Tag: euthanasia

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 Guest Post: Withdrawing life-prolonging treatment in the patient’s best interests: The implications of Briggs

Guest Post: Jenny Kitzinger, Celia Kitzinger and Jakki Cowley

Paper:  When ‘Sanctity of Life’ and ‘Self-Determination’ clash

In a recent landmark judgment in the Court of Protection (Briggs v Briggs [2016] EWCOP 53), a judge authorised withdrawal of life-prolonging treatment from a minimally conscious patient with potential for further recovery.  Our article in Journal of Medical Ethics addresses the implications of this judgment, highlighting its potential to strengthen compliance with the Mental Capacity Act 2005, and the delivery of person-centred care.

How this will work in practice is another question.

We have supported families (CK and JK) and represented patients (JC) in a series of cases – several of which have reached court – in which families sought treatment withdrawal and doctors refused.  We know many families who believe that their brain-injured relative would not want to receive on-going life-prolonging interventions.  It usually takes years for families to come to this view and even longer to communicate it to doctors. Some health care professionals can be dismissive – or even hostile – when families speak up.   Even when doctors acknowledge that a patient will never regain consciousness, some have ethical objections to withdrawing treatment from a clinically stable patient.  It feels, they say, like ‘euthanasia’.

An ethical imperative to give treatment is experienced even more acutely, by some doctors, when the patient may make some degree of ‘progress’ – perhaps recovering consciousness and the ability to interact with others.  The treating clinician in the Briggs case was firmly of the view that it would be unethical to withdraw treatment from a patient whose level of consciousness might improve over time. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Pope Francis’ Appointments to Bioethics Board Suggest Progressive Turn

Four notable American ethicists have been appointed by Pope Francis to his bioethics advisory board, and are projected to potentially “temper the group’s conservative views on sexual morality and life issues,” according to the National Catholic Reporter. The group is among 45 international members of the Pontifical Academy for Life, composed of both renewed and newly added experts that will counsel the pontiff on bioethical challenges.

Pope Francis has thus far maintained the Church’s opposition to abortion, contraception, abortion and euthanasia. In 2016, he defined human life as encompassing “conception to natural death.”

The group of American ethicists includes John Haas (President of the National Catholic Bioethics Center, Philadelphia), Ignatius John Keown (Professor of Christian Ethics, Georgetown University, Washington), Kathleen Foley (Neurologist at Memorial Sloan Kettering Cancer Center, New York, and Professor of Neurology, Cornell University, Ithaca), and Carl Anderson (CEO and Chairman of the Knights of Columbus, Connecticut [a Catholic-based fraternal service organization]).

Though reappointed member Anderson resolutely opposes abortion, the stances of other new board members “reflect a desire for a less combative tone on the issue,” noted the Reporter. Additionally, some members who had vocalized opposition to a Vatican conference on infertility at which certain ethicists had not endorsed Church positions were not invited to rejoin the board.

The post Pope Francis’ Appointments to Bioethics Board Suggest Progressive Turn appeared first on Global Bioethics Initiative (GBI).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Rethinking the Belmont Report?

Some bioethicists link the beginnings of our field to the Nazi Medical experiments and the Nuremberg Trial (Annas). Whether this is the beginning of bioethics is debatable, but without a doubt, research ethics has been a central topic in the field. In fact, the very first federal bioethics commission laid out the principles of research ethics in the Belmont Report. Later, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research recommended to the President and Congress that a uniform framework and set of regulations should govern human subjects research.  This effort reached fruition under The Federal Policy for the Protection of Human Subjects or the “Common Rule” that was issued in 1991.  Since then, there have been no major changes to the regulations – until now.  After a five-year process and thousands of comments, the new “final rule” was released on January 19th, 2017.  The July 2017 issue of the American Journal of Bioethics addresses these changes.  In addition to our usual open peer commentaries, we are posting a number of blog posts written in response to the AJOB target article.


by Ibrahim Garba, MA, JD, LLM, Elizabeth Hall-Lipsy, JD, MPH, Leila Barraza JD, MPH

Norms supporting ethical research have been part of international human rights law from the start. The Doctors Trial in 1947 convicting 23 Nazi physicians and officials accused of euthanasia and unethical medical experiments produced the Nuremburg Code. The Code became a blueprint for subsequent human subject protection frameworks, most notably the World Medical Association’s Ethical Principles for Medical Research Involving Human Subjects (i.e.,

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Medical Decision-Making In the Tragic Life of Charlie Gard

by Craig Klugman, Ph.D.

On Friday, Charlie Gard is scheduled to have his life support discontinued. Charlie Gard is an 11-month-old baby born with RRM2B encephalomyopathic mitochondrial DNA depletion syndrome—a rare genetic disorder with no cure. Those with the mutation live at most into early childhood with a multitude of life threatening conditions (lactic acidosis, ammonia build up, heart abnormalities). Charlie suffers from seizures, cannot independently breathe. He is also blind and deaf. Great Ormond Street Hospital (London) and Charlie’s doctors believe there is nothing more medically that can be done to benefit him and requested to remove his life sustaining treatment. Connie Yates and Chris Gard, his parents, believe that there is a chance of a miraculous cure in an experimental nucleoside treatment in the United States, even though the technique has never been tried for this condition. In the words of the unnamed U.S. specialist, nucleoside treatment would provide a “small hope” for helping

The case has gone through the British courts and the European Court of Human Rights, all of which agreed with the hospital. They declared that prolonging Charlie’s life would be “inhumane and unreasonable.” The courts believed that the experimental treatment in the US would be futile and could cause Charlie much suffering. The European Court ruled on July 4 that life support can be removed on Friday.

