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01-07-2010 | Short Commentary

“The choice for death” and neurology

Authors: Anna Durnová, Herbert Gottweis

Published in: Journal of Neurology | Issue 7/2010

Abstract

In the last decade, "end-of-life" issues have gained prominence in political and social debates in many countries. The deliberate ending of the life of a patient upon his/her own request has become a hotly contested topic. This paper discusses the implications of this debate and of corresponding policy and legal developments for neurology. We discuss the nomenclature of the "choices for death", euthanasia, doctor-assisted suicide and palliative care as well as the social dynamics underlying these developments. We suggest that we need a more nuanced and empirically based understanding of the process of the "choice for death and its implications for medical practice."

Data on the aging population can be found in the archive of the current project of the French National Institute of Demographic Studies (INED): http://www.ined.fr/fr/recherches_cours/projets_recherche/projets_phares/bdd/projet/P0517/.

“Passive euthanasia” presents a key controversy because the respective classification of the refusal of the patient as “treatment withdrawal” or “passive euthanasia” diverges in relation to (1) the classification of what is “medical treatment” and what is not, e.g., a feeding tube, and to (2) the respective estimation of ethical committees that either do not want to speak about euthanasia at all or, on the contrary, want to pay attention to the fact that these decisions affect the end of a person’s life.

One case before the European Court of Human Rights was brought by British patient Diane Pretty, who, having developed a neurological disease, was physically incapable of performing her own suicide, but the British justice system, which doesn’t allow assisted suicide, prevented her husband from assisting her. Other cases sparking debate were that of Spanish Inmaculada Echevarría, who wanted to refuse treatment in order to end her 15 years of suffering muscular dystrophy, and the Italian Piergiorgio Welby, also suffering from muscular dystrophy, who brought his right to die to the President in 2006.

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Durnová A, Gottweis H (2009) Politik zwischen Tod und Leben. In: Weiß (ed) Bios und Zoe. Die menschliche Natur im Zeitalter ihrer technischen Reproduzierbarkeit. Frankfurt/M., Suhrkamp, pp 273–303

Kübler-Ross E (2009) On death and dying: what the dying have to teach doctors, nurses, clergy and their own families. Routledge, London

Clark D (2002) Between hope and acceptance: the medicalisation of dying. BMJ 324:905–907CrossRefPubMed

Pasman HR, Rurup ML, Willems DL et al (2009) Concept of unbearable suffering in context of ungranted requests for euthanasia: qualitative interviews with patients and physicians. BMJ 339:b4362CrossRefPubMed

Durnová A (2009) Towards a politics of intimacy: policies on dying in European societies. Dissertation, University of Vienna

Veldink JH, Wokke JHJ, van der Wal G et al (2002) Euthanasia and physician-assisted suicide among patients with amyotrophic lateral sclerosis in The Netherlands. N Engl J Med 347:1041–1043CrossRef

Title: “The choice for death” and neurology
Authors: Anna Durnová
Herbert Gottweis
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: Journal of Neurology / Issue 7/2010
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-010-5554-z

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“The choice for death” and neurology

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