GESTIÓN EN SALUD PÚBLICA: BioEdge: Should happy demented people be euthanized?

domingo, 5 de junio de 2016

BioEdge: Should happy demented people be euthanized?

Should happy demented people be euthanized?

by Michael Cook | 4 Jun 2016 | 4 comments

One problem sector in regimes which have legalised euthanasia is demented people who have made advance directives asking for euthanasia. They have drifted away from terra firma, but they often are sailing quite happily along and no longer request life-ending treatment. They seem to have an adequate quality of life. In technical terms, they have undergone a “response shift”. Should they be denied a choice they made when their feet were firmly on the ground?

A recent article in the Journal of Medical Ethics argues that their choice should probably be honoured. Three authors from the Netherlands and Germany contend that demented people do not really undergo a response shift because their disease makes them unable to change their values.

Dementia patients do not choose what they forget, therefore what they still remember and the values they still express are not to be considered the ones with the highest priority. Which values and preferences remain is not the result of a conscious choice but is dictated by the disease. It is therefore a false conclusion to say that the dementia patient no longer ‘cares’ about the things that mattered when he did not have dementia.

This implies that the current wishes of a person with dementia should not necessarily be respected if they have made an advance directive requesting euthanasia: “It is unwarranted to argue that one's current well-being should always take precedence over all other values once a person is incapacitated.” The authors stress that advance directives should not followed blindly, but neither should carers refrain from euthanasing demented people simply because they look happy as Larry in their present condition.

- See more at: http://www.bioedge.org/bioethics/should-happy-demented-people-be-euthanized/11905#sthash.WXfmLdeb.dpuf

Ali defeated Sonny Liston in 1964

The death of Muhammed Ali at the age of 74 is reminder of the uneasy ethical status of boxing. Only in boxing is the brain the target. Ali’s Parkinson’s disease was probably a result of punishing blows to the head over the course of his career. Gloves probably make the problem worse, as they increase the weight and the force of impact. Headgear may not protect boxers from rotational acceleration.

John Hardy, a neuroscientist at University College London, wrote a couple years ago: “nothing can be more killing of joy than personality changes, violence, substance abuse and dementia. I also think it is demeaning as a society for people to get pleasure out of watching others fight and that we should consign this public spectacle, as we have done public executions, to the dustbin of history.”

What do you think? Should professional boxing be banned? It seems hard to justify a sport which, in the words of Joe Frazier, who beat Ali in the brutal “fight of the century” in 1971, “boxing is the only sport you can get your brain shook, your money took and your name in the undertaker book.”