Tag: murder

Bioethics Blogs

Conscientious Objection Accommodation in Healthcare – Clashing Perspectives

by Brian D. Earp / (@briandavidearp)

On behalf of the Journal of Medical Ethics, I would like to draw your attention to the current issue, now available online, which is almost entirely dedicated to the vexing question of conscientious objection in healthcare. When, if ever, should a healthcare provider’s personal conviction about the wrongness of some intervention (be it abortion, euthanasia, or whatever) be accommodated?

In a paper that has already attracted much attention, Ricardo Smalling and Udo Schuklenk argue that medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

In part, they base their argument on their judgment that “the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive” (emphasis added).

It seems clear that a lot hinges on what is meant by “unreasonable” there–and on who should get to decide what falls under that label. One answer to this question might be, “society should get to decide, through the enactment of laws, which ideally express the view of the majority of people as to what is reasonable or unreasonable in medical and other contexts.”

“Therefore,” this answer continues, “if a doctor thinks that some legally allowed service X is immoral, then she should rally her fellow citizens to lobby their representatives to change the relevant law; but she should not be excused from providing the service, if by law the patient is entitled to receive it.”

“And if she really doesn’t want to do X,” the answer concludes, “she can always leave the profession and take up some other line of work.”

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.

Bioethics News

Diabetic Boy’s Parents ‘Didn’t Believe in Doctors’

Now they’re guilty of his murder. Alexandru Radita’s first medical crisis began when he was on the verge of turning 3. His parents brought him — thirsty, feverish, vomiting and suffering from abdominal pain — to a hospital in British Columbia in December 2000. Lab tests confirmed that young Alex had Type 1 diabetes

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.

Bioethics News

Should Quebec’s Alzheimer’s patients be eligible for euthanasia?

Quebec is about to embark upon a debate on the involuntary euthanasia of demented elderly after a  55-year-old man in Montreal allegedly smothered his Alzheimer’s stricken wife and posted what he had done on Facebook. Michel Cadotte was charged with second-degree murder after his 60-year-old wife died in an assisted care facility.

He said on Facebook that he had “cracked” and “consented to her demands to help her die.” Although the facts are not clear yet, the media has reported that the woman requested medical aid in dying but was refused.

Under Quebec’s 2015 law, euthanasia for the demented is specifically excluded. “A person who makes a request for medical assistance in dying must be capable of consent,” Jean-Pierre Ménard, a Montreal medical lawyer, told the Montreal Gazette. “This means the patient must understand their state of health and can express their will. A patient with advanced Alzheimer’s no longer has the capacity to consent, no longer has the cognitive capacity to understand.”

The Gazette reports that Quebec parliamentarians now want to open a public debate on legalizing euthanasia for persons unable to give informed consent. This debate about extending eligibility for euthanasia is happening just a bit more than a year after the law came into effect.

The Quebec Alzheimer’s Society contends that demented patients need to be protected. “It’s very difficult with the complexity of dementia to know for sure what a person with dementia would want today,” April Hayward, of the Society told CTV News. “They may have expressed a wish ten years ago and do we know for certain that’s what they would want today?”

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.

Bioethics News

Calling Hollywood: have we got a script for you!

Liz Van Note acquitted   

Amongst the exiguous collateral benefits of the legalisation of assisted suicide and euthanasia are scripts for B-grade Hollywood films and TV dramas. On cable TV in Canada and the US “Mary Kills People” is currently being screened. This being is billed as “a provocative six-episode dark comedic drama series” about an ER doctor who illegally moonlights as an “angel of death” for the terminally ill.

But the best plots come from real life. This one from Missouri shows how family quarrels, criminal weaknesses and money intersect in advance directives.

Susan “Liz” Van Note has been found innocent of the murders of her father, William Van Note, and his partner, Sharon Dickson in 2010. They were shot and stabbed to death at their home. Ms Dickson died at the scene; Mr Van Note was unconscious and taken to hospital. Liz Van Note was described in the media as a lawyer specialising in end-of-life issues. She was also the executor of her father’s estate. At the hospital she produced a durable power of attorney which in which he had declared that life support should be turned off after four days. She insisted, the doctors complied and he died.

