domingo, 10 de enero de 2016

BioEdge: Demented patients can be euthanized in Netherlands || BioEdge




Demented patients can be euthanized in Netherlands
     

The Netherlands health ministry has revised its guidelines to allow severely demented patients to be euthanized. However, an advance directive which was made when the patient was lucid is required.
The guidelines acknowledge that patients often do not seem to be suffering unbearably because of their dementia. However, they still suffer from conditions like severe anxiety and pain. “In those cases a doctor may give euthanasia, even if a patient can not make it clear in words or gesture,” says the ministry. “But there has to be a written request for euthanasia, that the patient drew up earlier.”
The guidelines were updated to make the position of doctors more legally secure. Some demented patients have been euthanized, but there is uncertainty about whether or not such actions were lawful. Hence, many doctors refuse to euthanise their demented patients.
The guidelines include instructions for drafting a euthanasia declaration. Patients are encouraged to keep in touch with their physicians to ensure that their wishes are carried out.
Other news on the Dutch euthanasia front: the Dutch medical association, the KNMG, has declared that doctors should have the right to refuse to perform euthanasia. It is alarmed by news that the Dutch right-to-die association is lobbying for a “last wish pill” which would allow patients to kill themselves, although it would have to be prescribed by a doctor.
“Euthanasia is just one of the options, there must be room for consideration. Do we want the government to allow an end of life pill being available to everyone? How do we protect the vulnerable against pressure from the environment, against their own impulsive acts?” said Rutger Jan van der Gaag, chairman of the KNMG. “The doctor is now at least an important safety valve which ensures that reasonable alternatives can not be overlooked and euthanasia resources are not misused … it never becomes ‘you ask, we inject’.”
- See more at: http://www.bioedge.org/bioethics/demented-patients-can-be-euthanized-in-netherlands/11706#sthash.ehWJZ41G.dpuf


US should stop physician participation in detainee force-feeding, say ethicists
     

The US government should rescind directives authorizing participation of health professionals in interrogation and force-feeding because they are inconsistent with professional ethics, argue ethicists in PLoS Medicine.
A 2015 report of the Defense Health Board found that the Department of Defense “does not have an enterprise-wide, formal, integrated infrastructure to systematically build, support, sustain, and promote an evolving ethical culture within the military health care environment.”
The Board declared that health care professionals should not have to perform medical procedures that violate their professional code of ethics, State medical board standards of conduct, or the core tenets of their religious or moral beliefs.
In the wake of scandals about torture of detainees at Guantanamo Bay and other sites run by the CIA or the military, the government accepted most of the Board’s recommendations.
However, there were some loose ends. “The Board’s failure to call for a prohibition of any military health professional involvement in interrogation or force-feeding hunger strikers in its recommendations is a serious deficiency. It should also have recommended transparency and oversight in the reform process,” say Leonard S. Rubenstein, of Johns Hopkins University and co-authors in the PLoS article.
They conclude with a ringing call for respect for conscientious objection:
“Health professionals who have volunteered to serve for their country should never be asked or directed to violate their professional ethics, nor be allowed to be instruments in detainee abuse. To be true to their role in setting ethical standards for practice and creating an environment that enables health professionals to follow them, professional associations must do everything in their power to make sure that military rules do not require health professionals to choose between service to their country and ethical practice.”
- See more at: http://www.bioedge.org/bioethics/us-should-stop-physician-participation-in-detainee-force-feeding-say-ethici/11702#sthash.iwoOUXpv.dpuf
Bioedge




Happy New Year! BioEdge is gearing up for a big year, with lots of news and more interviews with bioethicists from around the world.
Animal rights is one of the areas which we cover from time to time – which explains the photo above, one which I have been dying to use. It is a famous selfie of a male crested macaque named Naruto in an Indonesian wlldlife reserve.
British nature photographer David Slater placed the camera amongst the monkeys in 2011 and Naruto pressed the trigger. Later on the image appeared on Wikipedia without Slater’s permission, but Wikipedia refused to take it down, because Naruto was the “author”, not Slater.
In September PETA (People for the Ethical Treatments of Animals) became involved. It argued in United States District Court in San Francisco that Naruto held the copyright. On his behalf PETA wanted to licence the image and use the proceeds to protect his species. Implicit in its case was the notion that animal are also persons and have legal rights.
The bemused judge, William H. Orrick, disagreed. “While Congress and the president can extend the protection of law to animals as well as humans,” he wrote, “there is no indication that they did so in the copyright act.”
This was a blow for PETA, but its attorney was philosophical. “We will continue to fight for Naruto and his fellow macaques,” said Jeff Kerr. “As my legal mentor used to say, ‘In social-cause cases, historically, you lose, you lose, you lose, and then you win.’”

Michael Cook
Editor
BioEdge

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