included in the law, but the duty to live. This should be done first by drafting an adequate law to the terminal states that would guide their medical practice and comply with the world legislative trends.

  18. Euthanasia and Death with Dignity

    Directory of Open Access Journals (Sweden)

    Yuvraj Dilip Patil

    2016-07-01

    Full Text Available Dying has become imposition upon humans, who seek to avoid it as they encounter the inevitably fatal aging process. After the case of Aruna Shanbag a nurse who spent 42 years in a vegetative state as a result of sexual assault, the issue of euthanasia-mercy killing gained attention. The formulation of regulatory provision for euthanasia was earlier examined in Health Ministry in th 2006 based on the 196 report of the law commission of India however; health ministry at that time had opted not to make law on it. Interestingly the health ministry has enacted bill for terminally ill patient in 2016. In this article author has discussed The Medical Treatment of Terminally Ill Patients (Protection of patients and medical practitioners bill- 2016 with position in other countries.

  19. Levinas and the euthanasia debate.

    Science.gov (United States)

    Nuyen, A T

    2000-01-01

    The philosophers' tendency to characterize euthanasia in terms of either the right or the responsibility to die is, in some ways, problematic. Stepping outside of the analytic framework, the author draws out the implications of the ethics of Emmanuel Levinas for the euthanasia debate, tracing the ways Levinas' position differs not only from the philosophical consensus but also from the theological one. The article shows that, according to Levinas, there is no ethical case for suicide or assisted suicide. Death cannot be assumed or chosen--not only because suicide is a logically and metaphysically contradictory concept but also because in the choice of death ethical responsibility turns into irresponsibility. However, since Levinas holds that one must be responsible to the point of expiation, he can be said to approve certain actions that may have the consequence of hastening death.

  20. Euthanasia of mouse fetuses and neonates.

    Science.gov (United States)

    Klaunberg, Brenda A; O'malley, James; Clark, Terri; Davis, Judith A

    2004-09-01

    We sought to determine whether any of the common methods of euthanasia for adult rodents would lead to an acceptable death for fetuses or neonates. We wanted to identify a method that was rapid, free of signs of pain or distress, reliable, and minimally distressful to the person performing the procedure and that minimized the amount of handling required to perform the procedure. We evaluated six methods of euthanasia, with and without anesthesia, in three age groups of mice: gravid mice (E14-20) and neonatal pups (P1-P7 and P8-P14). Euthanasia methods included: halothane inhalation, carbon dioxide inhalation, intraperitoneal sodium pentobarbital, intravenous potassium chloride, and cervical dislocation with and without anesthesia. Noninvasive echocardiography was used to assess heartbeat during euthanasia. With cardiac arrest as the definition of death, no method of euthanasia killed fetal mice. Halothane inhalation (5% by vaporizer) was not an acceptable method of euthanasia for mice of the age groups tested. Intraperitoneal administration of sodium pentobarbital for euthanasia required a higher dose than the previously established dose, and there is a risk of reduced efficacy in pregnant animals due to potential intrauterine injection. Carbon dioxide asphyxiation was the most efficient method of euthanasia for neonatal mouse pups P1-14. For pregnant adult mice, intravenous potassium chloride under anesthesia, carbon dioxide asphyxiation, and cervical dislocation alone or under anesthesia were excellent methods of euthanasia. Copyright 2004 American Association for Laboratory Animal Science

  1. Dilemmas surrounding passive euthanasia--a Malaysian perspective.

    Science.gov (United States)

    Talib, Norchaya

    2005-09-01

    In western societies where the principle of autonomy is jealously guarded, perhaps active euthanasia is more often the focus of public concern and debates rather than any other forms of euthanasia. However due to the advance in technology and its corresponding ability in prolonging life, in Malaysia passive euthanasia presents more of a dilemma. For those concerned and involved with end of life decision-making, it is generally agreed that this is an area fraught with not only medical but legal and ethical issues. In Malaysia where the society is not homogenous but is multi-cultural and multi-religious, in addition to medical, legal and ethical issues, religious principles and cultural norms further impact and play significant roles in end of life decision-making. This paper seeks to identify the issues surrounding the practice of passive euthanasia in Malaysia. It will be shown that despite applicable legal provisions, current practice of the medical profession combined with religious and cultural values together affect decision-making which involves the withholding and/or withdrawing of life-saving treatment.

  2. Life shortening and physician assistance in dying: euthanasia from the viewpoint of German legal medicine.

    Science.gov (United States)

    Oehmichen, M; Meissner, C

    2000-01-01

    Around the world heated debates have broken out on the topic of active euthanasia. Specialists in the field of 'forensic medicine' have taken full part in these discussions. The present survey from the point of view of forensic medicine begins with a look at current terminology and at the laws pertaining to euthanasia in Germany. These laws are then contrasted with actual practice, including a description of the increasing acceptance of active euthanasia by the German population and its legalization in Holland. The main argument against active euthanasia is that its formal acceptance in law would cause the dam of restraint to burst, culminating in widespread misuse, as already seen in recent serial killings by nurses in hospitals and homes for the elderly around the world. Contrasted to this are the arguments for taking active steps at the end of life, including emotional considerations such as the revulsion against mechanized medicine and the fear of pain and rational arguments such as the necessity to end a 'life unworthy of life', to save medical costs, and obtaining prior consent in 'living wills'. Such considerations have put in jeopardy the moral integrity of the medical profession - and thus the layperson's trust in physicians - around the world. In Germany especially the history of mass killing during the Nazi era constitutes a fundamental argument against active euthanasia. As a consequence, in Germany active euthanasia will not receive legal sanction, although recommendations on rendering dying more bearable are permitted. Copyright 2000 S. Karger AG, Basel

  3. Euthanasia – a Contemporary Issue

    Directory of Open Access Journals (Sweden)

    Florentina PUSCĂ

    2010-03-01

    Full Text Available The right to life is one of the fundamental rights of people that have to be respected and protected by each state’s legislation. The connection between the right to life and criminal law is a significant one, as the Criminal Code incriminates a few categories of crimes that can prejudice it. Although that as an object of crimes against life, a person’s life is recognized, the right to life remains a value that can suffer from criminal attempts. Often, in literature, the correlation or the relation between certain criminal acts is discussed, such as the genocide, illegal abortion, euthanasia, infanticide and the right to life, the possibility of mutual influence and their coexistence. Furthermore, the problem ofeuthanasia involves also the examination of practical and juridical connotations connected to the free accomplishment of the human fundamental rights and the right to life in particular. Can thecompatibility or the incompatibility of euthanasia with the right to law be decisive? The answer can only be an affirmative one, as through this approach the judicial statute and the scope of euthanasia can be determined.

  4. Voluntary activation of ankle muscles is accompanied by subcortical facilitation of their antagonists

    DEFF Research Database (Denmark)

    Geertsen, Svend Sparre; Zuur, Abraham T.; Nielsen, Jens Bo

    2010-01-01

    Flexion and extension movements are organized reciprocally, so that extensor motoneurones in the spinal cord are inhibited when flexor muscles are active and vice versa. During and just prior to dorsiflexion of the ankle, soleus motoneurones are thus inhibited as evidenced by a depression...... MEPs were also facilitated (although to a lesser extent) at a similar time in relation to the onset of dorsiflexion. TA MEPs were facilitated 50 ms prior to onset of dorsiflexion and neither depressed nor facilitated prior to plantar flexion. No difference was found between the facilitation...

  5. [Physician practice patterns and attitudes to euthanasia in Germany. A representative survey of physicians].

    Science.gov (United States)

    Kirschner, R; Elkeles, T

    1998-04-01

    Growing life expectancy and increasing pharmaceutical and technical methods in medicine are leading to more and more discussions among the general population and among physicians as to whether methods to shorten the sufferings of mortally ill persons should be legalised further. In Australia 60% of physicians wish to be able to perform active euthanasia if this would be legal. In the Netherlands physicians do not commit an offence if they perform euthanasia on the basis of ethically consented rules. In the FRG the National Board of Physicians (Bundesärztekammer) still rejects any liberalisation concerning active euthanasia. However, little is known of the attitudes and behaviour of physicians concerning the questions of active and passive euthanasia. Sponsored by Gruner and Jahr publishers for a magazine "Stern" publication we conducted a representative study among physicians working in hospitals and their colleagues in free practices concerning this topic. Beginning with qualitative interviews with 50 physicians we tested the questionnaire developed and looked for the data production method best fitting for this difficult matter resulting in telephone interviews or a self-administered questionnaire. In the main study a representative sample of n = 282 physicians in free practices and n = 191 physicians in hospitals were interviewed. The response rates were 94% and 51% respectively. Analysis of non-responses did not indicate any bias. Half of the physicians think that a broader discussion on euthanasia is necessary, 34% disagree and 17% consider even a discussion already dangerous. 6% of the physicians in hospitals and 11% in free practices have already experienced methods of active euthanasia. Half of the physicians have seen patients who strongly wished euthanasia, a situation which happens once in every two years. The majority of physicians feel a deep understanding but only a minority of 4% comply with the wish. The vast majority of physicians advocate

  6. From Advance Euthanasia Directive to Euthanasia: Stable Preference in Older People?

    Science.gov (United States)

    Bolt, Eva E; Pasman, H Roeline W; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

    2016-08-01

    To determine whether older people with advance directive for euthanasia (ADEs) are stable in their advance desire for euthanasia in the last years of life, how frequently older people with an ADE eventually request euthanasia, and what factors determine this. Mortality follow-back study nested in a cohort study. The Netherlands. Proxies of deceased members of a cohort representative of Dutch older people (n = 168) and a cohort of people with advance directives (n = 154). Data from cohort members (possession of ADE) combined with after-death proxy information on cohort members' last 3 months of life. Multiple logistic regression analysis was performed on determinants of a euthanasia request in individuals with an ADE. Response rate was 65%. One hundred forty-two cohort members had an ADE at baseline. Three months before death, 87% remained stable in their desire for euthanasia; 47% eventually requested euthanasia (vs 6% without an ADE), and 16% died after euthanasia. People with an ADE were more likely to request euthanasia if they worried about loss of dignity. The majority of older adults who complete an ADE will have a stable preference over time, but an advance desire for euthanasia does not necessarily result in a euthanasia request. Writing an ADE may reflect a person's need for reassurance that they can request euthanasia in the future. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  7. Suicide and euthanasia in late life.

    Science.gov (United States)

    De Leo, Diego; Spathonis, Kym

    2003-04-01

    Epidemiological studies of suicide in the elderly indicate that, in the last few decades, there has been a relevant increase in suicide rates in old age in a number of Asian and Latin nations, with an almost parallel decrease in Anglo-Saxon counties. Mental disorders, particularly depression, physical illness, personality traits such as hostility, hopelessness, the inability to verbally express psychological pain and dependency on others, recent life events and losses are all factors that may contribute to suicide in later life. Compared with suicide in other age groups, mors voluntaris in late life is associated with the use of highly lethal methods, less ambivalence and impulsivity, and more determination and intent to die. Accordingly, elderly suicidal individuals are more likely than younger subjects to complete rather than attempt suicide. Some evidence suggests also that the characteristics of elderly individuals who attempt suicide may not overlap with those who complete suicide. Death thoughts and suicidal ideations are relatively rare among mentally healthy elderly adults, and are less predominant in this age bracket. However, whether elderly suicidal behaviour exists along a continuum, progressing in severity from death thoughts and suicidal ideation to suicide attempts and completed suicide, remains unclear. Assisted suicide and euthanasia in the elderly have been associated with the desire to escape chronic physical pain and suffering caused by terminal illness, and to relieve mental anguish and feelings of hopelessness, depression and extreme "tiredness of life." The role of the family and those treating chronically ill members is crucial in the final stages of life, particularly when autonomy and the ability of the elderly individual to make end-of-life decisions are compromised. The main aspects associated with these controversial phenomena, particularly from a transcultural perspective, are reviewed in this article.

  8. Comparative adaptations in oxidative and glycolytic muscle fibers in a low voluntary wheel running rat model performing three levels of physical activity.

    Science.gov (United States)

    Hyatt, Hayden W; Toedebusch, Ryan G; Ruegsegger, Greg; Mobley, C Brooks; Fox, Carlton D; McGinnis, Graham R; Quindry, John C; Booth, Frank W; Roberts, Michael D; Kavazis, Andreas N

    2015-11-01

    A unique polygenic model of rat physical activity has been recently developed where rats were selected for the trait of low voluntary wheel running. We utilized this model to identify differences in soleus and plantaris muscles of sedentary low voluntary wheel running rats and physically active low voluntary wheel running rats exposed to moderate amounts of treadmill training. Three groups of 28-day-old male Wistar rats were used: (1) rats without a running wheel (SEDENTARY, n = 7), (2) rats housed with a running wheel (WHEEL, n = 7), and (3) rats housed with a running wheel and exercised on the treadmill (5 days/week for 20 min/day at 15.0 m/min) (WHEEL + TREADMILL, n = 7). Animals were euthanized 5 weeks after the start of the experiment and the soleus and plantaris muscles were excised and used for analyses. Increases in skeletal muscle gene expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha and fibronectin type III domain-containing protein 5 in WHEEL + TREADMILL group were observed. Also, WHEEL + TREADMILL had higher protein levels of superoxide dismutase 2 and decreased levels of oxidative damage. Our data demonstrate that the addition of treadmill training induces beneficial muscular adaptations compared to animals with wheel access alone. Furthermore, our data expand our understanding of differential muscular adaptations in response to exercise in mitochondrial, antioxidant, and metabolic markers.

  9. Movement-related cortical activation with voluntary pinch task: simultaneous monitoring of near-infrared spectroscopy signals and movement-related cortical potentials

    Science.gov (United States)

    Sato, Yosuke; Fukuda, Masafumi; Oishi, Makoto; Fujii, Yukihiko

    2012-07-01

    This study was designed to evaluate hemodynamic and electrophysiological motor cortex responses to voluntary finger pinching in humans, with simultaneous recording of near-infrared spectroscopy (NIRS) signals and movement-related cortical potentials (MRCP). Six healthy, right-handed subjects performed 100 trials of voluntary right-thumb index-finger pinching with about a 10-second interval at their own pace. Throughout the session, 48 regions over the bilateral motor cortex were assessed by NIRS, while MRCP and electromyogram (EMG) were simultaneously monitored. MRCP started 1536+/-58 ms before EMG onset and peaked 127+/-24 ms after EMG onset. NIRS data showed bilateral prefrontal cortex at 0.5+/-0.1 s before EMG onset and bilateral dorsal premotor cortex activations at 0.6+/-0.1 s before EMG onset. The hand area of the sensorimotor cortex was activated left-dominantly, seen obviously peaked at 3.7+/-0.2 s after EMG onset. The comparison between MRCP and NIRS results raised the possibility that the vascular response to neural activity occurs within 4 s with a voluntary pinch task. These results indicate that our technique allows detailed study of the motor control. Our method is a promising strategy for event-related motor control and neurovascular coupling studies.

  10. Three-dimensional localization of SMA activity preceding voluntary movement. A study of electric and magnetic fields in a patient with infarction of the right supplementary motor area.

    Science.gov (United States)

    Lang, W; Cheyne, D; Kristeva, R; Beisteiner, R; Lindinger, G; Deecke, L

    1991-01-01

    Previous studies by magnetoencephalography (MEG) failed to consistently localize the activity of the supplementary motor area (SMA) prior to voluntary movements in healthy human subjects. Based on the assumption that the SMA of either hemisphere is active prior to voluntary movements, the negative findings of previous studies could be explained by the hypothesis that magnetic fields of current dipole sources in the two SMAs may cancel each other. The present MEG study was performed in a patient with a complete vascular lesion of the right SMA. In this case it was possible to consistently localize a current dipole source in the intact left SMA starting about 1200 msec prior to the initiation of voluntary movements of the right thumb. Starting at about 600 msec prior to movement onset the assumption of a current dipole source in the left primary motor cortex was needed to account for the observed fields. Measurements of brain potentials were consistent with MEG findings of activity of the left SMA starting about 1200 msec prior to movement onset.

  11. Voluntary Environmental Governance Arrangements

    NARCIS (Netherlands)

    van der Heijden, J.

    2012-01-01

    Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently

  12. Voluntary Environmental Governance Arrangements

    NARCIS (Netherlands)

    van der Heijden, J.

    2012-01-01

    Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently specify

  13. Voluntary Service System (VSS)

    Data.gov (United States)

    Department of Veterans Affairs — Voluntary Service System (VSS) is a national-level application which replaced the site-based Voluntary Timekeeping System (VTK). VTK was used for many years at the...

  14. Electromyographic Responses during Elbow Movement at Two Angles with Voluntary Contraction: Influences of Muscle Activity on Upper Arm Biceps Brachii

    Directory of Open Access Journals (Sweden)

    Nizam Uddin Ahamed

    2012-11-01

    Full Text Available Analysis of Electromyography (EMG signals generated by individuals is part of human musculoskeletal system research and signals are always influenced by the electrode placement in the muscle. This characteristic is also obvious at Biceps Brachii (BB muscles during the movement of elbow at different angles. The purpose of this study was to monitor and determine the BB muscle function in 3 conditions: (i electrodes were placed at 3 locations on the BB, (ii elbow was fixed at the two angles (90° and 150° and (iii isometric contractions were performed to record EMG data. EMG data were obtained from six healthy subjects (n = 6, mean±SD age = 24.4±3.1 years, body mass = 68±6.3 kg, height = 164±4.1 cm, BMI = 21.2±2.3, right arm dominated. A Bluetooth-enabled laptop, wireless EMG sensors, digital dynamometer and angle meter were used for data recording. EMG data were calculated and analyzed by average value, standard deviation, Root Mean Square (RMS and highest peak of the signal during maximum voluntary contraction. All the dependent variables were calculated using repeated measures Analysis of Variance (ANOVA. The results from the research showed that (i according to the calculation of average RMS and the maximum peaks of EMG signals, there was a significant difference between 2 angles (p = 0.047, i.e., p<0.05, but no interaction at the same angles when overall average EMG and standard deviation value are considered and (ii majority of the outcomes showed that EMG activity is higher in the order of middle, upper and lower BB muscle. It is therefore important that electrical signals generated upon different electrode placements and angles on the BB muscle are used for biceps rehabilitation and other physiological measurements on upper arm.

  15. Euthanasia in the Netherlands: a slippery slope?

    NARCIS (Netherlands)

    Toebes, Brigit

    2017-01-01

    The Dutch euthanasia legislation has been lauded as well as criticized by legal scholars and physicians in the Netherlands and abroad. The legal framework so established is renowned for setting a number of valuable due-care criteria for the physician to follow when performing euthanasia on a

  16. Euthanasia in Belgium five years after legalisation.

    Science.gov (United States)

    Lewis, Penney

    2009-06-01

    In 2002, Belgium became the second country to legalise euthanasia after the Netherlands. Three biannual reports have been published by the Federal Control and Evaluation Commission, the body which monitors the application of the law. This article explores how the Belgian law works and what is known about Belgian euthanasia practice both before and since legalisation.

