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End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices

Published online by Cambridge University Press:  29 July 2009

Timothy E. Quill
Affiliation:
Professor of Medicine and Psychiatry at the University of Rochester School of Medicine and Dentistry, The Genesee Hospital, Rochester, New York.
Gerrit Kimsma
Affiliation:
A family practitioner and philosopher who lectures on family practice medicine and medical ethics in the departments of Family and Nursing Home Medicine and Philosophy and Medical Ethics at the Free University of Amsterdam.

Extract

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

Type
Special Section: Alpha and Omega: Ethics at the Edges of Life
Copyright
Copyright © Cambridge University Press 1997

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