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1.
During the summer of 1999, extensive interviews with some of the leading authorities on euthanasia policy were conducted in the Netherlands. They were asked: Daniel Callahan argues that there is a 'culture of death' in the Netherlands. What do you think? The majority of interviewees disagreed with the statement. They said that the Netherlands is not fundamentally different than other countries. If at all, the Dutch culture is open and tolerant, welcomes debates and plurality of views, and physicians are decent people who wish to help their patients, not to kill them. A small minority acknowledged that there is some truth in Callahan's observations, arguing that the Dutch actually do not welcome critique and are quite conservative in their liberal attitude toward euthanasia.  相似文献   

2.
This article provides a critical analysis of Dutch euthanasia policy and practice. The research benefited from twenty-eight interviews conducted in the Netherlands during the summer of 1999 with some of the leading figures who dictate the decision-making process and take an active part in the debates. The discussion begins with a review of the two major Dutch reports on euthanasia and the conflicting views and interpretations offered by the literature. Next, I provide some data about the interviews, and then analysis indicating that the Dutch Guidelines on the policy and practice of euthanasia do not provide ample mechanisms against abuse. I argue that the Dutch Guidelines are insufficient, do not provide adequate control over the practice of euthanasia, and that the entire policy should be revised and made more coherent and more comprehensive.  相似文献   

3.
This article examines the evidence for the empirical argument that there is a slippery slope between the legalization of voluntary and non-voluntary euthanasia. The main source of evidence in relation to this argument comes from the Netherlands. The argument is only effective against legalization if it is legalization which causes the slippery slope. Moreover, it is only effective if it is used comparatively-to show that the slope is more slippery in jurisdictions which have legalized voluntary euthanasia than it is in jurisdictions which have not done so. Both of these elements are examined comparatively.  相似文献   

4.
During the summer of 1999, twenty-eight interviews with some of the leading authorities on euthanasia policy were conducted in the Netherlands. They were asked about cases of non-voluntary (when patients are incompetent) and involuntary euthanasia (when patients are competent and made no request to die). This study reports the main findings, showing that most respondents are quite complacent with regard to breaches of the guideline that require the patient's consent as a prerequisite to performance of euthanasia.  相似文献   

5.
Euthanasia has been decriminalised in The Netherlands for the last 30 years, but it was only in April 2001 that the Dutch Parliament legalised voluntary physician-assisted suicide. The legislation incorporates developments in case law, including scope for peer review, and provides common ethical principles for a clear system of control over doctors' actions in regard to patients who request euthanasia. The legalised regulatory system may prove more effective in controlling voluntary and non-voluntary euthanasia in The Netherlands than in countries where euthanasia remains illegal.  相似文献   

6.
7.
Dutch author Ubaldus de Vries reviews the current state of the euthanasia law in the Netherlands. The legislation, enacted in 2001, creates a medical exception that allows for euthanasia in cases where patients experience "hopeless and unbearable suffering." A brief history of the Dutch approach to euthanasia is set forth, case law is reviewed, and the unique role of the doctor is examined in seeking to understand the extent of one's right to euthanasia in the Netherlands. Because the courts must determine what constitutes "hopeless and unbearable suffering," Professor de Vries analyzes the judicial interpretation of "suffering" and concludes that judicial interpretation has reached its limits, and thus by implication, the limits of lawful euthanasia have been reached.  相似文献   

8.
A major reason that The Netherlands has taken a different approach to the rest of the world on such a fundamental moral issue is that the courts and legislature in that country have accorded the interests of doctors a cardinal role in the euthanasia debate. This article argues that the interests of doctors are of only incidental and peripheral relevance in relation to the moral status of euthanasia. The moral status of euthanasia has little to do with the preparedness of doctors to administer the lethal injection or their general attitude towards the practice. Euthanasia is principally about the interests of the patient and the impact that the practice may have on the community in general, not preserving the conscience or improving the working life of doctors.  相似文献   