  17. Euthanasia in the Netherlands: a slippery slope?

    NARCIS (Netherlands)

    Toebes, Brigit

    2017-01-01

    The Dutch euthanasia legislation has been lauded as well as criticized by legal scholars and physicians in the Netherlands and abroad. The legal framework so established is renowned for setting a number of valuable due-care criteria for the physician to follow when performing euthanasia on a patient

  18. Techniques to Pass on: Technology and Euthanasia

    Science.gov (United States)

    Martin, Brian

    2010-01-01

    Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the mid-1990s, following the world's first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search for do-it-yourself technological means of dying with dignity. The Australian government has opposed…

  19. Euthanasia and Mental Retardation: Suggesting the Unthinkable.

    Science.gov (United States)

    Hollander, Russell

    1989-01-01

    The article examines current opinions toward euthanasia of persons with mental retardation in light of the history of public and professional attitudes. It also discusses the rejection of euthanasia on moral and religious grounds, and notes the use of lifelong incarceration, based on eugenics principles, to accomplish similar ends. (DB)

  20. A comparative study on permissiveness toward euthanasia

    NARCIS (Netherlands)

    Verbakel, C.M.C.; Jaspers, E.

    2010-01-01

    This study explores explanations for the approval of euthanasia by assessing differences among individuals and countries, using four main arguments used by opponents and proponents in the public debate over euthanasia. We performed multilevel analysis on data from thirty-three countries, obtained fr

  1. Techniques to Pass on: Technology and Euthanasia

    Science.gov (United States)

    Martin, Brian

    2010-01-01

    Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the mid-1990s, following the world's first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search for do-it-yourself technological means of dying with dignity. The Australian government has opposed…

  2. [Euthanasia in advanced dementia: a moral impossibility].

    Science.gov (United States)

    Keizer, A A Bert

    2013-01-01

    Advance directives containing a request for euthanasia in cases of severely debilitating dementia are of no use. In such an advanced stage of the disease, the doctor would have to administer lethal medication to a patient who does not realise what is happening to him/her. The Dutch Euthanasia Act is ambivalent about this possibility.

  3. A comparative study on permissiveness toward euthanasia

    NARCIS (Netherlands)

    Verbakel, C.M.C.; Jaspers, E.

    2010-01-01

    This study explores explanations for the approval of euthanasia by assessing differences among individuals and countries, using four main arguments used by opponents and proponents in the public debate over euthanasia. We performed multilevel analysis on data from thirty-three countries, obtained

  4. Euthanasia and Mental Retardation: Suggesting the Unthinkable.

    Science.gov (United States)

    Hollander, Russell

    1989-01-01

    The article examines current opinions toward euthanasia of persons with mental retardation in light of the history of public and professional attitudes. It also discusses the rejection of euthanasia on moral and religious grounds, and notes the use of lifelong incarceration, based on eugenics principles, to accomplish similar ends. (DB)

  5. ELECTROMYOGRAPHIC ACTIVITY OF THE VASTUS MEDIALIS OBLIQUE AND VASTUS LATERALIS DURING MAXIMUM VOLUNTARY ISOMETRICS IN DIFFERENT WEIGHT BEARING POSITIONS OF THE FOOT

    Directory of Open Access Journals (Sweden)

    Sreekar Kumar Reddy.R

    2014-09-01

    Full Text Available Background: Patellofemoral pain syndrome is a very common disorder. 90% of the general population has some degree of pathologic changes of the patellofemoral joint. Knowledge regarding the cause and prevention of patellofemoral pain syndrome is essential. Therefore the purpose of this study is intended to know whether different foot positions alter Vastus Medialis Oblique and Vastus Lateralis that leads to dysfunctions of knee joint. Method: 30 subjects are included in study and investigated foot in different foot positions are in neutral, pronated and supinated foot positions and performed maximum voluntary isometric contractions are recorded with electromyography. Results: EMG amplitudes (microvolts of VL and VMO at three different weight bearing positions of foot during maximum voluntary contraction analysis by using one-way Analysis of Variance. Mean amplitudes of foot positions in pronation shown significant difference while comparing with neutral and supination. Conclusion: The VMO and VL activity shows significant difference in the pronated foot weight bearing position compared to the neutral and supinated foot. Performing the maximum voluntary isometric contractions of VMO and VL with pronated foot elicited significantly higher EMG activity compared to Neutral or supinated weight bearing positions of foot. The results of this study also suggested that for patellofemoral pain which is caused by pronated foot can be treat with by using the soft foot orthoses

  6. Dying cancer patients talk about euthanasia.

    Science.gov (United States)

    Eliott, Jaklin A; Olver, Ian N

    2008-08-01

    Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

  7. Facing requests for euthanasia: a clinical practice guideline

    Science.gov (United States)

    Gastmans, C; Van Neste, F; Schotsmans, P

    2004-01-01

    On 23 September 2002, the Belgian law on euthanasia came into force. This makes Belgium the second country in the world (after the Netherlands) to have an Act on euthanasia. Even though there is currently legal regulation of euthanasia in Belgium, very little is known about how this legal regulation could be translated into care for patients who request euthanasia. PMID:15082821

  8. The biological control of voluntary exercise, spontaneous physical activity and daily energy expenditure in relation to obesity: human and rodent perspectives

    Science.gov (United States)

    Garland, Theodore; Schutz, Heidi; Chappell, Mark A.; Keeney, Brooke K.; Meek, Thomas H.; Copes, Lynn E.; Acosta, Wendy; Drenowatz, Clemens; Maciel, Robert C.; van Dijk, Gertjan; Kotz, Catherine M.; Eisenmann, Joey C.

    2011-01-01

    Mammals expend energy in many ways, including basic cellular maintenance and repair, digestion, thermoregulation, locomotion, growth and reproduction. These processes can vary tremendously among species and individuals, potentially leading to large variation in daily energy expenditure (DEE). Locomotor energy costs can be substantial for large-bodied species and those with high-activity lifestyles. For humans in industrialized societies, locomotion necessary for daily activities is often relatively low, so it has been presumed that activity energy expenditure and DEE are lower than in our ancestors. Whether this is true and has contributed to a rise in obesity is controversial. In humans, much attention has centered on spontaneous physical activity (SPA) or non-exercise activity thermogenesis (NEAT), the latter sometimes defined so broadly as to include all energy expended due to activity, exclusive of volitional exercise. Given that most people in Western societies engage in little voluntary exercise, increasing NEAT may be an effective way to maintain DEE and combat overweight and obesity. One way to promote NEAT is to decrease the amount of time spent on sedentary behaviours (e.g. watching television). The effects of voluntary exercise on other components of physical activity are highly variable in humans, partly as a function of age, and have rarely been studied in rodents. However, most rodent studies indicate that food consumption increases in the presence of wheels; therefore, other aspects of physical activity are not reduced enough to compensate for the energetic cost of wheel running. Most rodent studies also show negative effects of wheel access on body fat, especially in males. Sedentary behaviours per se have not been studied in rodents in relation to obesity. Several lines of evidence demonstrate the important role of dopamine, in addition to other neural signaling networks (e.g. the endocannabinoid system), in the control of voluntary exercise. A

  9. The biological control of voluntary exercise, spontaneous physical activity and daily energy expenditure in relation to obesity: human and rodent perspectives.

    Science.gov (United States)

    Garland, Theodore; Schutz, Heidi; Chappell, Mark A; Keeney, Brooke K; Meek, Thomas H; Copes, Lynn E; Acosta, Wendy; Drenowatz, Clemens; Maciel, Robert C; van Dijk, Gertjan; Kotz, Catherine M; Eisenmann, Joey C

    2011-01-15

    Mammals expend energy in many ways, including basic cellular maintenance and repair, digestion, thermoregulation, locomotion, growth and reproduction. These processes can vary tremendously among species and individuals, potentially leading to large variation in daily energy expenditure (DEE). Locomotor energy costs can be substantial for large-bodied species and those with high-activity lifestyles. For humans in industrialized societies, locomotion necessary for daily activities is often relatively low, so it has been presumed that activity energy expenditure and DEE are lower than in our ancestors. Whether this is true and has contributed to a rise in obesity is controversial. In humans, much attention has centered on spontaneous physical activity (SPA) or non-exercise activity thermogenesis (NEAT), the latter sometimes defined so broadly as to include all energy expended due to activity, exclusive of volitional exercise. Given that most people in Western societies engage in little voluntary exercise, increasing NEAT may be an effective way to maintain DEE and combat overweight and obesity. One way to promote NEAT is to decrease the amount of time spent on sedentary behaviours (e.g. watching television). The effects of voluntary exercise on other components of physical activity are highly variable in humans, partly as a function of age, and have rarely been studied in rodents. However, most rodent studies indicate that food consumption increases in the presence of wheels; therefore, other aspects of physical activity are not reduced enough to compensate for the energetic cost of wheel running. Most rodent studies also show negative effects of wheel access on body fat, especially in males. Sedentary behaviours per se have not been studied in rodents in relation to obesity. Several lines of evidence demonstrate the important role of dopamine, in addition to other neural signaling networks (e.g. the endocannabinoid system), in the control of voluntary exercise. A

  10. Attitudes to animal euthanasia do not correlate with acceptance of human euthanasia or suicide.

    Science.gov (United States)

    Ogden, U; Kinnison, T; May, S A

    2012-08-18

    Several reasons have been suggested for the elevated risk of suicide experienced by those in the veterinary profession. The current study aimed to investigate possible links between veterinarians' attitudes to 'convenience' or non-justified animal euthanasia and attitudes towards human euthanasia and suicide. Veterinary students and graduates had a negative attitude towards convenience animal euthanasia, but their attitudes changed over time (pre-clinical studies, clinical studies and recently graduated). A greater tolerance to euthanasia was displayed in the later years of study and post qualification - primarily by males. Attitudes towards both human euthanasia and suicide, however, remained stable over time and indicated on average a neutral stance. No correlations were found between attitudes to convenience euthanasia and either human euthanasia or suicide, suggesting a tolerance to convenience euthanasia of animals does not lead to desensitisation in valuing human life and a changed attitude to human euthanasia or suicide, or vice versa. Attitudes to human euthanasia and suicide were predictably correlated, perhaps suggesting an overarching attitude towards control over human death. The results of the current study throw into question the argument that it is the changes in attitudes to animal life that affect veterinarian's attitudes to human life and contribute to the high suicide rate.

  11. Euthanasia and physicians' moral duties.

    Science.gov (United States)

    Seay, Gary

    2005-10-01

    Opponents of euthanasia sometimes argue that it is incompatible with the purpose of medicine, since physicians have an unconditional duty never to intentionally cause death. But it is not clear how such a duty could ever actually be unconditional, if due consideration is given to the moral weight of countervailing duties equally fundamental to medicine. Whether physicians' moral duties are understood as correlative with patients' moral rights or construed noncorrelatively, a doctor's obligation to abstain from intentional killing cannot be more than a defeasible duty.

  12. [Euthanasia: status report in 2014].

    Science.gov (United States)

    Lossignol, D

    2014-09-01

    Since 2002, the Belgian legal framework authorizes the practice of euthanasia, under certain conditions. All cases have to be reported to the Assessment and Control Commission (ACC). To date, more than 6000 cases have been reported since 2002. To make a statement about the Belgian experience requires considering different points: data and evaluation from the ACC reports, their analysis, consequences on medical practice, legal and medical perspectives, critics and attacks about the legal framework, the concept of individual and institutional conscience clause. Regarding all these topics, we note that the Belgian experience is more than an example and shows that adequate answers may be provided to patients experiencing intolerable suffering.

  13. Neonatal euthanasia: A claim for an immoral law.

    Science.gov (United States)

    Vanden Eijnden, Serge; Martinovici, Dana

    2013-06-01

    Active ending of the life of a newborn baby is a crime. Yet its clandestine practise is a reality in several European countries. In this paper, we defend the necessity to institute a proper legal frame for what we define as active neonatal euthanasia. The only legal attempt so far, the Dutch Groningen protocol, is not satisfactory. We critically analyse this protocol, as well as several other clinical practises and philosophical stances. Furthermore, we have tried to integrate our opinions as clinicians into a law project, with the purpose of pinpointing several issues, specific of perinatality that should be addressed by such a law. In conclusion, we argue that the legalisation of neonatal euthanasia under exceptional circumstances is the only way to avoid all the "well-intentioned" malpractices associated with ending life at the very dawn of it.

  14. Neonatal euthanasia: A claim for an immoral law

    Science.gov (United States)

    Martinovici, Dana

    2013-01-01

    Active ending of the life of a newborn baby is a crime. Yet its clandestine practise is a reality in several European countries. In this paper, we defend the necessity to institute a proper legal frame for what we define as active neonatal euthanasia. The only legal attempt so far, the Dutch Groningen protocol, is not satisfactory. We critically analyse this protocol, as well as several other clinical practises and philosophical stances. Furthermore, we have tried to integrate our opinions as clinicians into a law project, with the purpose of pinpointing several issues, specific of perinatality that should be addressed by such a law. In conclusion, we argue that the legalisation of neonatal euthanasia under exceptional circumstances is the only way to avoid all the “well-intentioned” malpractices associated with ending life at the very dawn of it. PMID:24068880

  15. Comparing Voluntary and Mandatory Gameplay

    Directory of Open Access Journals (Sweden)

    Esther Kuindersma

    2016-09-01

    Full Text Available Gameplay is commonly considered to be a voluntary activity. Game designers generally believe that voluntary gameplay is essentially different from mandatory gameplay. Such a belief may be a challenge for serious games, as instruction is usually mandatory. The article describes the outcomes of two experiments on the impact of voluntariness on the learning effect and enjoyment of a serious game. In the first experiment freedom of choosing to play a serious game was studied, with participants who had volunteered to participate. The results suggested that, contrary to the opinion of many game designers, being required to play a serious game does not automatically take the fun out of the game. The second experiment had voluntary participants and mandatory participants, who had to participate as part of a homework assignment. The outcomes show that mandatory participants enjoyed the game as much as the voluntary participants, even if they had to play the game for a minimum required time. These studies indicate that mandatory gameplay does not reduce enjoyment and learning effect.

  16. Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

    Science.gov (United States)

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

    2014-05-01

    As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.

  17. [Good death: euthanasia in the eyes of medical students].

    Science.gov (United States)

    Kuře, Josef; Vaňharová, Michaela

    2014-01-01

    Both in the general public and in the professional communities, very diverse notions of euthanasia can be found. At the same time determining of the precise semantics of euthanasia is one of the crucial prerequisites for subsequent meaningful ethical discussion of euthanasia. The paper analyzes an empirical study investigating the understanding of euthanasia by medical students. The aim of the conducted research was to identify the semantic definitions of euthanasia used by the first-year medical students.

  18. Pulling up the runaway: the effect of new evidence on euthanasia's slippery slope.

    Science.gov (United States)

    Ryan, C J

    1998-10-01

    The slippery slope argument has been the mainstay of many of those opposed to the legalisation of physician-assisted suicide and euthanasia. In this paper I re-examine the slippery slope in the light of two recent studies that examined the prevalence of medical decisions concerning the end of life in the Netherlands and in Australia. I argue that these two studies have robbed the slippery slope of the source of its power--its intuitive obviousness. Finally I propose that, contrary to the warnings of the slippery slope, the available evidence suggests that the legalisation of physician-assisted suicide might actually decrease the prevalence of non-voluntary and involuntary euthanasia.

  19. Medical legal and ethical questions in palliative medicine and euthanasia.

    Science.gov (United States)

    Pribilla, O

    1994-12-16

    The increasing importance of legal and ethical questions in palliative medicine and euthanasia due to the increased technical possibilities for extending life will be considered. In palliative medicine, the choice of the best therapy will be discussed, especially in the case of oncological diseases. Here, consideration of the prospects of success, for example, in chemotherapy, is faced with partly serious side-effects. The requirements of palliative medicine that the patient has to be fully informed of the fatal prognosis of his disease is equally debated as the optimum pain therapy. In this respect, the modification of the Narcotics Act of 1 February 1993 is also under discussion. In the field of euthanasia, the technical development of life extension versus dying has raised considerable legal and ethical problems regarding termination of therapy. Additionally, fiscal considerations are of increasing relevance. The common development of the legal and ethical discussion, for example, with regard to the publicity of the work of the so-called 'Gesellschaft für humanes Sterben', the public discussion leading up to a hearing of the 'Bundestag' regarding active euthanasia leads to a realization of the subject. The proposals for an active termination of life by discontinuing therapy for adults and also for malformed newborns are discussed. A dispute concerning the new legal regulation of active euthanasia in the Netherlands of February 1993 is also discussed. There, around 2% of all deaths per year result from active termination of life and also cases where persons are not able to consent. This also has enormous consequences for the position of the physician.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Alleviation of Motor Impairments in Patients with Cerebral Palsy: Acute Effects of Whole-body Vibration on Stretch Reflex Response, Voluntary Muscle Activation and Mobility.

    Science.gov (United States)

    Krause, Anne; Schönau, Eckhard; Gollhofer, Albert; Duran, Ibrahim; Ferrari-Malik, Anja; Freyler, Kathrin; Ritzmann, Ramona

    2017-01-01

    Individuals suffering from cerebral palsy (CP) often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV) has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP. 44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16-25 Hz, 1.5-3 mm). Assessment included (1) recordings of stretch reflex (SR) activity of the triceps surae, (2) electromyography (EMG) measurements of maximal voluntary muscle activation of lower limb muscles, and (3) neuromuscular activation during active range of motion (aROM). We recorded EMG of m. soleus (SOL), m. gastrocnemius medialis (GM), m. tibialis anterior, m. vastus medialis, m. rectus femoris, and m. biceps femoris. Angular excursion was recorded by goniometry of the ankle and knee joint. After WBV, (1) SOL SRs were decreased (p control. This facilitation of muscle and joint control is probably due to a reduction of spasticity-associated spinal excitability in favor of giving access for greater supraspinal input during voluntary motor control.

