Men have been talking of death from time immemorial - sometimes sublimely in prose and poetry, in painting and sculpture and in music - till silence seemed to fall in the recent past. Now men are again talking about death - interminably but colloquially. They talk on television, on the radio, in books and in pamphlets. Dr Kenneth Boyd therefore finds it entirely timely to offer this historical sketch of attitudes to death. The earlier part of his (...) paper covers fairly familiar ground but his final and longest section on the work of a social historian, Philippe Ariès, may be new to many. Ariès is reinterpreting the long history of attitudes to death in a form which may well interest those who today are concerned with helping modern man to accept his own death - death which still, for most people, is the death of another, not of oneself. (shrink)

Ariès traces Western man's attitudes toward mortality from the early medieval conception of death as the familiar collective destiny of the human race to the modern tendency, so pronounced in industrial societies, to hide death as if it were an embarrassing family secret.

This study was an investigation of which distinctive elements would best describe good and bad death, preferences for life-sustaining treatment, and advance directives. The following elements of a good death were identified by surveying 185 acute-care hospital nurses: comfort, not being a burden to the family, a good relationship with family members, a readiness to die, and a belief in perpetuity. Comfort was regarded as the most important. Distinctive elements of a bad death were: persistent vegetative state, (...) sudden death, pain and agony, dying alone, and being a burden to the family. Of the 185 respondents, 90.8% answered that they did not intend to receive life-sustaining treatment if they suffered from a terminal illness without any chance of recovery; 77.8% revealed positive attitudes toward advance directives. Sixty-seven per cent of the respondents stated that they were willing to discuss their own death and dying; the perception of such discussions differed according to the medical condition (p = 0.001). The elements of a bad death differed significantly depending on the disease state (p = 0.003) and on economic status (p = 0.023). (shrink)

Using Bakhtin's notion of polyphony, this study explored the discussion of the end-of-life issues in the Course on Life and Death Education in one Chinese university. Ethnographic methods were adopted to investigate the collision between the classroom voices and the voices of the mainstream culture on end-of-life in the process of developing students' attitudes toward death. The findings revealed that “to understand death” involved challenging the voice of “strangeness and fear of death”; “honestly facing up to (...) and accepting the feelings of the fear, pain, and helplessness” was the response to “be brave”; and the goal “to die peacefully” resisted the notion of “extending life at any cost.” Through the collision between these voices, students developed their attitudes toward death in facing, understanding, accepting, and choosing how to die. The analysis further revealed that providing only one “answer” to death by the teacher is not sufficient or effective to foster students' attitudes toward death because the students are a diverse group holding different views on the end-of-life issues, which demonstrated the importance of creating dialogues in the life and death education. (shrink)

Background:Attitudes of nurses towards death and related concepts influence end-of-life care. Determining nurses’ views and attitudes towards these concepts and the factors that affect them are necessary to ensure quality end-of-life care.Objectives:The purpose of this study was to determine nurses’ views and attitudes about death, dying patient, euthanasia and the relationships between nurses’ characteristics.Methods:Participants consist of the nurses who volunteered to take part in this descriptive study from 25 hospitals which has a paediatric or adult intensive care unit (...) and located within the boundaries of Ankara, Turkey. ‘Nurse Information Form’ and ‘Attitude Scale about Euthanasia, Death and Dying Patients ’ were used as data collection tool.Ethical consideration:Written permissions were received from the ‘Noninterventional Clinical Researches Ethics Board’ of authors’ university and education councils of each hospital. Informed consent was obtained from participants.Findings:It is found that there are statistically significant difference among the factors of marital status, having a child, years of experience, bereavement experience, affected by working with dying patient, definition of euthanasia, views about patients who are appropriate for euthanasia, views about patients who desire to die and feeling need for counselling on these concepts according to the mean total score of nurses’ attitudes about euthanasia, death and dying patient.Conclusion:The results indicate that nurses are negatively affected to face the concepts of death, euthanasia and work with dying patient. This is reflected in their attitude. In order to gain positive attitude towards death, dying patient and euthanasia, the implementation of training and consulting services to nurses at appropriate intervals during both education and professional life are required. (shrink)