Under British law, when parents and physicians disagree on treatment, the courts normally intervene and are the final decision-makers. Unlike in the US, the highest value is the best interest (benefit) to the child rather than parental rights to make decisions for their child.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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The Neuroethics Blog Series on Black Mirror: Be Right Back

By Somnath Das
Somnath Das recently graduated from Emory University where he majored in Neuroscience and Chemistry. He will be attending medical school at Thomas Jefferson University starting in the Fall of 2017. The son of two Indian immigrants, he developed an interest in healthcare after observing how his extended family sought help from India’s healthcare system to seek relief from chronic illnesses. Somnath’s interest in medicine currently focuses on understanding the social construction of health and healthcare delivery. Studying Neuroethics has allowed him to combine his love for neuroscience, his interest in medicine, and his wish to help others into a multidisciplinary, rewarding practice of scholarship which to this day enriches how he views both developing neurotechnologies and the world around him. 
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Humans in the 21st century have an intimate relationship with technology. Much of our lives are spent being informed and entertained by screens. Technological advancements in science and medicine have helped and healed in ways we previously couldn’t dream of. But what unanticipated consequences may be lurking behind our rapid expansion into new technological territory? This question is continually being explored in the British sci-fi TV series Black Mirror, which provides a glimpse into the not-so-distant future and warns us to be mindful of how we treat our technology and how it can affect us in return. This piece is part of a series of posts that will discuss ethical issues surrounding neuro-technologies featured in the show and will compare how similar technologies are impacting us in the real world. 

*SPOILER ALERT* – The following contains plot spoilers for the Netflix television series Black Mirror

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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A medical, legal and ethical approach of paediatric euthanasia in Belgium

We believe it interesting to refer to an article published in JAMA (311, 1963-1964) last May, which discussed various aspects of paediatric euthanasia en Belgium.

On 13 February 2014, the Belgian Parliament approved an amendment to the Act regulating euthanasia in Belgium, in order to legalise euthanasia in children with serious illnesses. The amendment in question, supported by the majority of Belgians and recently signed into law by King Philippe, will allow euthanasia in children who are permanently in severe pain. As in all cases of euthanasia, parental consent will be required, and it will exclude children with intellectual disabilities or mental illnesses and must be approved by a multidisciplinary medical team, who will carefully assess the mental capacity of these children.

The approval of this law marks the culmination of the gradual acceptance of euthanasia in Belgium. To date, the Netherlands, Belgium and Luxemburg are the only countries in the European Union in which euthanasia is legal.

Euthanasia for adults has been legal in Belgium since May 2002, unlike paediatric euthanasia. A preliminary study examining the opinion of physicians on child euthanasia showed that 69% were in favour of legalising it.

In March 2005, recognising that euthanasia in children was rising, without the due legal protection, doctors from the University of Groningen in the Netherlands published practice guidelines for euthanasia in severely disabled newborns. This document is in favour of the legalisation of active euthanasia in children “with a hopeless prognosis who experience […] unbearable suffering”. The protocol specifies that terminating the life of these children may be acceptable if four requirements are met: a) the presence of hopeless and unbearable suffering; b) the consent of both parents; c) consultation with physicians; and d) that the procedure for terminating the life of these children be in accordance with medical standards.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Confronting Medicine in the Holocaust & Beyond

By Hedy S. Wald

Galilee, Israel, May 7-11, 2017. I was privileged to be at the Second International Scholars Workshop on “Medicine in the Holocaust and Beyond.” Why so meaningful?  Why so needed? 140 purposeful, passionate scholars from 17 countries delved into the past history of medicine at its worst in order to inform the future.  From 1933-1945, presumed healers within mainstream medicine (sworn to uphold the Hippocratic Oath) turned into killers (1).  Yes, medical ethics in Nazi-era medical school curricula existed, yet included “unequal worth of human beings, authoritative role of the physician, and priority of public health over individual-patient care”(2).  In Western Galilee College, (Akko), Bar-Ilan University Faculty of Health Sciences (Safed), and Galilee Medical Center and Ghetto Fighters’ Museum, (both in Nahariya), historians, physicians, nurses, medical and university educators, medical students, ethicists and more gathered to grapple with this history and consider how learning about medicine in the Holocaust can support healthy professional identity formation with a moral compass for navigating the future of medical practice with issues such as prejudice, assisted reproduction and suicide, resource allocation, obtaining valid informed consent, and challenges of genomics and technology expansion (3)…

