Thesis (Ph.D.)--Edith Cowan University, 2003. / Submitted to the Faculty of Community Services, Education and Social Sciences. Includes bibliographical references.

Bakgrund: Dödshjälp har under många år varit en omdiskuterad debatt. Huruvida dödshjälp är lagligt eller inte skiljer sig åt mellan olika länder. I Sverige är dödshjälp ännu inte legaliserat. När en människa har en obotlig sjukdom eller vid vård i livets slutskede kan vissa människor uttrycka en önskan om att få hjälp att avsluta sitt eget liv, något som kan innebära att sjuksköterskan då behöver ta itu med dödshjälpsförfrågningar oavsett om dödshjälp är legaliserat eller inte samt finnas där för patienten. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskors erfarenheter av att vårda patienter som önskar dödshjälp. Metod: En beskrivande litteraturstudie som grundades på 12 vetenskapliga kvalitativa artiklar. Sökning av artiklar gjordes i databasen CINAHL. Därefter bearbetades och analyserades artiklarna enligt Aveyard tematiska analysmetod. Huvudresultat: Resultatet visade att sjuksköterskors erfarenheter var att dödshjälp utgjorde en komplex, känslomässig och intensiv process. Lidande och att bibehålla sin autonomi var de främsta orsakerna till patienters önskan om dödshjälp. Olika faktorer var avgörande för om sjuksköterskan valde att delta eller inte delta i dödshjälp.  Resultatet presenterades i tre huvudteman: dödshjälp är en komplex process, huvudorsaker till varför patienter önskar dödshjälp och sjuksköterskors erfarenheter av faktorer som påverkar ställningstagandet till dödshjälp.  Slutsats: Studier visar att sjuksköterskor kommer möta patienter som önskar dödshjälp oavsett var sjuksköterskorna är verksamma. Dödshjälp är förknippat med starka känslor och är en komplex process som utmanar sjuksköterskorna professionellt och personligen. Olika faktorer påverkar hur sjuksköterskorna förhåller sig till dödshjälpsprocessen och patienternas förfrågningar om dödshjälp. Litteraturstudien syftar till att sprida kunskap och förståelse om dödshjälp utifrån sjuksköterskors tidigare erfarenheter. / Background: Euthanasia has been a controversial debate for many years. Whether or not euthanasia is legal differs from country to country. In Sweden euthanasia is not legalized yet. When a person has an incurable disease or in end-of-life care, some people may express a desire to be helped to end their own life, which may mean that the nurse then needs to deal with euthanasia requests regardless of whether euthanasia is legalized or not and to be there for the patient. Aim: The aim of the literature study was to describe nurses' experiences of caring for patients who wish to be euthanized.  Method: A descriptive literature study based on 12 scientific qualitative articles. Articles were searched in the CINAHL database. The articles were then processed and analyzed according to Aveyard's thematic analysis method. Main Results: The results showed that nurses' experiences were that euthanasia was a complex, emotional and intense process. Suffering and maintaining one's autonomy were the main reasons for patients' desire for euthanasia. Different factors were decisive for whether the nurse chose to participate or not participate in euthanasia. The results were presented in three main themes: euthanasia is a complex process, main reasons why patients wish euthanasia and nurses' experiences of factors that influence attitudes towards euthanasia. Conclusion: Several studies show that nurses will encounter patients who wish to be euthanized regardless of where the nurses work. Euthanasia is associated with strong emotions and is a complex process that challenges nurses professionally and personally. Different factors influence how nurses relate to the euthanasia process and patient’s request for euthanasia. The literature study aims to spread knowledge and understanding about euthanasia based on nurses' previous experiences.

