This book examines the ethics of end of life care, focusing on the kinds of decisions that are commonly made in clinical practice. Specific attention is paid to the intensification of treatment for terminal symptoms, particularly pain relief, and the withdrawal and withholding of care, particularly life-saving or life-prolonging medical care. The book is structured into three sections. The first section contains essays examining end of life care from the perspective of moral theory and theology. The second sets out various conceptual terms and distinctions relevant to decision-making at the end of life. The third section contains chapters that focus on substantive ethical issues. This format not only provides for a comprehensive analysis of the ethical issues that arise in the context of end of life care but allows readers to effectively trace the philosophical, theological and conceptual underpinnings that inform their specific interests. This work will be of interest to scholars working in the area as well as clinicians, specialists and healthcare professionals who encounter these issues in the course of their practice.
Inhoudsopgave
Chapter 1. Introduction (Nathan Emmerich).- Section 1. Philosophical and theological Perspectives on Care at the End of Life.- Chapter 2: Human Rights and Patient Rights (Anne-Marie Duguet).- Chapter 3. Utilitarianism (Michael Quante).- Chapter 4. Virtue Ethics.- Chapter 5. A Feminist Ethics of Care at the End of Life (Carlo Leget).- Chapter 6. Islam and Care at the End of Life (Alireza Bagheri).- Chapter 7. Judaism and Care at the End of Life (Michael Barilan).- Chapter 8. Catholicism and Care at the End of Life (Pierre Mallia).- Chapter 9. Protestantism and Care at the End of Life (Andrea Dörries).- Section 2. Ethical Concepts in End of Life Care: Definitions and Distinctions.- Chapter 10. Dignity (Roberto Andorno).- Chapter 11. Intentions and the Doctrine of Double Effect (Simon Woods).- Chapter 12. Futility (Lindy Wilmott).- Chapter 13: Proportionality and the Difference Between Ordinary and Extra-ordinary Care (Alan Kearns).- Chapter 14. Difference Between Withdrawing and Withholding Lifesaving and Life Prolonging Treatment (Andrew Mc Gee).- Chapter 15. Killing and Letting Die, and / or Acts and Omissions (Richard Huxtable).- Section 3. Moral Concerns and Ethical Problems in the Clinical Practice of End of Life Care.- Chapter 16. The Ethics of Sedation at the End of Life (Soren Holm.).- Chapter 17. Advanced Directives: A Pan-European Perspective (Ruth Horn).- Chapter 18. Disorders of Consciousness and End of Life Care (Francesca Pistola).- Chapter 19. Patient Refusal of Life Saving Treatment (Christoph Rehmann-Sutter).- Chapter 20. Intentions of Physicians and End of Life Care Team (Vinnie Nambisan).- Chapter 21. Moral Distress in End of Life Care (Georgina Morely).- Chapter 22. Social Factors in Care at the End of Life: Gender and the Family (Marian Verkerk ).- Chapter 23. Ethics and Intercultural Issues in End of Life Care (Ayesha Ahmad).- Chapter 24. The Role of Guidelines and Pathways in End of Life Care (Micheal Bone).- Chapter 25. Conclusion.
Over de auteur
Nathan Emmerich is a Research Fellow in Bioethics in the Australian National University’s Medical School. He was previously a Postdoctoral Research Fellow in Ethics and End of Life Care at the Institute of Ethics, Dublin City University, and a Visiting Research Fellow at Queen’s University Belfast. He has a background in Philosophy and took his Ph D, which concerned the connection between the informal moral socialisation of medical students and their formal medical ethics education, under the supervision of medical sociologist. His work is interdisciplinary in nature and he has published on ethical expertise, social science research ethics and in bioethics more generally. He tweets at @Bioethics AUS.
