Introduktion: Trots mycket forskning inom cancer som genererar nya riktlinjer och behandlingsmetoder är ett cancerbesked ofta förknippat med döden. Om cancerns påverkan på kroppen är tillräckligt allvarlig kan inte längre behandling tillgås. Med det övergår individens vård till palliativ vård, vilket betyder symtomlindring, närståendestöd samt kommunikation för att nå en god och värdig död. Sjuksköterskor har rapporterat att de mottagit önskan om dödshjälp av cancerpatienter, i syfte att bestämma själv och avsluta lidandet.  Syfte: Syftet var att undersöka terminala cancerpatienters syn på en god och värdig död samt dödshjälp. Metod: En systematisk litteraturöversikt utfördes med innehåll från tolv kvalitativa originalartiklar. För att få fram artiklar användes PubMed. En tematisk analys användes för att sammanställa teman baserat på studiernas resultat.  Resultat: Deltagare för dödshjälp motiverade sin ståndpunkt med hänvisning till individens autonomi, samt såg det som en möjlighet att få slut på lidande. Deltagare mot dödshjälp ansåg att det var likvärdigt med självmord, risk för bruk i fel syfte, ej överensstämmer med individens tro och att det alltid fanns hopp och mening. Synen på en god död och värdig död delgavs av deltagarna till förberedelser och rätten att få bestämma själv, att finna nya perspektiv och uppnå acceptans för sitt tillstånd. För att nå en god och värdig död behövdes stöd från anhöriga och vårdpersonal. Det ansågs att sjuksköterskan behövde ha en tät dialog med patienten och involverade patienten i beslut för att tillgodose autonomin.  Slutsats: För att en god och värdig död ska tillgodoses krävs det att vårdpersonal tillsammans med anhöriga strävar efter att uppfylla autonomin hos cancerpatienter. / Introduction: Although cancer research has given new methods and treatment guidelines, a cancer diagnosis is still often associated with death. If the impact of the cancer is too major, treatment is no longer an option. With that the treatment transitions to palliative care, focusing on relief of symptoms, support for related and communication working towards a good death. Nurses have reported that they have received a request from cancer patients to obtain euthanasia or physician-assisted suicide (PAS).  Purpose: The purpose of this systematic literature review was to investigate the views of terminal cancer patients regarding a good death as well as euthanasia and PAS.  Method: A literature review has been constructed from twelve qualitative original articles. The search for articles were found using the database - PubMed. A thematic analysis was used to identify themes, based on the studies results.  Result: These generated three central themes; Support for euthanasia and PAS, Opposition towards euthanasia and PAS and lastly A good death with under themes. Participants who supported euthanasia and PAS motivated it with a person's right to decide and a possibility to end suffering. Participants opposed towards euthanasia and PAS viewed it as an act equal to suicide, and saw a risk of it being abused, some also believed euthanasia and PAS to go against their beliefs and that there always is hope and meaning. The participants' view of a good death was preparedness, the right to decide by themselves, finding new perspectives and acceptance for their condition. To reach a good death support from related and healthcare workers, as well as frequent dialogs with the nurse to involve the patient in decisions to cater to their autonomy was of great importance. Conclusion: To reach a good death the autonomy of cancer patients need to be respected by healthcare workers and relatives.

Background: The need for palliative care and end-of-life care increases as the world population grows older and as people, more extensively, suffer from chronic diseases. End-of-life care is described as a part of palliative care and people in need of end-of-life care can be met anywhere in the health care system, therefore, education about end-of-life care is necessary for nursing students. Assisted suicide, or, euthanasia is legal in Belgium and can also be a part of end-of-life care, which makes it a convenient subject to include in nursing education in Belgium.Aim: The aim was to delve into the experiences of nursing students in Belgium regarding their education in end-of-life care.Method: The school project had a qualitative-descriptive design, with an inductive approach, and was analyzed through a qualitative content analysis.Result: The results describe how Belgian nursing students experience end-of-life care, their perception of euthanasia and their satisfaction with their end-of-life care education.Conclusion: Belgian nursing students are in general pleased with their education in end-of-life care. However, there is still room for development regarding education in end-of-life care and euthanasia.