M.Cur. / The purpose of this study is to establish guidelines for the utilization of narratives in popular literature in nursing education in order to facilitate reflective thinking with nursing students. The purpose of nursing education is to equip the prospective nursing practitioner to be able to function independently and effectively in a multicultural, technological and scientific nursing practice where caring is important. Quality nursing care demands critical analytical thinking (cognitive skills) and moral values (affective skills) of the nursing practitioner. This study investigates firstly the "what" of reflective thinking and concludes that reflection accommodates both thinking skills and values that should be facilitated at the prospective nursing practitioner. The facilitation of reflective thinking is demanding as it is a complex cognitive and affective thinking skill. The research focuses secondly on the way in which the narrative in popular literature can be applied to facilitate reflective thinking in nursing education. According to the constructivist learning approach meaningful learning and reflective thinking occur when coupled to previous knowledge and experience. The nursing student as adult learner has at his/her disposal certain advance knowledge and previous experience. Narratives and popular literature form part of the adult learner's advance knowledge and previous experience. The research design is a philosophical inquiry in which the following research strategies are used namely philosophical analysis as well as qualitative, exploratory, descriptive and contextual strategies. In order to meet the purpose of the research, four goals were set and which were executed in four phases. At first the term reflective thinking was subjected to the process of concept analysis in order to clarify it's specific meaning (connotations and denotations). A theoretical definition of reflective thinking was formulated for the study from the connotations whereas denotations were used as the basis of learning outcomes for the Programme of Euthanasia as an Ethical Issue in Nursing Education (the Programme).

Bakgrund: Eutanasi är lagligt i ett fåtal platser i världen. I länder där det är otillåtet är detta ett outforskat ämne, särskilt ur ett patientperspektiv. Palliativ vård anses vara ett alternativ till eutanasi, trots detta önskar en del personer att avsluta livet med eutanasi. Syfte: Att beskriva anledningar till varför vuxna personer vill påskynda döden med hjälp av eutanasi och att beskriva undersökningsgruppen i utvalda artiklar. Metod: En deskriptiv litteraturstudie byggd på elva kvalitativa vetenskapliga artiklar hämtade ur databaserna Cinahl, PubMed och PsycINFO. Huvudresultat: Resultatet visade att bristande symtomkontroll, i synnerhet smärta, var en vanlig anledning till att önska eutanasi. Funktionsförluster gjorde att deltagare förlorat sig själva och inte längre kunde delta i aktiviteter som tidigare. Rädslor för framtida lidande och förlust av självständighet uttrycktes. De önskade en värdig död genom att återta kontroll över sin kropp och sitt liv. De ville inte vara en börda ochkände sig inte längre behövda. Undersökningsgrupperna innehöll deltagare från länderdär eutanasi är lagligt såväl som olagligt. Deltagare varierade i antal, ålder ochmedicinskt tillstånd. Slutsats: Eutanasi är relativt outforskat ur perspektivet från de som önskar sjukvårdens hjälp med att avsluta livet. Det förekommer att svårt sjuka och äldre utan livshotande sjukdom, vill dö i förtid. En vanlig anledning bland deltagarna, var att återta kontroll över kroppen samt bestämma hur och när livet tar slut. Eftersom individens syn på en värdig död ibland skiljer sig från vad sjukvården tillåter och anser värdigt, förekom rädslor för en smärtsam och utdragen död. / Background: Euthanasia is legal in a few places in the world. This is a subject with limited research made in countries where it is not legal especially from a patientperspective. Palliative care is considered an alternative to euthanasia but requests foreuthanasia still occurs. Aim: Describe the reasons behind a wish to hasten death through euthanasia among dults and to describe the study group of selected items. Methods: A descriptive literature study based on eleven scientific articles with qualitative approach collected from the databases Cinahl, PubMed and PsycINFO. Main results: The result showed that lack of symptom control and pain in particular seemed to be a common motivating factor to wish for euthanasia. Also loss of functions among participants led to feelings of identity loss and being unable to participate inactivities like before. Participants expressed fears of having to endure suffering as well as being dependent on others. They wanted to die with dignity by regaining control of their own bodies and lives with euthanasia. They did not want to be a burden and no longer felt needed. Study groups included participants from countries where euthanasia is legal and illegal. Participants varied in number, age and medical condition. Conclusion: Euthanasia is a relatively unexplored subject from the perspectives of people who wish for medical help to end their lives. It occurs that severely ill people as well as elderly without a terminal disease want help to end their lives prematurely. A common desire among participants was to regain control of their bodies and determine how and when life should end. Fears of suffering a painful and prolonged death occured since the individual’s vision of a dignified death sometimes differs from what healthcare permit and deem worthy.

