This study was conducted using a qualitative descriptive approach. It was based on an analysis that was done to determine awareness and attitude of patients in end of life issues. The semi-structured interviews were conducted for data collection. A sample of ten patients, five inpatient and five outpatient, was purposively chosen. Permission was obtained from the hospital superintendent and heads of departments, and also consent from patients, for the study. Data was analyzed, using the NVIVO program, a computer software, for data coding, and a conceptual model for categorization. From the findings, the researcher concluded that poor communication causes lack of knowledge in patients, which in turn limits the capacity for decision making in patients. The researcher also noted that participants were not aware of their autonomy in decision-making. / Thesis (M.Cur.)-University of Natal, Durban, 2002.

Cette étude examine comment l’argument de la pente glissante est employé dans les débats sur l’avortement et sur l’euthanasie. L’hypothèse est la suivante : l’argument de la pente glissante peut être utilisé de manière fallacieuse dans certains cas, mais il peut également s’avérer raisonnable dans d’autres. L’objectif de cette étude est d’étudier certains arguments récurrents du discours bioéthique afin de tester leur pertinence, leur validité et leurs conséquences sur le plan philosophique. Cette étude se divise en deux parties. La première partie s’intéresse à l’usage de la pente glissante de type « sorite » dans le débat sur l’avortement. La deuxième partie se penche sur l’argument de la pente glissante complète telle qu’il est employé dans le débat sur l’euthanasie. / This study examines how the slippery slope argument is used in debates on abortion and euthanasia. The hypothesis is that the slippery slope argument can be used wrongfully in some cases, but it may also be reasonable in others. The objective of this study is to investigate some of the recurring arguments in bioethics in order to test their relevance, validity and their impact on the philosophical level. This study is divided into two parts. The first part focuses on the use of the “sorites” slippery slope argument in the abortion debate. The second part focuses on the “full slippery slope argument” as used in the debate on euthanasia.

The topic of this study, euthanasia, has become a modern-day issue that challenges some of societies traditionally held beliefs towards death and dying. This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the "right-to-die". It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what I have termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of "truth" regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. My findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing professions lack of preparation to deal with euthanasia if it becomes a legal option in end of life care.

Thesis (doctoral)--Universität, Giessen, 2007. / Includes bibliographical references.

Le patient de réanimation est dans la plus part des cas un patient vulnérable et dépendant. Les principes fondamentaux de l’éthique sont bousculés et le réanimateur est face à des de nombreuses interrogations éthiques qui jalonnent le parcours du patient de son admission à sa sortie. Malgré une réflexion éthique formalisée guidant les décisions d’admission et de non-admission en réanimation pour les malades à haut risque de mortalité, la part laissée à la subjectivité est importante. Il n’y a pas cependant de situation figée pour laquelle un patient ne doit pas bénéficier de la réanimation. Une décision de non-admission en réanimation s'apparente à une décision de limitation thérapeutique. Ce schéma éthique s’accorde avec les principes éthiques : autonomie, bienfaisance, non malfaisance et justice distributive mais l'urgence rend souvent difficile l'analyse complète du dossier du patient.Le manque de lits de réanimation disponibles est susceptible d’influer sur la stratégie de triage soulignant l’impact de critères subjectifs dans le processus décisionnel. Ceci peut conduire à une sur-mortalité. Les études princeps réalisées sur les décisions de limitations et d’arrêt thérapeutiques (LAT) ont été à l’origine du débat sur la non-obstination déraisonnable aboutissant à terme à la promulgation de la Loi Leonetti. Ces données ont permis de corriger des dysfonctionnements éthiques lors des décisions de LAT. A la suite des questionnements récents de notre société nous avons analysé la réflexion des réanimateurs sur l’euthanasie.La réalisation de prélèvements d’organe chez des patients décédés d’arrêt cardiaque impose l’admission en réanimation de patients pour les quels les traitements n’ont plus l’objectif de les sauver, mais de préserver leurs organes pour le bien d’autrui. Ces situations soulignent les interrogations sur : la définition de la mort, l’instrumentalisation du corps, le consentement au don, l’information des proches et plus largement du public. / The critically ill patient is a vulnerable and dependent patient. The fundamental principles of ethics are rushed and the physician is faced with many ethical issues along the route of the patient from the discussion of his admission to discharge.Despite a formal ethical reflection guiding decisions of admission and non ICU admission these decisions of patients at high risk of mortality, the part left to subjectivity is important. The evolution of medical knowledge and advances in supported patients that there are no fixed position for which a patient should not receive resuscitation. A determination of non-ICU admission is similar to a decision of withholding or withdrawing therapies. This ethical scheme fits well with the ethical principles autonomy, beneficence , non-maleficence and distributive justice. The urgency makes it difficult to complete analysis of patient records because the data are not always available. The lack of available beds is likely to affect the sorting strategy highlighting the impact of subjective criteria in decision-making. This could induce excess mortality. The initial studies dedicated to withholding and withdrawing therapies have been the source of debate on the non-unreasonable obstinacy leading eventually to the enactment of the Leonetti's Law. These data were used to correct malfunctions in real ethical decisions of withholding or withdrawing. Following the recent issues of our society on euthanasia, we completed our reflection and asked if intensivists would support a law of exception euthanasia.The realization of organ harvesting in patients who died of cardiac arrest requires taking in resuscitation of patients for which treatments have more goals to save for, but to preserve their bodies for the sake of other patients. These situations highlight the questions: the definition of death, the manipulation of the body, the implicit or explicit consent and the information aspects of family and wider public.

