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  • Title: Physician-Assisted Suicide and Euthanasia in the ICU: A Dialogue on Core Ethical Issues.
    Author: Goligher EC, Ely EW, Sulmasy DP, Bakker J, Raphael J, Volandes AE, Patel BM, Payne K, Hosie A, Churchill L, White DB, Downar J.
    Journal: Crit Care Med; 2017 Feb; 45(2):149-155. PubMed ID: 28098622.
    Abstract:
    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.
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