David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Journal of Law, Medicine and Ethics 40 (1):57-65 (2012)
Palliative care and hospice should be the standards of care for all terminally ill patients. The first place for clinicians to go when responding to a request for assisted death is to ensure the adequacy of palliative interventions. Although such interventions are generally effective, a small percentage of patients will suffer intolerably despite receiving state-of-the-art palliative care, and a few of these patients will request a physician-assisted death. Five potential “last resort” interventions are available under these circumstances: (1) accelerating opioids for pain or dyspnea; (2) stopping potentially life-prolonging therapies; (3) voluntarily stopping eating and drinking; (4) palliative sedation (potentially to unconsciousness); and (5) physician-assisted death. Patient, family, and clinicians should search for the least harmful way to respond to intolerable end-of-life suffering in ways that are effective and also respect the values of the major participants. A system that allows an open response to such cases ultimately protects patients by ensuring a full clinical evaluation and search for alternative responses, while reinforcing the need to be responsive and to not abandon
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References found in this work BETA
Eric J. Cassell (2004). The Nature of Suffering and the Goals of Medicine. Oxford University Press.
Susan W. Tolle, Virginia P. Tilden, Linda L. Drach, Erik K. Fromme, Nancy A. Perrin & Katrina Hedberg (2004). Characteristics and Proportion of Dying Oregonians Who Personally Consider Physician-Assisted Suicide. Journal of Clinical Ethics 15:111-118.
Citations of this work BETA
Robert M. Sade (2012). INTRODUCTION: The Graying of America: Challenges and Controversies. Journal of Law, Medicine and Ethics 40 (1):6-9.
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