bodies organs suicide 2012

8/2/2019 Bodies Organs Suicide 2012

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MHA Week 10Spring 2012

Denise Hill, JD, MPA


2/25

Bodies incineratedhttp://www.nj.com/news/index.ssf/2009/01/missing_jersey_city_babys_body.html

Bodies stolen

Bodies lostSee sample policieshttp://www.azumc.com/body.cfm?id=565
http://www.nj.com/news/index.ssf/2009/01/missing_jersey_city_babys_body.htmlhttp://www.azumc.com/body.cfm?id=565http://www.azumc.com/body.cfm?id=565http://www.azumc.com/body.cfm?id=565http://www.azumc.com/body.cfm?id=565http://www.azumc.com/body.cfm?id=565http://www.nj.com/news/index.ssf/2009/01/missing_jersey_city_babys_body.html


3/25

Balancing of individual interestsv. societal interests

ProstitutionImmunizations

DrugsSelling organs (reconsidered by the AMA).Suicide

3For Education only-Not legaladvice


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5/25

Has to be consent Can be decedent, healthcare power of attorney, or family.

Law went into effect July 1, 2002. First Person Consent Bill (Senate File 2195)allows "a written statement attached to or imprinted or noted on a driver's licenseor non-operator's id card, an entry in a donor registry, a donor's will or any otherwritten document used by a donor to make an anatomical gift.www.iowadonorregistry.org.

Is this consent informed?

http://www.iowadonorregistry.org/http://www.iowadonorregistry.org/http://www.iowadonorregistry.org/http://www.iowadonorregistry.org/http://www.iowadonorregistry.org/http://www.iowadonorregistry.org/


6/25

Many Legal and Ethical Issues:

Who decides if donor card andfamily disagrees?

When to Harvestnon-heartbeating

Dont sell legally

Confidentiality

Who should get the organs?Priority?

Great article on legal and ethicalissues re: organ allocation

http://bioethics.georgetown.edu/pcbe/backg

round/davispaper.html

For Education only-Not legal advice6
http://bioethics.georgetown.edu/pcbe/background/davispaper.htmlhttp://bioethics.georgetown.edu/pcbe/background/davispaper.htmlhttp://bioethics.georgetown.edu/pcbe/background/davispaper.htmlhttp://bioethics.georgetown.edu/pcbe/background/davispaper.htmlhttp://bioethics.georgetown.edu/pcbe/background/davispaper.html


7/25

94 year old woman who has been on the list longest; 3 year old girl in NY; 38 year old celebrity in CA who promises to contribute 5 million to

cancer; 41 year old scientist in Chicago who is on the cutting edge of finding

a cure for Parkinson's;

50 year old Iowa alcoholic who has 2 prior livers destroyed byalcohol will die tomorrow if does not get it;

Mexican teenager in NC where hospital made medical errorwrongblood type during prior transplant, urgently needs; or

3 year old Iowa Boy with Cerebral Palsy 2nd on the list.

For Education only-Not legal advice7


8/25


9/25

Practice for the benefit ofpatients--do no harm

Hippocrates (a.k.a. Father of Medicine)Ancient Greece 400 BC

May be considered harmful to die

May be considered harmful to live

Assumption that we all desire to live



10/25

PAS is Generally a Crime

AMA CEJA unethicalinconsistent with physicians role as healer and cant regulate.

National survey of DOsoverwhelmingly opposecontrary to oath



11/25

Vacco v. Quill & Washington v. Glucksberg(1997)

Parties: physicians & patients

Challenged states ban on physician-assisted suicide

Claimed denied liberty to choose death

Supreme Court: (9-0 decision)

Right to suicide is not fundamental liberty interest (offensive)

Ban rationally related to states interest in preserving life.


12/25

State authority to regulate suicide withoutviolating the 14thamendmentPatients noright to suicide, but states can permit.

Distinction between letting die (DNR) andmaking die (suicide).



13/25

Natural Death ActState Statute affirming terminally ill patients right torefuse treatment

Oregons Death with Dignity Act of 1997Legalized Physicians ability to write lethal prescriptionsfor terminally ill patients

Attorney General Ashcroft



14/25

Patients Determination Act

Slippery Slope Argument

Hippocratic Oath



15/25

AutonomyAuthority for a competent individual to choose how they want tobe treatedAuthority to choose how they want to die

BeneficenceHippocratic Oath is outdated

Protect the best interests of the patient

JusticeEquality of treatmentBenefits from treatment and nontreatment



16/25

Right to Refuse Treatment

Right to Advanced DirectivesWithdrawing life sustaining technology

Withholding life sustaining procedures



17/25

Conflicts:Prescriptions for lethal drugs

Physicians direct involvement in

states that prohibit Physician-assisted suicide

Passive Inaction versus activeeuthanasia (i.e. Dr. Kovorkian)



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IF PAS is legalized, there might bevulnerable individuals who will fall victim tothe euthanasia.

Beneficence versus Malfeasance



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How has medical technology impacted ourview on end of life choices?

Should the government decide how wechoose to die?



20/25

http://depts.washington.edu/bioethx/topics/pas.html

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http://depts.washington.edu/bioethx/topics/pas.htmlhttp://depts.washington.edu/bioethx/topics/pas.htmlhttp://depts.washington.edu/bioethx/topics/pas.htmlhttp://depts.washington.edu/bioethx/topics/pas.html


21/25

Background:

In the Netherlands physician assisted (& administered) suicideis legal if meet requirements:

2nd OpinionHopeless Suffering

No prospect of CurePatient repeated requests euthanasiaFurther life unacceptable to patient



22/25

Patient had ALSLou Gehrigs Disease

Semi paralyzed

Difficulty talking & breathing

Uncontrollable pain/outbursts of crying

Controlled death a comforting thought because alternative is suffocation



23/25

Follows physician through visits with patient and his spouse,

going through the mandatory process & choosing/getting thelethal drugs.

Highlights the patients (and spouses) physical suffering anddepression and how potential euthanasia at time of his deathat his control was liberating, yet difficult decision, he

postponed several times.Provides personal insight in to the physicians ethical/spiritualquandary



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There are no easy answers!

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2005-Dutch law enforcement cracking down on anynon-physician assisted suicide they find, sentencingan old man to six months imprisonment for helpinga sick, old woman to die

Assisted Suicide Around the Worldhttp://www.assistedsuicide.org/suicide_laws.html

http://www.assistedsuicide.org/suicide_laws.htmlhttp://www.assistedsuicide.org/suicide_laws.html

bodies organs suicide 2012

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