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Drawing the line on physician-assisted death
Lynn A Jansen1, Steven Wall2, Franklin G Miller3
1The Center for Ethics in Health Care, Oregon Health & Science University, Portland, Oregon, USA.
Journal of Medical Ethics
|November 23, 2018
Summary
Physician-assisted death (PAD) should be restricted to the terminally ill. Arguments from fairness-based paternalism and the social meaning of medicine support limiting PAD, especially for non-terminally ill patients.
Area of Science:
- Medical Ethics
- Bioethics
- Legal Medicine
Background:
- Physician-assisted death (PAD) is a growing medical practice with expanding legal acceptance.
- Determining the appropriate scope of PAD is a pressing ethical and legal challenge.
- Current debates involve PAD for both terminally ill and non-terminally ill patient groups.
Purpose of the Study:
- To present an argument for restricting PAD to terminally ill patients.
- To explore the ethical considerations of fairness-based paternalism and the social meaning of medical practice in relation to PAD.
- To analyze the implications of these principles for extending PAD to non-terminally ill populations.
Main Methods:
- Philosophical argumentation
- Ethical analysis
- Legal interpretation
- Case study analysis (treatment-resistant depression)
Main Results:
- The principles of fairness-based paternalism and the social meaning of medicine provide a strong ethical basis for limiting PAD to the terminally ill.
- These principles are less compelling when applied to proposals for extending PAD to non-terminally ill patients.
- The case of non-terminally ill patients with treatment-resistant depression presents a significant challenge to this restriction.
Conclusions:
- A principled argument exists for restricting PAD to the terminally ill, grounded in fairness and the societal role of medicine.
- Extending PAD beyond the terminally ill, particularly to those with conditions like treatment-resistant depression, requires careful ethical consideration.
- The debate on PAD necessitates a nuanced understanding of medical ethics, patient autonomy, and societal values.
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