This is an article about ethical issues in health care. For other meanings, including those involved in tort law, see Standard of Care (disambiguation).
Ordinary and extraordinary care are distinguished by some bioethical theories, including the teaching of the Catholic Church. [1]
In explaining the Catholic Church's attitude towards preserving life, Pope Pius XII, in a 1957 Address to Anaesthetists, stated: “[...] normally one is held to use only ordinary means – according to circumstances of persons, places, times and culture – that is to say, means that do not involve any grave burden for oneself or another.” [2]
A 1957 article by the Jesuit theologian Father Gerald Kelly provides further detail. Kelly maintains that medical professionals are morally obligated to use ordinary means to preserve the lives of their patients, but extraordinary care is not morally obligatory. He defined ordinary and extraordinary means as follows: [3]
Ordinary means to preserve life have also been defined as "what is reasonable", taking into account "reasonable/proportionate hope of benefit/success; common diligence; and not unreasonably demanding." In this view, elements of extraordinary needs are "what is inappropriate", characterized by “certain impossibility; excessive effort; level of pain; extraordinarily expensive; and causing severe dread or revulsion." [4]
The American Life League maintains that ordinary care can become extraordinary care under certain situations. [5]
Euthanasia is the practice of intentionally ending life to eliminate pain and suffering.
Karen Ann Quinlan was an American woman who became an important figure in the history of the right to die controversy in the United States.
Bioethics is both a field of study and professional practice, interested in ethical issues related to health, including those emerging from advances in biology, medicine, and technologies. It proposes the discussion about moral discernment in society and it is often related to medical policy and practice, but also to broader questions as environment, well-being and public health. Bioethics is concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, theology and philosophy. It includes the study of values relating to primary care, other branches of medicine, ethical education in science, animal, and environmental ethics, and public health.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
The principle of double effect – also known as the rule of double effect, the doctrine of double effect, often abbreviated as DDE or PDE, double-effect reasoning, or simply double effect – is a set of ethical criteria which Christian philosophers have advocated for evaluating the permissibility of acting when one's otherwise legitimate act may also cause an effect one would otherwise be obliged to avoid. The first known example of double-effect reasoning is Thomas Aquinas' treatment of homicidal self-defense, in his work Summa Theologica.
Palliative care is an interdisciplinary medical caregiving approach aimed at optimising quality of life and mitigating or reducing suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist.
The right to die is a concept based on the opinion that human beings are entitled to end their lives or undergo voluntary euthanasia. Possession of this right is often bestowed with the understanding that a person with a terminal illness, or in incurable pain has access to assisted suicide. The question of who, if anyone, may be empowered to make this decision is often the subject of debate.
In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, rather than fatal injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. An illness which is lifelong but not fatal is called a chronic condition.
Futile medical care is the continued provision of medical care or treatment to a patient when there is no reasonable hope of a cure or benefit.
Evangelium vitae translated in English as 'The Gospel of Life', is a papal encyclical published on 25 March 1995 by Pope John Paul II. It is a comprehensive document setting out the teaching of the Catholic Church on the sanctity of human life and related issues including murder, abortion, euthanasia, and capital punishment, reaffirming the Church's stances on these issues in a way generally considered consistent with previous church teachings.
Voluntary euthanasia is the purposeful ending of another person's life at their request, in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in the 21st century, surrounding the idea of a right to die. Some forms of voluntary euthanasia are legal in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand, and Spain.
In ethics and other branches of philosophy, suicide poses difficult questions, answered differently by various philosophers. The French Algerian essayist, novelist, and playwright Albert Camus (1913–1960) began his philosophical essay The Myth of Sisyphus with the famous line "There is but one truly serious philosophical problem and that is suicide.".
Involuntary euthanasia is illegal in all 50 states of the United States. Assisted suicide is legal in ten jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and Washington. The status of assisted suicide is disputed in Montana, though currently authorized per the Montana Supreme Court's ruling in Baxter v. Montana that "nothing in Montana Supreme Court precedent or Montana statutes [indicates] that physician aid in dying is against public policy."
The philosophy of healthcare is the study of the ethics, processes, and people which constitute the maintenance of health for human beings. For the most part, however, the philosophy of healthcare is best approached as an indelible component of human social structures. That is, the societal institution of healthcare can be seen as a necessary phenomenon of human civilization whereby an individual continually seeks to improve, mend, and alter the overall nature and quality of their life. This perennial concern is especially prominent in modern political liberalism, wherein health has been understood as the foundational good necessary for public life.
Affreightment is a legal term relating to shipping.
Child euthanasia is a form of euthanasia that is applied to children who are gravely ill or have significant birth defects. In 2005, the Netherlands became the first country since the end of Nazi Germany to decriminalize euthanasia for infants with hopeless prognosis and intractable pain. Nine years later, Belgium amended its 2002 Euthanasia Act to extend the rights of euthanasia to minors. Like adult euthanasia, there is world-wide public controversy and ethical debate over the moral, philosophical, and religious issues of child euthanasia.
There are many religious views on euthanasia, although many moral theologians are critical of the procedure.
A surrogate decision maker, also known as a health care proxy or as agents, is an advocate for incompetent patients. If a patient is unable to make decisions for themselves about personal care, a surrogate agent must make decisions for them. If there is a durable power of attorney for health care, the agent appointed by that document is authorized to make health care decisions within the scope of authority granted by the document. If people have court-appointed guardians with authority to make health care decisions, the guardian is the authorized surrogate.
Insect euthanasia is the process of killing insects "in a way that minimizes or eliminates pain and distress." It may apply to animals in the laboratory, schools, as pets, as food, or otherwise.