  1. THE DILEMMA "FOR" AND "AGAINST" EUTHANASIA AND LEGAL AWARENESS OF THE DISABLED

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    Paraskeva Mancheva

    2016-10-01

    Full Text Available Aim: to study the legal awareness of the disabled and to solve the "for" or "against" euthanasia issue Material and methods: The study includes 305 polymorbid disabled people and is certificated by the General territorial Expert Medical Commission (LEDC at University Hospital "St. Marina " Varna for the period October-December 2011. The study uses sociological method - direct and group inquiry and statistical methods: analysis (χ2, analysis of variance, correlation analysis (r, regression analysis (β. The processing of the results was performed by SPSS v.17.0 for Windows. Results: The study of the legal awareness of euthanasia revealed a need for more information among polymorbid disabled people. There is a discrepancy between their more positive, supportive attitude (acceptance of euthanasia and lack of willingness to actually conduct. The reasons for this can be found in the sporadic public discussions on the debate on euthanasia and in the increased distrust of the health care system. Respondents believe that euthanasia at this stage cannot be imputed as an obligation for the Bulgarian medics. Conclusion: The legal public awareness issue is essential to protect the rights of the citizens, for the realization of those activities that require strict compliance with the Constitution, laws and regulations. The legal awareness study of the disabled for solution of the "for" or "against" euthanasia issue presents an opportunity to discuss a way out of a hopeless situation for patients in terminal condition.

  2. Should euthanasia be legal? An international survey of neonatal intensive care units staff.

    Science.gov (United States)

    Cuttini, M; Casotto, V; Kaminski, M; de Beaufort, I; Berbik, I; Hansen, G; Kollée, L; Kucinskas, A; Lenoir, S; Levin, A; Orzalesi, M; Persson, J; Rebagliato, M; Reid, M; Saracci, R

    2004-01-01

    To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom); 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation.

  3. Should euthanasia be legal? An international survey of neonatal intensive care units staff

    Science.gov (United States)

    Cuttini, M; Casotto, V; Kaminski, M; de Beaufort, I; Berbik, I; Hansen, G; Kollee, L; Kucinskas, A; Lenoir, S; Levin, A; Orzalesi, M; Persson, J; Rebagliato, M; Reid, M; Saracci, R

    2004-01-01

    Objective: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. Design: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom); 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). Main outcome measure: The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Results: Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Conclusions: Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation. PMID:14711848

  4. Attitudes toward euthanasia among Swedish medical students.

    Science.gov (United States)

    Karlsson, Marit; Strang, Peter; Milberg, Anna

    2007-10-01

    Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life.

  5. The attitudes of nursing students to euthanasia.

    Science.gov (United States)

    Naseh, Ladan; Heidari, Mohammad

    2017-01-01

    One of the most common morally controversial issues in endof-life care is euthanasia. Examining the attitudes of nursing students to this issue is important because they may encounter situations related to euthanasia during their clinical courses. The aim of our study was to examine nursing students' attitudes to euthanasia in Shahrekord city in western Iran. This was done using the Euthanasia Attitude Scale. The scale is divided into four categories, ie ethical considerations, practical considerations, treasuring life and naturalistic beliefs. Of 132 nursing students, 120 participated in the study (response rate 93.1%). According to the study's findings, 52.5%, 2.5% and 45% of the students reported a negative, neutral and positive attitude to euthanasia, respectively. There was a significant correlation between the nursing students' attitudes to euthanasia and some demographic characteristics, including sex, age and religious beliefs. Iranian Muslim nursing students participating in the study had a negative attitude to euthanasia. Further studies are recommended among nursing students from different cultures and of different religious faiths.

  6. The euthanasia-religion nexus: exploring religious orientation and euthanasia attitude measures in a Muslim context.

    Science.gov (United States)

    Aghababaei, Naser

    Using religious orientation paradigm, this twofold study examined the relationship between euthanasia attitude and religiosity, and compared single-item and multi-item scales of euthanasia attitude. Three hundred students were asked whether they view euthanasia as moral. In addition, participants completed the Euthanasia Attitude Scale (EAS) and Religious Orientation Scale-Revised. Results indicated that intrinsic religiosity was the strongest correlate of negative attitudes toward euthanasia. This type of religiosity explained additional variance when added to the two types of extrinsic religiosity (social, personal), but the reverse was not the case. The fairly strong correlation of intrinsic religiosity with the EAS provides evidence of construct validity for the EAS and proved it to be a better measure for assessing euthanasia attitude, rather than the single-item scale.

  7. RELATIONS OF SELF-APPRAISAL AND MOOD CHANGES WITH VOLUNTARY PHYSICAL ACTIVITY CHANGES IN AFRICAN AMERICAN PREADOLESCENTS IN AN AFTER-SCHOOL CARE INTERVENTION

    Directory of Open Access Journals (Sweden)

    James J. Annesi

    2008-06-01

    Full Text Available There is an increasing prevalence of overweight in preadolescents that predicts physical problems over the lifespan. Physical inactivity has been implicated as an associated factor, with African American youth being at an increased risk. Based on social cognitive theory, and proposed correlates of physical activity in youth, changes over 12 weeks in measures of self-appraisal (general self, physical appearance, physical self-concept, exercise barriers self-efficacy and mood (tension, vigor, and their relations with voluntary physical activity changes, were assessed within an after-school care physical activity intervention. Participants were volunteers recruited from children already registered for a 12-week segment of YMCA after-school care. The treatment group consisted of 146 African American preadolescents with the control group comprised of 123 African American preadolescents who were scheduled to receive the program during the next sequence that it was offered. Results indicated the intervention group reported significantly more positive self-appraisals, reduced tension, and enhanced vigor. Bivariate and multiple regression analyses indicated that when each of the 4 self-appraisal and 2 mood factors were simultaneously entered into a regression equation, 36% of the variance in voluntary physical activity was explained. Findings support the treatment's association with theoretically based correlates of physical activity in the present sample, and suggest directions for physical activity interventions for youth

  8. Attitudes and experiences of Belgian physicians regarding euthanasia practice and the euthanasia law.

    Science.gov (United States)

    Smets, Tinne; Cohen, Joachim; Bilsen, Johan; Van Wesemael, Yanna; Rurup, Mette L; Deliens, Luc

    2011-03-01

    Since the legalization of euthanasia, physicians in Belgium may, under certain conditions, administer life-ending drugs at the explicit request of a patient. To study the attitudes of Belgian physicians toward the use of life-ending drugs and euthanasia law, factors predicting attitudes, and factors predicting whether a physician has ever performed euthanasia. In 2009, we sent a questionnaire to a representative sample of 3006 Belgian physicians who, because of their specialty, were likely to be involved in the care of the dying. Response rate was 34%. Ninety percent of physicians studied were accepting of euthanasia for terminal patients who had extreme uncontrollable pain/symptoms. Sixty-six percent agreed that the euthanasia law contributes to the carefulness of physicians' end-of-life behavior; 10% agreed that the law impedes the development of palliative care. Religious beliefs and geographic region were strong determinants of attitude. Training in palliative care did not influence attitudes regarding euthanasia, but trained physicians were less likely to agree that the euthanasia law impedes the development of palliative care than were nontrained physicians. One in five physicians had performed euthanasia; they were more likely to be nonreligious, older, specialist, trained in palliative care, and to have had more experience in treating the dying. Most physicians studied support euthanasia for terminal patients with extreme uncontrollable pain/symptoms and agree that euthanasia can be part of good end-of-life care. Although physicians had little involvement in the process of legalizing euthanasia, they now generally endorse the euthanasia law. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  9. [Ethics in intensive care and euthanasia : With respect to inactivating defibrillators at the end of life in terminally ill patients].

    Science.gov (United States)

    Trappe, H-J

    2017-04-01

    In critically ill patients, intensive care medical procedures allow diseases to be cured or controlled that were considered incurable many years ago. For patients with terminal heart failure or heart disease with other severe comorbidities (cancer, stroke), the questions whether the deactivation of defibrillators is appropriate or must be regarded as active euthanasia may arise. Notable cases from the author's hospital are analyzed. The literature on the topic euthanasia and basic literature regarding defibrillator therapy are discussed. It is undisputed that patients as part of their self-determination have the right to renounce treatment. Active euthanasia and the thereby deliberate induction of death is prohibited by law in Germany and will be prosecuted. Passive euthanasia is the omission or reduction of possibly life-prolonging treatment measures. Passive euthanasia requires the patient's consent and is legally and ethically permissible. Indirect euthanasia takes into account acceleration of death as a side effect of a medication. Unpunishable assisted suicide ("assisted suicide") is the mere assistance of self-controlled and self-determined death. Assisted suicide is fundamentally not a criminal offense in Germany. Deactivation of a defibrillator is a treatment discontinuation, which is only permitted in accordance with the wishes of the patient. It is not a question of passive or active euthanasia. Involvement of a local ethics committee and/or legal consultation is certainly useful and sometimes also allows previously unrecognized questions to be answered.

  10. [Could infant euthanasia be ever acceptable?].

    Science.gov (United States)

    Beca, J P; Leiva, A

    2014-10-01

    The recent enactment of a law that allows infant euthanasia in Belgium raises questions with varied answers. To contribute to a better understanding of the topic, euthanasia and legislation concepts are described. After a bioethical analysis, we propose as conclusion that children euthanasia could only be acceptable in very exceptional situations in which palliative measures have failed. The answer should be that it is not acceptable in our setting, not until we have public policies, protocols and palliative care services for terminally ill children.

  11. Principialism and Dworkin: some notes on Euthanasia

    Directory of Open Access Journals (Sweden)

    Mateus Salvadori

    2016-04-01

    Full Text Available This study aimed to carry out an analysis of the figure of euthanasia and its ethical implications. Addressed to aspects of bioethics and principlism, the theory developed by Beauchamp and Childress. Also presented is the right philosopher Ronald Dworkin position, in favor of euthanasia. Euthanasia is a complex, multidisciplinary subject, your debate is very timely because of the medical possibilities of keeping a person alive indefinitely, regardless of their suffering. The search for alternatives should continue in order to defend the autonomy of patients in their end of life choices and to respect their dignity.

  12. Guidelines for euthanasia of laboratory animals used in biomedical research

    Directory of Open Access Journals (Sweden)

    Adina Baias,

    2012-06-01

    Full Text Available Laboratory animals are used in several fields of science research, especially in biology, medicine and veterinary medicine. The majority of laboratory animals used in research are experimental models that replace the human body in study regarding pharmacological or biological safety products, studies conducted for a betterunderstanding of oncologic processes, toxicology, genetic studies or even new surgical techniques. Experimental protocols include a stage in which animals are euthanized in order to remove organs and tissues,or for no unnecessary pain and suffering of animals (humane endpoints or to mark the end of research. The result of euthanasia techniques is a rapid loss of consciousness followed by cardiac arrest, respiratory arrest and disruption of brain activity. Nowadays, the accepted euthanasia techniques can use chemicals (inhalant agents like: carbon dioxide, nitrogen or argon, overdoses of injectable anesthetics or physical methods (decapitation, cervical spine dislocation, stunning, gunshot, pitching.

  13. Nurses' participation in the euthanasia programs of Nazi Germany.

    Science.gov (United States)

    Benedict, S; Kuhla, J

    1999-04-01

    During the Nazi era, so-called euthanasia programs were established for handicapped and mentally ill children and adults. Organized killings of an estimated 70,000 German citizens took place at killing centers and in psychiatric institutions. Nurses were active participants; they intentionally killed more than 10,000 people in these involuntary euthanasia programs. After the war was over, most of the nurses were never punished for these crimes against humanity--although some nurses were tried along with the physicians they assisted. One such trial was of 14 nurses and was held in Munich in 1965. Although some of these nurses reported that they struggled with a guilty conscience, others did not see anything wrong with their actions, and they believed that they were releasing these patients from their suffering.

  14. Neonatal euthanasia: lessons from the Groningen Protocol.

    Science.gov (United States)

    Eduard Verhagen, A A

    2014-10-01

    Decisions about neonatal end-of-life care have been studied intensely over the last 20 years in The Netherlands. Nationwide surveys were done to quantify these decisions, provide details and monitor the effect of guidelines, new regulations and other interventions. One of those interventions was the Groningen Protocol for newborn euthanasia in severely ill newborns, published in 2005. Before publication, an estimated 20 cases of euthanasia per year were performed. After publication, only two cases in five years were reported. Studies suggested that this might be partly caused by the lack of consensus about the dividing line between euthanasia and palliative care. New recommendations about paralytic medication use in dying newborns were issued to increase transparency and to improve reporting of euthanasia. New surveys will be needed to measure the effects of these interventions. This cycle of interventions and measurements seems useful for continuous improvement of end-of-life care in newborns.

  15. AN ARTICLE ON EUTHANASIA (MERCY KILLING)

    National Research Council Canada - National Science Library

    Sreenivas; Sastry; Naga Sai

    2012-01-01

    The definition of Euthanasia is derived1 from the Greek “Eu - True; Thanatos - Death”, a deliberate intervention undertaken with the expressed intention of ending a life to relieve intract able suffering...

  16. Attitudes Toward Euthanasia Among Turkish University Students.

    Science.gov (United States)

    Ulas Karaahmetoglu, Gulsen; Kutahyalioglu, Nesibe Sumeyye

    2017-01-01

    This study aims to examine perceptions and attitudes toward euthanasia among university students who are pursuing bachelor's degrees. Although the legalization and application of euthanasia are discussed commonly by health-care professionals and partially by lawyers, the ideas of other segments of society, especially university students, are taken place very rarely. The research was conducted descriptively to determine the ideas of 1,170 students at Kastamonu University from six different departments: arts and sciences, theology, tourism, nursing, school of physical education, and sports with using a questionnaire. Findings demonstrated that 73.2% of the students do not approve euthanasia. Also, it was found that there are significant differences depending on age, gender, department of study, income level, place of living, and the loss of kinsmen. This study serves as a resource for future research to understand the effects of sociodemographic characteristics on the decision of euthanasia.

  17. Euthanasia: Murder or Not: A Comparative Approach

    National Research Council Canada - National Science Library

    Banović, Božidar; Turanjanin, Veljko

    2014-01-01

    Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public...

  18. Euthanasia techniques for small and large cetaceans

    National Research Council Canada - National Science Library

    2015-01-01

    Several circumstances may require the euthanasia of a cetacean: stranding, entanglement in fishing gear, entrapment in ice, significant injury of a free-swimming cetacean from ship-strike, or a terminally ill animal in a captive situation...

  19. Neonatal euthanasia: moral considerations and criminal liability.

    Science.gov (United States)

    Sklansky, M

    2001-02-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice.

  20. Euthanasia for children and young people?

    Science.gov (United States)

    Kelly, Daniel

    2014-05-01

    In February 2014 the Belgian parliament voted to extend the existing euthanasia law to cover children under the age of 18. The law sanctions euthanasia for children with terminal or incurable conditions who are near death, suffering 'constant and unbearable pain', and whose parents and health professionals agree with the decision. The child also has to be interviewed by a psychologist or psychiatrist to ascertain and certify their 'capacity of discernment'.

  1. GPs' views on changing the law on physician-assisted suicide and euthanasia, and willingness to prescribe or inject lethal drugs: a survey from Wales.

    Science.gov (United States)

    Pasterfield, Diana; Wilkinson, Clare; Finlay, Ilora G; Neal, Richard D; Hulbert, Nicholas J

    2006-06-01

    If physician-assisted suicide/euthanasia is legalised in the UK, this may be the work of GPs. In the absence of recent or comprehensive evidence about GPs' views on either legalisation or willingness to take part, a questionnaire survey of all Welsh GPs was conducted of whom 1202 (65%) responded. Seven hundred and fifty (62.4% of responders) and 671 (55.8% of responders) said that they did not favour a change in the law to allow physician-assisted suicide/voluntary euthanasia respectively. These data provide a rational basis for determining the position of primary care on this contentious issue.

  2. GPs' views on changing the law on physician-assisted suicide and euthanasia, and willingness to prescribe or inject lethal drugs: a survey from Wales

    Science.gov (United States)

    Pasterfield, Diana; Wilkinson, Clare; Finlay, Ilora G; Neal, Richard D; Hulbert, Nicholas J

    2006-01-01

    If physician-assisted suicide/euthanasia is legalised in the UK, this may be the work of GPs. In the absence of recent or comprehensive evidence about GPs' views on either legalisation or willingness to take part, a questionnaire survey of all Welsh GPs was conducted of whom 1202 (65%) responded. Seven hundred and fifty (62.4% of responders) and 671 (55.8% of responders) said that they did not favour a change in the law to allow physician-assisted suicide/voluntary euthanasia respectively. These data provide a rational basis for determining the position of primary care on this contentious issue. PMID:16762127

  3. Ontology or phenomenology? How the LVAD challenges the euthanasia debate.

    Science.gov (United States)

    Kraemer, Felicitas

    2013-03-01

    This article deals with the euthanasia debate in light of new life-sustaining technologies such as the left ventricular assist device (LVAD). The question arises: does the switching off of a LVAD by a doctor upon the request of a patient amount to active or passive euthanasia, i.e. to 'killing' or to 'letting die'? The answer hinges on whether the device is to be regarded as a proper part of the patient's body or as something external. We usually regard the switching off of an internal device as killing, whereas the deactivation of an external device is seen as 'letting die'. The case is notoriously difficult to decide for hybrid devices such as LVADs, which are partly inside and partly outside the patient's body. Additionally, on a methodological level, I will argue that the 'ontological' arguments from analogy given for both sides are problematic. Given the impasse facing the ontological arguments, complementary phenomenological arguments deserve closer inspection. In particular, we should consider whether phenomenologically the LVAD is perceived as a body part or as an external device. I will support the thesis that the deactivation of a LVAD is to be regarded as passive euthanasia if the device is not perceived by the patient as a part of the body proper. © 2011 Blackwell Publishing Ltd.

  4. [Euthanasia and other decisions at the end of life (Proposal for a more transparent terminology and some thoughts on the legal framework of medical treatment)].

    Science.gov (United States)

    Vadász, Gábor

    2010-10-24

    Indication of euthanasia is only one of several medical decisions at the end of life. Precise definition of this topic related to the clinical events happening around the sick-bed is not complete in the legal and medical literature. The present review attempts to classify the different end of life events with the aim of clarifying which of these do not belong to the concept of passive euthanasia. Euthanasia is not a legal category. The everyday expressions of active and passive euthanasia are simplifications, which cover actions of different purposes. Use of these in medical and legal literature can be confusing and misleading. We differentiate decisions at the end of life on basis of their purpose. Based on the definition and category of the Hungarian Doctors' Chamber, euthanasia is the act or the lack of action in order to mercifully shorten or end the life of a suffering fellow-man to help him. Concepts of active, passive and forced euthanasia are defined. The terms of indirect and intermediate euthanasia are not used in order to avoid misunderstanding. Help and participation of non-professionals in the implementation cannot be completely excluded from the concept of euthanasia, and we believe euthanasia is not merely related to doctors. We outline those medical decisions at the end of life which do not belong to the category of passive euthanasia, namely: withdrawal of ineffective and life sustaining treatments, letting go of the patient, contra-indication of therapy escalation, use of palliative therapy, pain-relieving treatment, compromise medicine, consideration of reanimation and choosing cost-effective therapy. We touch upon the subject of the living will, why it cannot be applied, and its relation to active and passive euthanasia. With reference to the legal regulation of life saving and life sustaining treatment, we deal with the expected spirit of medical legislation.

