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Philosophy and Medicine P&M136 Nathan Emmerich Pierre Mallia Bert Gordijn Francesca Pistoia   Editors Contemporary European Perspectives on the Ethics of End of Life Care Philosophy and Medicine Volume 136 Series Editors Søren Holm, The University of Manchester, Manchester, UK Lisa M. Rasmussen, UNC Charlotte, Charlotte, USA Founding Editors H. Tristram Engellhardt, Rice University, Houston, TX, USA † Stuart F. Spicker, Renodo Beach, USA † Editorial Board George Agich, National University of Singapore, Singapore, Singapore Bob Baker, Union College, Schenectady, NY, USA Jeffrey Bishop, Saint Louis University, St. Louis, USA Ana Borovecki, University of Zagreb, Zagreb, Croatia Ruiping Fan, City University of Hong Kong, Kowloon, Hong Kong Volnei Garrafa, International Center for Bioethics and Humanities, University of Brasília, Brasília, Brazil D. Micah Hester, University of Arkansas for Medical Sciences, Little Rock, AR, USA Bjørn Hofmann, Norwegian University of Science and Technology, Gjøvik, Norway Ana Iltis, Wake Forest University, Winston-Salem, NC, USA John Lantos, Childrens’ Mercy, Kansas City, MO, USA Chris Tollefsen, University of South Carolina, Columbia, USA Dr Teck Chuan Voo, Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore The Philosophy and Medicine series is dedicated to publishing monographs and collections of essays that contribute importantly to scholarship in bioethics and the philosophy of medicine. The series addresses the full scope of issues in bioethics and philosophy of medicine, from euthanasia to justice and solidarity in health care, and from the concept of disease to the phenomenology of illness. The Philosophy and Medicine series places the scholarship of bioethics within studies of basic problems in the epistemology, ethics, and metaphysics of medicine. The series seeks to publish the best of philosophical work from around the world and from all philosophical traditions directed to health care and the biomedical sciences. Since its appearance in 1975, the series has created an intellectual and scholarly focal point that frames the field of the philosophy of medicine and bioethics. From its inception, the series has recognized the breadth of philosophical concerns made salient by the biomedical sciences and the health care professions. With over one hundred and twenty five volumes in print, no other series offers as substantial and significant a resource for philosophical scholarship regarding issues raised by medicine and the biomedical sciences. More information about this series at http://www.springer.com/series/6414 Nathan Emmerich • Pierre Mallia Bert Gordijn • Francesca Pistoia Editors Contemporary European Perspectives on the Ethics of End of Life Care Editors Nathan Emmerich Pierre Mallia Australian National University The Faculty of Medicine and Surgery, Canberra, Australia Bioethics Research Programme University of Malta Bert Gordijn Msida, Malta The Institute of Ethics Dublin City University Francesca Pistoia Dublin, Ireland Department of Biotechnological and Applied Clinical Sciences, Neurological Institute University of L’Aquila Via Vetoio, L’Aquila, Italy ISSN 0376-7418 ISSN 2215-0080 (electronic) Philosophy and Medicine ISBN 978-3-030-40032-3 ISBN 978-3-030-40033-0 (eBook) https://doi.org/10.1007/978-3-030-40033-0 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Contents 1 Contemporary European Perspectives on the Ethics of End of Life Care: An Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Nathan Emmerich, Pierre Mallia, Bert Gordijn, and Francesca Pistoia Part I P hilosophical and Theological Perspectives on Care at the End of Life 2 Human Rights and Patient’s Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Benedetta Barbisan 3 Utilitarianism and Care at the End of Life . . . . . . . . . . . . . . . . . . . . . . 37 Nadine Mooren and Michael Quante 4 Virtue Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Alastair V. Campbell 5 End of Life: Care Ethical Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . 75 Carlo Leget and Helen Kohlen 6 End of Life Issues: An Islamic Perspective . . . . . . . . . . . . . . . . . . . . . . 93 Alireza Bagheri 7 End-of-Life Medical Decisions in Israeli Law – How Jewish Law Represents a Balance Between Principlist and Situationist Approaches to Medical Law . . . . . . . . . . . . . . . . . . . . 105 Oren Asman and Yechiel Michael Barilan 8 The Catholic Position on End of Life: Theological Foundations and Philosophical Reasoning . . . . . . . . . . . 117 Pierre Mallia 9 Protestant Perspectives on End of Life Care . . . . . . . . . . . . . . . . . . . . 131 Michael Coors and Andrea Dörries v vi Contents Part II E thical Concepts in End of Life Care: Definitions and Distinctions 10 Dignity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Roberto Andorno 11 Autonomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 John Lombard 12 Intentions and the Doctrine of Double Effect . . . . . . . . . . . . . . . . . . . . 