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Enforced death: enforced life.

G Fairbairn1

  • 1North East Wales Institute of Higher Education, Cartrefle, Wrexham.

Journal of Medical Ethics
|September 1, 1991
PubMed
Summary

Quality of life considerations are inconsistently applied, leading to ethical dilemmas in end-of-life care and the treatment of disabled infants. This disparity results in differing outcomes for patients based on their life stage and perceived quality of life.

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Area of Science:

  • Bioethics
  • Medical Ethics
  • Philosophy of Medicine

Background:

  • The concept of 'quality of life' is central to ethical debates concerning patient care at life's beginning and end.
  • A critical analysis reveals a significant disjunction in how 'quality of life' is applied in these distinct contexts.
  • This inconsistency raises profound ethical questions about medical decision-making and patient autonomy.

Purpose of the Study:

  • To examine the divergent application of 'quality of life' criteria in neonatal intensive care versus end-of-life care for adults.
  • To highlight the ethical implications of using 'quality of life' to justify non-treatment or hastened death for disabled infants.
  • To analyze the ethical paradox where quality of life arguments are dismissed for terminally ill adults seeking hastened death.

Main Methods:

  • Conceptual analysis of ethical frameworks surrounding 'quality of life'.
  • Comparative review of case studies and ethical guidelines for neonatal and adult end-of-life care.
  • Philosophical argumentation on the consistency and justification of ethical principles.

Main Results:

  • 'Quality of life' is used to justify withholding or withdrawing life-sustaining treatment for disabled newborns, often deeming them 'better off dead'.
  • Conversely, for terminally ill adults who wish to die due to poor quality of life, this principle is frequently disregarded, leading to enforced life.
  • This creates a stark ethical inconsistency in medical practice regarding patient autonomy and the value of life.

Conclusions:

  • The application of 'quality of life' is ethically inconsistent, leading to discriminatory practices based on age and disability.
  • A re-evaluation of ethical principles is necessary to ensure consistent and just treatment for all patients, regardless of their stage of life or perceived quality of life.
  • Ethical frameworks must be revised to uphold patient autonomy and the inherent value of life for all individuals.
Keywords:
Death and Euthanasia

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