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Refusing Medical Treatment Leading To Death  
User currently offlineDerico From Argentina, joined Dec 1999, 4313 posts, RR: 11
Posted (6 years 12 months 1 day 14 hours ago) and read 1383 times:

I was just wondering, what is this action called or considered?

I have heard a lot of debates about Euthanasia, which is the pro-active termination of someone's life on the basis that the individual's quality of life is so poor he or she should have the right to decide such action. But not so much on refusing treatment leading to death.

Do you consider both of these circumstances to be the same, or are they fundamentally different, and what are the laws in your country on either? Do they permit Euthanasia, or permit the patient to refuse further treament leading to death, or neither?

In Argentina this is left for each of the Provinces to decide, as with other things. Rio Negro just approved a law permitting patients to refuse further treatment that will knowingly lead to their demise without any kind of criminal against them or the patient's doctors, nurses, or caretakers.


My internet was not shut down, the internet has shut me down
10 replies: All unread, jump to last
 
User currently offlineFr8mech From United States of America, joined Sep 2005, 5599 posts, RR: 15
Reply 1, posted (6 years 12 months 1 day 14 hours ago) and read 1374 times:

I've heard them called Advanced Directives and Living Wills. In a hospital setting they may be referred to as DNR's or Do Not Resuscitate orders.


When seconds count...the police are minutes away.
User currently offlineCtbarnes From United States of America, joined Mar 2000, 3491 posts, RR: 50
Reply 2, posted (6 years 12 months 1 day 14 hours ago) and read 1359 times:

It is ethical to withdraw treatment in circumstances where the burdens of treatment (i.e. pain, suffering) outweigh any perceptable benefit, or if they are merely prolonging life with no improvement in the quality of that life, even if the decision results in death. Direct killing and allowing to die are considered two very different circumstances. In the United States, only the state of Oregon has an assisted suicide law on the books. Other states have tried and failed to enact it. AFAIK, only the Netherlands and Belgum have laws permitting euthanasia, which is the direct killing by a third party, i.e. a doctor or a nurse.

Hope this helps,

Charles, SJ



The customer isn't a moron, she is your wife -David Ogilvy
User currently offlineAndrej From United Kingdom, joined Jun 2001, 1015 posts, RR: 0
Reply 3, posted (6 years 12 months 1 day 14 hours ago) and read 1359 times:



Quoting Fr8mech (Reply 1):
I've heard them called Advanced Directives and Living Wills. In a hospital setting they may be referred to as DNR's or Do Not Resuscitate orders.

and in the State of NJ, only State DNR form is acceptable for BLS/ALS providers. There are many nursing homes that have "doctor's" DNRs and to be honest in pre-hospital setting BLS/ALS provider should disregard this directive.

State DNR must be present, with legitimate signatures and names, otherwise BLS/ALS will resuscitate. It is better be safe, and save a life.  Smile

Cheers
Andrej


User currently offlineRedngold From United States of America, joined Mar 2000, 6907 posts, RR: 44
Reply 4, posted (6 years 12 months 1 day 1 hour ago) and read 1319 times:

There is a difference between euthanasia and refusal of life-saving treatment. Euthanasia generally imples a deliberate act to end a person's life. Some people include acts that lead to a patient's death as a side effect of treatment (such as administering enough morphine to end suffering therefore causing respiratory arrest) under the term "passive euthanasia."

Some life-saving treatments are extremely invasive, such as insertion of breathing tubes and central venous access devices, CPR (invasive in the sense that it often causes broken ribs and organ bruising), and administration of medications that have severe side-effects causing loss of quality of life (chemotherapy.) Although sometimes I think that a person may be making a decision that's tantamount to suicide, I believe that a patient who is in his/her right mind should have the final say over treatment. This includes Advanced Directives and Living Wills, if the patient is in his/her right mind when signing (that's why witnesses are required.)



Up, up and away!
User currently offlineCOrocks From United States of America, joined Feb 2001, 1215 posts, RR: 0
Reply 5, posted (6 years 12 months 1 day ago) and read 1300 times:

I fully support ones right to Euthanasia as well as advanced directives. I think the issue that makes it difficult is when it is a minor (I am assuming this post started as a reaction to the story in the news today where a Jehovah's witness family refused treatment for their son with cancer and then he died. The kid said he did not want it for religious reasons - but is this just a case of brainwashing by his parents (actually a guardian in this case)? I think he was 13 or so. I think the state almost stepped in and ordered the treatment, but then decided against it as the son supposedly made a convincing case. I think these are way more difficult.