  5. Passive euthanasia in India: a critique.

    Science.gov (United States)

    Shukla, Rohini

    2016-01-01

    Given its preoccupation with the doctor's agency in administering euthanasia, the legal discourse on euthanasia in India has neglected the moral relevance of the patient's suffering in determining the legitimate types of euthanasia. In this paper, I begin by explicating the condition for the possibility of euthanasia in terms of the following moral principle: the doctor ought to give priority to the patient's suffering over the patient's life. I argue that the form of passive euthanasia legally permissible in India is inconsistent with this moral principle, owing to the consequences it entails for the patient. Inevitably, it is acts of commission on the part of the doctor that can provide the best possible death, which is the moral objective of euthanasia. To meet this objective, doctors must be seen as agents who possess the moral integrity and technical expertise to judge when and how the patient’s life ought to be terminated, depending on the patient’s medical condition. They are not bound to save lives and provide care unconditionally.

  6. Attitudes and Experiences of Belgian Physicians Regarding Euthanasia Practice and the Euthanasia Law

    National Research Council Canada - National Science Library

    Smets, Tinne; Cohen, Joachim; Bilsen, Johan; Van Wesemael, Yanna; Rurup, Mette L; Deliens, Luc

    2011-01-01

    ... and controversial medical acts possible, the law includes a mandatory notification procedure requiring physicians to report each euthanasia case to the Federal Control and Evaluation Committee, which assesses whether the physician has respected all the requirements of the law. 2 Since the enactment of the euthanasia law, the frequency and characteris...

  7. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act.

    Science.gov (United States)

    van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

    2010-04-01

    The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalizing euthanasia under strict conditions influences the number and nature of euthanasia requests. To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Retrospective dynamic cohort study comparing 5 years before (1998-2002) and 5 years after (2003-2007) implementation of the Act. Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. The mean annual incidence of requests before implementation amounted to 3.1/10,000 and thereafter to 2.8/10,000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10,000 to 2.6/10,000 (P = 0.008); the requests by females increased non-significantly from 2.6/10,000 to 3.1/10,000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females.

  8. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

    Science.gov (United States)

    van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

    2010-01-01

    Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

  9. Attitudes on euthanasia and physician-assisted suicide among medical students in Athens.

    Science.gov (United States)

    Kontaxakis, Vp; Paplos, K G; Havaki-Kontaxaki, B J; Ferentinos, P; Kontaxaki, M-I V; Kollias, C T; Lykouras, E

    2009-10-01

    Attitudes towards assisted death activities among medical students, the future health gatekeepers, are scarce and controversial. The aims of this study were to explore attitudes on euthanasia and physician-assisted suicide among final year medical students in Athens, to investigate potential differences in attitudes between male and female medical students and to review worldwide attitudes of medical students regarding assisted death activities. A 20- item questionnaire was used. The total number of participants was 251 (mean age 24.7±1.8 years). 52.0% and 69.7% of the respondents were for the acceptance of euthanasia and physician-assisted suicide, respectively. Women's attitudes were more often influenced by religious convictions as well as by the fact that there is a risk that physician-assisted suicide might be misused with certain disadvantaged groups. On the other hand, men more often believed that a request for physician-assisted suicide from a terminally ill patient is prima-facie evidence of a mental disorder, usually depression. Concerning attitudes towards euthanasia among medical students in various countries there are contradictory results. In USA, the Netherlands, Hungary and Switzerland most of the students supported euthanasia and physician-assisted suicide. However, in many other countries such as Norway, Sweden, Yugoslavia, Italy, Germany, Sudan, Malaysia and Puerto Rico most students expressed negative positions regarding euthanasia and physician assisted suicide.

  10. Euthanasia using gaseous agents in laboratory rodents.

    Science.gov (United States)

    Valentim, A M; Guedes, S R; Pereira, A M; Antunes, L M

    2016-08-01

    Several questions have been raised in recent years about the euthanasia of laboratory rodents. Euthanasia using inhaled agents is considered to be a suitable aesthetic method for use with a large number of animals simultaneously. Nevertheless, its aversive potential has been criticized in terms of animal welfare. The data available regarding the use of carbon dioxide (CO2), inhaled anaesthetics (such as isoflurane, sevoflurane, halothane and enflurane), as well as carbon monoxide and inert gases are discussed throughout this review. Euthanasia of fetuses and neonates is also addressed. A table listing currently available information to ease access to data regarding euthanasia techniques using gaseous agents in laboratory rodents was compiled. Regarding better animal welfare, there is currently insufficient evidence to advocate banning or replacing CO2 in the euthanasia of rodents; however, there are hints that alternative gases are more humane. The exposure to a volatile anaesthetic gas before loss of consciousness has been proposed by some scientific studies to minimize distress; however, the impact of such a measure is not clear. Areas of inconsistency within the euthanasia literature have been highlighted recently and stem from insufficient knowledge, especially regarding the advantages of the administration of isoflurane or sevoflurane over CO2, or other methods, before loss of consciousness. Alternative methods to minimize distress may include the development of techniques aimed at inducing death in the home cage of animals. Scientific outcomes have to be considered before choosing the most suitable euthanasia method to obtain the best results and accomplish the 3Rs (replacement, reduction and refinement).

  11. Why Palliative Care for Children is Preferable to Euthanasia.

    Science.gov (United States)

    Carter, Brian S

    2016-02-01

    Recent laws in Europe now allow for pediatric euthanasia. The author reviews some rationale for caution, and addresses why ensuring the availability of pediatric palliative care is an important step before allowing pediatric euthanasia.

  12. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    Science.gov (United States)

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  13. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    Science.gov (United States)

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  14. Euthanasia, assisted suicide, and cessation of life support: Japan's policy, law, and an analysis of whistle blowing in two recent mercy killing cases.

    Science.gov (United States)

    Akabayashi, Akira

    2002-08-01

    Issues pertaining to euthanasia, assisted suicide, and cessation of life support continue to be a subject of worldwide interest. Euthanasia- particularly "active" euthanasia- is not considered legally or socially acceptable in most countries. In Japan, the first judgment of a case involving euthanasia took place in 1949. Since then there have been another five cases that reached the point of sentencing in 1990. All six cases were examples of so called "active euthanasia", in which the termination of life was performed by family members. However, the focus of discussion has been changed dramatically in recent years, owing to two prominent cases of mercy killing in 1995 (Yokohama) and 1996 (Kyoto), respectively. Medical doctors were involved in both of these cases, and euthanasia moved from being a theoretical problem to a practical dilemma. These cases also drew attention to the fact that assisted suicide could be distinguished from euthanasia. The first part of this paper will summarize the current status of euthanasia and the cessation of life support in Japan, focusing on its historical background and policy. The second part will briefly sketch the characteristics of Japanese law and then will examine the two recent cases of mercy killing mentioned above to try and determine the roles of whistle blowing in the medical practice arena, with particular reference to Japanese culture. This analysis is a challenge to elucidate how ethics and the law interact, and influence medical practice in a specific cultural context.

  15. Euthanasia: Murder or Not: A Comparative Approach

    Science.gov (United States)

    BANOVIĆ, Božidar; TURANJANIN, Veljko

    2014-01-01

    Abstract Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public to its supporters and opponents. It also appears as one of the points where all three major religions (Catholic, Orthodox, and Islamic) have the same view. They are strongly against legalizing mercy killing, emphasizing the holiness of life as a primary criterion by which the countries should start in their considerations. Studying criminal justice systems in the world, the authors concluded that the issue of deprivation of life from compassion is solved on three ways. On the first place, we have countries where euthanasia is murder like any other murder from the criminal codes. Second, the most numerous are states where euthanasia is murder committed under privilege circumstances. On the third place, in the Western Europe we have countries where euthanasia is a legal medical procedure, under requirements prescribed by the law. In this paper, authors have made a brief comparison of the solutions that exist in some Islamic countries, where euthanasia is a murder, with Western countries, where it represents completely decriminalized medical procedure. PMID:26056652

  16. Neonatal euthanasia: moral considerations and criminal liability

    Science.gov (United States)

    Sklansky, M.

    2001-01-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice. Key Words: Euthanasia • neonatal intensive care • defective newborns PMID:11233379

  17. Euthanasia tactics: patterns of injustice and outrage.

    Science.gov (United States)

    Martin, Brian

    2013-12-01

    Struggles over euthanasia can be examined in terms of tactics used by players on each side of the issue to reduce outrage from actions potentially perceived as unjust. From one perspective, the key injustice is euthanasia itself, especially when the person or relatives oppose death. From a different perspective, the key injustice is denial of euthanasia, seen as a person's right to die. Five types of methods are commonly used to reduce outrage from something potentially seen as unjust: covering up the action; devaluing the target; reinterpreting the action, including using lying, minimising consequences, blaming others and benign framing; using official channels to give an appearance of justice; and using intimidation. Case studies considered include the Nazi T4 programme, euthanasia in contemporary jurisdictions in which it is legal, and censorship of Exit International by the Australian government. By examining euthanasia struggles for evidence of the five types of tactics, it is possible to judge whether one or both sides use tactics characteristic of perpetrators of injustice. This analysis provides a framework for examining tactics used in controversial health issues.

  18. Euthanasia: Murder or Not: A Comparative Approach.

    Science.gov (United States)

    Banović, Božidar; Turanjanin, Veljko

    2014-10-01

    Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public to its supporters and opponents. It also appears as one of the points where all three major religions (Catholic, Orthodox, and Islamic) have the same view. They are strongly against legalizing mercy killing, emphasizing the holiness of life as a primary criterion by which the countries should start in their considerations. Studying criminal justice systems in the world, the authors concluded that the issue of deprivation of life from compassion is solved on three ways. On the first place, we have countries where euthanasia is murder like any other murder from the criminal codes. Second, the most numerous are states where euthanasia is murder committed under privilege circumstances. On the third place, in the Western Europe we have countries where euthanasia is a legal medical procedure, under requirements prescribed by the law. In this paper, authors have made a brief comparison of the solutions that exist in some Islamic countries, where euthanasia is a murder, with Western countries, where it represents completely decriminalized medical procedure.

  19. Euthanasia: Murder or Not: A Comparative Approach.

    Directory of Open Access Journals (Sweden)

    Božidar Banović

    2014-10-01

    Full Text Available Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public to its supporters and opponents. It also appears as one of the points where all three major religions (Catholic, Orthodox, and Islamic have the same view. They are strongly against legalizing mercy killing, emphasizing the holiness of life as a primary criterion by which the countries should start in their considerations. Studying criminal justice systems in the world, the authors concluded that the issue of deprivation of life from compassion is solved on three ways. On the first place, we have countries where euthanasia is murder like any other murder from the criminal codes. Second, the most numerous are states where euthanasia is murder committed under privilege circumstances. On the third place, in the Western Europe we have countries where euthanasia is a legal medical procedure, under requirements prescribed by the law. In this paper, authors have made a brief comparison of the solutions that exist in some Islamic countries, where euthanasia is a murder, with Western countries, where it represents completely decriminalized medical procedure.

  20. [Walter Creutz and "euthanasia" in the rhein province: between resistance and collaboration].

    Science.gov (United States)

    Schmuhl, H-W

    2013-09-01

    Over many decades Walter Creutz, medical officer in the provincial administration of Rhine Province from 1935 to 1945, was held to be one of the few psychiatrists who had actively opposed the Nazi "Euthanasia" program. In the famous "Euthanasia trial" in Düsseldorf from 1948 to 1950, Creutz was acquitted of complicity in murder; the court attested that he had done his best to sabotage the "Euthanasia" program and in so doing had saved up to 3,000 patients in the Rhineland. This rendering was circulated further in the history of science literature, so that the Rhine Province was considered to be a center of resistance to the "Euthanasia" program. Doubts about this portrayal have arisen since the 1980s. Various authors attempted to prove that Walter Creutz collaborated with the "Euthanasia" apparatus claiming there was no evidence of opposition or resistance or only to a very limited degree. However, this new perspective is based on an equally one-sided, at times grossly distorted analysis of the sources. The article provides building blocks for a more differentiated interpretation.

  1. Euthanasia Acceptance as Related to Afterlife and Other Attitudes.

    Science.gov (United States)

    Klopfer, Frederick J.; Price, William F.

    1978-01-01

    Information on euthanasia attitudes was obtained from fixed-schedule interviews gathered from 331 respondents. It was found that a favorable attitude toward euthanasia coincided with (1) belief in an afterlife; (2) a less favorable attitude toward euthanasia if relatives make the decision; and (3) younger respondents. (Author)

  2. Euthanasia Acceptance as Related to Afterlife and Other Attitudes.

    Science.gov (United States)

    Klopfer, Frederick J.; Price, William F.

    1978-01-01

    Information on euthanasia attitudes was obtained from fixed-schedule interviews gathered from 331 respondents. It was found that a favorable attitude toward euthanasia coincided with (1) belief in an afterlife; (2) a less favorable attitude toward euthanasia if relatives make the decision; and (3) younger respondents. (Author)

  3. Process and outcomes of euthanasia requests under the belgian act on euthanasia: a nationwide survey.

    Science.gov (United States)

    Van Wesemael, Yanna; Cohen, Joachim; Bilsen, Johan; Smets, Tinne; Onwuteaka-Philipsen, Bregje; Deliens, Luc

    2011-11-01

    Since 2002, the administration of a lethal drug by a physician at the explicit request of the patient has been legal in Belgium. The incidence of euthanasia in Belgium has been studied, but the process and outcomes of euthanasia requests have not been investigated. To describe which euthanasia requests were granted, withdrawn, and rejected since the enactment of the euthanasia law in terms of the characteristics of the patient, treating physician, and aspects of the consultation with a second physician. A representative sample of 3006 Belgian physicians received a questionnaire investigating their most recent euthanasia request. The response rate was 34%. Since 2002, 39% of respondents had received a euthanasia request. Forty-eight percent of requests had been carried out, 5% had been refused, 10% had been withdrawn, and in 23%, the patient had died before euthanasia could be performed. Physicians' characteristics associated with receiving a request were not being religious, caring for a high number of terminally ill patients, and having experience in palliative care. Patient characteristics associated with granting a request were age, having cancer, loss of dignity, having no depression, and suffering without prospect of improvement as a reason for requesting euthanasia. A positive initial position toward the request from the attending physician and positive advice from the second physician also contributed to having a request granted. Under the Belgian Act on Euthanasia, about half of the requests are granted. Factors related to the reason for the request, position of the attending physician toward the request, and advice from the second physician influence whether a request is granted or not. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  4. Attitudes of Polish physicians and medical students toward breaking bad news, euthanasia and morphine administration in cancer patients.

    Science.gov (United States)

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria

    2013-12-01

    Medical students and physicians should possess basic knowledge concerning medical ethics and palliative care. The aim of the study was to explore the knowledge on the end-of-life ethics and palliative care in third-year medical students and physicians during internal medicine specialty training and their attitude towards breaking bad news and euthanasia. A voluntary and anonymous questionnaire survey with the participation of 401 students and 217 physicians filled after lectures concerning ethics for medical students and after palliative medicine course for physicians during internal medicine specialty training. A total of 28 % students and 24 % physicians (p = 0.282) were ready to reveal full information to advanced cancer patients. A total of 82 % of students and 90 % of physicians (p = 0.008) would not practice euthanasia; 67 % of students and 75 % of physicians (p = 0.039) were opponents of euthanasia legalisation. A total of 70 % doctors and 23 % students indicated oral as the most preferable route of morphine administration. A total of 74 % physicians and 43 % students stated that there is no maximal dose of morphine; 64 % of doctors and 6 % of students indicated constipation as a constant adverse effect of morphine. Breaking bad news is a significant difficulty for both students and physicians. There is a small percentage of those tending to practice euthanasia and bigger accepting its legalisation with fewer physicians than students. In contrast to medical students, the majority of physicians have knowledge concerning chronic morphine use in the treatment of cancer patients.

  5. Explaining the emergence of euthanasia law in the Netherlands: how the sociology of law can help the sociology of bioethics.

    Science.gov (United States)

    Weyers, Heleen

    2006-09-01

    The debate over the legalisation of voluntary euthanasia is most often seen to be the result of three changes in society: individualisation, diminished taboos concerning death and changes in the balance of power in medicine. The fact that these changes occurred in many western countries but led to legalisation in only a few makes this claim problematic. I examine whether socio-legal propositions, with respect to the emergence of laws which focus on social control, offer a better approach to understanding the development of rules allowing and governing euthanasia. After a short sketch of the history of the Dutch law regulating euthanasia, I discuss these three societal changes in the light of shifts in the social control of medical behaviour that shortens life. I show that the Dutch relaxation of the prohibition of euthanasia goes together with new forms of social control: doctors' self control is complemented with second-party control (by patients), professional third-party control and governmental control. My work calls attention to the fact that bioethics is part of larger systems of social control.

  6. Does the distinction between killing and letting die justify some forms of euthanasia?

    Science.gov (United States)

    Dines, A

    1995-05-01

    Nurses will often be at the forefront in a health care team which decides that it is ethically acceptable to allow a particular patient to die but the possibility of actually killing another patient who requests his own death is met with heartfelt resistance. This paper explores the distinction between killing and letting die and the connection these arguments have with justifications for euthanasia. Two practical examples of killing and letting die are analysed. Various issues are examined including the active-passive distinction, the difference between causing and preventing a death and the probability of outcome. Justifications for euthanasia are then revisited and some concluding remarks made.

  7. Euthanasia: reconciling culture and human rights.

    Science.gov (United States)

    Goolam, N M

    1996-01-01

    The constitutional justifiability of euthanasia will depend upon interpretation of the right to life and the right to respect for and protection of one's dignity. Pertinent issues arising hereto are: In our new value-based constitutional interpretation, what are the values underlying our multi-cultural society? Issues of death and dying are inter-linked to a civilization's world view and its approach to human dignity. Western, African and Islamic approaches will be compared. Does euthanasia negate the essential content of the right to life and is its limitation on such right reasonable/justifiable in an open and democratic society based on freedom and equality.

  8. [Euthanasia and general practice in Belgium].

    Science.gov (United States)

    Thomas, J M

    2014-09-01

    In Belgium, the GP can perform euthanasia or be called as a consultant. He must know the laws concerning the end of life and be able to explain his rights to his patients. He will know the best practices and techniques for euthanasia. If necessary, he will call help or refer to a more competent colleague. He negotiates with the patient an advanced care planning following the evolution of its pathologies and will witness its wishes regarding end of life against other institutions and doctors.