Bakgrund: Dödshjälp innebär att en person får hjälp av till exempel sjukvårdspersonal att förkorta sitt liv. Dödshjälp delas in i passiv och aktiv dödshjälp. Studien tar upp de begränsningar som finns gällande lagstiftning kring aktiv dödshjälp i Sverige, samt sjuksköterskans roll och det etiska perspektivet. Sjuksköterskans uppgift är att stödja patienters autonomi och lindra lidande.                                                                            Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter som befinner sig i ett dödligt tillstånd och önskar aktiv dödshjälp.                                                                      Metod: Den använda metoden i studien är en litteraturöversikt baserad på kvalitativ forskning. Analys av resultat gjordes av 11 vetenskapliga artiklar utifrån Fribergs femstegsmodell.                                                                                                          Resultat: Tre teman uppstod i resultatet: Tillfredsställelse och missnöje i vårdandet, Svårigheter i vårdandet och Påverkan i det egna välbefinnandet. Det framkom i resultatet att sjuksköterskor upplevde både positiva och negativa känslor kopplat till vårdandet vid aktiv dödshjälp. Sjuksköterskorna upplevde att det fanns svårigheter kopplat till samtal kring dödsprocessen och svårigheter kopplat till arbetsmiljö. Den emotionella påfrestningen sjuksköterskor upplevde i vårdandet kring den aktiva dödshjälpen var till stor del kopplat till etiska och moraliska konflikter.                                                                                Konklusion: Sjuksköterskans roll är att ta i beaktande att det är patientens autonomi som är i fokus vid vårdandet och att med en ökad förståelse för ämnet kan det bidra till en bättre vård av patienter som befinner sig i ett dödligt tillstånd. / Background: Euthanasia means that a person receives help from, for example, healthcare professionals to shorten their life. Euthanasia is divided into passive and active euthanasia. The study addresses the limitations that exist regarding legislation for active euthanasia in Sweden, as well as the nurse's role and the ethical perspective. Aim: To describe nurses' experience of caring for patients who are in a terminal condition and asking for euthanasia. Method: The method used in the study is a literature review based on qualitative research. Analysis of results was made of 11 scientific articles based on Friberg's five-step model. Findings: Three themes emerged in the results: Satisfaction and dissatisfaction in care, Difficulties in care and Impact on one's own well-being. It emerged that nurses experienced both positive and negative emotions connected to the care during active euthanasia. The nurses experienced difficulties connected to conversations about the deathprocess and difficulties linked to the work environment. The emotional strain nurses experienced working with active euthanasia was largely linked to ethical and moral conflicts. Conclusion: The nurses role is to keep the patient's autonomy the focus of care, an increased understanding of the subject can contribute to better care of terminally ill patients.

El presente estudio tuvo por objetivo Determinar las actitudes frente a la eutanasia en enfermeras de un hospital público de Chiclayo, 2023. Se llevó a cabo bajo una metodología de tipo cuantitativa, no experimental, transeccional y descriptivo; se trabajó con una muestra censal conformada por 72 profesionales de enfermería, mediante un muestreo no probabilístico por conveniencia. El instrumento empleado para el recojo de información fue la Escala de medición de Actitudes Frente a la Eutanasia (EAFE), con coeficiente de Cronbach de 0.927. Se utilizó la estadística descriptiva para el análisis de datos, a través del Software Microsoft Excel, obteniendo tablas y cuadros de frecuencias relativas. Se practicaron los principios éticos de Belmont. Los resultados demostraron que gran parte de las enfermeras mantienen actitudes desfavorables frente a la eutanasia (84.8%), según la dimensión conocimiento priman las actitudes neutras (52.8%), en la dimensión afectiva demuestran tener actitudes desfavorables (48.6%) y finalmente en la dimensión conductual las participantes predominan una actitud neutra frente a la eutanasia (80.5%). Concluyendo que las actitudes de las enfermeras frente a la eutanasia tuvieron en su gran mayoría una postura desfavorable. / The objective of this study was to determine the attitudes towards euthanasia in nurses of a public hospital in Chiclayo, 2023. It was carried out using a quantitative, non-experimental, transectional and descriptive methodology; We worked with a census sample made up of 72 nursing professionals, using a non-probabilistic test for convenience. The instrument used to collect the information was the Scale for the Measurement of Attitudes towards Euthanasia (EAFE), with a Cronbach coefficient of 0.927. Descriptive statistics for data analysis were extracted using Microsoft Excel software, obtaining tables and graphs of relative frequencies. Belmont's ethical principles were practiced. The results show that a large part of the nurses maintain unfavorable attitudes towards euthanasia (84.8%), according to the knowledge dimension neutral attitudes prevail (52.8%), in the affective dimension they show unfavorable attitudes (48.6%) and finally in the behavioral dimension the participants predominate a neutral attitude towards euthanasia (80.5%). Concluding that the attitudes of nurses towards euthanasia were mostly unfavorable.

