8: End of Life Ethics ✅ Flashcards

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1
Q

Hippocratic Oath quote

A

“I will give no deadly medicine to any one if asked, nor suggest any such counsel”

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2
Q

Palliative care

A

“Medical care that concentrates on reducing the severity of symptoms rather trying to provide a cure or halt the progression of the disease” —HMS

“An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering” —WHO

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3
Q

Palliative care vs End-of-life care

A

Palliative is broader and can last longer

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4
Q

Euthanasia

A

Act undertaken by one person with the intention of ending the life of another person to relieve the person’s suffering

“Easy and good death”

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5
Q

Active euthanasia

A

Physician takes an active step to end the patients life

E.g. By injecting potassium chloride into the patient

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6
Q

Passive Euthanasia

A

Intentionally letting a person die by withholding artificial life support such as a ventilator or feeding tube

e.g. not giving medication or performing a surgery that would save the patients life

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7
Q

Acts regarding Active and Passive suicide

A

Mental Capacity Act (2005): states that patients with capacity can refuse life-saving treatment.

Human Rights Act (1998): protects the right to freedom from inhuman and degrading treatment and the right to private and family life.

The Suicide Act (1961): states that suicide is not unlawful.

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8
Q

Suicide

A

Act of intentionally ending ones life

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9
Q

Assisted suicide

A

Suicide undertaken with the aid of another person

Often physician-assisted suicide
-where they are helped by a medical profession

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10
Q

Voluntary Euthanasia

A

Behaviour which caused the patients death at the patients request

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11
Q

Non-Voluntary euthanasia

A

Occurs when the person is unconscious or otherwise unable to make a meaningful choice between living and dying, and an appropriate persona takes the decision on their behalf

-behaviour which causes euthanasia without the consent or objection of the patient

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12
Q

Arguments for euthanasia

A
  • Suicide is accepted
  • Autonomy
  • Beneficence
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13
Q

Arguments against euthanasia

A
  • Sanctity of life
  • Palliative care
  • Slippery slope argument
  • Killing is wrong
  • Non-maleficence
  • Physician integrity
    Protection of the vulnerable
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14
Q

Terminal sedation

A

Palliative sedation is the practise of relieving distress in terminally ill people in the last hours before they die.

Done by special catheter designed to provide comfortable and discreet administration of ongoing medication

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15
Q

Doctrine of double effect

A

The nature of the act is not bad

At least one of the acts consequences is good and one is bad

There is sufficiently serious reason for allowing the bad consequence to occur

The bad consequence is not a means for the good consequence

The agent foresees the bad consequence but intends the good consequence

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16
Q

Legality of Palliative sedation

A

Allowed in some cases

e.g. administration of painkillers

17
Q

Death tourism

A

Located in Dignitas

A cocktail of drugs that can cause death are available

18
Q

Euthanasia: DDP in favour

A

Clear settled and informed wish to die

Unequivocal and consistent about dying

Process was initiated by person who died

Terminal illness

Motivation was solely by compassion

Person offering assistance has a long-standing and supportive relationship

Assistance provided was minor

19
Q

Euthanasia: DPP against

A

Under 18

Questions about capacity

Unclear/ no clear settled an informed wish to die

Equivocal about dying

Process not initiated by person who dies

No terminal illness or severe degenerative disease

Not motivated by compassion

Evidence of persuasion, coercion or undue influence of pressure

20
Q

GMC End of Life Care: guidelines

A

(112) Clinically assisted nutrition includes intravenous feeding, and feeding by nasogastric tube and by percutaneous endoscopic gastrostomy.

(113) Providing nutrition and hydration by tube or drip may provide symptom relief or prolong or improve the quality of the patient’s life.

(114) Nutrition and hydration provided by tube or drip are regarded in law as medical treatment, and should be treated in the same way as other medical interventions.

21
Q

Key Disputes in the controversy over euthanasia

A
  1. Killing vs letting die - both end in the same outcome
  2. Ordinary vs extraordinary treatment -

3.Death intended vs anticipated