  9. [Euthanasia as a moral problem in individual and social dimensions].

    Science.gov (United States)

    Kopania, Jerzy

    2002-01-01

    In the article, the author conducts a reasoning which results in a moral consent to perform an act of euthanasia on oneself. However, the problem of our times is the demand for the right to assisted euthanasia, particularly the doctor-assisted euthanasia. It is argued that the only situation in which an assistance in performing euthanasia finds a moral justification is a situation of a complete physical incapability to terminate a patient's own life. It is also argued that an assistant cannot be a doctor because in such a case we would be forced to acknowledge euthanasia as the final stage of the treatment process.

  10. Flemish palliative care nurses' attitudes toward euthanasia: a quantitative study.

    Science.gov (United States)

    Gielen, Joris; van den Branden, Stef; van Iersel, Trudie; Broeckaert, Bert

    2009-10-01

    To adequately measure the attitudes of Flemish palliative care nurses toward euthanasia, and assess the relationship between these attitudes and demographic factors and the (perceived) influence of experience in palliative care on death anxiety. An anonymous questionnaire was sent to all nurses (n=589) employed in palliative care in Flanders, Belgium: 70.5% of the nurses (n=415) responded. A majority of the nurses supported the Belgian law regulating euthanasia but also believed that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care. Three clusters were discovered: staunch advocates of euthanasia (150 nurses, 41.1%); moderate advocates of euthanasia (135 nurses, 37%); and (moderate) opponents of euthanasia (80 nurses, 21.9%). An absolute opposition between advocates and opponents of euthanasia was not observed. A statistically significant relationship was found between the euthanasia clusters and years of experience in palliative care, and (perceived) influence of experience in palliative care on anxiety when a patient dies. Flemish palliative care nurses' attitudes toward euthanasia are nuanced and contextual. By indicating that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care, the nurses applied a 'palliative filter' a standard procedure in the case of a euthanasia request.

  11. Control of heart rate variability by cardiac parasympathetic nerve activity during voluntary static exercise in humans with tetraplegia.

    Science.gov (United States)

    Takahashi, Makoto; Matsukawa, Kanji; Nakamoto, Tomoko; Tsuchimochi, Hirotsugu; Sakaguchi, Akihiro; Kawaguchi, Kotaro; Onari, Kiyoshi

    2007-11-01

    Heart rate (HR) is controlled solely by via cardiac parasympathetic outflow in tetraplegic individuals, who lack supraspinal control of sympathetic outflows and circulating catecholamines but have intact vagal pathways. A high-frequency component (HF; at 0.15-0.40 Hz) of the power spectrum of HR variability and its relative value against total power (HF/Total) were assessed using a wavelet transform to identify cardiac parasympathetic outflow. The relative contribution of cardiac parasympathetic and sympathetic outflows to controlling HR was estimated by comparing the HF/Total-HR relationship between age-matched tetraplegic and normal men. Six tetraplegic men with complete cervical spinal cord injury performed static arm exercise at 35% of the maximal voluntary contraction until exhaustion. Although resting cardiac output and arterial blood pressure were lower in tetraplegic than normal subjects, HR, HF, and HF/Total were not statistically different between the two groups. When tetraplegic subjects developed the same force during exercise as normal subjects, HF and HF/Total decreased to 67-90% of the preexercise control and gradually recovered 1.5 min after exercise. The amount and time course of the changes in HF/Total during and after exercise coincided well between both groups. In contrast, the increase in HR at the start of exercise was blunted in tetraplegic compared with normal subjects, and the HR recovery following exercise was also delayed. It is likely that, although the withdrawal response of cardiac parasympathetic outflow is preserved in tetraplegic subjects, sympathetic decentralization impairs the rapid acceleration of HR at the onset of exercise and the rapid deceleration following exercise.

  12. Pediatric Euthanasia and Palliative Care Can Work Together.

    Science.gov (United States)

    Hanson, Stephen S

    2016-06-01

    Since the Netherlands produced the Groningen protocol describing the methods to be used for pediatric euthanasia and Belgium passed laws authorizing euthanasia for children who consent to it, the issue of pediatric euthanasia has become a relevant topic to discuss. Most rejections of pediatric euthanasia fall into 1 or more of 3 categories, each of which has problems. This article shows how several recent arguments against pediatric euthanasia fail to prove that pediatric euthanasia is unacceptable. It does not follow from this that the practice is permissible but rather that if one is to reject such a practice, stronger arguments will need to be made, especially in countries where adult euthanasia or assisted suicide is already permitted. © The Author(s) 2015.

  13. Differential effects of low-intensity motor cortical stimulation on the inspiratory activity in scalene muscles during voluntary and involuntary breathing

    DEFF Research Database (Denmark)

    Petersen, Nicolas Caesar; Taylor, Janet L; Murray, Nicholas P S

    2011-01-01

    To assess the cortical contribution to breathing, low-intensity transcranial magnetic stimulation (TMS) was delivered over the motor cortex in 10 subjects during: (i) voluntary static inspiratory efforts, (ii) hypocapnic voluntary ventilation (end-tidal CO(2), 2.7±0.4% mean±SD), and (iii) hyperca...

  14. "Euthanasia": A confusing term, abused under the Nazi regime and misused in present end-of-life debate.

    Science.gov (United States)

    Michalsen, Andrej; Reinhart, Konrad

    2006-09-01

    Legal provisions in The Netherlands and Belgium currently allow physicians to actively end a patient's life at his or her request under certain conditions. The term that is used for this is "euthanasia." The same term, "euthanasia," was used in Germany during the Nazi regime for a program of cleansing the "German nation" in which untold thousands of persons were denied human empathy or medical care and were thereby condemned to death. The medical profession played a leading role in the planning, administration, and supervision of this "euthanasia" program, with a large proportion of German physicians proactively shirking all moral responsibility and ultimately paving the way for the Holocaust. The term "euthanasia" was so abused during the Nazi regime as a camouflage word for murder of selected subpopulations with the willing participation of physicians, we believe that, regardless of the benevolent goals of current euthanasia practices, for historical reasons the term "euthanasia" must not be used with regards to current end-of-life care.

  15. Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

    Science.gov (United States)

    2009-01-01

    Background The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN) and Life End Information Forum (LEIF) in Belgium. The aim of this study is to describe and compare these initiatives. Methods We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols). Results In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. Conclusion In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a consultation provision could also

  16. Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium.

    Science.gov (United States)

    Van Wesemael, Yanna; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D; Bilsen, Johan; Deliens, Luc

    2009-12-04

    The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN) and Life End Information Forum (LEIF) in Belgium. The aim of this study is to describe and compare these initiatives. We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols). In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a consultation provision could also be considered in order to safeguard

  17. Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

    Directory of Open Access Journals (Sweden)

    Bilsen Johan

    2009-12-01

    Full Text Available Abstract Background The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN and Life End Information Forum (LEIF in Belgium. The aim of this study is to describe and compare these initiatives. Methods We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols. Results In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. Conclusion In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a

  18. A Bibliography on Euthanasia, 1958-1978.

    Science.gov (United States)

    Hilker, Christine; And Others

    This collection of materials represents a 20-year span (1958-1978) of references on euthanasia found through select indexes and abstracting services. The contents are organized into two general reference sections, periodicals and books, with citations listed alphabetically by author. The last two sections focus on the locations of these materials…

  19. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    Science.gov (United States)

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  20. Euthanasia in International and Comparative Perspective

    NARCIS (Netherlands)

    Groenhuijsen, M.S.; van Laanen, F.

    2006-01-01

    Euthanasia probably is one of the most natural issues to study in a comparative way. 14 national reports, submitted for discussion during the XVIIth Congress of the International Academy of Comparative Law, as well as a general report were edited and published in this volume. Thus it provides

  1. AN ARTICLE ON EUTHANASIA (MERCY KILLING)

    OpenAIRE

    Sreenivas; Sastry; Naga Sai

    2012-01-01

    The definition of Euthanasia is derived1 from the Greek “Eu - True; Thanatos - Death”, a deliberate intervention undertaken with the expressed intention of ending a life to relieve intract able suffering. Similarly death may be defined as “complete and irreversible stoppage of circulation, respiration and brain function “(bishop’s triad of life)

  2. AN ARTICLE ON EUTHANASIA (MERCY KILLING

    Directory of Open Access Journals (Sweden)

    Sreenivas

    2012-04-01

    Full Text Available The definition of Euthanasia is derived1 from the Greek “Eu - True; Thanatos - Death”, a deliberate intervention undertaken with the expressed intention of ending a life to relieve intract able suffering. Similarly death may be defined as “complete and irreversible stoppage of circulation, respiration and brain function “(bishop’s triad of life

  3. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    Science.gov (United States)

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  4. A Bibliography on Euthanasia, 1958-1978.

    Science.gov (United States)

    Hilker, Christine; And Others

    This collection of materials represents a 20-year span (1958-1978) of references on euthanasia found through select indexes and abstracting services. The contents are organized into two general reference sections, periodicals and books, with citations listed alphabetically by author. The last two sections focus on the locations of these materials…

  5. Should euthanasia be legal? : An international survey of neonatal intensive care units staff

    NARCIS (Netherlands)

    Cuttini, M.; Casotto, V.; Kaminski, M.; Beaufort, I.D. de; Berbik, I.; Hansen, G.; Kollee, L.A.A.; Kucinskas, A.; Lenoir, S.; Levin, A.V.; Orzalesi, M.; Persson, J.; Rebagliato, M.; Reid, M.; Saracci, R.

    2004-01-01

    OBJECTIVE: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. DESIGN: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden,

  6. Should euthanasia be legal? : An international survey of neonatal intensive care units staff

    NARCIS (Netherlands)

    Cuttini, M.; Casotto, V.; Kaminski, M.; Beaufort, I.D. de; Berbik, I.; Hansen, G.; Kollee, L.A.A.; Kucinskas, A.; Lenoir, S.; Levin, A.V.; Orzalesi, M.; Persson, J.; Rebagliato, M.; Reid, M.; Saracci, R.

    2004-01-01

    OBJECTIVE: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. DESIGN: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hung

  7. Carbon dioxide euthanasia in rats: Oxygen supplementation minimizes signs of agitation and asphyxia

    NARCIS (Netherlands)

    Coenen, A.M.L.; Drinkenburg, W.H.I.M.; Hoenderken, R.; Luijtelaar, E.L.J.M. van

    1995-01-01

    This paper records the effects of carbon dioxide when used for euthanasia, on behaviour, electrical brain activity and heart rate in rats. Four different methods were used. Animals were placed in a box (a) that was completely filled with carbon dioxide; (b) into which carbon dioxide was streamed at

  8. Carbon dioxide euthanasia in rats: Oxygen supplementation minimizes signs of agitation and asphyxia

    NARCIS (Netherlands)

    Coenen, A.M.L.; Drinkenburg, W.H.I.M.; Hoenderken, R.; Luijtelaar, E.L.J.M. van

    1995-01-01

    This paper records the effects of carbon dioxide when used for euthanasia, on behaviour, electrical brain activity and heart rate in rats. Four different methods were used. Animals were placed in a box (a) that was completely filled with carbon dioxide; (b) into which carbon dioxide was streamed at

  9. Should euthanasia be legal? : An international survey of neonatal intensive care units staff

    NARCIS (Netherlands)

    Cuttini, M.; Casotto, V.; Kaminski, M.; Beaufort, I.D. de; Berbik, I.; Hansen, G.; Kollee, L.A.A.; Kucinskas, A.; Lenoir, S.; Levin, A.V.; Orzalesi, M.; Persson, J.; Rebagliato, M.; Reid, M.; Saracci, R.

    2004-01-01

    OBJECTIVE: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. DESIGN: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hung

  10. Why is the ethics of euthanasia wrong?

    Science.gov (United States)

    Narbekovas, Andrius; Meilius, Kazimieras

    2004-01-01

    Human beings are made in the image and likeness of God and are therefore of intrinsic worth or value, beyond all prices. Almost all Christian pro-life arguments spring from the fountain of personal dignity. Euthanasia would make moral sense only if it were possible to say, morally, that this dignity had vanished. To commit euthanasia is to act with the specific intention that somebody should be nobody. This is the fundamental error of all immorality in human relations. To commit euthanasia is to fail to see the intrinsic worth or dignity of the person. The judgement that what has worth, intrinsically, somehow does not have worth, is both logically and morally wrong. The ethics of euthanasia is based on dualistic anthropology and wrong moral presuppositions underlying the defence of euthanasia, namely, proportionalism and consequentialism. The basic claim of proponents of the ethics of euthanasia is that human persons are consciously experiencing subjects whose dignity consists of their ability to made choices and to determine their own lives. Bodily life, according to them, is a condition for personal life because without bodily life one cannot be a consciously experiencing subject. It means that bodily life is distinct from personal life. Thus, the body and bodily life are instrumental goods, goods for the person, not goods of the person. It thus follows that there can be such a thing as a life not worth living--one can judge that bodily life itself is useless or burdensome, and when it is, the person, i.e., the consciously experiencing subject, is at liberty to free himself of this useless burden. Today a key in fighting euthanasia and assisted suicide is better care for the sick and dying. The dignity of the sick cannot be erased by illness and suffering. Such procedures are not private decisions; they affect the whole society. Death with dignity, in the end, is the realisation that human beings are also spiritual beings. We have to promote the way of caring for

  11. Euthanasia: why people want to die earlier.

    Science.gov (United States)

    Seale, C; Addington-Hall, J

    1994-09-01

    The results from two surveys in England of relatives and others who knew people in samples drawn from death certificates are reported. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. The incidence of people saying they wanted to die sooner, and of requests for euthanasia are reported. Excluding a proportion who did not wish to express a view, or did not know the answer, about a quarter of both respondents and the people who died expressed the view that an earlier death would be, or would have been, preferable. 3.6% of people in the 1990 study were said to have asked for euthanasia at some point in the last year of life. The extent to which such views were determined by the experience of pain, other distressing symptoms, dependency and social and cultural factors such as religious belief and social class is explored. The finding that dependency was important in causing the feeling that an earlier death would have been better, as well as requests for euthanasia, is related to the public debate about euthanasia, which often contains the assertion that fear of pain is a dominant factor. Pain was found to be a significant factor in death from cancer, but not as important for other causes of death. Social class, place of residence of the deceased, and strength and type of religious faith were found to be largely insignificant in influencing feelings about an earlier death and requests for euthanasia.

  12. Effects of transcranial magnetic stimulation during voluntary and non-voluntary stepping movements in humans.

    Science.gov (United States)

    Solopova, I A; Selionov, V A; Kazennikov, O V; Ivanenko, Y P

    2014-09-05

    Here, we compared motor evoked potentials (MEP) in response to transcranial magnetic stimulation of the motor cortex and the H-reflex during voluntary and vibration-induced air-stepping movements in humans. Both the MEPs (in mm biceps femoris, rectus femoris and tibialis anterior) and H-reflex (in m soleus) were significantly smaller during vibration-induced cyclic leg movements at matched amplitudes of angular motion and muscle activity. These findings highlight differences between voluntary and non-voluntary activation of the spinal pattern generator circuitry in humans, presumably due to an extra facilitatory effect of voluntary control/triggering of stepping on spinal motoneurons and interneurons. The results support the idea of active engagement of supraspinal motor areas in developing central pattern generator-modulating therapies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. [Euthanasia of patients in coma vigil. Results on German medical staff attitudes].

    Science.gov (United States)

    Böttger-Kessler, G; Beine, K H

    2007-07-01

    An examination was made concerning doctors' and nursing staff's attitudes towards active euthanasia of patients suffering from coma vigil (2652 doctors and 5785 nursing staff were interviewed). This investigation made clear that most of the persons asked about this group of patients voted for a change in German laws following the Dutch example. There were noticeable differences observed between the professional groups. A majority (64.79%) were convinced that under certain circumstances it is justified to end intentionally the life of persons in a coma vigil. Of the nursing staff, 70.38% were in favour of this attitude, and 51.53% of the doctors share this opinion. Certain groups supported the question of active euthanasia more clearly than others. These were young participants in the investigation, first-time employees, nondenominational interviewees, those who are dissatisfied with their job situation, who are from the newly-formed German states, and who are divorced. The attitudes expressed by all these people originate in many different motives: thoughts about the patients, aspects concerning jobs, and personal aspects had an influence on results of the investigation. This single investigation which was restricted to patients suffering from coma vigil and to employees of the public health service, does not prove that the total population has generally changed its attitude toward active euthanasia. It is impossible to justify the necessity of new laws about euthanasia based on the above results.

  14. End of Life Care

    Science.gov (United States)

    ... implications of using physical or chemical restraint. Active Euthanasia Euthanasia (also called mercy killing) is the act of ... non-voluntary (where consent is not possible) involuntary. Euthanasia is illegal and not practiced in the United ...

  15. [Legal issues of physician-assisted euthanasia. Part III--Passive euthanasia, comparison of international legislation, conclusions for medical practice].

    Science.gov (United States)

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2013-01-01

    The generic term "passive euthanasia" includes different issues dealing with the omission, discontinuation or termination of life-sustaining or life-prolonging medical treatments. The debate around passive euthanasia focuses on the constitutional right of self-determination of every human being on the one hand and the constitutional mandate of the State to protect human life on the other. Issues of passive euthanasia always require a differentiated approach. Essentially, it comes down to the following: In Germany, the human right of self-determination includes the right to prohibit the performance of life-sustaining treatments, even if this leads to the death of the patient. A physician who does not take life-sustaining treatment measures because this is the free will expressed by the patient is not subject to prosecution. On the other hand, if the physician treats the patient against his will, this can be deemed a punishable act of bodily injury. The patient's will is decisive even if his concrete state of health does no longer allow him to freely express his will. In the Patient's Living Will Act of 2009, the German legislator clarified the juridical assessment of such constellations being of particular relevance in practice. A written living will of a person in which he requests to take or not to take certain medical treatment measures in case that he is no longer able to make the decision himself shall be binding for the people involved in the process of medical treatment. If there is no living will, the supposed will of the patient shall be relevant. In its judgment in the "Putz case", the German Federal Court of Justice ruled in 2010 that actions terminating a life-sustaining treatment that does not correspond to the patient's will must be limited to letting an already ongoing disease process run its course. In this context it is not important, however, whether treatment is discontinued by an active act or by omission. Under certain circumstances, the

  16. Attitudes toward euthanasia among Polish physicians, nurses and people who have no professional experience with the terminally ill.