9.
The aims of this essay are twofold: to point out the main problems of the Chabot precedent and to report the findings of a fieldwork in the Netherlands during which some experts were asked to voice an opinion regarding the psychiatrist's conduct and the legal precedent. During the summer of 1999, twenty-eight interviews with some of the leading authorities on the euthanasia policy were conducted in the Netherlands. Multiple reasons were mentioned to either condone or condemn Chabot's practice.  相似文献   

10.
In December 2005 the first national guideline for palliative sedation in the Netherlands was published. This guideline was developed by a committee of the Royal Dutch Medical Association, at the request of the Dutch government. The guideline defines palliative sedation as 'the intentional lowering of consciousness of a patient in the last phase of his or her life'. According to the guideline the objective of palliative sedation is to relieve suffering, and lowering consciousness is a means to achieve this. It is very important that palliative sedation is given for the right indication, proportionally, and adequately. It is the degree of symptom control, not the level to which consciousness is lowered, which determines the dose and combinations of the sedatives used and duration of treatment. The assessment and decision-making processes must focus on adequate relief of the patient's suffering, so that a peaceful and acceptable situation is created. Palliative sedation is given in the last phase of life, in the imminently dying patient. Palliative sedation raises several legal questions. In this article we describe the structure and contents of the guideline, with special attention for the main legal issues involved, like the distinction between palliative sedation and euthanasia and the process of informed consent.  相似文献   

11.
On 1 April 2002 the Dutch Bill 'Termination of Life on Request and Assisted Suicide (Review Procedures) Act' (Wet toetsing levensbeeindiging op verzoek en hulp bij zelfdoding) came into force. This article starts with an outline of the former legal position in The Netherlands regarding euthanasia and medically assisted suicide, followed by an explanation of the new Act. The main focus of this contribution lays on the requirements of due care, the obligation to notify euthanasia to the coroner and the revised legal position of the so-called Regional Review Commissions. Furthermore, the article considers the termination of life in the case of minors and the function and requirements of written statements of euthanasia by patients no longer capable of communication. Finally, the article gives an overview of the problems [that] may come in the future concerning the approach to euthanasia in The Netherlands.  相似文献   

12.
The euthanasia debate has been re-ignited by the decision of the Dutch Parliament to legalise the practice. This will make the Netherlands the first nation in the world to legalise euthanasia. This paper explains the key aspects of the legislation and considers whether it provides a viable model for reform.  相似文献   

13.
Euthanasia has been legally sanctioned in the Netherlands by a series of court decisions going back to the 1970s. The author discusses the cultural and historical factors that may have contributed to this development. In the past decade, studies sanctioned by the Dutch government reveal that guidelines established for the regulation of euthanasia--a voluntary, well-considered, persistent request, intolerable suffering that cannot be relieved, consultation with a colleague, and reporting of cases--are consistently violated. Of greatest concern is the number of patients who are put to death without their consent--there are more involuntary than voluntary cases. Euthanasia intended originally for the exceptional case has become an accepted way of dealing with the physical and mental distress of serious or terminal illness. In the process palliative care has become one of the casualties while hospice care lags behind that of other countries. Case examples are given.  相似文献   

14.
In order to explore the usefulness and acceptability of the provisions of the Medical Treatment Act 1988 (Vic) for palliative care patients in a rural region in Victoria, Australia, between July and December 2004 patients were given information explaining the Act and the opportunity to discuss it with the research officer. Grounded theory methodology was used to evaluate client responses. Findings suggested that palliative care patients are willing to engage in advance care planning but they have to be well enough and need skilled, practical, face-to-face assistance to complete the required legal forms. Written materials alone are not adequate, but provide the opportunity for medical staff to have conversations about death and dying. Doctors and nurses should understand the provisions of the Act to assist patients and families. It is recommended that advance care planning, appropriate to the jurisdiction, be an integral part of the palliative care assessment process.  相似文献   

15.
Debate over euthanasia is not a recent phenomenon. Over the years, public opinion, decisions of courts, and legal and medical approaches to the issue of euthanasia has been conflicting. The connection between murder and euthanasia has been attempted in a few debates. Although it is widely accepted that murder is a crime, a clearly defined stand has not been taken on euthanasia. This article considers euthanasia from the medical, legal, and global perspectives and discusses the crime of murder in relation to euthanasia, taking into consideration the issue of consent in the law of crime. This article concludes that in the midst of this debate on euthanasia and murder, the important thing is that different countries need to find their own solution to the issue of euthanasia rather than trying to import solutions from other countries.  相似文献   