At the trial it emerged that Mr Van Note’s estate was worth about US$8 million and that he had left the bulk of it to Ms Dickson, to the consternation of his daughter, who was in serious financial difficulties. The defence attorney pinned the the murder on a mysterious man who was unable to repay a debt of $600,000 to Mr Van Note.

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.

Bioethics Blogs

Rights to so close and yet, so far away

by Jenji Cassandra Learn

This is the second in a series of personal articles about living as a trans-woman facing insurance denial, discrimination, and medical mistreatment in the current political environment.

This New Year’s Day—Sunday the 1st, 2017—was supposed to be the first day that I and people like me had equal access to healthcare in America. It was supposed to the first time we were regarded as equal to our fellow citizens and not required to pay out-of-pocket for basic healthcare needs, or even surgery, without any help from insurance providers that the rest of America depends on and that we are never the less obliged to give our money to even while they regard us as non-entities and less-than. After decades of struggle and misery, all of that was finally about to change. It didn’t.

There is a tragic irony in the fact that, after a century of stigmatization and repression, trans*, intersex, and genderqueer people have finally come to be understood, respected, and treated humanely within much of the medical and scientific community… only to at the same time find ourselves in the most hostile, oppressive, and socially regressive political environment the United States has seen since beginning of the Cold War.

The assault on the civil-rights protections and the legal and political gains made by trans, intersex, and genderqueer Americans in recent years began at the state level even before Donald Trump was inaugurated, and his top rival in the Republican primary was openly demagoguing trans* and intersex women as a danger to children, advocating the segregationist HB 2 law in North Carolina, and having his guards lay hands on a trans teen and his mother at one of his campaign events while an angry mob cheered, for no reason other than his identity.

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.

Bioethics News

Remembering the ‘Forgotten Victims’ of Nazi ‘Euthanasia’ Murders

January 27, 2017

(Deutsche Welle) – The mass murder of the supposed physically and mentally unfit was a project central to Hitler’s thinking and the ideology of National Socialism. The Nazi leader translated ideas from the international eugenics and Social Darwinist movements of the early 20th century into a homicidal urge to cleanse the corpus of the German people from ailments and weaknesses. This obsession would cost the lives of more than 70,000 people in Germany and many, many more in countries occupied by the Third Reich. But those murders would not have been possible without the active participation of doctors, judges, administrators, scientists and others.

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.

Bioethics Blogs

Medicine and the Holocaust in Medical Education: International Holocaust Remembrance Day – January 27

By Hedy S. Wald

“Medicine was used for villainous ends during the Holocaust.  The Holocaust was an enormous trauma inflicted on human dignity and the human person; medicine was implicated in crimes against humanity.”  His Eminence Daniel Cardinal DiNardo, Archbishop of Galveston-Houston.1

January 27 is International Holocaust Remembrance Day, a day designated by the United Nations General Assembly resolution 60/7 in 2005 after a special session marking the 60th anniversary of the liberation of the Nazi concentration camps and the end of the Holocaust. In the words of Secretary General Ban-Ki Moon (2008), “The International Day in memory of the victims of the Holocaust is a day on which we must reassert our commitment to human rights… We must also go beyond remembrance, and make sure that new generations know this history.  We must apply the lessons of the Holocaust to today’s world.”2

Indeed.  A recent medical humanities article (co-authored with my colleagues Drs. Rubenfeld and Fins)1 was a resounding call for teaching lessons of the Holocaust within medical education.  We joined others in the medical education/bioethics community calling for a curriculum that would create space for a mix of reflective practice and historical awareness to grapple with the medical profession’s central role in “using science to help legitimize persecution, murder and ultimately genocide.”3

“Almost every aspect of contemporary medical ethics is influenced by the history of physician involvement in the Holocaust,” Wynia and colleagues wrote.1  The United States Holocaust Memorial Museum’s (USHMM) “Deadly Medicine: Creating the Master Race” exhibit3 documents the moral failures of individual physicians and the medical establishment during the Third Reich including participation in horrific experimentation and medicalized genocide. 

