Autonomy and paternalism in geriatric medicine. The Jewish ethical approach to issues of feeding terminally ill patients, and to cardiopulmonary resuscitation
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 24 (1):44-48 (1998)
Respecting and encouraging autonomy in the elderly is basic to the practice of geriatrics. In this paper, we examine the practice of cardiopulmonary resuscitation (CPR) and "artificial" feeding in a geriatric unit in a general hospital subscribing to jewish orthodox religious principles, in which the sanctity of life is a fundamental ethical guideline. The literature on the administration of food and water in terminal stages of illness, including dementia, still shows division of opinion on the morality of withdrawing nutrition. We uphold the principle that as long as feeding by naso-gastric (N-G) or percutaneous endoscopic gastrostomy (PEG) does not constitute undue danger or arouse serious opposition it should be given, without causing suffering to the patient. This is part of basic care, and the doctor has no mandate to withdraw this. The question of CPR still shows much discrepancy regarding elderly patients' wishes, and doctors' opinions about its worthwhileness, although up to 10 percent survive. Our geriatric patients rarely discuss the subject, but it is openly ventilated with families who ask about it, who are then involved in the decision-making, and the decision about CPR or "do-not-resuscitate" (DNR) is based on clinical and prognostic considerations
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Y. M. Barilan (2004). Is the Clock Ticking for Terminally Ill Patients in Israel? Preliminary Comment on a Proposal for a Bill of Rights for the Terminally Ill. Journal of Medical Ethics 30 (4):353-357.
Eve Garrard & Anthony Wrigley (2009). Hope and Terminal Illness: False Hope Versus Absolute Hope. Clinical Ethics 4 (1):38-43.
Kay Norton (2011). How Music-Inspired Weeping Can Help Terminally Ill Patients. Journal of Medical Humanities 32 (3):231-243.
Bjørn Hofmann (2003). Technological Paternalism: On How Medicine has Reformed Ethics and How Technology Can Refine Moral Theory. Science and Engineering Ethics 9 (3):343-352.
Charles Weijer, Cardiopulmonary Resuscitation for Patients in a Persistent Vegetative State: Futile or Acceptable?
R. Sivakumar (2004). Communicating Information on Cardiopulmonary Resuscitation to Hospitalised Patients. Journal of Medical Ethics 30 (3):311-312.
G. E. Mead & C. J. Turnbull (1995). Cardiopulmonary Resuscitation in the Elderly: Patients' and Relatives' Views. Journal of Medical Ethics 21 (1):39-44.
Sami Alsolamy (2014). Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients. Bioethics 28 (2):96-99.
Erika Kleiderman, Denise Avard, Lee Black, Zuanel Diaz, Caroline Rousseau & Bartha Knoppers (2012). Recruiting Terminally Ill Patients Into Non-Therapeutic Oncology Studies: Views of Health Professionals. [REVIEW] BMC Medical Ethics 13 (1):33-.
M. Hilberman, J. Kutner, D. Parsons & D. J. Murphy (1997). Marginally Effective Medical Care: Ethical Analysis of Issues in Cardiopulmonary Resuscitation (CPR). Journal of Medical Ethics 23 (6):361-367.
Udo Schüklenk & Christopher Lowry (2009). Terminal Illness and Access to Phase 1 Experimental Agents, Surgeries and Devices: Reviewing the Ethical Arguments. British Medical Bulletin 89 (1):7-22.
C. Dickerman Williams (1980). The Case of Brother Fox: Immunity Procedures in the Treatment of Terminally Ill Incompetent Patients. Journal of Law, Medicine & Ethics 8 (4):11-13.
Stephan W. Sahm (2000). Palliative Care Versus Euthanasia. The German Position: The German General Medical Council's Principles for Medical Care of the Terminally Ill. Journal of Medicine and Philosophy 25 (2):195 – 219.
A. Bremer & L. Sandman (2011). Futile Cardiopulmonary Resuscitation for the Benefit of Others: An Ethical Analysis. Nursing Ethics 18 (4):495-504.
Added to index2010-09-13
Total downloads5 ( #359,105 of 1,724,888 )
Recent downloads (6 months)1 ( #349,126 of 1,724,888 )
How can I increase my downloads?