Chapter 5: Dignity in Dying

• Dignity


  The inherent worth and respect that every human being deserves, regardless of status, beliefs, or background
• Dignity in healthcare


  • Medical confidentiality
  • Treating patients with dignity and compassion
  • Respecting patient autonomy
• Dying with dignity


  An end-of-life option that permits certain individuals with a terminal illness to lawfully and voluntarily ask their doctor for prescription medication so they can hasten their death in a peaceful, humane, and dignified manner
• Qualifications for dying with dignity

  • Adult resident of a state where such a law is in effect
  • Capable of making and communicating own healthcare decisions
  • Diagnosed with a terminal illness that will lead to death within six months
  • Capable of self-administering and ingesting medications without assistance
• Dying with dignity


  • Euthanasia
  • Assisted suicide
• Euthanasia


  The deliberate act of ending someone's life, typically to alleviate suffering
• Prolongation of life


  The use of medical treatments and interventions to extend the lifespan of an individual
• Inviolability of human life


  The principle that it is always wrong to try to extinguish a patient's life, whether by act or omission
• Medical procedures that are often considered to go against the inviolability of life include abortion, euthanasia, assisted suicide, non-voluntary euthanasia, and physician-assisted death
• Aiding and abetting


  The act of ending a person's life
• Non-voluntary Euthanasia


  When a person's life is intentionally ended without their explicit consent, often in cases where the person is unable to communicate their wishes, such as in the case of severe cognitive impairment
• Non-voluntary euthanasia is seen as going against the inviolability of life because it involves making a life-ending decision on behalf of a person without their consent
• Physician-Assisted Death


  Situations where a physician provides a patient with the means to end their own life, such as prescribing lethal medication
• Physician-Assisted Death is considered to go against the inviolability of life because it involves actively participating in the act of ending a person's life
• Euthanasia


  The act of painlessly putting to death people suffering from incurable or distressing disease
• Active Euthanasia


  Performing an action that directly causes someone to die
• Passive Euthanasia


  Allowing someone to die by not doing something that would prolong life
• Voluntary Euthanasia


  Euthanasia conducted with consent
• Involuntary Euthanasia


  Euthanasia conducted on a person who is unable to consent due to their current health condition
• Involuntary euthanasia can be considered as murder when it is performed on a person who can and would provide informed consent, but does not because they do not want to die or they were not asked
• Suicide


  The direct and willful destruction of one's own life
• Assisted Suicide


  The act of intentionally killing oneself with the assistance of another who deliberately provides the knowledge, means, or both
• Physician-Assisted Suicide (PAS)


  When a doctor gives a person the means to commit suicide when requested for
• Euthanasia and suicide overlap, but there are several differences. Euthanasia is for medical reasons, while assisted suicide is when a doctor gives a person the means to commit suicide when requested for
• Dysthanasia


  The extension of the dying process through treatment that only prolongs patients' biological life, without quality of life or dignity
• Examples of Dysthanasia

  • Implantable cardioverter defibrillator
  • Artificial ventilation
  • Ventricular assist devices
  • Extracorporeal membrane oxygenation
• Cardiopulmonary resuscitation (CPR) can be considered a form of dysthanasia in some cases
• Orthothanasia


  The practice of allowing a terminally ill or dying patient to die naturally, without extraordinary measures to prolong life
• Principles of Orthothanasia

  • Respect for patient dignity
  • Relief of suffering
  • Right to self-determination
• Orthothanasia is closely tied to the principles of palliative care, which aims to provide comfort, pain management, and holistic support to terminally ill patients and their families
• When a terminally ill patient has no hope of recovery and is in excruciating pain

  Orthothanasia may be considered as a more humane and compassionate option than continuing aggressive treatment
• Roles of healthcare professionals in Orthothanasia

  • Physicians
  • Nurses
  • Legal Experts
• Euthanasia


  The intentional act of ending someone's life to relieve suffering, typically done by a physician at the request of a patient who is terminally ill or experiencing unbearable pain
• Disthanasia


  The prolongation of life using medical technology and interventions even when there is no hope of recovery or when the patient's quality of life is significantly compromised
• Orthothanasia


  Allowing death to occur naturally without unnecessary medical interventions to prolong life when a person is dying from a terminal illness or in an irreversible vegetative state
• Ethical considerations in Orthothanasia

  • Respect for Autonomy
  • Beneficence and Non-Maleficence
  • Fairness and Justice
  • Emotional and Psychological Factors
• Orthothanasia


  Respect for the patient's autonomy and right to self-determination. Patients should be empowered to make informed decisions about their end-of-life care
• Beneficence and Non-Maleficence


  • Healthcare providers must balance the principles of beneficence (doing good) and non-maleficence (avoiding harm) when considering orthothanasia. The goal is to relieve suffering and provide a peaceful death, rather than prolong a life filled with pain and indignity
• Fairness and Justice


  • Ethical frameworks must consider issues of fairness and justice, ensuring that access to orthothanasia and end-of-life care is equitable and not determined by factors such as socioeconomic status or geographic location
• Emotional and Psychological Factors


  • The emotional and psychological impact of end-of-life decisions on patients, families, and healthcare providers must be carefully navigated. Open communication, empathy, and support are crucial in this sensitive process