    Science.gov (United States)

    Glebocka, A; Gawor, A; Ostrowski, F

    2013-01-01

    Euthanasia is an issue that generates an extensive social debate. Euthanasia is generally classified as either active or passive. The former is usually defined as taking specific steps to cause the patient's death, while the latter is described as withdrawal of medical treatment with the deliberate intention of bringing the patient's life to an end. The dispute on euthanasia involves a multitude of aspects including religious, legal, cultural, ethical, medical, and spiritual issues. The purpose of the present study was to examine the views of medical professionals toward the highly controversial issue of euthanasia. Accordingly, the research has been conducted among a group of Polish nurses and physicians working in Intensive Care and Oncology Units. Their views have been compared to those of the control group, which included the members of the general public, who do not work in medical profession. It was expected that the education and training and the day-to-day exposure to vegetative patients might influence the views of medical personnel concerning euthanasia. The research demonstrated that the members of all groups supported liberal views. Conservative views were not popular among the respondents. The physicians turned out to be the least conservative group. The survey has also demonstrated that there is a broad consensus that informational and psychological support should be provided to terminally ill patients and their relatives. The attitude toward the passive form of euthanasia seems to have broad support. In particular doctors tend to approve this form of bringing a terminally ill patient's life to an end. The active euthanasia is regarded with much less favor and physicians, in particular, appear to disapprove of it.

  17. Nurses' attitudes to euthanasia: a review of the literature.

    Science.gov (United States)

    Verpoort, Charlotte; Gastmans, Chris; De Bal, Nele; Dierckx de Casterlé, Bernadette

    2004-01-01

    This article provides an overview of the scarce international literature concerning nurses' attitudes to euthanasia. Studies show large differences with respect to the percentage of nurses who are (not) in favour of euthanasia. Characteristics such as age, religion and nursing specialty have a significant influence on a nurse's opinion. The arguments for euthanasia have to do with quality of life, respect for autonomy and dissatisfaction with the current situation. Arguments against euthanasia are the right to a good death, belief in the possibilities offered by palliative care, religious objections and the fear of abuse. Nurses mention the need for more palliative care training, their difficulties in taking a specific position, and their desire to express their ideas about euthanasia. There is a need to include nurses' voices in the end-of-life discourse because they offer a contextual understanding of euthanasia and requests to die, which is borne out of real experience with people facing death.

  18. Exposure of Research Personnel to Carbon Dioxide during Euthanasia Procedures

    Science.gov (United States)

    Amparan, Ashlee A; Djoufack-Momo, Shelly M; Grunden, Beverly; Boivin, Gregory P

    2014-01-01

    CO2 is one of the most commonly used euthanasia agents for laboratory animals. Considerable research has gone into the effect of the agent on animals, but little has been done to examine potential human exposure during these procedures. In this study, we examine the CO2 concentrations to which personnel are exposed while euthanizing rodents with CO2. To examine the environmental levels of CO2 generated during euthanasia, we examined several variables including flow rate, inclusion of a cage in the euthanasia chamber, inversion of the euthanasia chamber, chamber size, distance from the euthanasia chamber, and room size. Under all conditions, CO2 concentrations in the room temporarily increased significantly to 600 to 4000 ppm. The results of this study show that, under several testing scenarios, occupational levels of CO2 did not exceed governmentally mandated allowable exposure limits during routine rodent euthanasia procedures. PMID:25199093

  19. Treatment limitation decisions under uncertainty: the value of subsequent euthanasia.

    Science.gov (United States)

    Savulescu, Julian

    1994-01-01

    This paper examines how decisions to limit treatment to critically ill patients under uncertainty can be made rationally. Expected utility theory offers one way of making rational decisions under uncertainty. One problem with using this approach is that we may not know the value of each option. One rational course open is to treat until further information becomes available. However, treatment can limit the range of options open. With treatment, a patient may recover such that he no longer requires life-supporting treatment. However, his life may be not worth living. If active euthanasia of 'non-terminal' conditions is prohibited, the option of dying will no longer be available. Taking a rational 'wait and see' course may result in being trapped within an unbearable life. On the other hand, sometimes present practice 'lets nature take its course'. Critically ill patients are allowed to die because it is believed that their lives will be not worth living. It is likely that some patients are allowed to die when there is some objective chance of worthwhile future life. This paper argues that a policy of treating critically ill patients until the nature of future options can be better evaluated, in company with an offer of subsequent euthanasia where appropriate, allows a more rational and humane approach to treatment limitation decisions under uncertainty.

  20. Effect of tongue position on masseter and temporalis electromyographic activity during swallowing and maximal voluntary clenching: a cross-sectional study.

    Science.gov (United States)

    Valdés, C; Astaburuaga, F; Falace, D; Ramirez, V; Manns, A

    2014-12-01

    The purpose of this study was to measure and compare the tonic electromyographic (EMG) activity of the temporalis and masseter muscles following placement of the tongue either on the palate or in the floor of the mouth during swallowing and maximal voluntary clenching (MVC). Thirty healthy dental students with natural dentition and bilateral molar support, between the ages of 18 and 22, with no prior history of oro-facial injury, or current or past pain in the jaw, mouth or tongue participated in the study. Tonic masseter and temporalis EMG activities were recorded using surface electrodes. Subjects were instructed to passively place the tongue either on the anterior hard palate or in the floor of the mouth during swallowing and MVC. At each tongue position, the resulting EMG was recorded. During swallowing, no significant difference in EMG activity was found either for the masseter (P-value = 0.1592) or the temporalis (P-value = 0.0546) muscles, regardless of the tongue position. During MVC, there was a statistically significant difference for both the masseter (P-value = 0.0016) and the temporalis (P-value = 0.0277) muscles with lower levels recorded with the tongue in the floor of the mouth. This study found that in normal, pain-free subjects, placing the tongue in the floor of the mouth significantly reduces masticatory muscle activity during MVC. Thus, it may be considered as a possible therapeutic option to decrease masticatory muscle activity; however, further research is needed in patients with oro-facial pain.

  1. Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?

    Science.gov (United States)

    de Boer, Marike E; Dröes, Rose-Marie; Jonker, Cees; Eefsting, Jan A; Hertogh, Cees M P M

    2010-12-01

    To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases. A written questionnaire was completed by 434 elderly care physicians (ECPs). Over the years 2005-2006, many ECPs took care of patients with dementia and an ADE, actual life termination of these patients took place very rarely and never in incompetent patients. ECPs reported practical difficulties in determining the 'unbearableness' of the suffering and choosing the right moment of carrying out the ADE. Although the enactment of the Dutch euthanasia law in theory provided a window of opportunity for euthanasia in incompetent patients with dementia and an ADE, it has not led to obvious changes in compliance with ADEs of this patient group in practice. Crucial in the reticent attitudes of ECPs appears to be the impossibility of patient-physician communication. This raises questions on the feasibility of the law on this point. In our opinion, the role of ADEs in end-of-life care of patients with advanced dementia in the Netherlands deserves serious reconsideration. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Attitude to Euthanasia of Workers in Palliative Care

    OpenAIRE

    Poštová, Lenka

    2015-01-01

    This bsachelor thesis is devided into two parts, theoretical and practical. The work focuses on opinions of workers in palliative care on euthanasia. The theoretical part deals with the definition of palliative care, its goals and principles. Futhermore, it also introduced quality of palliative care in Czech Republic. Second chapter explains the term euthanasia and its forms. It also contains opinions of citizens of the Czech Republic on euthanasia. Third chapter is dedicated to terms such as...

  3. Nurses’ Opinion About Euthanasia in East Azerbaijan Province, Iran

    Directory of Open Access Journals (Sweden)

    Rahimi

    2015-08-01

    Full Text Available Background Euthanasia is one of the important challenges in the field of end of life care. There are few studies investigated the attitude of Shiite Muslim nurses about different aspects of euthanasia. Objectives The aim of present study was to investigate the attitude of Iranian Shiite nurses about different aspects of euthanasia in East Azerbaijan Provence, Iran, 2012. Patients and Methods In this descriptive study, 209 nurses (census sampling method from 6 educational hospitals in East Azerbaijan Province were participated. The attitude of nurses was investigated with Euthanasia Attitude Questionnaire, which is a 31-item scale. This scale investigate the attitude of nurses in 5 domains, including general attitude (3 items, legal and religious issues (5 items, end of life care (8 items, euthanasia decision making (8 items, and attitude toward different types of euthanasia (7 items. Descriptive statistics were used for data analysis using SPSS software (ver. 13. Results Participants had a negative attitude towards all aspects of euthanasia. They reported that they would not participate in euthanasia procedure even this procedure was accepted by religious leaders and legal authorities. They believed that caring of end of life patients is a burden but this is not a reason for euthanasia and also they did not consider patients or their relative as decision makers for euthanasia. In addition, participants rejected all types of euthanasia. Conclusions Iranian nurses in East Azerbaijan Provence have negative attitudes toward different aspects of euthanasia and this negative attitude is not related to religious or legal issues. So, searching for the reasons for such an attitude needs more investigation.

  4. CLINICAL APPLICATIONS AND ETHICAL OF EUTHANASIA OF SMALL ANIMALS

    OpenAIRE

    Léga, Elzylene; Faculdade Dr. Francisco Maeda; Agostinho, Janaína Jorge; FE/FAFRAM

    2009-01-01

    This work brings us awareness about euthanasia, its agents and methods of application used, in which cases should be done and what agents are prohibited, as well as highlight the dedication and care in the hours of practice to share, since the word Euthanasia in Greek, means Good Death. Moreover, the clear position emphasizes ethics and responsibility of the veterinarian to recommend euthanasia, explaining when, why and how it should be done, not causing stress and suffering to th...

  5. 青年志愿活动促进大学生心理健康教育%Youth voluntary activities to promote college students' mental health education

    Institute of Scientific and Technical Information of China (English)

    王颖群; 徐秉锋; 刘甜

    2016-01-01

    大学生参与青年志愿活动有利于促进其个体心理及群体心理的形成与发展。同时,青年志愿活动为大学生提供了与其他志愿者及社会各界人士交流的机会,进而提升了大学生的人际交往能力及团队意识,促进其综合素质的发展,并且在志愿活动的参与过程中找到了成长的方向。可见,青年志愿活动在促进大学生心理健康教育方面具有重要的指导意义。本文简要概述了新时期大学生心理健康教育的现状,着重分析了青年志愿活动促进大学生心理健康教育的有效措施。%College students' participation in youth voluntary activities is conducive to the formation and development of individual psychology and group psychology. At the same time, the youth volunteer activities provide colege students opportunities to communicate with other volunteers and social people from al walks of life, so as to improve the colege students interpersonal skils and team work spirit, promote the development of the comprehensive quality, and in the participation of volunteer activities found the direction of growth. Obviously, the youth volunteer activity has the important instruction significance in promoting the university student psychologicaly healthy education. This paper briefly outlines the current situation of colege students' mental health education in the new period, and emphaticaly analyzes the effective measures to promote colege students' mental health education.

  6. Physicians' opinions on palliative care and euthanasia in the Netherlands.

    Science.gov (United States)

    Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D; van der Heide, Agnes; van der Wal, Gerrit; van der Maas, Paul J

    2006-10-01

    In recent decades significant developments in end-of-life care have taken place in The Netherlands. There has been more attention for palliative care and alongside the practice of euthanasia has been regulated. The aim of this paper is to describe the opinions of physicians with regard to the relationship between palliative care and euthanasia, and determinants of these opinions. Cross-sectional. Representative samples of physicians (n = 410), relatives of patients who died after euthanasia and physician-assisted suicide (EAS; n = 87), and members of the Euthanasia Review Committees (ERCs; n = 35). Structured interviews with physicians and relatives of patients, and a written questionnaire for the members of the ERCs. Approximately half of the physicians disagreed and one third agreed with statements describing the quality of palliative care in The Netherlands as suboptimal and describing the expertise of physicians with regard to palliative care as insufficient. Almost two thirds of the physicians disagreed with the suggestion that adequate treatment of pain and terminal care make euthanasia redundant. Having a religious belief, being a nursing home physician or a clinical specialist, never having performed euthanasia, and not wanting to perform euthanasia were related to the belief that adequate treatment of pain and terminal care could make euthanasia redundant. The study results indicate that most physicians in The Netherlands are not convinced that palliative care can always alleviate all suffering at the end of life and believe that euthanasia could be appropriate in some cases.

  7. Euthanasia of Danish dairy cows evaluated in two questionnaire surveys

    DEFF Research Database (Denmark)

    Thomsen, Peter; Sørensen, Jan Tind

    2008-01-01

    a random sample of 196 Danish dairy farmers that had reported a dead cow to the Danish Cattle Database in 2002 and 196 dairy farmers that had reported a dead cow in 2006. Our objectives were to evaluate the proportion of euthanized cows, changes in the behaviour of farmers regarding euthanasia of cows over...... the years and possible reasons for these changes. Results It seems that the threshold for euthanasia of cows among farmers has changed. Farmers generally reported a lower threshold for euthanasia compared to 5-10 years ago. Conclusions The threshold for euthanasia of cows has, according to the dairy farmers...

  8. The Choice of Euthanasia Method Affects Metabolic Serum Biomarkers.

    Science.gov (United States)

    Paula, Pierozan; Fredrik, Jernerén; Yusuf, Ransome; Oskar, Karlsson

    2017-02-28

    The impact of euthanasia methods on endocrine and metabolic parameters in rodent tissues and biological fluids is highly relevant for the accuracy and reliability of the data collected. However, few studies concerning this issue are found in the literature. We compared the effects of three euthanasia methods currently used in animal experimentation (i.e. decapitation, CO2 inhalation, and pentobarbital injection) on the serum levels of corticosterone, insulin, glucose, triglycerides, cholesterol and a range of free fatty acids in rats. The corticosterone and insulin levels were not significantly affected by the euthanasia protocol used. However, euthanasia by an overdose of pentobarbital (120 mg/kg intraperitoneal injection) increased the serum levels of glucose, and decreased cholesterol, stearic and arachidonic acids levels compared with euthanasia by CO2 inhalation and decapitation. CO2 inhalation appears to increase the serum levels of triglycerides, while euthanasia by decapitation induced no individual discrepant biomarker level. We conclude that choice of the euthanasia methods are critical for the reliability of serum biomarkers and indicate the importance of selecting adequate euthanasia methods for metabolic analysis in rodents. Decapitation without anaesthesia may be the most adequate method of euthanasia when taking both animal welfare and data quality in consideration. This article is protected by copyright. All rights reserved.

  9. About the practice of psychiatric euthanasia: a commentary.

    Science.gov (United States)

    Lopez-Castroman, Jorge

    2017-06-27

    Euthanasia motivated by mental disorders is legal in only a few countries and has a short history. In a recent report of all psychiatric euthanasia cases in Belgium between 2002 and 2013, Dierickx and colleagues suggest that the number of these cases is increasing, and provide a profile of the applicants. To date, knowledge of the practice of psychiatric euthanasia is limited, but rising public awareness might increase the number of requests. The authors reveal several shortcomings in cases of psychiatric euthanasia and open avenues for future research.Please see related article: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1369-0.

  10. Reflections on the state of current debate over physician-assisted suicide and euthanasia.

    Science.gov (United States)

    Winkler, Earl

    1995-07-01

    This paper is part of a larger project. My overall aim is to argue that the evolution of familiar forms of termination of life sustaining treatment, constituting so called passive euthanasia, has severely undercut the logic of every form of reasoning that has traditionally been used to oppose active euthanasia and assistance in suicide. Basically, there are two such forms of traditional opposition, each represented in a range of different versions. There is the inevitable argument concerning social utilities -- that permitting euthanasia and assisted suicide will have bad social consequences. But more fundamentally, the idea persists that killing is intrinsically worse than letting-die in some sense that justifies the current practice of prohibiting the first while allowing the latter. In this paper, I first consider this latter claim. My ultimate strategy, as I have said, is to show that the nature of certain things we have all come to approve regarding termination of treatment makes it next to impossible to convincingly explain, in either of these ways, what is wrong with certain forms of assistance in suicide and euthanasia. In the second part of this paper I take another step in this direction by discussing, in a preliminary way, a special case of the argument from social risks.

  11. Euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Swarte, N B; Heintz, A P

    1999-12-01

    In the Netherlands there are about 9700 explicit requests for euthanasia or physician-assisted suicide (EAS) each year, of which approximately 3600 are granted. Other countries have criticized the Dutch policy concerning EAS. It has been suggested that palliative care in the Netherlands is not adequate and that euthanasia is often requested by patients with depression. In addition, this criticism is partly based on the firm stance that 'human life has an absolute value and a human being has under no circumstances the right of self-determination over his or her own life'. Many aspects of EAS are currently the focus of attention in the literature. In this review the following aspects of EAS are discussed: ethics, judicial questions, the relationship between depression and euthanasia, and the impact of EAS on members of the family. Also, the current situation concerning EAS in the Netherlands is summarized and described. Despite the fact that EAS have been widely discussed in the literature, the association between depression and the number of requests for EAS remains to be discovered. It is also not yet known what the effects of EAS are on members of the family, and whether unnatural death causes a higher incidence of complicated grief.

  12. [The fringes of the euthanasia law].

    Science.gov (United States)

    Boer, Theo A

    2015-01-01

    A survey published in the Dutch Journal of Medicine (NTvG) shows that doctors asked to assess the suffering of patients making a request for euthanasia may give very different opinions. In this paper, I argue that this stems from the subjective character of the term 'unbearable' and that differences are bound to occur even more frequently in 'borderline' cases, such as those presented here. In my opinion, such differences do not justify a plea to abandon the assessment of unbearable suffering altogether. Rather, differences in assessment may serve as indications that the boundaries of the Dutch law on euthanasia and physician-assisted suicide are within sight. Moreover, it is argued that advance directives can only be seen as euthanasia requests in a legal sense if, at the time of issue of the directive, the patient was informed about his or her diagnosis and had discussed different treatment options with the physician. Such a directive may never serve as a generic request which is valid under hypothetical conditions.

  13. The number of active motor units and their firing rates in voluntary contraction of human brachialis muscle.

    Science.gov (United States)

    Kanosue, K; Yoshida, M; Akazawa, K; Fujii, K

    1979-01-01

    To make clear the control mechanism of force generation in human muscle, the electrical activity of the brachialis muscle was studied at various levels of contraction force by recording single motor unit discharges as well as mass electromyograms (EMGs). The firing rate of motor units increased with force along an S-shaped curve. At low levels of force, motor units increased their firing rates steeply with force. At intermediate levels of force, each motor unit increased its firing rate linearly with force at lower rates. As the maximum of force was approached, the firing rate increased very steeply, reaching as high as 50 Hz or more. By applying a new method of statistical processing to mass EMGs, the number of active motor units and the size of action potential were estimated at each level of force. The number of active motor units increased monotonously with muscle force. Motor units recruited at high levels of force had larger amplitudes of action potentials than those recruited at lower levels. Calculations were made to determine how the relative contribution to an increase in muscle force is varied between recruitment and the increase in firing rate. The contribution of recruitment gradually decreased with the increase in force. Up to about 70% of the maximum force, recruitment is the major mechanism for increasing the force of contraction.