Advances in technology and medicine have greatly impacted on religious thought and have contributed to a large extent in bringing to the fore questions regarding euthanasia, suicide and abortion. This has raised a plethora of questions regarding actions and consequent ethical choices. What impact this has had on the Durban Hindu regarding the interpretation and re-interpretation of scripture to accommodate euthanasia, suicide and abortion is examined in the background of karma and dharma. A cross-section of Durban Hindus consisting of lawyers, doctors, academics, schoolteachers, Hindu scholars, priests and housewives were interviewed. Their views on karma and dharma, to what extent these concepts underlie their thinking with respect to euthanasia, suicide and abortion and what influence classical views based on Hindu scripture as well as Western thinking have had on the contemporary Hindus of the Durban area, are examined. Consequently, karma and dharma are viewed from a hermeneutical perspective and examined in the light of the phenomenological approach. The key hermeneutical concepts of karma and dharma have been modified and re-interpreted to accommodate changing circumstances. The views expressed range from the extremely liberal to the ultra conservative. Although the subjects were not all familiar with Hindu scripture, the views expressed were similar to scripture. Many Hindus therefore are reasoning on traditional lines, although the basis of their reasoning has shifted from scripture. Ethics and morality are not the only underlying principles affecting the euthanasia, suicide and abortion debate: financial and social considerations are also important. Although euthanasia and abortion are strongly condemned by the conservative Hindu they are accepted on medical, social and utilitarian grounds. / Religious Studies and Arabic / D. Litt. et Phil. (Religious Studies)

This thesis defends an individual's moral right to be aided in dying by a physician (that is, voluntary active euthanasia, or VAE), but departs significantly from the view in its favor generally accepted in the bioethics literature. The prevailing view appeals to both respect for an individual's autonomy and promotion of an individual's well-being as necessary conditions for a right to VAE, so as to justify the right only for those suffering grave illnesses and/or disabilities. The author argues that such a view is logically untenable; one or another aspect must be given up. Since invoking the premise that certain individuals would be better off dead necessarily relies on controversial assumptions about both the value of life and the nature and value of death, about which reasonable people disagree, it is the justification from an individual's best interest which must be excluded in a liberal society. The author endorses a self-determination justification for the right to VAE, but rejects understanding this in terms of respecting personal autonomy, instead making the case for a right to VAE grounded in self-ownership. The author's main conclusion is that the right to VAE is a general right applying to all competent adults, not only those suffering grave illnesses or disabilities, or those whose choice for VAE is an exercise of autonomy. Moreover, by analyzing the basis of physician authority over prescription medicine and how this can be justified to a society of self-owners, she maintains that individuals have not only the right to choose VAE without state interference, but also the right to be provided VAE by doctors. Nevertheless, both rights are compatible with reasonable limitations to protect both the interests of VAE seekers and the rights of others.

