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11 - Where there is hope, there is life: a view from the hospice

Published online by Cambridge University Press:  03 May 2010

John Keown
Affiliation:
University of Cambridge
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Summary

INTRODUCTION

In this chapter, ‘euthanasia’ is used to describe:

The compassion–motivated, deliberate, rapid and painless termination of the life of someone afflicted with an incurable and progressive disease. A suffering and terminally ill person is not allowed to die — his or her life is terminated.

(Roy and Rapin 1994)

In the course of the chapter, I shall make the following points:

  • Patients do not always receive adequate pain and symptom relief or, with their families, adequate psychological and practical support.

  • Hope is an essential part of hospice/palliative care, and stretches far beyond cure and survival.

  • Provided there is ‘good enough’ pain and symptom relief, suicide and a desire ‘to end it all’ are generally associated with a transient mood disorder, a depressive illness or delirium (confusion).

  • Careful evaluation is necessary whenever a patient expresses suicidal thoughts or a desire ‘to end it all’.

  • ‘Good enough’ pain relief is virtually always possible in patients with incurable cancer. In patients where pain persists, the goal becomes ‘mastery over pain’.

  • Other distressing symptoms can also be alleviated, often considerably. Changes in the patient's way of life, however, may well be necessary.

  • At the end of life, allowing nature to take its course and not intervening with ‘heroic’ measures is good practice both medically and ethically.

  • […]

Type
Chapter
Information
Euthanasia Examined
Ethical, Clinical and Legal Perspectives
, pp. 141 - 168
Publisher: Cambridge University Press
Print publication year: 1995

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