In his seminal book on the historical periods of Western attitudes toward death, Philippe Aries describes four consecutive periods through which these attitudes evolved and transformed. According to him, the historical attitudes of Western cultures have passed through four major parts described above: “Tamed Death,” One’s Own Death,” “Thy Death,” and “Forbidden Death.” This paper, after exploring this concept through the lens of Persian Poetic Wisdom, concludes that he historical attitudes of Persian-speaking people toward (...) class='Hi'>death have generally passed through two major periods. The first period is an amalgamation of Aries’ “Tamed Death” and “One’s Own Death” periods, and the second period is an amalgamation of Aries’ “Thy Death” and “Forbidden Death” periods. This paper explores the main differences and similarities of these two historical trends through a comparative review of the consecutive historical periods of attitudes toward death between the Western and Persian civilizations/cultures. Although both civilizations moved through broadly similar stages, some influential contextual factors have been very influential in shaping noteworthy differences between them. The concepts of after-death judgment and redemption/downfall dichotomy and practices like deathbed rituals and their evolution after enlightenment and modernity are almost common between the above two broad traditions. The chronology of events and some aspects of conceptual evolutions and ritualistic practices are among the differences. (shrink)

This study investigates the status quo and influencing factors of death attitudes and death anxiety among medical interns in China as measured by the Death Attitude Scale and Death Anxiety Scale following the outbreak of “Novel Coronavirus Pneumonia” in China in early 2020. Results of this study show that under the influence of COVID-19, in terms of death attitude, medical interns scored the highest in neutral acceptance and the lowest in escape acceptance. There (...) were significant differences in death attitude and anxiety among the groups with different backgrounds, including their families’ approaches to discussions of death, the number of funeral experiences, and other factors. There were two additional factors affecting attitudes that were related to the epidemic situation: whether the individual had participated in work to treat COVID-19 and whether their close friends or relatives had been diagnosed with COVID-19. The study reveals the ways that the epidemic had an impact on death attitude and death anxiety. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Unique Response to Death:Day of the Dead Fiestas and Communal Articulations of ResistanceDenise Meda-LambruIntroductionPhilosophers such as Octavio Paz and Emilio Uranga theorize death grounded in Mexican circumstances to show an intimate relational dynamic with life. In their view, death is embedded in the everydayness of the living. Carlos A. Sánchez, in "Death and the Colonial Difference," explains that the Mexican idea of death (...) reveals much about the life and the situatedness of those who subscribe to the relational dynamic between life and death. Death is linked to the living, especially for those who are situated in inferiorized positions. In the accounts promoted by Paz and by Uranga, the historical and social conditions of lived experience provide the context for how death is conceived, and, subsequently, treated. They advance Mexican conceptions of death and provide interesting perspectives into how some colonized peoples are resisting narrow narratives of death. This is to say that their approaches do not grant the dominant assumption that death is merely a biological event or a life event ceasing the life of the individual. In this essay, I examine their critiques of dominant assumptions of death to elaborate on conceptions of death contextualized within historical and social entanglements, namely, a Mexican analysis of death. In particular, I utilize Paz's work on Day of the Dead fiestas to study communal practices and theorize the ritual dimensions of the life and death relationship. Through an examination of a Mexican approach to death, I contend that rituals of death help locate the non-dominant social logics that engender resistant activity and cultivate a distinct interconnected communal relation.To develop this position, I clarify the historical and social distinctions between Mexican and Anglo-American approaches to death and analyze literature promoting a Mexican view of death. Ultimately, I share a similar view [End Page 31] with Paz, Uranga, and Sánchez who charge that there is a unique Mexican idea of death. However, to be clear, my interest in their work does not assume they represent the Mexican view of death (Brandes, Skulls to the Living). Rather, I am interested in exploring how their discussions of death, from a particular socio-historical situation, reveal ways in which colonized peoples refuse dichotomous narratives of death. Sánchez's work, in particular, provides valuable insights into the Mexican relation with death, particularly the role of coloniality/modernity with temporality. Lastly, as I return to Paz's own discussion of death, I refer to the sensibilities and practices relevant to the resistant dimensions of a Mexican relationship with death. An analysis of Paz's focus on fiestas offers a focus distinct from Sánchez in that it pays significant attention to the ritual dimensions of death and helps illustrate the resistant responses to hegemonic social norms. Thus, paying attention to communal practices, this essay emphasizes the relationship between death rituals and deviant activity to dominant modes of being.What Is Death? Examining the DistinctionsScholars have noted a distinction between the logics involved in European and Anglo-American approaches to death and those of Mexican people. Emilio Uranga asserts that "[f]or the North American (el norteamericano), death is a reality that must be hidden, a phenomenon that is silenced and masked as much as possible so that it will not disturb, with its impertinence, the flow of a life that unfolds in radical dedication to [self]-realization and work" (qtd. in Sánchez 180). Paz shares a similar view of this concealment. He writes that "the word death is not pronounced in New York, in Paris, in London, because it burns the lips" ("Day of the Dead" 57). Paz describes death for the Euro-Anglo as one that is treated as a stinging topic to be avoided. In both Uranga's view and Paz's view, the Euro-Anglo phenomenon of death is not socially discussed or regarded as part of the daily lived realities of the subject. If we take their accounts as at least generally accurate, then for Anglos, death is something that is to be treated as separate from life.1In distinction, however, the Mexican attitude toward death is described as... (shrink)