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.

Bioethics News

Italian doctor describes his handiwork as mercy, not murder

Leonardo Cazzaniga escorted by carabinieri   

LATE FLASH! Here’s an update on the romantically involved doctor and nurse accused of killing at least five patients and possibly dozens more between 2011 and 2014 in a hospital near Milan. Last week BioEdge reported that “The police are not treating the deaths as euthanasia, or mercy killing, but as homicides.”

We spoke too soon. While this may be the position of the police, it appears that Leonardo Cazzaniga, the doctor who has been arrested, is spinning a different story.

“Everything I did I did to alleviate the suffering of patients. It is not true that I wanted to kill them,” he told the magistrate. However, the Italian media has reported that he often said “I am like God; I am the Angel of Death,” which tends to undermine this line of defence. 

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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.

Bioethics Blogs

"American Horror Story" in Real Life: Understanding Racialized Views of Mental Illness and Stigma

By Sunidhi Ramesh
Racial and ethnic discrimination has taken various forms in the
United States since its formation as a nation. The sign in the image
reads: “Deport all Iranians. Get the hell out of my country.”
Image courtesy of Wikipedia.
From 245 years of slavery to indirect racism in police sanctioning and force, minority belittlement has remained rampant in American society (1). There is no doubt that this history has left minorities in the United States with a differential understanding of what it means to be American and, more importantly, what it means to be an individual in a larger humankind.

Generally, our day-to-day experiences shape the values, beliefs, and attitudes that allow us to navigate the real world (2). And so, with regards to minorities, consistent exposure to these subjective experiences (of belittlement and discrimination, for example) can begin to shape subjective perceptions that, in turn, can mold larger perspectives and viewpoints.

Last spring, I conducted a project for a class to address the reception (3) of white and non-white, or persons of color (POC), students to part of an episode from American Horror Story: Freak Show. The video I asked them to watch portrays a mentally incapacitated woman, Pepper, who is wrongfully framed for the murder of her sister’s child. The character’s blatant scapegoating is shocking not only for the lack of humanity it portrays but also for the reality of being a human being in society while not being viewed as human.
Although the episode remains to be somewhat of an exaggeration, the opinions of the interview respondents in my project ultimately suggested that there exists a racial basis of perceiving the mental disabilities of Pepper—a racial basis that may indeed be deeply rooted in the racial history of the United States.

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.

Bioethics Blogs

With Sotomayor’s Elmore Dissent, Another Inroad for Neuroscience into Law

Roland Nadler

With the U.S. Supreme Court’s new term officially underway in October, the time has come for court-watchers to once again scrutinize the Justices’ every word for signs of impending developments in the law.  Myself, I’ve never had the confidence in my prognosticating ability to fill out a FantasyScotus bracket, fascinated though I am by the Court as an institution.  But to this autumnal flurry of tea-leaf reading I’ll just add one modest contribution: Justice Sotomayor’s dissent from the denial of certiorari in Elmore v. Holbrook tells us that some basic measure of neuroscientific literacy is going to become more of a necessity for criminal defense lawyers as time goes on.  Counsel who fail to inquire into their clients’ brains will increasingly run the risk that their legal assistance is later deemed ineffective.

In one sense, this is an easy prediction because it is already true.  Work by Nita Farahany and Ellen Koenig, among many others, tells us that neuroscience is — and should be — on the minds of attorneys who wish to avoid ending up on the wrong side of Strickland v. Washington.  All the same, seeing signs of this trend reaching the pages of the United States Reports feels like a significant step.

By way of summary: the petitioner in this case, Clark Elmore, spent much of his childhood and young adulthood being exposed to serious neurotoxins, including pesticides and Agent Orange.  By the time he was in his 20s, he was having clear difficulties functioning in society; a later series of tests would reveal that his capacity for “cognitive control,” that all-important function of the prefrontal cortex that exercises veto power over impulsive emotional behavior, was in the first (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.