169 Simon Woods and Vibeke Graven 13 Futile, Non-beneficial, Potentially Inappropriate or ‘Disputed’ Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Ben P. White, Lindy Willmott, and Eliana Close 14 The Distinction between Ordinary and Extraordinary Treatment: Can It Be Maintained? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Alan J. Kearns, Nathan Emmerich, and Bert Gordijn 15 The Difference Between Withholding and Withdrawing Life-Sustaining Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Andrew McGee and Drew Carter 16 On Killing and Letting Die, Acts and Omissions: For and Against the Distinctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 Richard Huxtable Part III Moral Concerns and Ethical Problems in the Clinical Practice of End of Life Care 17 The Ethics of Sedation at the End of Life . . . . . . . . . . . . . . . . . . . . . . . 245 Søren Holm 18 Law, Public Debates and Professionals’ Attitudes: A Comparative Study on the Use of Advance Directives in England, France and Germany . . . . . . . . . . . . . . . . . . . . 259 Ruth Horn 19 Disorders of Consciousness: Ethical Implications in Diagnosis, Prognosis and Management . . . . . . . . . . . . . . . . . . . . . . 277 Stephen Holland and Francesca Pistoia 20 When a Patient Refuses Life-Sustaining Treatments. . . . . . . . . . . . . . 297 Christoph Rehmann-Sutter 21 Intentions of Physicians and End of Life Care Team . . . . . . . . . . . . . 315 Morten Magelssen and Joseph Shaw 22 Moral Distress in End-of-Life Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335 Georgina Morley, Caroline Bradbury-Jones, and Jonathan Ives Contents vii 23 Families and End of Life Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355 Marian A. Verkerk 24 Ethics and Intercultural Issues in End of Life Care . . . . . . . . . . . . . . 367 Ayesha Ahmad 25 Postscript: Future Developments in Addressing Ethics and Care at the End of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381 Nathan Emmerich, Pierre Mallia, Bert Gordijn, and Francesca Pistoia Contributors Ayesha Ahmad St Georges, University of London, and the Institute for Global, University College London, London, UK Roberto Andorno School of Law and Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland Oren  Asman Nursing Department, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Medical Law, First Moscow State Medical University, Moscow, Russia Alireza Bagheri The School of Medicine, Tehran University of Medical Sciences, Tehran, Iran The Centre for Health Care Ethics, Lakehead University, ON, Canada Benedetta Barbisan University of Macerata, Macerata, Italy Georgetown University Law Center, Washington, DC, USA Yechiel Michael Barilan The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Caroline Bradbury-Jones University of Birmingham, Birmingham, UK Alastair V. Campbell Centre for Biomedical Ethics Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Drew Carter Adelaide Health and Medical Sciences, University of Adelaide, Adelaide, Australia Eliana  Close Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia Michael Coors Institute of Social Ethics, Faculty of Theology, University of Zurich, Zurich, Switzerland ix x Contributors Andrea Dörries Zentrum für Gesundheitsethik (ZfG), Hannover, Germany Nathan  Emmerich The Medical School, College of Health and Medicine, Australian National University, Canberra, Australia Bert Gordijn The Institute of Ethics at Dublin City University, Dublin, Ireland Vibeke Graven The Danish Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark Stephen Holland Professor, Departments of Philosophy and Health Sciences, University of York, York, UK Søren Holm University of Manchester, Manchester, UK University of Oslo, Oslo, Norway Ruth Horn Ethox Centre and Wellcome Centre for Ethics and Humanities in the Nuffield Department of Population Health, University of Oxford, Oxford, UK Richard Huxtable Centre for Ethics in Medicine, Medical School at the University of Bristol, Bristol, UK Jonathan Ives Centre for Ethics in Medicine, University of Bristol, Bristol, UK Alan J. Kearns School of Theology, Philosophy, and Music, Dublin City University (DCU), Dublin, Ireland Helen Kohlen The Philosophical-Theological University of Vallendar, Vallendar, Germany The University of Alberta (UoA) in Edmonton, Edmonton, Canada Carlo Leget The University of Humanistic Studies in Utrecht, Utrecht, The Netherlands John Lombard School of Law, University of Limerick, Limerick, Ireland Morten Magelssen Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway Pierre  Mallia The Faculty of Medicine and Surgery, Bioethics Research Programme, University of Malta, Msida, Malta Andrew McGee Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia Nadine Mooren Department of Philosophy, University of Münster, Müenster, Germany Georgina Morley Center for Bioethics, and Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA Francesca Pistoia Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L’Aquila, Via Vetoio, L’Aquila, Italy

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