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End of life legislation

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https://www.readbyqxmd.com/read/29306500/nurses-perspectives-on-whether-medical-aid-in-dying-should-be-accessible-to-incompetent-patients-with-dementia-findings-from-a-survey-conducted-in-quebec-canada
#1
G Bravo, C Rodrigue, M Arcand, J Downie, M-F Dubois, S Kaasalaine, C M Hertogh, S Pautex, L Van den Block
We conducted a survey in a random sample of 514 Quebec nurses caring for the elderly to assess their attitudes towards extending medical aid in dying to incompetent patients and to explore associated factors. Attitudes were measured using clinical vignettes featuring a hypothetical patient with Alzheimer disease. Vignettes varied according to the stage of the disease (advanced or terminal) and the presence or absence of a written request. Of the 291 respondents, 83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably...
January 3, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29302599/what-are-the-ethical-aspects-surrounding-the-collegial-decisional-process-in-limiting-and-withdrawing-treatment-in-intensive-care
#2
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
The decision to limit or withdraw life-support treatment is an integral part of the job of a physician working in the intensive care unit, and of the approach to care. However, this decision is influenced by a number of factors. It is widely accepted that a medical decision that will ultimate lead to end-of-life in the intensive care unit (ICU) must be shared between all those involved in the care process, and should give precedence to the patient's wishes (either directly expressed by the patient or in written form, such as advance directives), and taking into account the opinion of the patient's family, including the surrogate if the patient is no longer capable of expressing themselves...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29287691/protocol-for-the-assessment-of-patient-capacity-to-make-end-of-life-treatment-decisions
#3
Richard B Stuart, Stephen Thielke
Patients' right to decide what happens to their bodies, especially around the end of life, is enshrined in legislation across the world, but questions often arise about whether a patient is capable of meaningfully participating in such decisions. Because of uncertainties about capacity, care providers and administrative agencies often must decide whether to honor, or even to elicit, patients' wishes. General decision-making capacity has been well studied, but few clear protocols exist for ascertaining capacity at the end of life...
December 26, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29284475/existential-decision-making-in-a-fatal-progressive-disease-how-much-do-legal-and-medical-frameworks-matter
#4
Christian Weber, Barbara Fijalkowska, Katarzyna Ciecwierska, Anna Lindblad, Gisela Badura-Lotter, Peter M Andersen, Magdalena Kuźma-Kozakiewicz, Albert C Ludolph, Dorothée Lulé, Tomasz Pasierski, Niels Lynöe
BACKGROUND: Healthcare legislation in European countries is similar in many respects. Most importantly, the framework of informed consent determines that physicians have the duty to provide detailed information about available therapeutic options and that patients have the right to refuse measures that contradict their personal values. However, when it comes to end-of-life decision-making a number of differences exist in the more specific regulations of individual countries. These differences and how they might nevertheless impact patient's choices will be addressed in the current debate...
December 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29214967/fear-of-life-fear-of-death-and-fear-of-causing-death-how-legislative-changes-on-assisted-dying-are-doomed-to-fail
#5
Matti Häyry
Fear of life, fear of death, and fear of causing death form a combination that prevents reasoned changes in laws concerning end-of-life situations. This is shown systematically in this article using the methods of conceptual analysis. Prevalent fears are explicated and interpreted to see how their meanings differ depending on the chosen normative stance. When the meanings have been clarified, the impact of the fears on the motivations and justifications of potential legislative reforms are assessed. Two main normative stances are evoked...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#6
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29145100/environmental-assessment-of-microwaves-and-the-effect-of-european-energy-efficiency-and-waste-management-legislation
#7
Alejandro Gallego-Schmid, Joan Manuel F Mendoza, Adisa Azapagic
More than 130 million microwaves are affected by European Union (EU) legislation which is aimed at reducing the consumption of electricity in the standby mode ('Standby Regulation') and at more sustainable management of end-of-life electrical and electronic waste ('WEEE Directive'). While legislation focuses on these two life cycle stages, there is little information on the environmental impacts of the entire life cycle of microwaves. To address this gap, this paper presents a comprehensive life cycle assessment of microwaves and assesses the environmental implications of the Standby Regulation and the WEEE Directive at the EU level...