This article provides an overview of the scarce international literature concerning nurses’ attitudes to euthanasia. Studies show large differences with respect to the percentage of nurses who are in favour of euthanasia. Characteristics such as age, religion and nursing specialty have a significant influence on a nurse’s opinion. The arguments for euthanasia have to do with quality of life, respect for autonomy and dissatisfaction with the current situation. Arguments against euthanasia are the right to a good death, belief in (...) the possibilities offered by palliative care, religious objections and the fear of abuse. Nurses mention the need for more palliative care training, their difficulties in taking a specific position, and their desire to express their ideas about euthanasia. There is a need to include nurses’ voices in the end-of-life discourse because they offer a contextual understanding of euthanasia and requests to die, which is borne out of real experience with people facing death. (shrink)

This article provides an overview of the scarce international literature concerning nurses’ attitudes to euthanasia. Studies show large differences with respect to the percentage of nurses who are (not) in favour of euthanasia. Characteristics such as age, religion and nursing specialty have a significant influence on a nurse’s opinion. The arguments for euthanasia have to do with quality of life, respect for autonomy and dissatisfaction with the current situation. Arguments against euthanasia are the right to a good death, belief (...) in the possibilities offered by palliative care, religious objections and the fear of abuse. Nurses mention the need for more palliative care training, their difficulties in taking a specific position, and their desire to express their ideas about euthanasia. There is a need to include nurses’ voices in the end-of-life discourse because they offer a contextual understanding of euthanasia and requests to die, which is borne out of real experience with people facing death. (shrink)

ABSTRACTThe remarkable philosophical present-day turn to Paul pays a lot of attention to the particular role played by the famous distinctions that structure Paul’s rhetoric such as the distinction between faith and law, life and death, and spirit and flesh. These distinctions lead to the question of whether Paul endorses a dualism or not. In this essay, the author investigates Badiou’s and Agamben’s readings of Paul and asks whether one cannot find a form of dialectics rather than dualism in (...) these readings. The concept of the exception seems to corroborate this suggestion. To examine whether this suggestion makes sense, the author first discusses Badiou’s focus on the antidialectics of death and resurrection as well as the dialectical remnants in Badiou’s reading of Paul. Subsequently, the author analyses Agamben’s dialectical account of the Pauline terms katargein, chrēsis and charis. (shrink)

In this short study, I attempt to reconstruct the main conceptual components of Edmund Husserl’s concept of death following the leading clue of his late transcendental phenomenological methodology. First, I summarise his thoughts on death, from the point of view of “the natural attitude”, as an event in the world. Then, I try and explore the manifold senses of the limit phenomenon of death as a multidimensional transcendental phenomenological problem in all of its intersubjective-world constitutive, personal-primordial, (...) and metaphysical-constructive layers of meanings, respectively. By doing so, I also hope that the path we travel can serve the reader as an opportunity for a personal and reflective confrontation with death. (shrink)

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making.Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large (...) life-stance groups in each country.Results: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten the patient’s death , physicians with specific religious affiliations had significantly less accepting attitudes, and less willingness to perform it, than non-religious physicians. They had also actually performed PAD less often. However, in most countries, both Catholics and Protestants reported ever having made such a decision.Discussion: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients and circumstances. Physicians seem to embrace religious belief in a non-imperative way, allowing adaptation to particular situations. (shrink)

: Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD (...) telephone survey was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: "brain dead," in a coma, or in a persistent vegetative state (PVS). Respondents provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. More than 98 percent of respondents had heard of the term "brain death," but only one-third (33.7%) believed that someone who was "brain dead" was legally dead. The majority of respondents (86.2%) identified the "brain-dead" patient in the first scenario as dead, 57.2 percent identified the patient in a coma as dead (Scenario 2), and 34.1 percent identified the patient in a PVS as dead (Scenario 3). Nearly one-third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed, or held beliefs that were not congruent with current definitions of "brain death." This study highlights the need for more public dialogue and education about "brain death" and organ donation. (shrink)

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were (...) recruited. 80% emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction. (shrink)

