To examine health professionals' experiences of and attitudes towards the provision chemotherapy to patients with end stage cancer.Purposive, qualitative design based on in-depth interviews. Setting Oncology departments at university hospitals general in Netherlands.14 physicians 13 nurses who cared for metastatic cancer.Physicians reported trying inform fully about their poor prognosis treatment options. They would carefully consider (side) effects sometimes doubted whether further...

abstract Opt‐out systems of postmortal organ procurement are often referred to as ‘presumed consent’ systems. A presumption directs us, in a case which no compelling evidence is available hold that P, nevertheless proceed if P were true, unless there sufficient it false. It recommended presume consent this case, because, the absence registered objections deceased, held be more probable she consented than did not. Whether suggestion makes sense, however, turns out depend on proper...

To explore the extent to which patients have a directing role in decisions about chemotherapy palliative phase of cancer and (want to) anticipate on last stage life.Qualitative interview study.In depth-interviews with 15 advanced colorectal or breast at medical oncology department Dutch teaching hospital; interviews were analysed following principles thematic content-analysis.All reported know that they received was intent. Most them did not express wish for information (other) treatment...

On the standard view we assess a person's competence by considering her relevant abilities without reference to actual decision she is about make. If deemed satisfy certain threshold conditions of competence, it still an open question whether could ever be overruled on account its harmful consequences for ('hard paternalism'). In practice, however, one normally uses variable, risk dependent conception which really means that in or not respect decision-making authority weigh several...

Abstract In suicidology, the common view is that ‘rational’ suicides occur only rarely, because competence of people who want to end their lives compromised by mental illness. Netherlands and Flanders, however, patients’ requests for euthanasia or assistance in suicide are granted 5300 1400 cases a year respectively, all these at least two doctors have confirmed patient's competence. The combination findings puzzling. other countries one would expect some own lives. article argues we can...

When a severely suffering dying patient is deeply sedated, and this sedated condition meant to continue until his death, the doctor involved often decides abstain from artificially administering fluids. For dual procedure almost all guidelines require that should not have life expectancy beyond stipulated maximum of days (4–14). The reason obviously in case longer life-expectancy may die dehydration rather than lethal illness. But no guideline tells us how we describe life-expectancy. Many...

In almost all opt-in systems of postmortal organ procurement, if the deceased has not made a decision about donation, his relatives will be asked to make it. Can this power justified? I consider three possible justifications. (1) We could presume have delegated relatives. (2) It argued that, decision, proxy in best interests. (3) The standing their own because they are singled out from parties whose interests being affected by special relation had deceased. None these arguments turns convincing.

The common objection to opt-out systems of postmortal organ procurement is that they allow removal a deceased person's organs without their actual consent. However, under certain conditions it possible for 'silence'--failure register any objection--conventionally and/or legally count as genuine Prominent are the consenter should be fully informed about meaning his or her silence and costs registering dissent insignificant. This paper explicates this thesis discusses some objections it: (1)...

ABSTRACT In a Living Donor List Exchange program, the donor makes his kidney available for allocation to patients on postmortal waiting‐list and receives in exchange kidney, usually an O‐kidney, be given recipient he favours. The program can solution candidate who is unable donate directly or participate paired because of blood group incompatibility positive cross‐match. Each donation within LDLE additional organ transplantation. But most pairs making use will A/O incompatible, it also tend...

It has often been proposed to restrict access postmortal organs registered donors, or at least give them priority on the waiting list. Such proposals are motivated by considerations of fairness: everyone benefits from existence a pool available and an organised system distributing it is unfair that people who prepared contribute this public good duped not. This paper spells out rationale goes discuss main principled objections have brought forward such proposals. The most fundamental...

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I argue that the concept 'physician-assisted suicide' covers two procedures should be distinguished: giving someone access to humane means end his own life, and taking co-responsibility for safe effective execution of plan. In first section explain distinction, in following sections show why it is important. To begin with we expect laws permit these kinds 'assistance' different their justificatory structure. Laws only presuppose right self-determination implies a suicide, but doctors take...

Opt-out systems of postmortem organ procurement are often supposed to be justifiable by presumed consent, but this justification turns out depend on a mistaken mental state conception consent. A promising alternative appeals the analogical situation that occurs when an emergency decision has made about medical treatment for patient who is unable give or withhold his In such cases, should in best interests patient. The analogous suggestion considered, then, is, if potential donor not...

It has been proposed that an old and ill person may have a 'duty to die', i.e. refuse life-saving treatment or end her own life, when she is dependent on the care of intimates burdens are becoming too heavy for them. In this paper I argue three contentions: (1) You cannot strict duty die, correlating claim-right your relatives, because if they reach point at which larger than you can reasonably expect them take, natural conclusion their ends. (2) They be prepared, however, go caring beyond...

L'A. souligne la pertinence de theorie egalitariste justice developpee par M. Walzer dans son ouvrage intitule «Spheres of justice» (1983), qui propose une alternative a Grande Theorie representee Rawls, Nozick, Dworkin ou Habermas. Malgre le pluralisme et l'adequation locale sa theorie, applique structure theorique question l'echange des biens n'est pas reelle qu'il decrite. Examinant version complexe l'egalite, ainsi que definition l'appartenance communaute politique en termes bien...

The basic question concerning the compatibility of donation after circulatory death (DCD) protocols with dead donor rule is whether such can guarantee that loss relevant biological functions truly irreversible. Which are ones? I argue answer to this be derived neither from a proper understanding meaning term “death” nor nature as phenomenon. concept made fully determinate only by stipulation. propose focus on irreversible capacity for consciousness and spontaneous breathing. Having accepted...

Guidelines that have been published on sedation until death take the following positions: patient's consciousness should not be lowered more than is necessary for preventing her from suffering; it must impossible to alleviate suffering in any alternative way; and mere preference dying peacefully cannot justify procedure. Some guidelines also stipulate purely existential do so either. I will discuss (few) arguments can found literature these restrictions. focus particular argument either a...