Physician-Assisted Death Scanning the Landscape: Proceedings of a Workshop (2018) / Chapter Skim
Currently Skimming:
4 Experiences with and Reflections on Physician-Assisted Death Internationally
4 Experiences with and Reflections on Physician-Assisted Death Internationally
Pages 65-74
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 65... ...
• Data from the Netherlands show that physicians are reluc tant to grant euthanasia requests from psychiatric patients. (Onwuteaka-Philipsen)
|
From page 66... ...
As Bregje Onwuteaka-Philipsen, a professor of end-of-life research at the Vrije University Medical Center and the Amsterdam Public Health Research Institute, explained, if something goes wrong after self-administration, the physician is then expected to perform euthanasia to complete the process. She also said that in the Netherlands there would be concern about the potential abuse of a prescription if a physician was not present to deliver the lethal medication at the time of death.
|
From page 67... ...
OnwuteakaPhilipsen said that the Dutch government has commissioned a nationwide evaluation study every 5 years since 1990, the first three of which led to changes in the regulation procedure and eventually to the Dutch law in 2002 regarding euthanasia. These studies consist of a death certificate analysis in which a questionnaire is sent to the attending physician of a stratified sample of deaths as well as a survey among a stratified sample of physicians in order to study trends in end-of-life decisions.
|
From page 68... ...
SOURCES: Onwuteaka-Philipsen presentation, February 13, 2018. Data from van der Heide et al., 2017.
|
From page 69... ...
Furthermore, Onwuteaka-Philipsen said, a survey of the Dutch public and Dutch physicians revealed how reluctant physicians are to grant a request for euthanasia or physician-assisted suicide for a patient with a psychiatric diagnosis. While 80 percent of the physicians said it was conceivable they would grant such a request from a cancer patient, only 37 percent said it was conceivable to ever grant a request from a p sychiatric patient.
|
From page 70... ...
Frances Norwood Assistant Research Professor of Anthropology George Washington University When Frances Norwood, an assistant research professor of anthropology at George Washington University, began studying euthanasia and end-of-life care, she went to the Netherlands. Norwood explained that what she discovered through her research in the Netherlands was not what she expected.
|
From page 71... ...
The three main reasons she found for people not ultimately choosing euthanasia were that a family member was not ready, the person changed his or her mind over time, or the patient never restarted the process after the physician stalled on the initial request for assisted death. In practice, Norwood said, patients get activated by the process and begin talking about what matters most to them.
|
From page 72... ...
Norwood replied that Dutch practitioners generally are very involved with the families of patients from the beginning, but once a request for euthanasia is made, it gives practitioners more power to initiate difficult discussions. THE CANADIAN EXPERIENCE Jennifer Gibson Sun Life Financial Chair in Bioethics University of Toronto Jennifer Gibson, the Sun Life Financial Chair in Bioethics and the director of the University of Toronto Joint Centre for Bioethics, agreed with Norwood on the importance of cultural and historical context.
|
From page 73... ...
The law permits both clinician- and selfadministration for a person over age 18 who is capable of making his or her own decisions related to health and who is legally eligible for health care in Canada. In addition, the individual must have a "grievous and irremediable" medical condition, must make a voluntary request that is not the result of external pressure, and must be informed of all available alternative options for his or her care.
|
From page 74... ...
Gibson said that in his opinion, the Canadian law attempts to balance a respect for individual autonomy and suffering with protection for the vulnerable. Since the law was passed, less than 1 percent of Canadian deaths have resulted from medically assisted death, with more than 99 percent of those deaths being clinician administered.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.