- CRIMINAL LIABILITY IN MEDICAL LAW The purpose of my thesis is to analyse criminal liability of healthcare professionals and paramedical staff. The thesis is composed of seven chapters. The first chapter is introductory and reveals my objections. Chapter Two provides definition of liability in general. Furthermore, civil, administrative, disciplinary and employee's liability are discussed and compared to criminal liability. The aim is to explain differences and similarities of individual liabilities and to clarify that criminal liability serves as a last resort (the ultima ratio principle). Chapter Three explains requirements for criminal liability. Especially, criminal offence, unlawfulness and defences are discussed and compared to the Dutch regulation. Chapter Four concentrates on criminal liability of natural persons. The first part of this chapter is about offender; the minimum age for criminal responsibility and sanity are examined. The second part lists and describes some major crimes. Chapter Five looks at The Criminal Liability of Legal Persons Act. Besides, liberation from the criminal liability of legal persons is discussed. The Chapter recommends preventive and reactive measures to be adopted by health care institutions. The topic of the Sixth Chapter is the termination of life on...

In this thesis, I examined the definition of euthanasia and its different forms, as well as the legal evolution of this term and its constitutional foundations in the Czech Republic. Furthermore, I focused on the legislative treatment of euthanasia in the Czech criminal law, and compared it to the legislative treatment of euthanasia in Australia, Colombia, and England. In every individual state, I tried to capture the most important moments concerning the legal regulation of euthanasia and assisted suicide. In Australia, I focused mainly on the very first legal regulation of euthanasia, in Colombia, progression of an application of the Constitutional Court judgment on active euthanasia and in England, the evolution of relevant case law, usually related to assisted suicide. The most detailed explanation, of course, focuses on the Czech Republic. In my analysis, I used a variety of Czech and foreign legal sources, including modern sources such as video conferencing. By comparing the approaches, I provided a general overview of differentiation of euthanasia and its potential criminal impact. I subsequently listed some foreign legal examples of judicial treatment and legal regulation of euthanasia and assisted suicide, currently unrecognized in the Czech legal literature. The main contribution and...

The aim of this thesis is the analysis of domestic legislation affecting euthanasia and analysis of such adjustments abroad. The author questions the appropriateness of such adjustments in the Czech Republic. The current legal regulation does not regulate euthanasia in any way, and so the adoption of such regulation is appropriate. Domestic experts criticize this fact for a long time. In the first part the author deals with the most comprehensive definition of the subject of euthanasia and its development abroad and, particularly, in the Czech Republic. Other parts, using the historical-empirical methods, deal with the legal arrangements and their analysis in the Benelux countries, where the euthanasia is legal under certain given conditions. They describe not only the current treatment, but also the path that led to it. In the last section the author assesses the non-legal aspects of euthanasia and outlines two basic directions, which the domestic legislation could take in the future.

LL.M. / Please refer to full text to view abstract

Aquatic hypoxia, or low dissolved oxygen, is a growing environmental concern and has detrimental effects on many fishes. Research on fish responses to hypoxia includes whole animal studies as well as organ culture systems. In this thesis, the gulf killifish, Fundulus grandis, was used to determine the interaction between hypoxic exposure and four common euthanasia techniques on selected blood and gill variables and to develop an in vitro gill incubation system. Euthanasia techniques had differential effects on blood and gill, with the common fish anesthetic MS-222 having the greatest effects, but none altered the response to hypoxia. During the development of gill culture, the highest gill viability was measured in isosmotic seawater medium and shorter incubation times. This study provides insight into the applicability of different euthanasia techniques in hypoxia research, as well as preliminary observations on an incubation system for isolated gills.

Extensive research has been conducted on the attitudes of physicians and nurses toward euthanasia. However, little is known on the attitudes of suicide prevention workers (SPWs). The objectives of this study were to: (1) examine the attitudes of SPWs toward euthanasia for a non-descript person versus for a loved one; (2) verify the association between personal factors (experiences, sociodemographics) and attitudes, and (3) explore personal experiences of SPWs in relation to grievous illness. A survey was sent out to all suicide prevention centres across Quebec (n=32). A majority of SPWs (55.7%) held positive attitudes toward euthanasia for a non-descript person and for a loved one (49.5%). Statistically significant differences were found in attitudes among SPWs who had personal and professional experiences. There were no other statistically significant differences in the attitudes of SPWs toward euthanasia for a non-descript person or for a loved one, and any of the sociodemographic factors. Three themes emerged from the qualitative analysis of open-ended question on personal experiences of SPWs: respect of choice, suffering/low quality of life and palliative care. While some findings may be concluded from this study, it is essential that this topic be explored further as research on SPWs’ attitudes on euthanasia is limited. Research outcomes of this study can have important short-term and long-term implications on suicide prevention and training of SPWs to improve services offered to clients.