The conference, in essence, served as a lens for the here and now, reinforcing my contention (and others’) that history of medicine in the Holocaust curricula including confronting the Nazi physicians’ and scientific establishment’s euthanasia of “lives unworthy of life,” forced sterilizations, horrific experimentation on their victims, and medicalized genocide (leading to the destruction of a third of the European Jewish population and many others) is a “moral imperative” in healthcare professions education (1,4).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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The most permissive assisted suicide country is Switzerland

Assisted suicide is legal in Switzerland, and moreover, is accessible without having to provide any reason. There are no rules that require the participation of a doctor, and most suicides are assisted by associations that support the right to a dignified death. Even though, in Europe, euthanasia and assisted suicide are permitted in Holland, Belgium and Luxemburg, and in some states in the United States, the situation of assisted suicide facilities in Switzerland is unique because of the facilities that exist specifically for it. A recent study recorded 611 cases in a centre in Zurich, which is where most assisted suicides occurred between 2008 and 2012 (see HERE).

Euthanasia and assisted suicide. Attitudes and practice in countries where they have been legalised

Photo ABC

La entrada The most permissive assisted suicide country is Switzerland aparece primero en Bioethics Observatory.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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National Right to Life Tackles End of Life Medicine

Several sessions at next week’s National Right to Life Conference address end-of-life medicine, including the general session: How to Prevent an Assisted Suicide Roe v. Wade.


Assisted Suicide Battles Rage in Nearly Every State: Is Your State Next?
Mary Hahn Beerworth, Scott Fischbach
The threat of doctor-prescribed suicide is advancing in the states. Moreover, the next Supreme Court nomination could lead to legalization of euthanasia nationwide. Assisting suicide is now legal in California, Oregon, Washington, Vermont, and, via the courts in Montana. With battles raging in states
across the country, the ongoing battle in Vermont will be discussed as will other battles nationwide. This workshop will give background and break open the myths surrounding doctor-prescribed suicide. The speakers will cover the current legal and legislative landscape, describe some different kinds of successful winning (and losing strategies), and talk about what you can do in your own state. In the wake of massive state legislative push and upcoming Supreme Court nominations, it is more important than ever that doctor-prescribed suicide be stopped in its tracks.


The Battle Against Simon’s Law: How Dirty Tricks Lost To Smart Negotiations
Kathy Ostrowski
When hospitals choose to fight against parental decision-making rights – the battle for life can take two paths, and only one leads to life. This workshop will provide a firsthand account of those who fought for Simon’s Law in Kansas. Simon’s Law is a very significant pro-life measure that combats selectively “rationed” care and medical discrimination against children with life-limiting diagnoses.  Kathy Ostrowski will share how the triumph of artful dialogue beat back bullying tactics and whisper campaigns.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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2nd International Conference on End-of-Life Law, Ethics, Policy, and Practice

Check out this remarkable collection of concurrent sessions coming up at the 2nd International Conference on End-of-Life Law, Ethics,
Policy, and Practice (ICEL) in Halifax.



The Ethics of POLST
Lloyd Steffen


The Perils of POLST
Jean Abbott


Advanced Directives and Advanced Care Planning
Peter Saul


“Rock, Paper, Scissors” – Ideologies of End of Life Care for Older People in Hospital
Laura Green


The Cultural Construction of End of Life Issues in Biomedicing: Anthropological Perspectives
Betty Wolder Levin


Caregiver Perspectives of Palliative and End of Life Care for Individuals at End-Stage Dementia in Newfoundland and Labrador: A Qualitative 
Phenomenological Perspective
Barbara Mason


End of Life Regulation and Recent Evolutions in France
Veronique Fournier


To Live and Let Die. Withholding and Withdrawing Life Sustaining Treatment in Argentina: From Therapeutic to Judicial Obstinacy
Maria Ciruzzi


When and How I Shan’t Live: Refusing Life-Prolonging Medical Treatment and Article 8 ECHR
Isra Black


Divorcing Mercy Killing from Euthanasia
Bryanna Moore


The Shift Away from Suicide Talk: Incorporating Voices of Experience
Phoebe Friesen


Elderly Who are Ready to Give Up on Life and the Right to Autonomy
Michelle Habets


Dutch GP’s Views on Good Dying and Euthanasia
Katja ten Cate


Medical Aid in Dying in New York State: Physician Attitudes and Impact of Framing Bias
Brendan Parent


Physicians’ Perceptions of Aid in Dying in Vermont
Ari Kirshenbaum


A New American Threat to Open Discussion of End-of-Life Issues
Robert Rivas


Demedicalised Assistance in Suicide
Martijn Hagens


The Human Rights Implications of the Blanket Ban on Assisted Suicide in England and Wales
Stevie Martin


A Year in Review: The Who, When, Why and How of Requests for Medical Aid in Dying in Quebec
Lori Seller and Veronique Fraser


Medical Aid in Dying: An Update from Québec
Michelle Giroux


Regulating MAiD: The Medical Regulatory Perspective
Andréa Foti


Patients with Parkinson’s Disease, Caregivers’, and Healthcare Providers’ Perspectives on Advance Care Planning on End-of-Life Care
Kim Jameson


‘You’re Going to Die.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.