User currently offlineJAGflyer From Canada, joined Aug 2004, 3568 posts, RR: 4
Reply 6, posted (6 years 12 months 23 hours ago) and read 1289 times:

When my grandmother had a stroke and was paralyzed on her left side/unable to speak she was in the hospital for 1.5 weeks. The doctor called my dad and asked him about giving her morphine to keep her comfortable. We also knew this would help end her suffering. We chose to begin the morphine treatment, she was moved to palliative care and a few hours later she passed away. I went right from school to the hospital.

In this case the morphine was to keep her comfortable as well as help speed up her passing away. It was not given to be a "lethal dose" but it did slow down her already reduced respiration. We knew that she wouldn't have any life like this and it was better she pass on then live in a state where you cannot talk, move or eat. I was very relieved to know she was not suffering anyone.

Although not "euthanasia" morphine is used to help ease someone's suffering and allow them to pass sooner.

[Edited 2007-11-30 12:54:28]


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User currently offlineCtbarnes From United States of America, joined Mar 2000, 3491 posts, RR: 50
Reply 7, posted (6 years 12 months 4 hours ago) and read 1239 times:



Quoting JAGflyer (Reply 6):
In this case the morphine was to keep her comfortable as well as help speed up her passing away. It was not given to be a "lethal dose" but it did slow down her already reduced respiration. We knew that she wouldn't have any life like this and it was better she pass on then live in a state where you cannot talk, move or eat. I was very relieved to know she was not suffering anyone.

This is what is known in the business as terminal sedation and is used when lower doses of a pain killer such as morphene do not seem to be doing the job. In these cases the dosage mayh be increased even though it may hasted death. As long as the intent is not to bring about death but is to make someone comfortable, it is considered ethical to do so.

Charles, SJ



The customer isn't a moron, she is your wife -David Ogilvy
User currently offlineGlydrflyr From United States of America, joined Jan 2005, 207 posts, RR: 0
Reply 8, posted (6 years 11 months 4 weeks 1 day 21 hours ago) and read 1215 times:

Christian Scientists routinely refuse medical treatment that may save their lives, and just as routinely die as a result of their actions. When this happens, the others describe it as Gods' will, and go on about their lives. I'm talking about an illness that can be cured with an antibiotic or a shot or two of penicillin, but they consider that as interfering with the will of God. There is a large Christian Scientist village near Princeton, NJ, and even though there are many deaths there from refusal of medical treatment, I can not recall any actions on the part of the Sate of New Jersey to force a CS member to accept treatment.


if ya gotta crash, hit something soft and cheap!
User currently offlineMCOflyer From United States of America, joined Jun 2006, 8690 posts, RR: 16
Reply 9, posted (6 years 11 months 4 weeks 1 day 21 hours ago) and read 1209 times:



Quoting Derico (Thread starter):

Do you consider both of these circumstances to be the same, or are they fundamentally different, and what are the laws in your country on either?

In our country, the US, one can go if the parents or the patient wants too. Take the Terri Shivo case or my ex co-workers wife. She was handicapped and wanted to be taken off life support. He, the husband, did so with the consent of his wife.

Hunter



Never be afraid to stand up for who you are.
User currently offlineCtbarnes From United States of America, joined Mar 2000, 3491 posts, RR: 50
Reply 10, posted (6 years 11 months 4 weeks 1 day 21 hours ago) and read 1208 times:



Quoting Glydrflyr (Reply 8):
Christian Scientists routinely refuse medical treatment that may save their lives, and just as routinely die as a result of their actions. When this happens, the others describe it as Gods' will, and go on about their lives.

Christian scientists have a rather interesting theology that is predicated on the belief that people are spiritual beings whom have already attained perfection. For this reason, their belief is that nothing that is on or experienced on earth is real; it is merely an illusion and that their job is to learn about that perfection. Illness and death are illusions as well, and it is their belief that prayer and other techniques can help free themselves from the illusion of sickness and death.

That being said, Christian scientists are free to seek medical treatment if their conscience dictates, and doing so incurs no sanction.

Bringing this back to healthcare ethics, any competant adult can refuse treatment for any reason, provided they are informed of the risks of refusal. Children are another matter. There is significant case law which can compel parents to seek treatment that is believed to be of benefit, as children are not, under the law, legally competant to make decisions regarding consent for treatment. This includes for religious reasons.

Charles, SJ



The customer isn't a moron, she is your wife -David Ogilvy
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