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"Assisted suicide -- Law and legislation -- United States"
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At Liberty to Die
Over the past hundred years, average life expectancy in America has nearly doubled, due largely to scientific and medical advances, but also as a consequence of safer working conditions, a heightened awareness of the importance of diet and health, and other factors. Yet while longevity is celebrated as an achievement in modern civilization, the longer people live, the more likely they are to succumb to chronic, terminal illnesses. In 1900, the average life expectancy was 47 years, with a majority of American deaths attributed to influenza, tuberculosis, pneumonia, or other diseases. In 2000, the average life expectancy was nearly 80 years, and for too many people, these long lifespans included cancer, heart failure, Lou Gehrig's disease, AIDS, or other fatal illnesses, and with them, came debilitating pain and the loss of a once-full and often independent lifestyle. In this compelling and provocative book, noted legal scholar Howard Ball poses the pressing question: is it appropriate, legally and ethically, for a competent individual to have the liberty to decide how and when to die when faced with a terminal illness? At Liberty to Die charts how, the right of a competent, terminally ill person to die on his or her own terms with the help of a doctor has come deeply embroiled in debates about the relationship between religion, civil liberties, politics, and law in American life. Exploring both the legal rulings and the media frenzies that accompanied the Terry Schiavo case and others like it, Howard Ball contends that despite raging battles in all the states where right to die legislation has been proposed, the opposition to the right to die is intractable in its stance. Combining constitutional analysis, legal history, and current events, Ball surveys the constitutional arguments that have driven the right to die debate.
eBook
The future of assisted suicide and euthanasia (New forum books)
The Future of Assisted Suicide and Euthanasia provides the most thorough overview of the ethical and legal issues raised by assisted suicide and euthanasia--as well as the most comprehensive argument against their legalization--ever published. In clear terms accessible to the general reader, Neil Gorsuch thoroughly assesses the strengths and weaknesses of leading contemporary ethical arguments for assisted suicide and euthanasia. He explores evidence and case histories from the Netherlands and Oregon, where the practices have been legalized. He analyzes libertarian and autonomy-based arguments for legalization as well as the impact of key U.S. Supreme Court decisions on the debate. And he examines the history and evolution of laws and attitudes regarding assisted suicide and euthanasia in American society.
eBook
Endings and Beginnings: Law, Medicine, and Society in Assisted Life and Death
As society struggles to cope with the many repercussions of assisted life and death, the evening news is filled with stories of legal battles over frozen embryos and the possible prosecution of doctors for their patients' suicide. Using an institutional approach as an alternative to the prevailing rights based analysis of problems in law and medicine, this study explains why society should resist the tendency to look to science and law for a resolution of intimate matters, such as how our children are born and how we die. Palmer's institutional approach demonstrates that legislative analysis is often more important than judicial analysis when it comes to issues raised by new reproductive technologies and physician-assisted suicide. A reliance on individual rights alone for answers to the complex ethical questions that result from society's faith in scientific progress and science's close alliance with medicine will be insufficient and ill-advised. Palmer predicts that the key role of the family as a societal institution will mean that questions of assisted reproduction will be resolved more in response to market forces than through legal intervention. However, he does support a strong role for legislatures in decisions involving the physicians' role in our deaths. These findings are based on the differing views of the Supreme Court justices in these matters: a tendency to protect family formation from state interference (as in abortion decisions), but support of a legislative obligation to control medicine (assisted suicide). According to Palmer, recent Supreme Court decisions on physician assisted suicide usher in a new era in how legal institutions will resolve biomedical dilemmas.
eBook
Access to Aid-in-Dying in the United States: Shifting the Debate From Rights to Justice
Much of the literature on aid-in-dying (AID) has drawn heavily on rights-based ethical and legal frameworks that emphasize patients’ rights of self-determination in end-of-life decision-making. Less attention has focused on how terminally ill people actually experience such putative rights once they are legally authorized. This analytic essay draws on findings from the Vermont Study on Aid-in-Dying, an ethnographic study of the implementation of AID in Vermont (2015–2017). First, I show that terminally ill people can face a range of barriers to accessing AID in permissive jurisdictions, and that access to AID is mediated by various inequalities endemic to US health care, as well as some that are unique to AID. I then build on these findings to examine the utility of the concept of justice for public health scholarship on AID. By integrating empirical, ethical, and policy analysis, I reframe rights-based frameworks that emphasize the role of individual choice and decision-making at the end of life. In doing so, I draw attention to health care justice as a neglected issue in public health perspectives on AID.
Journal Article
Aid-in-dying laws and the physician's duty to inform
On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying (AID) laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an end-of-life option. Much of the literature on clinical communication about AID addresses how physicians should respond to patient requests for assisted dying, but neglects the question of how physicians should approach patients who may not know enough about AID to request it. In this article, I examine the possibility of an affirmative duty to inform terminally ill patients about AID in light of ethical concerns about professional responsibilities to patients and the maintenance of the patient–provider relationship. I suggest that we should not take for granted that communication about AID ought to be patient-initiated, and that there may be circumstances in which physicians have good reasons to introduce the topic themselves. By identifying ethical considerations that ought to inform such discussions, I aim to set an agenda for future bioethical research that adopts a broader perspective on clinical communication about AID.
Journal Article
Assisted death gaining acceptance in US
The Colorado End of Life Options Act (Proposition 106) was opposed by many in the state. The editorial board of The Denver Post said the measure lacked proper safeguards, and recommended rejecting it \"because we fear the cultural, legal and medical shift that it would create.\" The group Coloradans Against Assisted Suicide claimed that right-todie legislation \"leads people to give up on treatment and lose good years of their lives.\" Another group, No Prop 106, suggested the new law would put too much power in the hands of physicians, who sometimes make mistakes, to determine who has six months to live and is therefore eligible for assisted dying. \"Rarely do voters get to vote on ballot issues about life and death. We appreciate the support of so many Coloradans who reject a culture of compromise on suicide,\" Peggi O'Keefe, spokesperson for No Prop 106, said in an email. \"We hope that the state legislature, as it has on two prior occasions, recognizes the flaws embedded in Proposition 106 and takes appropriate steps to correct them.\"
Journal Article
New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia
People use advance directives to express preferences that direct their future care when they lack decision-making capacity. One form of advance directive, a “dementia directive,” records preferences about living in various stages of dementia. This is important because many Americans want to avoid living with advanced progressive dementia. Unfortunately, traditional advance directives cannot dependably achieve this goal. In contrast, some dementia directives can achieve this goal, by directing cessation of manually assisted feeding and drinking. While many dementia directives have been published, most have gaps and omissions that thwart the goal of avoiding extended intolerable life in advanced dementia. To overcome these problems, we formulated a new dementia directive. This article explains the value of this new directive. We proceed in six stages. First, we review the prevalence of advanced dementia. Second, we identify the disadvantages of another option for accomplishing the goal of not living into advanced dementia, preemptive VSED. Third, we distinguish notable court cases where dementia directives were unsuccessful. Fourth, we review nine prominent dementia directives, noting how the Northwest Justice Project’s Advance Directive for VSED remedies those shortcomings. Fifth, we review this directive’s legal status. Sixth, we articulate its ethical justification.
Journal Article