Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues

Goligher, EC; Ely, EW; Sulmasy, DP; Bakker, J; Raphael, J; Volandes, AE; Patel, BM; Payne, K; Hosie, A; Churchill, L; White, DB; Downar, J

Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues

Goligher, EC Ely, EW Sulmasy, DP Bakker, J Raphael, J Volandes, AE Patel, BM Payne, K Hosie, A

Churchill, L White, DB Downar, J

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Publication Type:: Journal Article
Citation:: Critical Care Medicine, 2017, 45 (2), pp. 149 - 155
Issue Date:: 2017-02-01

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Field	Value	Language
dc.contributor.author	Goligher, EC	en_US
dc.contributor.author	Ely, EW	en_US
dc.contributor.author	Sulmasy, DP	en_US
dc.contributor.author	Bakker, J	en_US
dc.contributor.author	Raphael, J	en_US
dc.contributor.author	Volandes, AE	en_US
dc.contributor.author	Patel, BM	en_US
dc.contributor.author	Payne, K	en_US
dc.contributor.author	Hosie, A https://orcid.org/0000-0003-1674-2124	en_US
dc.contributor.author	Churchill, L	en_US
dc.contributor.author	White, DB	en_US
dc.contributor.author	Downar, J	en_US
dc.date.issued	2017-02-01	en_US
dc.identifier.citation	Critical Care Medicine, 2017, 45 (2), pp. 149 - 155	en_US
dc.identifier.issn	0090-3493	en_US
dc.identifier.uri	http://hdl.handle.net/10453/124803
dc.description.abstract	© 2017 Society of Critical Care Medicine and Wolters Kluwer Health, Inc. Objective: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. Synthesis: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. Conclusions: We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.	en_US
dc.relation.ispartof	Critical Care Medicine	en_US
dc.relation.isbasedon	10.1097/CCM.0000000000001818	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Euthanasia	en_US
dc.subject.mesh	Suicide, Assisted	en_US
dc.subject.mesh	Withholding Treatment	en_US
dc.subject.mesh	Attitude to Death	en_US
dc.subject.mesh	Intention	en_US
dc.subject.mesh	Morals	en_US
dc.subject.mesh	Physicians	en_US
dc.subject.mesh	Intensive Care Units	en_US
dc.title	Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	45	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	45	en_US

Abstract:

© 2017 Society of Critical Care Medicine and Wolters Kluwer Health, Inc. Objective: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. Synthesis: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. Conclusions: We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/124803