Advances in technology and medicine have greatly impacted on religious thought and have contributed to a large extent in bringing to the fore questions regarding euthanasia, suicide and abortion. This has raised a plethora of questions regarding actions and consequent ethical choices. What impact this has had on the Durban Hindu regarding the interpretation and re-interpretation of scripture to accommodate euthanasia, suicide and abortion is examined in the background of karma and dharma. A cross-section of Durban Hindus consisting of lawyers, doctors, academics, schoolteachers, Hindu scholars, priests and housewives were interviewed. Their views on karma and dharma, to what extent these concepts underlie their thinking with respect to euthanasia, suicide and abortion and what influence classical views based on Hindu scripture as well as Western thinking have had on the contemporary Hindus of the Durban area, are examined. Consequently, karma and dharma are viewed from a hermeneutical perspective and examined in the light of the phenomenological approach. The key hermeneutical concepts of karma and dharma have been modified and re-interpreted to accommodate changing circumstances. The views expressed range from the extremely liberal to the ultra conservative. Although the subjects were not all familiar with Hindu scripture, the views expressed were similar to scripture. Many Hindus therefore are reasoning on traditional lines, although the basis of their reasoning has shifted from scripture. Ethics and morality are not the only underlying principles affecting the euthanasia, suicide and abortion debate: financial and social considerations are also important. Although euthanasia and abortion are strongly condemned by the conservative Hindu they are accepted on medical, social and utilitarian grounds. / Religious Studies and Arabic / D. Litt. et Phil. (Religious Studies)

Abstract Euthanasia from the points of view of theology and ethics Key words: euthanasia, suffering, death, dying, dignity, human rights, doctor, patient, palliative medicine, hospice care, assisted suicide, religious motivation, followers, objectors of euthanasia In my thesis I am covering the topic of ?qeuthanasia??. The main objective of this paper is to introduce the reader to the problem of euthanasia from the points of view of theology and ethics. This thesis consists of theoretical and practical parts. The theoretical part further consists of eleven chapters. In the first chapter, the types of euthanasia ares discussed (active, passive, prenatal, and assisted suicide). In the second chapter, the history of euthanasia is discussed in a great detail. The third chapter mainly concentrates on euthanasia in the world. The fourth chapter is about the criteria of death. In the fifth chapter, I address the questions of euthanasia and death in recent years. The sixth chapter is about the relationship between a doctor and a patient. The seventh chapter covers palliative medicine and the eighth chapter further expands on this subject with the topic of hospice care. In the ninth chapter, I pursue the point of religious motivational impact. The tenth and eleventh chapters are dedicated to the followers and objectors of euthanasia. The practical part concentrates on exploratory research. I have chosen sociological research using the methods of discussion. Here are three interviews with experts, who interact with dying individuals on a daily basis. These questioned specialists are believers and therefore the discourses are anonymous. The objective of these discussions was to uncover how professional in different facilities view the issues of euthanasia. This objective was sucessfully achieved.

Approved for public release, distribution is unlimited / Europe in the twentieth century witnessed the large-scale displacement and mass murder of civilian populations because of their ethnic or national identity. Genocide is the ultimate expression of this form of integral nationalism. As a result of the Second World War, the term "genocide" was introduced to describe the victimization of nations, and became codified in international law and agreements. The end of the century saw the introduction of a new term: "ethnic cleansing". This term was used to signify something less than the total physical annihilation of a people in the Balkans wars, in contrast to the extermination campaign of the Nazis in World War Two, or the Turks following World War One. This work looks at both campaigns, the Nazis against the Jews and the Serbs against the Bosnians, to argue, however, that ethnic cleansing is genocide. While much of the debate of the 1990s focuses on body counts to justify the distinction between the two, a careful analysis of the original work on genocide and the UN Agreement which outlaws such phenomenon reveal that this "body count" notion is neither correct nor justifiable. Similarly, a look at these two cases reveals act of genocide developed gradually, rather than as part of pre-existing master plans. / Major, United States Army

