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References
- Georgetown University Press
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156 Glossary confidentiality. The requirement that information gained in the therapeutic relationship not be given to those who have no right to it. consultation. See ethics consultation. cumulative legislation. A statutory law that is not intended to change or restrict existing rights or previous laws. direct/indirect euthanasia (or active/passive). Older and confusing term whereby forgoing treatment is included as euthanasia and euthanasia includes not only killing but also allowing to die Direct or active means killing; indirect or passive means allowing to die, including certain cases of pain control. The distinction is often made according to the principle of double effect. double effect principle. See principle of double effect. durable power of attorney. Legal directive whereby a person appoints another to be attorney in fact with power to perform certain functions, including admission to hospitals, consent to treatment, and consent to forgo treatment, when that person becomes unable to do so. It is a form of proxy advance directive, sometimes used when states do not have an advance directive law that provides for appointment of a health care proxy. ethics consultation. A consultation initiated by someone connected with a clinical case for getting advice concerning ethical issues, usually done by a team of members from the Institutional Ethics Committee. euthanasia. Literally, in a wider sense, it means ‘‘good death’’ or ‘‘dying well.’’ In its more usual, narrower sense, it is killing a terminally ill patient (see also voluntary/nonvoluntary/involuntary and direct/indirect euthanasia). extraordinary means (of preserving life). Procedures whose burdens outweigh the benefits so that a patient has no moral obligation to accept them; morally optional treatment. forgoing treatment. Withholding or withdrawing treatment. informed consent. The process of giving necessary information to the patient or surrogate to enable that person to consent to or refuse to consent to treatment or the process of obtaining the consent. informed consent form. The actual piece of paper that the patient signs. Not a legal substitute for informed consent. justice. The principle or value of rendering to each person his or her due, of acting fairly, and including social distribution and allocation issues; one of the four basic principles. Glossary 157 killing. Actually doing something that kills or hastens death and is intended to do precisely that. living will. See advance directive. nonmaleficence. The principle or value of doing no harm, traditional in medical ethics; one of the four basic principles. ordinary means (of preserving life). Procedures whose benefits outweigh the burdens to the extent that a patient has a moral obligation to accept them; morally obligatory treatment. pain control. Relief of pain, usually by pharmacological agent. Ethically and legally pain may and, if the proper decision maker agrees, must be eliminated in a dying patient, even if this contributes causally to the hastening of death, provided no one intends (wants as an end to be chosen for its own sake) that the patient die and provided the amount and means of delivery of the agent are such that they are proper for the elimination of pain. palliative support. Treatment aimed at relieving pain and suffering rather than sustaining the patient’s life. palliative support care orders form. The form used by physicians to order palliative support and to order the forgoing of certain life-sustaining treatments, based on the informed consent of patient or surrogate. paternalism (or parentalism). Choosing (treatment) for others on the basis of their good whether or not they want it; opposed to autonomy. Patient Self-Determination Act (PSDA). The federal law requiring that admitted patients be informed about hospital policy and state law concerning forgoing treatment, that they be asked about their advance directives, and that these be recorded if they are available. persistent vegetative state (PVS). A condition usually caused by oxygen deprivation to the cerebral cortex (higher brain) resulting in total and irreversible inability to perform internal or external conscious acts. PVS patients undergo sleep-wake cycles (eyes open and close) and other movements directed by the brain stem but are unaware of these movements or of themselves or anything around them. physician-assisted suicide. Patient-chosen and patient-accomplished suicide with the direct and formal help of the physician, usually by prescribing drugs and informing the patient how much to take to accomplish the suicide. Illegal in most states. The Oregon law permitting it was implicitly found constitutional by the Supreme Court; [3.238.228.191] Project MUSE (2024-03-28 19:31 GMT) 158 Glossary circuit court decisions concluding...