This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual face-to-face interviews. Our study has two main findings: (1) (...) In the context of organ procurement, HPs believe that BD is a more reliable standard for determining death than circulatory death, and (2) While the vast majority of HPs consider it morally acceptable to retrieve organs from brain-dead donors, retrieving organs from DCD patients is much more controversial. We offer the following possible explanations. DCD introduces new conditions that deviate from standard medical practice, allow procurement of organs when donors’ loss of circulatory function could be reversed, and raises questions about “death” as a unified concept. Our results suggest that, for many HPs, these concerns seem related in part to the fact that a rigorous brain examination is neither clinically performed nor legally required in DCD. Their discomfort could also come from a belief that irreversible loss of circulatory function has not been adequately demonstrated. If DCD protocols are to achieve their full potential for increasing organ supply, the sources of HPs’ discomfort must be further identified and addressed. (shrink)

The aim of this book, by providing a set of conceptual tools drawn from critical theory, is to open up questions and new problems and new research agendas for the study of environmental politics.

Context Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. Objective To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of (...) physicians practising at Japanese teaching hospitals. Design, setting and participants We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Results Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (p<0.0001). Currently in Japan the debate about the role autopsy should play in the case of error related to death is underway. The results from this study will be important in informing related decisions. (shrink)

Introduction Context: In Portugal assisted death was approved in February 2020 by the Parliament, although the law is not yet in force. Objectives To find out what doctors think about those practices. Methods A link to a questionnaire was sent by email three times, at intervals of one week, to the doctors registered in the Northern Section of the Portuguese Medical Association, before the Parliamentary approval. Results The questionnaire was returned by 1148 physicians. A minority of doctors would practice (...) a form of assisted death under the present law or if it was legalized, but a higher percentage think that euthanasia should be legalized, and more would like to have that option if they themselves were in a terminal phase of a disease. Religion has a strong influence on the attitudes of doctors, so too does their contact with patients in a terminal phase, as doctors who deal with more patients with far advanced diseases are more likely to be unfavorable to assisted death. On the other hand, younger doctors are more in favor of these practices. Conclusion The small percentage of questionnaires sent back is a weakness in this study and casts doubts on the generalizability of the conclusions. However, this is, so far, the best approximation to the opinions of Portuguese doctors on assisted death. (shrink)

The Navarre-Venezuelan philosopher Juan David García Bacca is one of the most notable and original figures of Spanish-speaking thought, although his work has not yet received the attention it deserves. One of the pillars of his philosophy consists of what he calls a transfinite anthropology that considers man as an entity that strives to enhance his being. This anthropological approach is based on a phenomenology of nature that emphasizes the becoming and the transformations that man effects in the world. In (...) this philosophical context, García Bacca soon became interested in the work of Husserl, Scheler y Heidegger. This article deals with the way in which García Bacca describes and values Husserl’s descriptions of intentional consciousness. The problem that García Bacca poses to transcendental phenomenology concerns neither the reality of pure consciousness nor its objective scope. García Bacca is interested in finding out if there is a potentiation of the being of consciousness superior to or deeper than the self-reflection proper to the transcendental attitude. He discovers this potentiation in the notion of an “agonic consciousness” that resists the representation of its annihilation, and whose philosophical antecedent is found in the work of Miguel de Unamuno. Without sharing all of García Bacca’s interpretation of Husserlian phenomenology, the author of the article considers that it nevertheless raises relevant questions concerning the facticity and necessity proper to the transcendental subject. (shrink)

A challenge of performing research in the paediatric emergency and acute care setting is obtaining valid prospective informed consent from parents. The ethical issues are complex, and it is important to consider the perspective of participants, health care workers and researchers on research without prospective informed consent while planning this type of research. We performed a systematic review according to PRISMA guidelines, of empirical evidence relating to the process, experiences and acceptability of alternatives to prospective informed consent, in the paediatric (...) emergency or acute care setting. Major medical databases and grey sources were searched and results were screened and assessed against eligibility criteria by 2 authors, and full text articles of relevant studies obtained. Data were extracted onto data collection forms and imported into data management software for analysis. Thirteen studies were included in the review consisting of nine full text articles and four abstracts. Given the heterogeneity of the methods, results could not be quantitatively combined for meta-analysis, and qualitative results are presented in narrative form, according to themes identified from the data. Major themes include capacity of parents to provide informed consent, feasibility of informed consent, support for alternatives to informed consent, process issues, modified consent process, child death, and community consultation. Our review demonstrated that children, their families, and health care staff recognise the requirement for research without prior consent, and are generally supportive of enrolling children in such research with the provisions of limiting risk, and informing parents as soon as possible. Australian data and perspectives of children are lacking and represent important knowledge gaps. (shrink)