The diploma thesis deals with the problem of euthanasia, especially with its legal and ethical aspects. The legal aspects are discussed with respect to human rights, to the legislative system of the European countries that legalized euthanasia, and to the potential dangers connected with the legalization of mercy killing. The chapters considering ethical aspects draw on essential ethical values and their application in the connection with euthanasia. A particular ethical theory, utilitarianism, is briefly described, and attention i also given to the current development of the social consciousness from the moral concern to the emphasis on efficiency. The discussion of both legal and ethical aspects involves the opinions of the supporters as well as the opponents of euthanasia. In the conclusion the thesis refers to the possible conflict between the ethical and legal norms, which can be initiated by the legalization of euthanasia.

The thesis provides a comprehensive view of the "good death" and euthanasia from antiquity to the 1930s. It describes the attitudes of physicians and other scholars in different historical periods. The research is based on published sources and literature. The author examines the phenomenon in general, compares published sources and makes a comparison of the phenomenon from a historical perspective. The first part describes basic terminology related to the topic. Death and dying are viewed from the historical and ethical points of view. The second part describes the individual historical periods from antiquity to the 1930s in terms of social and cultural changes. The emphasis is placed on the opinions of philosophers, scholars and doctors about good death and euthanasia. The general view on death and euthanasia is even better illustrated by the medical care of a given period, the development of medical science and medicine. The thesis presents a theoretical base from which information for practical research of the phenomenon of death can be drawn. The examined phenomenon could be equally important and challenging for the present.

The diploma thesis titled Euthanasia in the film an analysis of selected pieces, is divided into theoretical and practical parts. I devoted to a description of a current state of euthanasia in the theoretical part. First I focused on definitions of euthanasia, assisted suicide etc. A chapter is also devoted to a history of euthanasia. I wanted to highlight the fact, that euthanasia is not only a problem of the modern society, but beginnings of a discussion about euthanasia we could find already in the ancient world. Through the concept of euthanasia in the Middle Ages and modern times I got up to the World War II, which is in my opinion an important milestone in the history of euthanasia, because at that time euthanasia was perceived as a tool for a disposal of persons who, in the context of its time, seemed to be undesirable. Among such people there were classified for example people so called racially unsuitable, weak and sick. Because there are legally different views of euthanasia, in chapters I mention the fact how euthanasia is perceived in the world. In terms of acceptance of euthanasia and assisted suicide I particularly emphasize the Netherlands and Switzerland. One chapter I also dedicate to euthanasia in the Czech Republic. It includes a description of the discussion and arguments for and against euthanasia. One more separate chapter I devoted to questions whether to legalize or not to legalize euthanasia. I found out that a discussion on this topic is very extensive and here could be applied the rule that each man has his own opinion. It turned out that even experts in one area, doctors of philosophers, are not unanimous in the issue of euthanasia and its pros and cons are from both sides argued with plenty of arguments that are worth thinking about. A separate chapter I devoted to a man, who I consider to be the main promoter of euthanasia and assisted suicide and if you pronounce his name, people would link him with that theme. This is Dr. Jack Kevorkian, nicknamed Dr. Death. Jack Kevorkian, who understood his acts as medical services for terminally ill people, helped with the voluntary termination of life to several hundred of people. Although he had written certain "rules" about the situations when he can people "help" to solve their suffering and pain, it turned out that those people in many cases had no anatomical evidence of disease in their body. Jack Kevorkian has had and even currently has many supporters and opponents. In case of Jack Kevorkian there are arguments for and against euthanasia as in the whole debate about it. The aim of the study was to analyse how the topic of euthanasia has been reflected in the film production. At the beginning of the research I have asked this research question: Which are usual attitudes to euthanasia reflected in filmmaking? In order to find out the given objective and to answer the research question I chose a qualitative research based on the method of disinterested observation of six selected movie titles. Titles in their alphabetical order were following: Doktor smrt (You Don´t Know Jack, USA, 2010, 134 min), Hlas moře (Mar adentro, Španělsko/Francie/Itálie, 2004, 125 min), Hodinu nevíš, Česko, 2009, 94 min), Invaze barbarů (Invasion barbares, Kanada/Fancie, 2003, 99 min), Millon Dollar Baby, (USA, 2004, 132 min) a Skafandr a motýl (Le Scaphandre et le papillon, Francie/USA, 2007, 107 min).

