Euthanasia and Withholding Treatment

By jeff01 on February 25th 2009

Ethical issues in palliative medicine and palliative care arise with particular intensity, although not exclusively, at the bedsides of gravely ill and dying people. There would be no issues to resolve if there were no uncertainties and conflicts about what clinically should and should not be done in the care of patients afflicted with advanced and irreversible disease. The issues are ethical because they centre upon beliefs about how human beings should live and die, about the values individuals and groups should uphold, and about which values may be sacrificed when all values at stake in a specific situation cannot be honoured and maintained. The issues are also ethical because they centre on the purposes and responsibilities of the medical and nursing professions as well as upon the relationships of law to medical and nursing practice.

This consideration of withholding or withdrawing life-prolonging treatment and of euthanasia opens with a brief discussion of clinical ethics, the primary perspective of the entire chapter. Of course, what happens at the bedsides of sick and dying people happens also within hospitals and health care institutions, and these are societal institutions. So the ethical issues raised by the withholding of life-prolonging treatment and by euthanasia and physician-assisted suicide could be analysed and discussed by focusing attention on the ethics of a health care institution, or on the ethics of the medical and nursing professions, or more broadly, on the public ethics of a given society. However, the choice taken here is to consider withholding treatment and euthanasia primarily from the perspective of clinical ethics, a specialization of ethics that is not to be identified with, although it inevitably intersects with, the ethics of an institution, of a profession, of a religion, or of the public ethics of a society.

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