Deprivationism cannot accommodate the common sense assumption that we should lament our death iff, and to the extent that, it is bad for us. Call this the Nothing Bad, Nothing to Lament Assumption. As such, either this assumption needs to be rejected or deprivationism does. I first argue that the Nothing Bad, Nothing to Lament Assumption is false. I then attempt to figure out which facts our attitudes concerning death should track. I suggest that each person should have (...) two distinct attitudes toward death: one determined by agent’s reasonable expectations about when she will die and one determined by the amount of metaphysically possible good one reasonably believes death precludes. (shrink)

Background Doctors often deal with end-of-life issues other than assisted death, such as incompetent patients and treatment withdrawal, including food and fluids. Methods A link to a questionnaire was sent by email three times, at one-week intervals, to the doctors registered in the Northern Section of the Portuguese Medical Association. Results The questionnaire was returned by 1148 (9%) physicians. This study shows that only a minority of Portuguese doctors were willing to administer drugs in lethal doses to cognitively incompetent (...) patients at the request of a family member or other close person, and even less would do it on their initiative. Most doctors favored the withdrawal of life support measures in advanced and progressive diseases at the patient’s request. Still, much fewer doctors agreed with the suspension of supportive life measures at the request of a family member, another close person, or by their own unilateral decision. However, fewer agreed with that action concerning the rest of the food and fluids. Portuguese doctors favor the administration of drugs for suffering control, even foreseeing they could shorten life. Conclusion Most doctors in this study respect patients’ autonomy but disagree with measures decided by others that have an impact on patients’ survival. They also agree with the administration of drugs for suffering control, even considering the possibility of shortening life. (shrink)

In this book, C. G. Prado addresses the difficult question of when and whether it is rational to end one's life in order to escape devastating terminal illness. He specifically considers this question in light of the impact of multiculturalism on perceptions and judgements about what is right and wrong, permissible and impermissible. Prado introduces the idea of a 'coincidental culture' to clarify the variety of values and commitments that influence decision. He also introduces the idea of a 'proxy premise' (...) to deal with reasoning issues that are raised by intractably held beliefs. Primarily intended for medical ethicists, this book will be of interest to anyone concerned about the ability of modern medicine to keep people alive, thereby forcing people to choose between living and dying. In addition, Prado calls upon medical ethicists and practitioners to appreciate the value of a theoretical basis for their work. (shrink)

According to John Martin Fischer and Anthony Brueckner’s unique version of the deprivation approach to accounting for death’s badness, it is rational for us to have asymmetric attitudes toward prenatal and posthumous nonexistence. In previous work, I have defended this approach against a criticism raised by Jens Johansson by attempting to show that Johansson’s criticism relies on an example that is incoherent. Recently, Duncan Purves has argued that my defense reveals an incoherence not only in Johansson’s example but also (...) in Fischer and Brueckner’s approach itself. Here I argue that by paying special attention to a certain feature of Fischer and Brueckner’s approach, we can dispense of not only Johansson’s criticism but also of Purves’s objection to Fischer and Brueckner’s approach. (shrink)

BackgroundFollowing the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon.MethodsThis study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling (...) to Switzerland for aid-in-dying.ResultsSeven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment.ConclusionThe desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration. (shrink)

This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient. The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships (...) between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK. Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved. (shrink)

The ethics of hastened death are complex. Studies on physicians’ opinions about assisted dying exist, but changes in physicians’ attitudes towards hastened death in clinical decision-making and the background factors explaining this remain unclear. The aim of this study was to explore the changes in these attitudes among Finnish physicians. A questionnaire including hypothetical patient scenarios was sent to 1182 and 1258 Finnish physicians in 1999 and 2015, respectively. Two scenarios of patients with advanced cancer were presented: one (...) requesting an increase in his morphine dose to a potentially lethal level and another suffering a cardiac arrest. Physicians’ attitudes towards assisted death, life values and other background factors were queried as well. The response rate was 56%. The morphine dose was increased by 25% and 34% of the physicians in 1999 and 2015, respectively. Oncologists approved the increase most infrequently without a significant change between the study years. Oncological specialty, faith in God, female gender and younger age were independent factors associated with the reluctance to increase the morphine dose. Euthanasia, but not assisted suicide, was considered less reprehensible in 2015. In both years, most physicians withheld cardiopulmonary resuscitation. Finnish physicians accepted the risk of hastening death more often in 2015 than in 1999. The physicians’ specialty and many other background factors influenced this acceptance. They also regarded euthanasia as less reprehensible now than they did 16 years ago. (shrink)