  14. Attitudes toward Euthanasia and Related Issues among Physicians and Patients in a Multi-cultural Society of Malaysia.

    Science.gov (United States)

    Rathor, Mohammad Yousuf; Abdul Rani, Mohammad Fauzi; Shahar, Mohammad Arif; Jamalludin, A Rehman; Che Abdullah, Shahrin Tarmizi Bin; Omar, Ahmad Marzuki Bin; Mohamad Shah, Azarisman Shah Bin

    2014-07-01

    Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public toward greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As euthanasia has gained world-wide prominence, the objectives of our study therefore were to explore the attitude of physicians and chronically ill patients toward euthanasia and related issues. Concomitantly, we wanted to ascertain the frequency of requests for assistance in active euthanasia. Questionnaire based survey among consenting patients and physicians. The majority of our physicians and patients did not support active euthanasia or physician-assisted suicide (EAS), no matter what the circumstances may be P < 0.001. Both opposed to its legalization P < 0.001. Just 15% of physicians reported that they were asked by patients for assistance in dying. Both physicians 29.2% and patients 61.5% were in favor of withdrawing or withholding life-sustaining treatment to a patient with no chances of survival. Among patients no significant differences were observed for age, marital status, or underlying health status. A significant percentage of surveyed respondents were against EAS or its legalization. Patient views were primarily determined by religious beliefs rather than the disease severity. More debates on the matter are crucial in the ever-evolving world of clinical medicine.

  15. The cost of demand creation activities and voluntary medical male circumcision targeting school-going adolescents in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    George, Gavin; Strauss, Michael; Asfaw, Elias

    2017-01-01

    Voluntary medical male circumcision is an integral part of the South African government's response to the HIV and AIDS epidemic. However, there remains a limited body of economic analysis on the cost of VMMC programming, and the demand creation activities used to mobilize males, especially among adolescent boys in school. This study addresses this gap by presenting the costs of a VMMC program which adopted two demand creation strategies targeting school-going males in South Africa. Cost data was collected from a VMMC program in the KwaZulu-Natal province of South Africa. A retrospective, micro-costing ingredient approach was applied to identify, measure and value resources of two demand creation strategies targeting young males. The program circumcised 4987 young males between May 2011 and February 2013, at a cost of $127.68 per circumcision. Demand creation activities accounted for 32% of the total cost, HCT contributing 10% with the medical circumcision procedure accounting for 58% of the total cost. Using the first demand creation strategy, 2168 circumcisions were performed at a cost of $149.57 per circumcision. Following this first strategy, a second demand creation strategy was adopted which saw the cost fall to $110.85 per circumcision. More young males were recruited following the second strategy with clinic services more efficiently utilized. Whilst the cost per circumcision of demand activities rose slightly between the first ($39.94) and second ($41.65) strategy, there was a substantial reduction in the cost of the circumcision procedure; $90.01 under the first strategy falling to $60.60 following the adoption of the second demand creation strategy. Ensuring the optimal use of clinic facilities was the primary driver in reducing the cost per circumcision. This VMMC program has illustrated the value of evaluating progress and instituting changes to attain better cost efficiencies. This adjustment resulted in a substantial reduction in the cost per

  16. Conditioning Bottlenose Dolphins (Tursiops Truncatus Gilli) for Voluntary Diving Studies

    Science.gov (United States)

    1992-12-31

    heartrate (EKG) to validate "voluntary" nature of dive EXAMINE ACTIVE DIVING CONDITIONS (open Ocean Mewwmenr) dive profiles using TDR respiration... heartrate electrodes Open Ocean Experiments ’wear instrument package (TDR) perform voluntary dive up to 200 meters readily present tail flukes for

  17. The labelling and reporting of euthanasia by Belgian physicians: a study of hypothetical cases.

    Science.gov (United States)

    Smets, Tinne; Cohen, Joachim; Bilsen, Johan; Van Wesemael, Yanna; Rurup, Mette L; Deliens, Luc

    2012-02-01

    Belgium legalized euthanasia in 2002. Physicians must report each euthanasia case to the Federal Control and Evaluation Committee. This study examines which end-of-life decisions (ELDs) Belgian physicians label 'euthanasia', which ELDs they think should be reported and the physician characteristics associated with correct labelling of euthanasia cases, the awareness that they should be reported and the reporting of them. Five hypothetical cases of ELDs: intensified pain alleviation, palliative/terminal sedation, euthanasia with neuromuscular relaxants, euthanasia with morphine and life-ending without patient request were presented in a cross-sectional survey of 914 physicians in Belgium in 2009. About 19% of physicians did not label a euthanasia case with neuromuscular relaxants 'euthanasia', 27% did not know that it should be reported. Most physicians labelled a euthanasia case with morphine 'intensification of pain and symptom treatment' (39%) or 'palliative/terminal sedation' (37%); 21% of physicians labelled this case 'euthanasia'. Cases describing other ELDs were sometimes also labelled 'euthanasia'. Factors associated with a higher likelihood of labelling a euthanasia case correctly were: living in Flanders, being informed about the euthanasia law and having a positive attitude towards societal control over euthanasia. Whether a physician correctly labelled the euthanasia cases strongly determined their reporting knowledge and intentions. There is no consensus among physicians about the labelling of euthanasia and other ELDs, and about which cases must be reported. Mislabelling of ELDs could impede societal control over euthanasia. The provision of better information to physicians appears to be necessary.

  18. [Active euthanasia or better palliative therapy?].

    Science.gov (United States)

    Csef, H

    1998-02-28

    The Dutch Supreme Court ruled that in exceptional instances, physician-assisted suicide might be justifiable for patients with unbearable mental suffering but no physical illness. A recent report shows that explicit requests for physician-assisted suicide are not uncommon in psychiatric practice in the Netherlands. Some of those requests were granted and their medical background was described. Psychiatric consultation for medical patients who request physician-assisted suicide is relatively rare. Therefore is seems to be necessary to establish better palliative care for the terminally ill. When psychiatrists help their patients to commit suicide there is a danger of abuse and "slippery slope".

  19. Oncology nurses' practices of assisted suicide and patient-requested euthanasia.

    Science.gov (United States)

    Matzo, M L; Emanual, E J

    1997-01-01

    To provide reliable and valid empirical data related to New England Oncology Nursing Society (ONS) members' self-reported practices of assisted suicide and patient-requested euthanasia. Analysis focused on the nurses' practices, a comparison of their practices to a similar sample of oncology physicians, and their use of the healthcare team. Quantitative survey. New England region of the United States. 600 ONS members surveyed by mail, 441 of whom responded (74% return rate). Only nurses who worked at least 20 hours per week, were ONS members for at least one year, and worked with adult patients with cancer were included. Replication and extension of a survey of oncology physicians. Frequency of requests for and responses to patient requests for assisted suicide and euthanasia and the use of the healthcare team in response to these requests. More physicians than nurses assisted their patients' suicides (11% versus 1%). However, nurses were more likely than physicians to have performed patient-requested euthanasia (4% versus 1%). Nurses frequently consulted with others--particularly physicians--about patient requests for assistance with death but rarely with one another including nursing supervisors. The relative number of healthcare professionals (physicians or nurses) who admit to hastening a patient's death is small. Nurses in this study received fewer requests to perform euthanasia than physicians, but they performed patient-requested euthanasia four times more frequently than physicians. Professional affiliation appears to be one factor in determining whether or not a patient's request for assistance with death will be granted. IMPLICATIONS FOR NURSING PRACTICES: The policy debate about professional roles in actions that end the lives of patients must be extended beyond physicians to include nurses. Nurses must take an active role in the discussion and definition of acceptable practice at the end of life.

  20. Kant on euthanasia and the duty to die: clearing the air.

    Science.gov (United States)

    Cholbi, Michael

    2015-08-01

    Thanks to recent scholarship, Kant is no longer seen as the dogmatic opponent of suicide that he appears to be at first glance. However, some interpreters have recently argued for a Kantian view of the morality of suicide with surprising, even radical, implications. More specifically, they have argued that Kantianism (1) requires that those with dementia or other rationality-eroding conditions end their lives before their condition results in their loss of identity as moral agents and (2) requires subjecting the fully demented or those confronting future dementia to non-voluntary euthanasia. Properly understood, Kant's ethics have neither of these implications (1) wrongly assumes that rational agents' duty of self-preservation entails a duty of self-destruction when they become non-rational, (2) further neglects Kant's distinction between duties to self and duties to others and wrongly assumes that duties can be owed to rational agents only during the time of their existence.

  1. Voluntary work organization in higher educational establishment: theory and practice

    Directory of Open Access Journals (Sweden)

    Sergey V. Polatayko

    2011-01-01

    Full Text Available The article analyses basic questions of voluntary work formation in higher educational establishment, its conceptual and legislative basis, defines basic directions of students agencies activities and forms of their participation in higher educational establishment activities.

  2. Terminal sedation and euthanasia: a comparison of clinical practices.

    Science.gov (United States)

    Rietjens, Judith A C; van Delden, Johannes J M; van der Heide, Agnes; Vrakking, Astrid M; Onwuteaka-Philipsen, Bregje D; van der Maas, Paul J; van der Wal, Gerrit

    2006-04-10

    An important issue in the debate about terminal sedation is the extent to which it differs from euthanasia. We studied clinical differences and similarities between both practices in the Netherlands. Personal interviews were held with a nationwide stratified sample of 410 physicians (response rate, 85%) about the most recent cases in which they used terminal sedation, defined as administering drugs to keep the patient continuously in deep sedation or coma until death without giving artificial nutrition or hydration (n = 211), or performed euthanasia, defined as administering a lethal drug at the request of a patient with the explicit intention to hasten death (n = 123). We compared characteristics of the patients, the decision-making process, and medical care of both practices. Terminal sedation and euthanasia both mostly concerned patients with cancer. Patients receiving terminal sedation were more often anxious (37%) and confused (24%) than patients receiving euthanasia (15% and 2%, respectively). Euthanasia requests were typically related to loss of dignity and a sense of suffering without improving, whereas requesting terminal sedation was more often related to severe pain. Physicians applying terminal sedation estimated that the patient's life had been shortened by more than 1 week in 27% of cases, compared with 73% in euthanasia cases. Terminal sedation and euthanasia both are often applied to address severe suffering in terminally ill patients. However, terminal sedation is typically used to address severe physical and psychological suffering in dying patients, whereas perceived loss of dignity during the last phase of life is a major problem for patients requesting euthanasia.

  3. Death Education and Attitudes toward Euthanasia and Terminal Illness.

    Science.gov (United States)

    Nagi, Mostafa H.; Lazerine, Neil G.

    1982-01-01

    Analyzed attitudes of 614 Protestant and Catholic Cleveland clergy toward terminal illness and euthanasia. Clergy responses revealed that, although eager to prolong life, terminally ill patients feared prolonged illness more than death. The controversial nature of euthanasia became more apparent with clergy who had more training in death…

  4. Suicide and Euthanasia - Special Types of Partner Relationships.

    Science.gov (United States)

    Pohlmeier, Hermann

    1985-01-01

    Concentrates on the joint issues of suicide and euthanasia in the context of the doctor-patient relationship. A new evaluation of suicide prevention and euthanasia, especially as they relate to the training of medical students and doctors, is advocated. (Author/BL)

  5. "Euthanasia" of Persons with Severe Handicaps: Refuting the Rationalizations.

    Science.gov (United States)

    Lusthaus, Evelyn

    1985-01-01

    The article examines two common rationalizations for euthanasia of persons with severe handicaps and presents arguments to refute them. The article calls for parents, professionals, and friends of persons with severe handicaps to be vocal in refuting euthanasia and its rationales. (Author/CL)

  6. Suicide and Euthanasia - Special Types of Partner Relationships.

    Science.gov (United States)

    Pohlmeier, Hermann

    1985-01-01

    Concentrates on the joint issues of suicide and euthanasia in the context of the doctor-patient relationship. A new evaluation of suicide prevention and euthanasia, especially as they relate to the training of medical students and doctors, is advocated. (Author/BL)

  7. "Euthanasia" of Persons with Severe Handicaps: Refuting the Rationalizations.

    Science.gov (United States)

    Lusthaus, Evelyn

    1985-01-01

    The article examines two common rationalizations for euthanasia of persons with severe handicaps and presents arguments to refute them. The article calls for parents, professionals, and friends of persons with severe handicaps to be vocal in refuting euthanasia and its rationales. (Author/CL)

  8. Euthanasia in the Broader Framework of Dutch Penal Policies

    NARCIS (Netherlands)

    Groenhuijsen, M.S.; van Laanen, F.; Groenhuijsen, M.S.; van Laanen, F.

    2006-01-01

    The authors have regarded euthanasia in the broader framework of Dutch penal policies. They present euthanasia as a typical example of the pragmatic - rather than dogmatic - way the Dutch try to tackle difficult moral problems in connection with the criminal justice system. Definitions, statutory la

  9. [Management of requests for euthanasia. Discussion of cases].

    Science.gov (United States)

    Englert, M

    2008-09-01

    Since September 2002, more than 2.000 legal euthanasia's were performed in Belgium. The present paper reviews the necessary steps to be followed by the physician for a correct achievement of the process initiated by the patient's demand to die. Interpretation of the legal conditions to be respected by the physician is discussed from reports of ten cases of requests for euthanasia.

  10. Euthanasia in the Broader Framework of Dutch Penal Policies

    NARCIS (Netherlands)

    Groenhuijsen, M.S.; van Laanen, F.; Groenhuijsen, M.S.; van Laanen, F.

    2006-01-01

    The authors have regarded euthanasia in the broader framework of Dutch penal policies. They present euthanasia as a typical example of the pragmatic - rather than dogmatic - way the Dutch try to tackle difficult moral problems in connection with the criminal justice system. Definitions, statutory

  11. Zasada podwójnego skutku i zasada moralnej symetrii a kwestia legalizacji eutanazji [Principles of Double Effect and Moral Symmetry and Legalization of Euthanasia

    Directory of Open Access Journals (Sweden)

    Wacław Janikowski

    2013-06-01

    Full Text Available In this essay I scrutinize importance of Principles of Double Effect and MoralSymmetry in regard to the question of moral acceptance of euthanasia legalization.My conclusion is that although there is no substantially moral difference betweenpassive and active euthanasia, the problem of morally justifiable legalization ofeuthanasia is still not resolved. That is because some reasons suggest the possibilityof special discrepancy between moral acceptability of euthanasia in certain cases andmoral demand to preserve legal prohibition of euthanasia in general. In the paperI criticize the popular opinion that utilitarianism cannot account of why we giveweight to the question of moral permissibility of intentions. I claim that contraryto this false platitude utilitarianism can even accommodate practical relevance ofPrinciple of Double Effect, but not as a valid per se principle.

  12. Role and Involvement of Life End Information Forum Physicians in Euthanasia and Other End-of-Life Care Decisions in Flanders, Belgium

    Science.gov (United States)

    Van Wesemael, Yanna; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D; Bilsen, Johan; Distelmans, Wim; Deliens, Luc

    2009-01-01

    Objective To describe role and involvement of Life End Information Forum (LEIF) physicians in end-of-life care decisions and euthanasia in Flanders. Study Design All 132 LEIF physicians in Belgium received a questionnaire inquiring about their activities in the past year, and their end-of-life care training and experience. Principal Findings Response rate was 75 percent. Most respondents followed substantive training in end-of-life care. In 1 year, LEIF physicians were contacted 612 times for consultations in end-of-life decisions, of which 355 concerned euthanasia requests eventually resulting in 221 euthanasia cases. LEIF physicians also gave information about various end-of-life issues (including palliative care) to patients and colleagues. Conclusions LEIF physicians provide a forum for information and advice for physicians and patients. A similar health service providing support to physicians for all end-of-life decisions could also be beneficial for countries without a euthanasia law. PMID:19780854

  13. Child euthanasia: should we just not talk about it?

    Science.gov (United States)

    Bovens, Luc

    2015-08-01

    Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults--viz, arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care--and show that these arguments are wanting. Second, there is another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman's 'Against the Right to Die' and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors.

  14. Euthanasia of rats with two concentrations of pentobarbitone

    DEFF Research Database (Denmark)

    Bollen, Peter; Saxtorph, Henrik

    2011-01-01

    Euthanasia of laboratory animals should be quick, painless and with a minimum of distress to the animal. Methods of euthanasia are the topic of an ongoing discussion, especially with respect to the degree of pain and distress associated with different methods. A common method of euthanasia of rats...... a reduced nociception, in the spine of rats receiving a mixture of pentobarbital and lidocaine, compared to rats receiving pentobarbital alone. However, it is our experience that visible signs of pain are not always observable during euthanasia. For this reason we performed a study comparing two...... concentrations of pentobarbitone (50 mg/ml vs. 200 mg/ml) for euthanasia in rats (n=12). The time point of loss of balance, immobility and respiratory stop were registered, and the behaviour was assessed from video recordings of the procedure. Our study revealed no differences between the two concentrations...

  15. Passive euthanasia in dementia: killing ... or letting die?

    Science.gov (United States)

    Salib, E; Tadros, G

    2001-07-01

    A sample of carers was asked to complete a self-administered questionnaire designed to collect information about carers' characteristics and obtain their views on passive euthanasia. Each carer was given an information sheet about the study, which included a detailed and clear account for the different types of euthanasia. The study showed a strong support for passive euthanasia from the non-professional carers of dementia patients. The strongest support was for the idea of a 'Living Will'. Having previous experience in looking after other people with dementia would appear to influence carers' perception of passive euthanasia. The subject of passive euthanasia and its ramifications for sufferers, carers and professionals warrants further exploration.

  16. Euthanasia of rats with two concentrations of pentobarbitone

    DEFF Research Database (Denmark)

    Bollen, Peter; Saxtorph, Henrik

    2011-01-01

    Euthanasia of laboratory animals should be quick, painless and with a minimum of distress to the animal. Methods of euthanasia are the topic of an ongoing discussion, especially with respect to the degree of pain and distress associated with different methods. A common method of euthanasia of rats...... a reduced nociception, in the spine of rats receiving a mixture of pentobarbital and lidocaine, compared to rats receiving pentobarbital alone. However, it is our experience that visible signs of pain are not always observable during euthanasia. For this reason we performed a study comparing two...... concentrations of pentobarbitone (50 mg/ml vs. 200 mg/ml) for euthanasia in rats (n=12). The time point of loss of balance, immobility and respiratory stop were registered, and the behaviour was assessed from video recordings of the procedure. Our study revealed no differences between the two concentrations...