November 13, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29133281/should-medical-assistance-in-dying-be-extended-to-incompetent-patients-with-dementia-research-protocol-of-a-survey-among-four-groups-of-stakeholders-from-quebec-canada
#8
Gina Bravo, Claudie Rodrigue, Vincent Thériault, Marcel Arcand, Jocelyn Downie, Marie-France Dubois, Sharon Kaasalainen, Cees M Hertogh, Sophie Pautex, Lieve Van den Block
BACKGROUND: Alzheimer's disease and related disorders affect a growing number of people worldwide. Quality of life is generally good in the early stages of these diseases. However, many individuals fear living through the advanced stages. Such fears are triggering requests for medical assistance in dying (MAiD) by patients with dementia. Legislation was recently passed in Canada and the province of Quebec allowing MAiD at the explicit request of a patient who meets a set of eligibility criteria, including competence...
November 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29077877/cryonics-in-the-courtroom-which-interests-whose-interests
#9
Richard Huxtable
In an apparent international first, the High Court has allowed a terminally ill 14-year-old to be cryopreserved after her death. The patient, JS, requested this, as she hoped one day to be reanimated and cured. Jackson J focused on the welfare (or best interests) of JS as she approached the end of her life and particularly on her (apparently) competent wish to be cryopreserved. I consider the interests involved in a decision to undergo cryonics, specifically exploring which interests and whose interests are engaged...
October 25, 2017: Medical Law Review
https://www.readbyqxmd.com/read/29056584/the-french-exception-the-right-to-continuous-deep-sedation-at-the-end-of-life
#10
Ruth Horn
In 2016, a law came into force in France granting terminally ill patients the right to continuous deep sedation (CDS) until death. This right was proposed as an alternative to euthanasia and presented as the 'French response' to problems at the end of life. The law draws a distinction between CDS and euthanasia and other forms of sympton control at the end of life. France is the first country in the world to legislate on CDS . This short report describes the particular context and underlying social values that led to this piece of legislation, and explores its meaning in the wider French context...
October 22, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29045631/implementation-of-advance-care-planning-in-israel-a-convergence-of-top-down-and-bottom-up-processes
#11
Netta Bentur, Shelley Sternberg
Although public health has traditionally been concerned with primary, secondary, and tertiary prevention, more attention needs to be focused on patient-centered care at the end of life. Improved access to quality end-of-life care can be achieved by advance care planning (ACP). In this article, we present an example of the processes of change regarding ACP and preparing advance directives (ADs) that have begun to take place in Israel in recent years. We argue that these processes derive from the synergy between legislation on the one hand, and initiatives and action by health organizations on the other...
October 13, 2017: Gerontologist
https://www.readbyqxmd.com/read/28944936/smoking-cessation-in-workplace-settings-quit-rates-and-determinants-in-a-group-behaviour-therapy-programme
#12
Yann Hausherr, Carlos Quinto, Leticia Grize, Christian Schindler, Nicole Probst-Hensch
INTRODUCTION: To capitalise on the opportunities that the smoking ban legislation in Switzerland offers for the prevention of tobacco-related diseases, a smoking cessation programme in a workplace setting was developed and implemented in companies across the language and cultural regions of Switzerland. Our goal was to identify factors associated with relapse into smoking that may be overcome during training sessions or that should be considered for the optimisation of future interventions...
September 25, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28902070/contending-with-preplanned-death-questions-for-clinicians
#13
Joel Yager
BACKGROUND AND OBJECTIVES: The goal of this column is to assist readers in reflecting on their attitudes and responses toward clinical and nonclinical situations involving preplanned deaths by decisionally capable individuals. Such circumstances range from encountering individuals in one's personal and professional lives who desire and intend to end their lives under their own terms, to having such individuals request assistance with predeath and postdeath arrangements. METHODS: Attending to pertinent literature, this essay uses Socratic inquiry to question conventional assumptions and attitudes, push readers' thoughts beyond typical comfort zones, and consider alternative modes of responding to challenges posed by preplanned death...