Abstract Scientific advances have made the end of life into the primary concern of medicine. But medicine also postpones the end of life, often until the time when we no longer have the mental and physical capacity to deal with it. I argue that we need to develop Nietzsche's idea of timely death, in order to find a moral basis for health care at the end of life, and that the crucial factor is the cultivation of the virtues that (...) would enable us to live in another and more reckless way. We should look on the problem not from the first-person point of view, but from the perspective of the other, and ask ourselves what is most admirable in another person, in his or her attitude to death. The point of timely death is to make death into the completion of life, where life is understood as a moral rather than a biological idea. (shrink)

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate and (...) logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

This article presents the first results of a study of the decisions made by health professionals in South Australia concerning the management of death, dying, and euthanasia, and focuses on the findings concerning the attitudes and practices of medical practitioners. Mail-back, self-administered questionnaires were posted in August 1991 to a ten per cent sample of 494 medical practitioners in South Australia randomly selected from the list published by the Medical Board of South Australia. A total response rate of 68 (...) per cent was obtained, 60 per cent of which (298) were usable returns. It was found that forty-seven per cent had received requests from patients to hasten their deaths. Nineteen per cent had taken active steps which had brought about the death of a patient. Sixty-eight per cent thought that guidelines for withholding and withdrawal of treatment should be established. Forty-five per cent were in favour of legalisation of active euthanasia under certain circumstances. (shrink)

This study, based on terror management theory from social psychology, examines how the thought of death affects journalism students' views toward relativism, idealism, and unethical journalistic behavior. College journalism students participated in an experiment where half were primed to think about death and the other half, the control group, thought about dental pain. Then, all of them completed a questionnaire measuring their attitudes toward ethics. Results showed that although those in the death group were no more fearful, (...) they were less relativistic and more strongly opposed to socially undesirable behavior by journalists, such as lying, publishing the names of rape victims, and reporting a public official's sexual affair. Implications for ethics research and journalists are discussed. (shrink)

This article responds to Ben Bradley, Sean McAleer, and Connie Rosati’s criticisms of The Solace. Broadly, the themes touched on include the sense of narrative value at work in the book; what attitudes we should have towards positive value, including especially narrative value; whether good opportunities are themselves good for us; how we should value extrinsic but final goodness like the positive value that death draws from life; and what kinds of questions about death are worth asking.