Conselho Nacional de Desenvolvimento Científico e Tecnológico / The ever increasing close contact between dogs and human beings stimulated in last years the production of a great deal of scientific information in canine medicine. However, as the major part of such information stems from work carried on in foreign countries, it is common that Brazilian veterinary clinicians and veterinary pathologists alike have to transpose these data on disease prevalence generated abroad to our situation. Thus, the main objective of this study is to investigate the prevalence of the diseases that culminate with death or motivate the euthanasia of dogs from the midland region of the Midwest of Rio Grande do Sul State, Brazil. In order to achieve this goal the necropsy files of the Laboratório de Patologia Veterinária (LPV) of the Universidade Federal de Santa Maria (UFSM) were accessed and necropsy protocols of dogs necropsied between January 1965 and December 2004 were reviewed in search for information allowing to establish a definitive diagnosis. When circumstances did not allow for a definitive diagnosis the case was considered as inconclusive. During this period 4,844 reports of canine necropsies were filed at the LPVUFSM. The case distribution in relation to the disease categories diagnosed was as follows: infectious and parasitic diseases (1,693 [35.0%]); neoplasms (378 [7.8%]), disorders caused by physical agents (369 [7.6%]), degenerative diseases (342 [7.1%]); poisonings and toxinfections (112 [2.3%]); euthanasia due to convenience (101 [2.1%]), metabolic and endocrinological diseases (97 [2.0%]); iatrogenic disorders (83 [1.7%]); developmental disorders (25 [0.5%]), immune mediate diseases (10 [0.2%]); and nutritional disorders (6 [0.1%]). Other disorders, including multifactorial or idiopathic diseases contributed 80 (1.6%) cases. In 1,548 (32.0%) out of the 4,844 cases it was not possible to establish either cause of death or reason for euthanasia. Infectious and parasitic diseases (mainly canine distemper, parvoviral enteritis and intestinal parasitism), neoplasia (mainly mammary neoplasms and lymphoma), disorders caused by physical agents (mainly accidents caused by automotive vehicles) and degenerative diseases (mainly chronic renal failure, cirrhosis, and congestive heart failure) were the main disease categories that caused death or motivated euthanasia in dogs of this midland region. However when cases were evaluated in relation with the age of the dog, the disease prevalence differs. The main causes of death in puppies were infectious and parasitic disease (mainly parvoviral enteritis, canine distemper, and intestinal parasitism). In adult dogs the most important causes of death were canine distemper, neoplasia and trauma. In age dogs, approximately half of the deaths could be attributed to neoplasia and degenerative disease. / A crescente aproximação afetiva entre os cães e o homem fez com que nos últimos anos fosse gerada muita informação científica sobre medicina canina. Entretanto, como a maior parte dessas informações é obtida através da literatura internacional, é comum que os clínicos e patologistas veterinários brasileiros necessitem extrapolar dados referentes à prevalência das diferentes doenças que causam morte de cães para nossa realidade. Baseado nisso, este estudo tem como objetivo principal determinar a prevalência das doenças que culminam em morte ou que fazem com que os cães da Mesorregião do Centro Ocidental Rio- Grandense sejam submetidos à eutanásia. Para isso, foram revisados todos os protocolos de necropsia de cães, arquivados no Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), realizadas entre janeiro de 1965 e dezembro de 2004. Desses protocolos foram retiradas informações para se estabelecer um diagnóstico definitivo. Quando as evidências não permitiram estabelecer o diagnóstico definitivo, os casos foram considerados inconclusivos. Nos arquivos do LPV-UFSM foram encontrados 4.844 protocolos de necropsia de cães. A distribuição dos casos em relação às categorias de doenças diagnosticadas foi a seguinte: doenças infecciosas e parasitárias (1.693 [35,0%]), neoplasmas (378 [7,8%]), distúrbios causados por agentes físicos (369 [7,6%]), doenças degenerativas (342 [7,1%]), intoxicações e toxiinfecções (112 [2,3%]), eutanásia por conveniência (101 [2,1%]), doenças metabólicas e endocrinológicas (97 [2,0%]), distúrbios iatrogênicos (83 [1,7%]), distúrbios do desenvolvimento (25 [0,5%]), doenças imunomediadas (10 [0,2%]) e doenças nutricionais (6 [0,1%]). Outros distúrbios, que incluem doenças multifatoriais ou idiopáticas, contribuíram com 80 (1,6%) casos. Dos 4.844 casos, em 1.548 (32,0%) não foi possível estabelecer a causa da morte ou a razão para a eutanásia. Doenças infecciosas e parasitárias (principalmente cinomose, parvovirose e verminose intestinal), neoplasmas (principalmente neoplasmas mamários e linfoma), distúrbios causados por agentes físicos (principalmente atropelamento por veículos automotivos) e doenças degenerativas (principalmente insuficiência renal crônica, cirrose e insuficiência cardíaca congestiva) foram as principais categorias de doenças relacionadas com morte ou eutanásia de cães dessa mesorregião. Entretanto, quando os cães são avaliados de acordo com suas idades, tais categorias possuem prevalências diferentes. As principais causas de morte em filhotes foram as doenças infecciosas e parasitárias, principalmente parvovirose, cinomose e verminose intestinal. Em adultos, as causas de morte mais importantes foram cinomose, neoplasmas e trauma. Em idosos, neoplasmas e doenças degenerativas foram responsáveis por aproximadamente a metade das mortes.