Des décisions médicales en fin de vie sont souvent prises pour des patients inaptes. Nous avons souhaité connaître les argumentations éthiques entourant ces décisions difficiles. Notre objectif était de pouvoir comprendre et apprécier ces lignes d’argumentation. Pour atteindre cet objectif, nous avons répertorié et analysé les lignes argumentatives présentes dans des articles scientifiques, incluant les sections de correspondance et commentaires des journaux savants. Afin d’éviter que les résultats de notre analyse soient trop influencés par les caractéristiques d’un problème médical spécifique, nous avons décidé d’analyser des situations cliniques distinctes. Les sujets spécifiques étudiés sont la non-initiation du traitement antibiotique chez des patients déments souffrant de pneumonie, et l’euthanasie de nouveau-nés lourdement hypothéqués selon le protocole de Groningen. Notre analyse des lignes d’argumentation répertoriées à partir des débats entourant ces sujets spécifiques a révélé des caractéristiques communes. D’abord, les arguments avancés avaient une forte tendance à viser la normativité. Ensuite, les lignes d’argumentation répertoriées étaient principalement axées sur les patients inaptes et excluaient largement les intérêts d’autrui. Nous n’avons trouvé aucune des lignes d’argumentation à visée normative répertoriés concluante. De plus, nous avons trouvé que l’exclusion catégorique d’arguments visant l’intérêt d’autrui des considérations entrainait l’impossibilité d’ évaluer leur validité et de les exclure définitivement de l’argumentaire. Leur présence non-explicite et cachée dans les raisonnements motivant les décisions ne pouvait alors pas être exclue non plus. Pour mieux mettre en relief ces conclusions, nous avons rédigé un commentaire inspiré par les argumentaires avancés dans le contexte de l’arrêt de traitement de Terri Schiavo, patiente en état végétatif persistant. Nous pensons que l’utilisation d’un argumentaire qui viserait davantage à rendre les actions intelligibles, et sans visée normative immédiate, pourrait contribuer à une meilleure compréhension réciproque des participants au débat. Une telle argumentation nous semble aussi mieux adaptée à la complexité et l’unicité de chaque cas. Nous pensons qu’elle pourrait mieux décrire les motivations de tous les acteurs participant à la décision, et ainsi contribuer à une plus grande transparence. Cette transparence pourrait renforcer la confiance dans l’authenticité du débat, et ainsi contribuer à une meilleure légitimation de pratiques cliniques. / Medical decision making is often occurring at the end of life of inapt patients. We wished to learn about and appreciate the ethical arguments concerning these difficult decisions. Our objective was to understand and evaluate these lines of argument. To reach this objective, we have listed and analyzed lines of argument as they were presented in scientific articles, including the sections correspondence and commentary of scholarly journals. In order to avoid that our results are too much influenced by the specifics of one given clinical problem, we decided to analyze distinct clinical settings. The specific subjects studied are the non-initiation of antibiotic treatment for demented patients suffering from pneumonia, and active euthanasia of severely affected newborns following the Groningen protocol. Our analysis of the indexed lines of arguments from debates dealing with these specific subjects has revealed common characteristics. First, the issued argumentations had a strong normative tendency. Second, the indexed argumentation was principally oriented towards the patient himself, while largely excluding the interests of others. We found that none of the indexed normative lines of argument was compelling. Moreover, we found that the systematic exclusion of arguments based on the interests of others entailed the impossibility to evaluate them, and potentially to exclude them definitively from the considerations. It was thus also impossible to evaluate their potentially concealed persistence as a driving force motivating the decisions made. In order to illuminate these conclusions, we have written a commentary inspired by the lines of arguments evoked in the context of the treatment withdrawal of Terri Schiavo, a patient in persistently vegetative state. We believe that the use of lines of argument that render decisions intelligible, without however aiming at immediate normativity, could contribute to a better mutual understanding between the participants of such debates. Such argumentation also seems, in our opinion, more adapted to take the complexity and uniqueness of each single clinical case into account. We believe that such argumentation could better describe the respective motivations of the participants in the decision, and thus increase its transparency. Increased transparency would reinforce the confidence in the authenticity of the debate, and thus better legitimate clinical practice.