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedThe Ahmadis: Community, Gender, and Politics in a Muslim Society. By Antonio Gualtieri. Montreal and Kingston: McGill-Queen's University Press, 2004. Pp. xvi + 192. Hardcover $65.00. Paper Cdn $24.95 / U.S. $19.95.American Knees. By Shawn Wong. Seattle and London: University of Washington Press, 2005. Pp. xxi + 229. Paper $14.95.The Art of Worldly Wisdom. By Baltasar Gracian and translated by Joseph Jacobs. Mineola, NY: Dover Publications, 2005. Pp. (...) xiii + 114. Paper $5.95.Bashō's Journey: The Literary Prose of Matsuo Bashō. Translated by David Landis Barnhill. Albany: State University of New York Press, 2005. Pp. xvii + 191. Hardcover $59.50. Paper $17.95.Bringing the Gods to Mind: Mantra and Ritual in Early Indian Sacrifice. By Laurie L. Patton. Berkeley: University of California Press, 2005. Pp. xv + 289. Hardcover $49.95/£32.50.Buddhist Inclusivism: Attitudes Towards Religious Others. By Kristin Beise Kiblinger. Burlington, VT: Ashgate Publishing Company, 2005. Pp. viii + 145. Hardcover $89.95.A Chinese Ethics for the New Century: The Ch'ien Mu Lectures in History and Culture, and Other Essays on Science and Confucian Ethics. By Donald J. Munro. Hong Kong: Chinese University Press, 2005. Pp. xlv + 158. Hardcover $33.00.Chinese Theories of Reading and Writing: A Route to Hermeneutics and Open Poetics. By Ming Dong Gu. Albany: State University of New York Press, 2005. Pp. xiv + 334. Hardcover $85.00.A Dictionary of Cantonese Slang: The Language of Hong Kong Movies, Street Gangs, and City Life. By Christopher Hutton and Kingsley Bolton. Honolulu: University of Hawai'i Press, 2005. Pp. xxiv + 492. Paper $28.00.Ghazālī and the Poetics of Imagination. By Ebrahim Moosa. Chapel Hill and London: University of North Carolina Press, 2005. Pp. xiii + 349. Hardcover $59.95. Paper $22.50.Going Forth: Visions of Buddhist Vinaya. Edited by William M. Bodiford. Honolulu: University of Hawai'i Press, 2005. Pp. x + 317. Hardcover $48.00.The Harem: Inside the Grand Seraglio of the Turkish Sultans. By N. M. Penzer. Mineola, NY: Dover Publications, 2005. Pp. 277. Paper $14.95.Ideals of the East: The Spirit of Japanese Art. By Kakuzo Okakura. Mineola, NY: Dover Publications, 2005. Pp. xiv + 106. Paper $5.95. [End Page 365]An Illustrated Chinese Materia Medica. By Jing-Nuan Wu. New York: Oxford University Press, 2005. Pp. 706. Price not given.Jews and Arabs: A Concise History of Their Social and Cultural Relations. By S. D. Goitein. Mineola, NY: Dover Publications, 2005. Pp. xv + 263. Paper $12.95.The Logic of Nothingness: A Study of Nishida Kitarō. By Robert J. J. Wargo. Honolulu: University of Hawai'i Press, 2005. Pp xi + 241. Paper $25.00.The Moral and Political Thought of Mahatma Gandhi. By Raghavan N. Iyer. New Delhi: Oxford University Press, 2000. Pp. xiii + 449. Paper Rs 520.00.Nietzsche's Epic of the Soul: Thus Spoke Zarathustra. By T. K. Seung. Lanham, MD: Lexington Books, 2005. Pp. xxviii + 370. Hardcover $83.00. Paper $27.95.Of Guilds, Companies, Corporations, and Governance: A Conceptual Sketch. By Leonardo R. Silos. Makati City, Philippines: Asian Institute of Management, 2005. Pp. xvi + 238. Price not given.The Path to Rome. By Hilaire Belloc. Mineola, NY: Dover Publications, 2005. Pp. ix + 251. Paper $12.95.The Philosophy of the Bhagavadgātā : A Study based on the Evaluation of the Commentaries of Śamkara, Rāmānuja and Madhva. By S. M. Srinivasa Chari. New Delhi: Munshiram Manoharlal Publishers, 2005. Pp. xxvi + 294. Hardcover Rs 575.00.The Philosophy of Rabindranath Tagore. By Kalyan Sen Gupta. Burlington, VT: Ash-gate Publishing Company, 2005. Pp. ix + 103. Hardcover $79.95.The Pristine Dao: Metaphysics in Early Daoist Discourse. By Thomas Michael. Albany: State University of New York Press, 2005. Pp. xi + 170. Hardcover $60.00. Paper $21.95.Three Mountains and Seven Rivers: Prof. Musashi Tachikawa's Felicitation Volume. Edited by Shoun Hino and Toshihiro Wada. Delhi: Motilal Banarsidass Publishers. 2004. Pp. xx + 903. Hardcover Rs. 1800.The Unity of Mystical Traditions: The Transformation of Consciousness in Tibetan and German Mysticism. By Randall Studstill. Leiden and Boston: Brill, 2005. Pp. xii + 304. Hardcover @89/$127.00.Writing the World: On Globalization. Edited by David... (shrink)

Faith healing deaths occur infrequently in Canada, but when they do they pose a considerable challenge for criminal justice. Similar to caregivers who absent-mindedly and fatally forget a child in a hot vehicle, faith healers do not intentionally harm their children. It can seem legally excessive and unjust to prosecute achingly bereaved parents. But unlike ‘hot-car’ deaths, faith healing parents are not absent minded in the deaths they cause. Rather, significant deliberation and strength of will is necessary to treat their (...) child’s ailment with faith alone. Two different Criminal Code provisions can be brought to bear upon these deaths, namely, s. 215 ‘Failing to provide the necessaries of life’ and s. 219 ‘Criminal negligence’. From a public, medical, and scientific perspective treating potentially fatal ailments with ‘faith’ and ‘prayer’ seems like reckless endangerment, giving apparent justification to the more serious criminal negligence charge. But, the fault element in the criminal negligence offence continues to be a vexing issue in Canadian jurisprudence. People accused of negligence-based offences are commonly held to the standard of what a reasonable person might predictably have done in similar circumstances. While it is unnecessary for the impartial trier of fact to conceive of faith healing as ‘reasonable’, it is an open question whether faith healers are sufficiently unreasonable to warrant serious criminal condemnation and possible incarceration when their course of action causes death. Is it justifiable to think of faith healers who cause death as criminally unreasonable? That is, do they depart markedly enough from the standard that criminal negligence is rightly attributed to them? Public attitudes toward religion, religious fundamentalism, and healthcare must be considered when trying to discern what a reasonable person does when treating an ailing child at risk of death. (shrink)