16.
The presence of undocumented migrants is increasing in many Western countries despite wide-ranging attempts by governments to increase border security. Measures taken to control the influx of immigrants include policies that restrict access to publicly funded health care for undocumented migrants. These restrictions to health care access are controversial, and evidence suggests they do not always have the intended effect. This study provides a comparative analysis of institutional, actor-related, and contextual factors that have influenced health care policy development on undocumented migrants in England and the Netherlands. For undocumented migrants, England restricts its access to care at the point of service, while the Netherlands restricts through the payment system for services. The study includes an analysis of policy papers and semistructured, in-depth interviews with various actors in both countries. Findings confirm the influence of such contextual factors as immigration considerations and cost concerns on health care policy making in this area. However, these factors cannot explain the differences between the two countries. Previously enacted policies, especially the organization of the health care system, affected the kind of restrictions for undocumented migrants. Concerns about the side effects of generous treatment of undocumented migrants on other groups played a substantial role in formulating restrictive policies in both countries. Evidently, policy development and implementation is critically affected by institutional rules, which govern the degree of influence that doctors and professional medical associations have on the policy process.  相似文献   

17.
The literature on the interaction between research communities and policymaking processes comes mostly from scholars in large countries with hundreds if not thousands of people working on international environmental issues. In small countries like Belgium and The Netherlands, however, policy networks of academics and decision makers are quite small. Not only are there opportunities for academic researchers to influence policy decisions - there are high expectations that they do so.  相似文献   

18.
The purpose of this article is to explain what has happened in the euthanasia debate in the Australian States and Territories, and to give a more detailed account of how the Northern Territory's euthanasia laws were overturned by the Federal Government. Dr. Fleming begins with a review of euthanasia legislation in each State and Territory, then proceeds with an analysis of the events in the Northern Territory leading to reversal of its euthanasia laws, and includes the effect of the euthanasia law on the Aboriginal people. He concludes that the repeal of the 1995 Northern Territory's Rights of the Terminally Ill Act was a significant setback for the pro-euthanasia movement not only in Australia, but worldwide.  相似文献   

19.
Despite there having been a positive context for initiating health care reforms in Portugal in the past fifteen years (accompanied by political consensus on the nature of the structural problems within the health care system), there has been a lack of reform initiatives. We use a process-based framework to show how institutional arrangements have influenced Portuguese health care reform. Evidence is presented to demonstrate inertia and nondecision making in three critical areas of Portuguese health policy: clarifying the public-private mix in coverage and provision, creating financial incentives and motivation for human resources, and introducing changes in the pharmaceutical market. Several factors seem to explain these processes, namely, problems in the balance of power within the political system, which have contributed to a lack of proper policy discussion; a lack of pluralism in the formation of health care policies (with low participation from citizens and high mobilization among structural interest groups); and the low priority of health care in public sector reforms. Portuguese politicians should be aware of the pitfalls of the current political system that constrain participatory arrangements and pluralism in policy making. In order to pursue health care reform, future governments will need to counterbalance the strong influence of structural interest groups.  相似文献   

20.
This paper addresses the governance of families in the context of a political philosophy that endorses a rights perspective in social policy and the need to promote transparent government. The status of parenting as a function of government has grown substantially under the present Labour administration and now commands cross-party support as a priority issue. However, it would be wrong to claim that there is a national consensus regarding the role of the state in supporting and regulating families in their upbringing of children. This paper assesses current parental rights and responsibilities in relation to financial support, and the physical and emotional care and control of children. Emerging themes and ambiguities are drawn out, and consideration is given to the need for a strategic policy statement embracing the broad ambit of government legislation, discussion documents, and commentaries. In conclusion, the case is made for a regular policy review and for a national debate as to whether there should an official statement of parents' rights and responsibilities.  相似文献   

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