Ethical points in caring for people nearing end-of-life
Published on : 23/09/2011
Author / Source : Etienne MONTERO
Issues linked to ageing and the end of life are complex and sometimes painful. The questions surrounding this topic are sensitive and cannot have a simple response. They challenge our sense of solidarity and our ingenuity in seeking ways and means to express true compassion and act appropriately.
Several people have become household names as part of the debate on the end of life. Whether we like it or not, they have become part of our collective memory: Karen Ann Quinlan and Terri Schiavo from the United States, Ramón Sampedro and Immaculada Echevarría from Spain, Vincent Humbert and Chantal Sébire from France, Piergiorgio Welby and Eluana Englaro from Italy, Hugo Claus from Belgium, and many others.
The media has focussed on extreme cases which have been brought to public attention because of their particularly dramatic nature. Thus, the discussion has largely been based around certain "unusual" situations with high emotional stakes. Because of this, the complex and sensitive public debate surrounding the end of life is all too often reduced to a few paltry clichés and stereotypes built on feelings rather than an exchange of rational arguments. There is no end to specialised publications on this topic; however, their distribution often remains limited to the narrow circles of legal expertise, philosophy and medicine. Meanwhile, public opinion oscillates between knowledge, misunderstandings and approximations, and rigorous examination often gives way to the feelings, spectres and fears surrounding death.
- end of life
- palliative care
- Palliative careThe purpose of this report is to describe the Belgian model of end of life care that, since 2002, has aimed at developing "palliative care for all", while nonetheless authorizing the practice of euthanasia under certain conditions.
The thirteen years since the passage of this decree have culminated in a clash between two opinions:
* one affirms that the decriminalization of euthanasia has truly enabled the development of continuous, palliative care;
* the other, conversely, stresses that ...
- Euthanasia and assisted suicideOn 28 May 2002, Belgium became the second country to decriminalise euthanasia, i.e. the act of "intentionally ending a person's life at the latter's request" because of his state of health.
After twenty years of applying the Belgian law on euthanasia, and given the current critical debates on the subject, it is essential to take stock of the practice of euthanasia in Belgium and draw some perspectives on its recent and future developments.
- Euthanasia and assisted suicideUntil now, only three countries in the world have decriminalised euthanasia: the Netherlands, Belgium and Luxembourg. This practice is available only to people who are mentally competent when they apply (if necessary, via a declaration in advance requesting euthanasia).
A notable exception to the voluntary nature of the request for euthanasia concerns newborns who face suffering that is deemed intolerable and who have no prospect of enjoying an acceptable "quality of life" at any point in the...