Herbert, Dilinie As part of the Inquiry into End of Life Choices, commissioned by the Victorian State Government on 7 May 2015, members of the community were invited to share their attitudes towards assisted dying by written submissions. The Inquiry also hosted a panel discussion with a few selected respondents. The final report prepared by the Inquiry is a comprehensive document that identified common themes relating to the benefits and concerns about a possible assisted dying framework. Some respondents used the (...) opportunity to advocate in favour of palliative care services and advance care planning. There were other respondents that were apprehensive about possible changes to the law and wary that it could incite permissible practices of assisted death in Victoria which are in contradiction to existing ethical beliefs, values and norms. Their anxiety was in relation to a potential slippery slope effect of these laws in the future. In this article I will explore how the slippery slope effect has been used to criticise euthanasia legislation, using data from the Netherlands. Although there are indications that the slippery slope is apparent in the Netherlands, there are also contrary indications that are otherwise open for interpretation. I propose that the Inquiry was a valuable opportunity to reflect on community attitudes towards assisted death and that the recommendations to better resource palliative care services, is a positive outcome. (shrink)

In this paper, I am concerned with elucidating and expanding our attitudes toward our own death. As it is, our common attitudes toward our death are the following: we fear our premature death, and we dread our inevitable death. These attitudes are rational, but I want to argue that our attitudes toward death should be more complicated than this. A condition upon our value, our preciousness, as creatures is that we are vulnerable, and our vulnerability (...) is, at bottom, a vulnerability to death. A corollary of this is that we could not be loved, either by ourselves or by others, for one cannot love—be concerned for—a being invulnerable to death. As a consequence, death plays a deep and abiding role in our value systems. Our susceptibility to premature and inevitable death is a condition upon our being valuable creatures and, in turn, it is a condition upon our being loved. Given the high value that we place on being valuable creatures who deserve love, we should equally place a high value on the const.. (shrink)

In a recent article, I criticized Anthony L. Brueckner and John Martin Fischer’s influential argument—appealing to the rationality of our asymmetric attitudes towards past and future pleasures—against the Lucretian claim that death and prenatal non-existence are relevantly similar. Brueckner and Fischer have replied, however, that my critique involves an unjustified shift in temporal perspectives. In this paper, I respond to this charge and also argue that even if it were correct, it would fail to defend Brueckner and Fischer’s proposal (...) against my critique. (shrink)

Volume 19, Issue 12, December 2019, Page 44-45.

In previous work we have presented a reply to the Lucretian Symmetry, which has it that it is rational to have symmetric attitudes toward prenatal and posthumous nonexistence. Our reply relies on Parfit-style thought-experiments. Here we reply to a critique of our approach by Huiyuhl Yi, which appears in this journal: Brueckner and Fischer on the evil of death. We argue that this critique fails to attend to the specific nature of the thought-experiments (and our associated argument). More specifically, (...) the thought-experiments seek to elicit attitudes about (say) past pleasures per se, and not insofar as such pleasures are connected to more pleasures in the future or a greater total amount of pleasures in one’s life overall. (shrink)

_Existential and Spiritual Issues in Death Attitudes_ provides: an in-depth examination of death attitudes, existentialism, and spirituality and their relationships; a review of the major theoretical models; clinical applications of these models to issues such as infertility, bereavement, anxiety, and suicide; and an introduction to meaning management theory and how it can be applied to grief counseling. In this new volume, death is treated both as a threat to meaning and as an opportunity to create meaning. The (...) first section introduces theory and methodology to connect the latest empirical research on death attitudes to the philosophical/psychological existential and spirituality literature. Part II presents the latest empirical research on subjects such as end-of-life decisions and living with HIV. The final section considers therapeutic applications to issues including suicide, infertility, bereavement, and anxiety. The concluding chapter highlights the book’s common themes and provides questions to encourage further investigation of the most critical topics. Psychologists, counselors, social workers, physicians, nurses, and religious leaders, as well as academics in the fields of psychology, gerontology, philosophy, religion, counseling, social work, sociology, and medicine will value this new resource. Main points summarize important ideas of each chapter, making it an appropriate text in courses on death and dying and/or and spirituality. Its clinical applications will appeal to practicing professionals. (shrink)

The aim of this article is to generate knowledge about parents’ participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents’ attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the interview. (...) The comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents’ child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants’ future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented. (shrink)

Global Justice: The Basics is a straightforward and engaging introduction to the theoretical study and practice of global justice. It examines the key political themes and philosophical debates at the heart of the subject, providing a clear outline of the field and exploring: the history of its development the current state of play its ongoing interdisciplinary development. Using case studies from around the world which illustrate the importance of the debates at the heart of global justice, as well as activist (...) campaigns for global justice, the book examines a wide range of theoretical debates from thinkers worldwide making it ideal for those seeking a balanced introduction to global justice. (shrink)