GESTIÓN EN SALUD PÚBLICA: BioEdge: Is euthanasia really the ‘best’ way to die?

sábado, 3 de junio de 2017

BioEdge: Is euthanasia really the ‘best’ way to die? | BioEdge

BioEdge: Is euthanasia really the ‘best’ way to die?

Is euthanasia really the ‘best’ way to die?

by Michael Cook | 2 Jun 2017 | 2 comments

New York’s supreme court began weighing up arguments for and against physician-assisted suicide this week, so it was no surprise that the New York Times reported the euthanasia death in British Columbia of an expatriate New Yorker.

What was surprising, writes bioethicist Franklin Miller, of Weill Cornell Medical College, was the tone, spread and length of the feature. Published on May 25, a photo of John Shields, the dead man, took up a quarter of the front page, and there were five full pages of text and images inside the newspaper.

Dr Miller supports physician assisted suicide for the terminally ill, but he found the gushing coverage alarming. He writes in the The Hastings Center blog:

It seems significant that the New York Times—an arbiter of culture—devoted an extraordinary amount of attention to a planned, physician-assisted death [PAS] and the rituals associated with it. There is a human interest story here, but the article had scant discussion of the ethical and policy issues raised by Canada’s form of legalized medical assistance in dying. Presented to the readers, in lavish detail, as the “Gift of Death,” with a very appealing protagonist, this article romanticizes the death of John Shields. More importantly, I see it as describing, and prescribing, a model for the good death in North America today.

Dr Miller insists that PAS is not the only “good death”, but the coverage implies that it may be the best way to depart this world. “Letting death happen, with the aid of palliative care, is no less good than making it happen,” Dr Miller argues. “We should beware of prescribing a particular form of ‘death with dignity’ as a model for the end of life and not acknowledging other perspectives.”

The article was not a model of the Times’s new slogan “discover the truth with us”. As Miller points out, the article shed no light at all upon the ethical, medical and social complexities of Canada’s new legislation for euthanasia, or medical assistance in dying (MAID), as it is called in Canada. Mr Shields, a former Catholic priest who found a new career as a union organiser in BC and, in retirement, as an environmental activist, was terminally ill, although he was not suffering unbearable pain. But he did fear becoming dependent. He fit the profile of most euthanasia patients: worried, white, and well-off. From the Times’s account, it appears that the hospice doctors were not top-notch palliative care experts.

As in other portrayals of assisted dying, a cool, competent, compassionate doctor becomes a central figure in the narrative. In this case, she was a 48-year-old mother of two, Stefanie Green, who is so committed to euthanasia that she attended a conference in the Netherlands a month before it became legal. It seems relevant to coverage of Mr Shields’s death that she is also the founder of the Canadian Association of MAID Assessors and Providers and has been involved in a quarrel with the BC government about insufficient compensation for euthanasia services. But nothing was mentioned about this in the article.

Saturday, June 3, 2017

Now that President Donald Trump has backed out of the Paris Climate Change agreement, employment prospects for bioethicists may pick up. Let me explain

The boundaries of bioethics are very elastic, and on some maps they take in care for the natural environment. I would predict that in the measure that scientists lose faith in a political solution to global warming, some will back geoengineering projects to cool the planet.

These include tactics such as injecting aerosols into the upper atmosphere, dumping iron filings into the sea to promote algal blooms, and machines to capture carbon dioxide. These involve significant risk and place great power in the calculations of technocrats. They need to be studied very carefully. As University of Chicago climate scientist Raymond Pierrehumbert said a few years ago, “I see lots [of geoengineering ideas] that are feasible but they all terrify me.”

A 2010 conference on the ethics of climate intervention at Asilomar, in California, addressed some of these issues using principles drawn from the famous Belmont principles of autonomy, beneficence, non-malificence and justice. And who knows more about these than bioethicists? Dust off those resumés.