Overview

Several medical options in palliative care can have complex moral, religious, cultural, medical and legal issues. These treatment options, such as assisted suicide, rehydration, parenteral nutrition and cardiopulmonary resuscitation have been heavily debated in the literature. Physician-assisted suicide is a controversial topic for debate, with growing pressure from advocacy groups for legalisation in regions that have yet to decide. Currently, there is substantial opposition from concerned medical professionals. However, a school of medical professionals acknowledges that physician-assisted suicide may have a role in terminal care. The debate over the use of artificial nutrition and hydration (ANH) in terminal illness is also contentious despite extensive ethical and empirical research. Advocates for and against ANH both agree that the most compassionate and humane option for patients near the end of life is hospice and/or palliative care. However, many of those who support ANH do not seem to appreciate that the standard palliative practice is to avoid the use of ANH in almost all instances. These topics remain heavily disputed in the medical community. In formulating a satisfactory answer, we need to remind ourselves that we cannot generalise a treatment as a correct or incorrect option. Rather, we need to consider each case individually, weigh the risks and benefits of each treatment, and individually consider treatment options in a multidisciplinary care model.

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9781634839051

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Breanne Lechner, MD(C) is a clinical research assistant in the Rapid Response Radiotherapy Program at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada and also a medical student at the University of Toronto. She was the recipient of the J Frank Brookfield Scholarship from the University of Waterloo in 2012 for excellence in biology. Joav Merrick, MD, MMedSci, DMSc, born and educated in Denmark is professor of pediatrics, child health and human development, Division of Pediatrics, Hadassah Hebrew University Medical Center, Mt Scopus Campus, Jerusalem, Israel and Kentucky Childrens Hospital, University of Kentucky, Lexington, Kentucky United States and professor of public health at the Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, United States, the medical director of the Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem, the founder and director of the National Institute of Child Health and Human Development in Israel.

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