  17. Attitudes towards euthanasia in Iran: the role of altruism.

    Science.gov (United States)

    Aghababaei, Naser

    2014-03-01

    Altruism is arguably the quintessential moral trait, involving willingness to benefit others and unwillingness to harm them. In this study, I explored how altruism and other personality variables relate to acceptance of euthanasia. In addition, I investigated the role of culture in attitudes to subcategorical distinctions of euthanasia. 190 Iranian students completed the Attitude Towards Euthanasia scale, the HEXACO Personality Inventory-Revised, and an interest in religion measure. Higher scores on altruism, Honesty-Humility, Agreeableness, Conscientiousness and religiousness were associated with viewing euthanasia as unacceptable. As expected, altruism explained unique variance in euthanasia attitude beyond gender, religiosity and broad personality factors. Cultural and individual differences should be taken into consideration in moral psychology research and end-of-life decision-making.

  18. A Dutch perspective: the limits of lawful euthanasia.

    Science.gov (United States)

    de Vries, Ubaldus

    2004-01-01

    Dutch author Ubaldus de Vries reviews the current state of the euthanasia law in the Netherlands. The legislation, enacted in 2001, creates a medical exception that allows for euthanasia in cases where patients experience "hopeless and unbearable suffering." A brief history of the Dutch approach to euthanasia is set forth, case law is reviewed, and the unique role of the doctor is examined in seeking to understand the extent of one's right to euthanasia in the Netherlands. Because the courts must determine what constitutes "hopeless and unbearable suffering," Professor de Vries analyzes the judicial interpretation of "suffering" and concludes that judicial interpretation has reached its limits, and thus by implication, the limits of lawful euthanasia have been reached.

  19. Attitudes of nurses towards euthanasia and towards their role in euthanasia: A nationwide study in Flanders, Belgium

    NARCIS (Netherlands)

    Inghelbrecht, E.; Bilsen, J.J.; Mortier, F.; Deliens, L.H.J.

    2009-01-01

    BACKGROUND: Nurses have an important role in caring for terminally ill patients. They are also often involved in euthanasia. However, little is known about their attitudes towards it. OBJECTIVES: To investigate on a nationwide level nurses' attitudes towards euthanasia and towards their role in euth

  20. Attitudes of nurses towards euthanasia and towards their role in euthanasia: A nationwide study in Flanders, Belgium

    NARCIS (Netherlands)

    Inghelbrecht, E.; Bilsen, J.J.; Mortier, F.; Deliens, L.H.J.

    2009-01-01

    BACKGROUND: Nurses have an important role in caring for terminally ill patients. They are also often involved in euthanasia. However, little is known about their attitudes towards it. OBJECTIVES: To investigate on a nationwide level nurses' attitudes towards euthanasia and towards their role in euth

  1. Attitudes of nurses towards euthanasia and towards their role in euthanasia: A nationwide study in Flanders, Belgium

    NARCIS (Netherlands)

    Inghelbrecht, E.; Bilsen, J.J.; Mortier, F.; Deliens, L.H.J.

    2009-01-01

    BACKGROUND: Nurses have an important role in caring for terminally ill patients. They are also often involved in euthanasia. However, little is known about their attitudes towards it. OBJECTIVES: To investigate on a nationwide level nurses' attitudes towards euthanasia and towards their role in

  2. Voluntary Euthanasia and the Right to Die: A Dialogue with Derek Humphry.

    Science.gov (United States)

    Sinnett, E. Robert; And Others

    1989-01-01

    Presents interview with Derek Humphry, founder of the Hemlock Society (an international right-to-die organization), who shares his personal experiences, as well as his efforts to educate the public and stimulate legal reform. Notes Humphry has dedicated more than a decade to this highly charged universal problem. (Author/ABL)

  3. EUTANÁSIA VOLUNTÁRIA: A MORTE COM DIGNIDADE / VOLUNTARY EUTHANASIA: DEATH WITH DIGNITY

    OpenAIRE

    Demarchi, Clovis; UNIVALI; Bastos, Barbara Von Mecheln; Universidade do Vale do Itajaí́ – UNIVALI

    2013-01-01

    O presente artigo tem como objetivo investigar acerca da autonomia do paciente terminal para dispor da própria vida por meio da eutanásia, ante o princípio da dignidade da pessoa humana. Inicia-se a pesquisa com o estudo dos aspectos gerais da eutanásia tradicional: história, conceito, variantes e suas formas de execução. Num segundo momento, define-se morte encefálica e os princípios da autonomia e dignidade da pessoa humana. Por fim, busca-se esclarecer alguns aspectos éticos e jurídicos da...

  4. Voluntary Euthanasia and the Right to Die: A Dialogue with Derek Humphry.

    Science.gov (United States)

    Sinnett, E. Robert; And Others

    1989-01-01

    Presents interview with Derek Humphry, founder of the Hemlock Society (an international right-to-die organization), who shares his personal experiences, as well as his efforts to educate the public and stimulate legal reform. Notes Humphry has dedicated more than a decade to this highly charged universal problem. (Author/ABL)

  5. QALYs, euthanasia and the puzzle of death.

    Science.gov (United States)

    Barrie, Stephen

    2015-08-01

    This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be 'better off dead'. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an 'anchor' for the surveyed preferences on which QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Palliative sedation versus euthanasia: an ethical assessment.

    Science.gov (United States)

    ten Have, Henk; Welie, Jos V M

    2014-01-01

    The aim of this article was to review the ethical debate concerning palliative sedation. Although recent guidelines articulate the differences between palliative sedation and euthanasia, the ethical controversies remain. The dominant view is that euthanasia and palliative sedation are morally distinct practices. However, ambiguous moral experiences and considerable practice variation call this view into question. When heterogeneous sedative practices are all labeled as palliative sedation, there is the risk that palliative sedation is expanded to include practices that are actually intended to bring about the patients' death. This troublesome expansion is fostered by an expansive use of the concept of intention such that this decisive ethical concept is no longer restricted to signify the aim in guiding the action. In this article, it is argued that intention should be used in a restricted way. The significance of intention is related to other ethical parameters to demarcate the practice of palliative sedation: terminality, refractory symptoms, proportionality, and separation from other end-of-life decisions. These additional parameters, although not without ethical and practical problems, together formulate a framework to ethically distinguish a more narrowly defined practice of palliative sedation from practices that are tantamount to euthanasia. Finally, the article raises the question as to what impact palliative sedation might have on the practice of palliative care itself. The increasing interest in palliative sedation may reemphasize characteristics of health care that initially encouraged the emergence of palliative care in the first place: the focus on therapy rather than care, the physical dimension rather than the whole person, the individual rather than the community, and the primacy of intervention rather than receptiveness and presence.

  7. [Assessment of euthanasia request by SCEN physicians].

    Science.gov (United States)

    Ypma, Tjipke D; Hoekstra, Herman L

    2015-01-01

    To determine how uniformly Support and Consultation on Euthanasia in the Netherlands (SCEN) doctors assess a euthanasia request in patients not in the final stages of a terminal illness. Qualitative research. Internal survey among SCEN doctors in the 'SCEN-Drenthe' peer group, who were asked to provide an opinion on the requirements of due care, items a to d, of the Termination of life on request and assisted suicide act (WTL) in three fictitious patients. Sixty assessments were received from 20 SCEN physicians. Half of the reviews were assessed as 'due care requirements not met". 45% of these were for a patient whose request was based on the grounds of a "completed life", 50% for a patient with Alzheimer's, and 55% for a patient with a reduced level of consciousness. Uncertainty about the place of Article 2.2 of the WTL, personal assessment of the unbearable nature of hopeless suffering and the rejection of alternative solutions were responsible for the heterogeneous assessments. Uniformity of assessment is important to avoid legal disparity in this patient group. We found no medical or ethical benchmarks for determining the unbearable nature of suffering. A verifying assessment by the SCEN physician can only provide an opinion regarding the presence of hopeless pain that is classified as "unbearable". A negative SCEN assessment undermines a person's sense of justice at a difficult time, while the hopeless suffering may well be accepted as unbearable in comparable cases. Adapting the KNMG "Guidelines on euthanasia for patients in a state of reduced consciousness" so that they are in line with the WTL could also contribute to greater uniformity.

  8. Euthanasia, assistance to suicide and the law: developments in The Netherlands.

    Science.gov (United States)

    Leenen, H J

    1987-01-01

    In this article the developments in euthanasia in The Netherlands are discussed. To a large extent unanimity has been reached about the definition of euthanasia. Since 1973 the courts have become involved in euthanasia cases. The lower courts and the Supreme Court allowed for euthanasia on request under certain conditions. In 1982 a State Committee on Euthanasia was established. This Committee made a proposal of a law on euthanasia and assistance to suicide on request. The Committee delineated requirements to be followed for euthanasia not to be punishable. Although a majority of the Dutch population is in favour of a liberalizing legislation, the political situation delays its adoption.

  9. An academic internist looks at euthanasia.

    Science.gov (United States)

    Fitzgerald, Faith

    2004-09-01

    This paper points out that to persons unfamiliar with the context and suffering of dying patients, their loved ones, and last, but by no means least, the health care team can only discuss the very concrete question of euthanasia in an abstract way unaware of the fact that this question must, in the final analysis, be differently addressed in different specific patients and under specific circumstances. This paper poses questions which must be addressed and will rarely find a good answer but at least the best among a series of unpalatable options. It again points out the important and legitimate place that emotions play in decision-making.

  10. The Dutch Euthanasia Act: recent legal developments.

    Science.gov (United States)

    Legemaate, Johan; Bolt, Ineke

    2013-12-01

    The Dutch Termination of Life on Request and Assisted Suicide Act [Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding (Wtl)] came into force in 2002. Its aim is to increase the degree of due care exercised by physicians when terminating a patient's life and to provide a legal framework within which physicians account for their actions in such cases. On the basis of the second evaluation of the Act, published in December 2012, this article provides an overview of the most recent legal developments regarding the Dutch Euthanasia Act. Special attention is given to patients with dementia, psychiatric patients and patient who are "weary of life".

  11. Euthanasia: the law in the United Kingdom.

    Science.gov (United States)

    Smith, A M

    1996-04-01

    The regulation of euthanasia by the criminal law has tended to be one of the more contentious areas of medical law, and continues to be the subject of debate. Few areas of the criminal law have been so consistently the target of reformist pressure, and certainly few areas have so strongly resisted change. Understandably, legislators are unwilling to involve themselves in a matter of law reform which engenders such moral disagreement, and it is significant that only two jurisdictions-The Netherlands and the Australian Northern Territories-have made any substantial change in their legal practice in this area. In other countries, including the UK, the courts and legislators have consistently refused to remove the fundamental criminal law objection to the practice of euthanasia. This is not to say, of course, that the courts have failed to recognise the medical subtleties in medical treatment at the end of life; in several important decisions, the courts in Britain have considered the boundaries of the criminal law's protection of life and have offered guidelines for doctors facing the delicate issues associated with treating the dying patient. Yet, in spite of several helpful decisions from the courts, the basic principle remains firm: the criminal law does not countenance the taking of life, no matter how good the motive. This means that there are very clear legal limits to the extent to which doctors can follow their individual consciences in this area.

  12. Health versus harm: euthanasia and physicians' duties.

    Science.gov (United States)

    Garcia, J L A

    2007-01-01

    This essay rebuts Gary Seay's efforts to show that committing euthanasia need not conflict with a physician's professional duties. First, I try to show how his misunderstanding of the correlativity of rights and duties and his discussion of the foundation of moral rights undermine his case. Second, I show aspects of physicians' professional duties that clash with euthanasia, and that attempts to avoid this clash lead to absurdities. For professional duties are best understood as deriving from professional virtues and the commitments and purposes with which the professional as such ought to act, and there is no plausible way in which her death can be seen as advancing the patient's medical welfare. Third, I argue against Prof. Seay's assumption that apparent conflicts among professional duties must be resolved through "balancing" and argue that, while the physician's duty to extend life is continuous with her duty to protect health, any duty to relieve pain is subordinate to these. Finally, I show that what is morally determinative here, as throughout the moral life, is the agent's intention and that Prof. Seay's implicitly preferred consequentialism threatens not only to distort moral thinking but would altogether undermine the medical (and any other) profession and its internal ethics.

  13. Turkey's physicians' attitudes toward euthanasia: a brief research report.

    Science.gov (United States)

    Ozkara, Erdem; Hanci, Hamit; Civaner, Murat; Yorulmaz, Coskun; Karagoz, Mustafa; Mayda, Atilla Senih; Goren, Suleyman; Kok, Ahmet Nezih

    2004-01-01

    Euthanasia and assisted suicide are subject to an ongoing debate and discussed with various aspects. Because physicians are in a profession closely related to euthanasia, their attitudes toward this subject are significant. Thus, research intending to explore their opinions is carried out in many countries. In this study, opinions of the physicians regarding euthanasia's definition, contents, legal aspects, and acceptable conditions for its application are addressed. The questionnaire was given to 949 physicians, more than 1% of the total working in Turkey. Of the physicians who participated in the study, 49.9% agreed with the opinion that euthanasia should be legal in certain circumstances. In addition, 19% had come across a euthanasia request and the majority of physicians (55.9%) believed that euthanasia is applied secretly in the country despite the prohibitory legislation. In conclusion, the authors infer from the study itself and believe that euthanasia should be legal in certain circumstances and that the subject, which is not in the agenda of the Turkish population, should continue to be examined.

  14. Voluntary Simplicity: A Lifestyle Option.

    Science.gov (United States)

    Pestle, Ruth E.

    This guide provides practical ideas for incorporating the concept of voluntary simplicity into home economics classes. Discussed in the first chapter are the need to study voluntary simplicity, its potential contributions to home economics, and techniques and a questionnaire for measuring student attitudes toward the concept. The remaining…

  15. Operant Variability and Voluntary Action

    Science.gov (United States)

    Neuringer, Allen; Jensen, Greg

    2010-01-01

    A behavior-based theory identified 2 characteristics of voluntary acts. The first, extensively explored in operant-conditioning experiments, is that voluntary responses produce the reinforcers that control them. This bidirectional relationship--in which reinforcer depends on response and response on reinforcer--demonstrates the functional nature…

  16. Role of nurses in institutional ethics policies on euthanasia.

    Science.gov (United States)

    Gastmans, Chris; Lemiengre, Joke; Dierckx de Casterlé, Bernadette

    2006-04-01

    This paper reports the findings of a survey that investigated whether Flemish Catholic hospitals and nursing homes had developed written ethics policies on euthanasia and how the role of nurses was described in these policies. International research shows undeniably that nurses are confronted with patients requesting euthanasia. Euthanasia has been legal in Belgium since 2002 and in Holland since 2001. Because of the vagueness in formal documents and policies on the role of nurses in euthanasia, there is an increasing need to establish institutional ethics policies that clearly describe the role of nurses in the euthanasia process. We used a cross-sectional descriptive mail questionnaire to survey the general directors of Catholic hospitals and nursing homes in Belgium (Flanders). Data were collected between October 2003 and February 2004. Of the 298 institutions targeted for survey, 81% of hospitals, 62% of nursing homes returned completed questionnaires. Of these, 79% of the hospitals and 30% of the nursing homes had a written ethics policy on euthanasia. The ethics policies of 87% of the hospitals and 77% of the nursing homes explicitly addressed the role of nurses in the euthanasia process. In the majority of hospitals and nursing homes, the ethics policies addressed the conscientious objections of nurses to euthanasia. Most hospitals and nursing homes voluntarily communicated their ethics policies to the nurses they employed. The written ethics policies of most Catholic healthcare institutions give explicit attention to the role of nurses in the euthanasia process. However, the meaning and content of the role of nurses, as indicated in these ethics policies, continue to be an issue. Further research is needed to verify how these policies are actually implemented within the institutions and whether they contribute to better support for nurses and to ethical care for patients.

  17. Toward voluntary parenthood.

    Science.gov (United States)

    Scarr, S

    2000-06-01

    David Lykken's proposal to license married parents for child rearing, and to deny the same opportunity to single and inept parents, springs from his deep concern for millions of youngsters cruelly subjected to abusive and neglectful rearing circumstances. Children from such inadequate homes grow up to have high rates of school failure, criminality, and drug addiction. The problem is clear, but Lykken's remedies of mandated marriage and parental licensure are unacceptable in U.S. society, where our reproductive rights are fortunately protected by our Constitution. As a devoted proponent of reproductive rights, I propose a legally and morally acceptable proposal to the same end. Increasing women's effective control of reproduction and moving toward entirely voluntary parenthood will accomplish the same goals without compromising our civil liberties.

  18. EUTHANASIA STIPULATED BY ROMANIAN CRIMINAL LAW, MITIGATING CIRCUMSTANCES VS. OFFENCE

    Directory of Open Access Journals (Sweden)

    MONICA POCORA

    2012-05-01

    Full Text Available This paper aims to be a scientific approach to the issue of euthanasia, bringing into the debate current and future controversies raised by euthanasia, as a result of the introduction into the Romanian penal law of the criminal offence of homicide by request of the victim. The study represents an approach to moral, religious, constitutional, civil, criminal procedure debates and last but not least to criminal debates regarding the legalization of the euthanasia, as the most difficult task lies with the criminal law.

  19. The issue of euthanasia in Greece from a legal viewpoint.

    Science.gov (United States)

    Voultsos, Polichronis; Njau, Samuel N; Vlachou, Maria

    2010-04-01

    Modern Greek society appears to be split regarding the legalization of euthanasia. The Greek Orthodox Church maintains a negative attitude. Research shows that some forms of euthanasia are carried out "behind closed doors". There is no specific legal provision. The government avoids bearing the political cost of regulating this marginal issue. According to the dominant view of Criminal Law jurists, some forms of euthanasia are considered permissible de lege lata, under certain conditions. The safety of the concurrence of these conditions, safeguarding of the acceptability of forms that are considered permissible and - mostly - the need to regulate the prohibited forms in exceptional cases, all force the legislators to promptly fill any legal vacuums.

  20. [Bioethics of Sigmund Freud´s death: euthanasia or appropriation?].

    Science.gov (United States)

    Figueroa, Gustavo

    2011-04-01

    The death of Freud raises the ethical dilemma about euthanasia. It can be characterized as indirect active euthanasia according to the rule of double effect, or terminal sedation, or palliated death. The primacy of the principle of autonomy over non maleficence, conditioned the physician's attitude toward his patient Freud. The physician assisted death was and remains punishable in western medicine. Therefore, a fundamental tradition was infringed. In contrast, the present study attempts to characterize the final position of Freud himself to his death and called it appropriation of his finitude; he assumes his being-unto-death, that is, he now projects his being not as a being-at-his-end but as a being-unto-end, indicating thereby that he understood that the end always penetrated his whole existence.