Pierre Mallia is Professor of Family Medicine and Biomedical Ethics at the University of Malta. He is attached to Malta’s Geriatric Karen Grech Hospital as a Clinical Ethicist and has published numerous papers and publications in Ethics, including on ethical issues with regard to aging. He is Chairman of the Dept. of Health’s Health Ethics Committee, and the Minister of Health’s Bioethics Consultative Committee. He is also the Ethics Advisor to the Medical Council of Malta and coordinates the University of Malta’s Bioethics Research Programme at the Medical School and was former Hon. Secretary to the National Bioethics Consultative Committee and founded and coordinates the Medical Law Unit in the Faculty of Laws. He is the President of the Malta College of Family Doctors and was awarded a Fellowship of the Royal College of General Practitioners (UK) for successfully introducing post graduate training and the MRCGP (INT) qualification in Malta. The Royal College of Physicians of London has also awarded him an honorary membership for advancing medicine in Malta.
Professor Mallia is a visiting Professor at the Laennec Universityof Lyon and regularly visits the Dept. of Health Sciences at the University of Maastricht and the Istituto Universitario di Sophia (Florence, Italy) with which he is collaborating to promote a theory of dialogue in bioethics. He has been invited by UNESCO to describe his method of teaching and chosen as the ‘regional bioethics expert’ in the Mediterranean. He is frequently invited as a keynote speaker in international meetings.
He has participated in several FP projects including Euroscreen, Privireal, Privileged, Bio TEthed, Patient-Partner, EUPATI and others and has been invited by the EC to give talks in Bratislava and Bucharest. He also lectured at the United Nations Institute on Aging (INIA) in their diploma in Gerontology.
Bert Gordijn is Professor and Director of the Institute of Ethics at Dublin City University in Ireland. He has studied Philosophy and History in Utrecht, Strasbourg and Freiburg in Breisgau. In 1995 he was awarded a doctorate in Philosophy from the Albert-Ludwigs-Universität Freiburg, followed by a doctorate in Bioethics from the Radboud University Nijmegen in 2003. Bert has been a Visiting Professor at Lancaster University (UK), Georgetown University (USA), the National University of Singapore, the Fondation Brocher (Switzerland), and Yenepoya University (Mangalore, Karnataka, India). He has served on Advisory Panels and Expert Committees of the European Chemical Industry Council, the European Patent Organisation, the Irish Department of Health and UNESCO. Bert is Editor-in-Chief of two book series: ‘The International Library of Ethics, Law and Technology’ and ‘Advances in Global Bioethics’ as well as a peer reviewed journal: ‘Medicine, Health Care and Philosophy’, all published by Springer. He is Secretary of the European Society for Philosophy of Medicine and Healthcare and President of the International Association of Education in Ethics.
Francesca Pistoia is Associate Professor of Neurology at the University of L’Aquila. She completed her degree summa cum laude in medicine and surgery, and thereafter specialized in neurology summa cum laude, at the University of L’Aquila. She earned a Ph D in Internal Medicine and Applied Immunology at the same University. She has contributed to 95 papers (83 in peer-reviewed international journals and 12 in Italian journals). She has presented her research at national and international congresses (resulting in 71 abstracts and communications). Her research is mainly focused on the topic of diagnosis, prognosis and rehabilitation of patients with severe brain injury with the aim of implementing validated assessment tools to identify physical, cognitive and behavioural disabilities and quantify rehabilitation-related outcomes. Research topics include: the evaluation of patients with disorders of consciousness (vegetative state and minimally conscious state) as a consequence of severe brain injury: her studies in this area have been aimed at evaluating the neurobiological and behavioral factors, which may influence the recovery of consciousness, and the implementation of new therapeutical approaches; the identification of disorders of motor imagery and the perception of emotions in patients with locked-in syndrome. She also contributed to research addressing the epidemiology of cerebrovascular diseases and of Parkinson’s disease in population-based registries, and the role of comorbidities in headache pathogenesis and of behavioral therapies in patients with chronic headache. She serves as a member of the Ethical Committee of the University of L’Aquila.
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