In this article, I consider whether the advance directive of a person in minimally conscious state ought to be adhered to when its prescriptions conflict with her current wishes. I argue that an advance directive can have moral significance after its issuer has succumbed to minimally conscious state. I also defend the view that the patient can still have a significant degree of autonomy. Consequently, I conclude that her advance directive ought not to be applied. Then I briefly assess whether considerations pertaining to respecting the patient's autonomy could still require obedience to the desire expressed in her advance directive and arrive at a negative answer.
We aim to improve the medical care and understanding of disorders of consciousness following an acute insult such as coma, vegetative state, minimally conscious state or locked-in syndrome. Coma Science Group Cyclotron Research Center & Neurology Dept University of Liège
A high court judge in England has ordered that doctors can force a woman without the capacity to decide for herself to have lifesaving treatment for aplastic anaemia. Mrs Justice Hogg made the ruling in the Court of Protection after an unnamed NHS trust applied to the court with the backing of the Official Solicitor, who looks after the interests of those lacking capacity. The judge said the 30 year old woman, named only as SB, who is detained under the Mental Health Act, has a serious psychiatric disorder and lacks the capacity to decide for herself whether or not to have the potentially lifesaving treatment.
Increasing understanding of the brain and associated advances in technologies to study it will enable improved treatment of neurodegenerative diseases & mental illnesses. But these advances will also increase our insights into normal human behaviour and mental wellbeing, as well as giving the possibility of other enhancement, manipulation, and even degradation of brain function. These developments are likely to provide significant benefits for society, and they will also raise major social and ethical issues due to wide ranging applications. Brain research is likely to have implications for a diverse range of public policy areas such as health, education, law, & security. More broadly progress in neuroscience is going to raise questions about personality, identity, responsibility, & liberty. Brain Waves explores the potential & the limitations of neuroscience insights for policymaking, as well as the benefits and the risks posed by applications of neuroscience and neurotechnologies.
Early in 2011, Illinois joined the ranks of states that recognize civil unions between both same-sex and opposite-sex couples. The law gives partners in these unions “the same legal obligations, responsibilities, protections and benefits as are afforded or recognized by the law of Illinois to spouses.” Despite the fact that Illinois and most other states still reserve marriage for opposite-sex couples, the option of civil unions will make it easier for some couples to make health care decisions for one another should one of them become incapacitated. Surrogate decision-makers for health care are a significant topic for everyone, but the issue has special resonance for same-sex couples because the law in most jurisdictions excludes same-sex couples from the benefits that marriage and some civil unions confer in those health care decisions. Timothy F. Murphy, "Surrogate Health Care Decisions and Same-Sex Relationships," Hastings Center Report 41, no. 3 (2011): 24-27.
The first reported case of a British person choosing to end their own life at a centre in Switzerland because they had dementia has taken place. The 83-year-old was thought to be in the early stages of the neurodegenerative disease. A psychiatric assessment found that he was mentally competent to make the decision.
An international leader in bioethics, Peggy [Battin] explored the right to a good and easeful death by their own hand, if need be, for people who were terminally ill, as well as for those whose lives had become intolerable because of chronic illness, serious injury or extreme old age. She didn’t shy away from contentious words like “euthanasia.” In the weeks after the accident, Peggy found herself thinking about the title character in Tolstoy’s “Death of Ivan Ilyich,” who wondered, “What if my whole life has been wrong?” Her whole life had involved writing “wheelbarrows full” of books and articles championing self-determination in dying. And now here was her husband, a plugged-in mannequin in the I.C.U., the very embodiment of a right-to-die case study.
New report finds half of dying Britons are not dying well At a pivotal time for end of life care in Britain the need for advance care planning is reinforced Divided in Dying, a new report from charity Compassion in Dying, finds that almost half of those who have lost someone close to them through a short or long illness, feel their loved one died badly (45%). In cases where the dying person had recorded their end of life wishes, relatives and friends are more likely to report that they had a good death (58%). Alongside recording end of life wishes (19%), better communication between the doctor and their loved one (39%), co-ordination of care (33%) and being able to die in a place of their choice (31%) were also identified as key aspects which could have improved the situation for the person who died in a bad way. Compassion in Dying surveyed over 2400 British adults who were asked to recall the experience of the last relative or close friend who died.
Lord Falconer's Assisted Dying Bill [HL Bill 24] is the fourth of its kind to come before the House of Lords in the last ten years. None of its predecessors has made progress and the last one (Lord Joffe's Assisted Dying for the Terminally Ill Bill) was rejected in May 2006. This latest bill is little different from Lord Joffe's - it seeks to license doctors to supply lethal drugs to terminally ill patients to enable them to end their lives. The bill contains no safeguards, beyond stating eligibility criteria, to govern the assessment of requests for assisted suicide. It relegates important questions such as how mental capacity and clear and settled intent are to be established to codes of practice to be drawn up after an assisted suicide law has been approved by Parliament. This is wholly inadequate for a bill, such as this, with life-or-death consequences. Parliament cannot responsibly be asked to approve such a radical piece of legislation without seeing the nature of the safegua...
National clinical guidelines on the care of people in a vegetative or minimally conscious state, following severe brain injury These long-awaited guidelines will be a major contribution to clinical and ethical standards of care for this group of patients, not only in the UK but internationally. For England and Wales, they provide much needed clarity on legal decision-making. You can buy a print copy of the guidelines (130 pp, £15) from our online shop, or download a free PDF below. The guidelines were developed by a panel of experts in the field, who have organised complicated and wide-ranging information into six coherent sections: 1 Defining criteria and terminology 2 Assessment, diagnosis and monitoring 3 Acute to longer-term management 4 Ethical and medico-legal issues 5 End-of-life issues 6 Service organisation and commissioning Each section is followed by a set of clear recommendations.