Does giving someone morphine hasten death10/12/2023 ![]() The central argument is that distinct moral and ethical (ethical frameworks are the formal theories and discourses and moral frameworks reflect informal theories and discourses) perspectives explain the divergence between the public and the medical ethics views of end-of-life practices as distinct from AD. Patients’ views are important because they make decisions about and receive such treatments based on their understandings of end-of-life therapeutic practices. Our aim in this article is not to resolve this debate, but to explore the relatedness of AD and common end-of-life practices from the perspectives of patients approaching the end of life. Yet, the perception of the relatedness of end-of-life practices, and hastening death persists among the public and some health professionals ( 13, 14). Even if they do shorten survival, medical ethicists stress that end-of-life practices and assisted dying (AD) are ethically distinct ( 11, 12). Research shows that such interventions do not hasten death when used proportionately ( 8- 10), though one critique suggested methodological limitations exist although no randomized-control trials have been conducted to give a definitive answer ( 6). Accepted for publication Jun 11, 2020.Įthical and conceptual debates continue back and forth about whether end-of-life practices ( 1), such as palliative sedation (PS) and use of opioids for pain relief, are equivalent to hastening dying or not ( 2- 7). Keywords: Analgesics opioid double effect principle ethics, medical euthanasia palliative care Participants’ challenge to the interpretation of legal end-of-life practices as AD represents an epistemic contest to the foundation of medical knowledge, authority and ethics and therefore carries implications for preferences in care, communication and palliative care practice. Participants’ perspective was consistent with a consequentialist framework whereas deontology often guides medical ethics at the end of life. ![]() There is a divide in what medical ethics and most health professionals and what some patients consider active hastening death. Participants asserted that active and passive practices for ending life were morally equivalent, and preferred to choose the time of death over other legal means for death.Ĭonclusions: This article contributes to what is known about how patients perceive end-of-life practices that potentially hasten death. ![]() They implied such practices were performed without patient consent, though they did not conceive of this as murder. Some participants did not agree with the ‘doctrine of double effect’ (‘DDE’) and saw such practices as ‘slow euthanasia’ and ‘covert euthanasia’. Results: Most of the participants viewed current palliative care practices, such as pain relief with opioids and symptom management with PS, as hastening death, in contrast to some medical research which concludes that proportional therapeutic doses do not hasten death. We compared the findings to prevailing ethical frameworks. Interview transcripts were inductively analyzed consistent with thematic analysis. We asked them about why they would consider AD if it was available. An additional six family members were also interviewed and included in analysis. ![]() Their mean age was 61 (range, 34–82) years and half were enrolled in Hospice. Methods: We recruited 14 people with life-limiting illness and life expectancy of less than a year. The aim of this article is to describe the perspectives of a group of New Zealanders with life-limiting illness, who want or would consider AD, on the provision of end of life services, including assisted death, withdrawal of life-prolonging treatment and symptom management with opioids or PS. Its relationship to other end-of-life practices such as palliative sedation (PS) is the subject of ongoing debate.
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