Orientador: Luzia Helena Queiroz da Silva / Banca: Silvia Helena Venturoli Perri / Banca: Fernando Ferreira / Banca: Luzia Helena Queiroz da Silva / Resumo: A população canina de Araçatuba foi acometida em um período dez anos (1994-2004) de duas importantes zoonoses: a Raiva e a Leishmaniose Visceral (LV). Este trabalho objetivou analisar as mudanças ocorridas nesta população durante este período. Para este fim foram utilizados os resultados dos censos caninos realizados nos anos de 1994, 1999 e 2004. Verificou-se que a relação cão/10 habitantes que era 1,69 em 1994 aumentou para 2,03 em 1999 e decresceu a 1,79 em 2004. A quantidade de animais com menos de um ano de idade aumentou de 20% em 1994 para 32% em 2004. No censo canino de 2004 foi observado que o número de cães e sua estrutura etária variaram nos diversos setores do município. Baseado nestes dados sugere-se que os programas de controle populacional canino e de zoonoses sejam direcionados aos setores mais problemáticos da cidade. / Abstract: The dog population of Araçatuba presented in a period of ten years (1994-2004) two important canine zoonosis: rabies and visceral leishmaniasis (VL). This work aimed at checking the changes that happened in this population during this time. For this purpose, we used the census results of the years 1994, 1999 and 2004. We found that the ratio dog/10 habitants that was 1.69 in 1994, increased to 2.03 in 1999 and decreased to 1.79 in 2004. The number of puppies less than 1 year of age increased from 20% in 1994 to 32% in 2004. The 2004 census showed that the number of dogs and the percentage of puppies found in the different areas of the city are variable. Based on these results we suggest that, zoonosis and population control programs could be aimed to the more problematic areas in the city. / Mestre