September 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28717769/end-of-life-care-in-latin-america
#14
REVIEW
Enrique Soto-Perez-de-Celis, Yanin Chavarri-Guerra, Tania Pastrana, Rossana Ruiz-Mendoza, Alexandra Bukowski, Paul E Goss
Cancer has become a global pandemic with disproportionately higher mortality rates in low- and middle- income countries, where a large fraction of patients present in advanced stages and in need of end-of-life care. Globally, the number of adults needing end-of-life care is greater than 19 million, and up to 78% of these patients are living in low- and middle- income countries. In the Americas alone, more than one million people are in need of end-of-life care, placing an enormous burden on local health systems, which are often unprepared to meet the challenge presented by this complex patient population...
June 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28608984/dialysis-in-the-undocumented-the-past-the-present-and-what-lies-ahead
#15
EDITORIAL
Shruti Gupta, Andrew Z Fenves
In many states undocumented immigrants with end stage renal disease (ESRD) do not have access to regular, thrice weekly dialysis. The term "compassionate dialysis" is used to describe dialysis that is provided on an emergent basis, when patients are in extremis from symptoms of volume overload or suffer from life-threatening electrolyte abnormalities. In this editorial, one particularly poignant anecdote is presented from the experience of one of the authors (AZF) as a nephrologist in Texas, a state where undocumented immigrants have faced difficulties in accessing regular dialysis...
September 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28587503/sense-of-responsibility-in-icu-end-of-life-decision-making-relatives-experiences
#16
Ranveig Lind
BACKGROUND: Relatives of intensive care unit patients who lack or have reduced capacity to consent are entitled to information and participation in decision-making together with the patient. Practice varies with legislation in different countries. In Norway, crucial decisions such as withdrawing treatment are made by clinicians, usually morally justified to relatives with reference to the principle of non-maleficence. The relatives should, however, be consulted about whether they know what the patient would have wished in the situation...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28427738/assessment-of-a-combined-dry-anaerobic-digestion-and-post-composting-treatment-facility-for-source-separated-organic-household-waste-using-material-and-substance-flow-analysis-and-life-cycle-inventory
#17
Morten Bang Jensen, Jacob Møller, Charlotte Scheutz
The fate of total solids, volatile solids, total organic carbon, fossil carbon, biogenic carbon and 17 substances (As, Ca, CaCO3, Cd, Cl, Cr, Cu, H, Hg, K, Mg, N, Ni, O, P, Pb, S, Zn) in a combined dry anaerobic digestion and post-composting facility were assessed. Mass balances showed good results with low uncertainties for non-volatile substances, while balances for nitrogen, carbon, volatile solids and total organic carbon showed larger but reasonable uncertainties, due to volatilisation and emissions into the air...
April 17, 2017: Waste Management
https://www.readbyqxmd.com/read/28426217/phosphorus-depletion-as-a-green-alternative-to-biocides-for-controlling-biodegradation-of-metalworking-fluids
#18
Yaldah Azimi, Ian P Thompson
Metalworking fluids (MWFs) are used as lubricants and coolants in the manufacturing operations. Their biodeterioration, while in operation, is a widespread problem leading to poor performance and worker health issues. Adding biocides, though effective in reducing microbial growth, leads to the production of more recalcitrant wastewaters that are difficult to dispose or recycle on-site. Increasing environmental concerns have led to robust legislation for reducing/eliminating the use of toxic biocides in MWFs, stimulating a growing interest in the development/application of alternative biological preservation strategies...
May 1, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28419505/assisted-dying-disability
#19
Christopher A Riddle
This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal...
July 2017: Bioethics
https://www.readbyqxmd.com/read/28393995/-euthanasia-in-chile
#20
REVIEW
Víctor Hugo Carrasco M, Francisca Crispi
Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chile’s history in euthanasia and the population’s opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation...
December 2016: Revista Médica de Chile
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