{"id":9603,"date":"2017-11-23T14:00:17","date_gmt":"2017-11-23T14:00:17","guid":{"rendered":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017.pdf"},"modified":"2017-11-23T14:00:17","modified_gmt":"2017-11-23T14:00:17","slug":"sahm-wma-eol-presentation-vatican-nov2017-2","status":"inherit","type":"attachment","link":"https:\/\/www.wma.net\/fr\/sahm-wma-eol-presentation-vatican-nov2017-2\/","title":{"rendered":"Sahm-WMA EoL Presentation Vatican-Nov2017"},"author":5,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"acf":[],"description":{"rendered":"

\"\"<\/a><\/p>\n

Sahm Ketteler-Krankenhaus 2017 DKD
\n\u00d8 Clinic for Gastroenterology\/
\nOncology, Palliative Care
\nKetteler Hospital Offenbach,
\nUniversity Center for Tumour
\nDiseases (UCT)
\nand
\n\u00d8 Institute of History and Ethics
\nin Medicine, Frankfurt University
\nOn Death and Dying \u2013
\nMedical Concepts and Ethics in Palliative Care
\nProf. Dr. med. Stephan Sahm
\nSahm Ketteler-Krankenhaus 2017
\nI: The philosophy behind: on rights and duties at
\nthe end of life
\nII: Normative concepts of medical acts at the
\nend of life
\nIII: Flaws and fallacies in the case for
\neuthanasia and assisted suicide
\nMedicine at the End of Life
\nSahm Ketteler-Krankenhaus 2017
\n\u00d8 right to non-interference vs. claims
\non others
\n\u00d8 foundational rule: preference of existence to
\nnon – existence of members of human society
\n\u00d8 justification of state interference to protect life
\nMoral and Political Rights
\nSahm Ketteler-Krankenhaus 2017
\n\u00a770% of deaths in clinics
\n(US-Hospital society)
\n\u00a750% limitation of specific
\ntreatments
\n(Van der Heide, 2003)
\n\u00a7 Stopping any treamtent
\nin 10% of all cases in an IC-Unit
\n(Wunsch 2005)
\nForegoing treatment as
\na clinical routine
\n(a survey)
\nSahm Ketteler-Krankenhaus 2017
\ncurative palliative
\npalliation is an indispensable obligation
\nSahm Ketteler-Krankenhaus 2017
\nMedical acts at the end of life:
\nnormative view
\n– Change of the Goal of Treatment
\nSahm Ketteler-Krankenhaus 2017
\nInappropriate concepts
\n– passive euthanasia
\n– indirect active euthanasia
\nSahm Ketteler-Krankenhaus 2017
\n\u00d8 symptome guided sedation if they are not to be
\nrelieved otherwise \/ depending on medical
\nindication and consent
\n\u00d8 reversible and to be controlled: with respect to
\ndeepness of sedation
\nA side remark:
\npalliative sedation
\nSahm Ketteler-Krankenhaus 2017
\n\u00d8 frequency of unwanted side effects not higher, yet,
\neven lower than with other medical treatments
\nPalliative sedation
\n\u00d8 Indication and performance not distinct from other
\nmedical treatments
\n\u00d8 Caveat: palliative sedation may be used as a pretence to practice euthanasia
\nwithout retrospective surveillance (s. Derde evaluatie 2017)
\nSahm Ketteler-Krankenhaus 2017
\n– there is no medical indication
\nto intend ending a patient\u00b4s life
\nInterim summary
\n– limitation of therapies
\nare part of clinical routine
\n– the preference for life is the
\nfoundation of human rights
\nSahm Ketteler-Krankenhaus 2017
\nIs there a case to overcome what
\nhad been laid out so far?
\nv patients\u2018 right to self-determination?
\nv Medical necessity or emergency?
\nSahm Ketteler-Krankenhaus 2017
\nFlaws and fallacies in the case for
\nassisted suicide
\nv assistance with sucide contradicts self-determination
\n– a) if restricted to cases of terminal illness
\n– b) it suggests social acceptability
\nv @ b): because refraining from judgement is the only appropriate
\nattitude in order to preserve liberty
\nSahm Ketteler-Krankenhaus 2017
\nFlaws and fallacies in the case for
\nassisted suicide
\nv assistance with suicide does not prevent suicidal acts\/
\nrather it is an independent risk factor increasing frequency
\nv suicide is \u201econtagious\u201c
\nv it underestimates palliative care and misinterprets
\nmedical acts at the end of life
\nSahm Ketteler-Krankenhaus 2017
\nSahm Ketteler-Krankenhaus 2017
\nSuicides in Switzerland:
\nwith\/ without assistance and total
\n0
\n200
\n400
\n600
\n800
\n1000
\n1200
\n1400
\n1600
\n1800
\nwithout Ass. with Ass. total
\nYear 2000\/ Data from Sitte, T: Inaugural thesis, 2015
\nSahm Ketteler-Krankenhaus 2017
\nSuicides in Switzerland:
\nwith\/ without assistance and total
\n10
\n210
\n410
\n610
\n810
\n1010
\n1210
\n1410
\n1610
\n1810
\nwithout Ass. with Ass. total
\nYear 2013; Data from Sitte T: Inaugural thesis, 2015
\nSahm Ketteler-Krankenhaus 2017
\nEuthanasia in the Netherlands
\n0
\n1000
\n2000
\n3000
\n4000
\n5000
\n6000
\n7000
\n2003 2016
\nDerde evaluatie \/ Wet toetsing levensbe\u00ebindiging op verzoek
\nen hulp bij zelfdoding 2017
\nSahm Ketteler-Krankenhaus 2017
\nTo restrict euthanasia and assisted suicide by law
\ndoes not criminalise state-of-the-art palliative care
\nSahm Ketteler-Krankenhaus 2017
\nFinal Summary
\n– There is no moral claim justifying
\neuthanasia and assistance with suicide
\n– rather, liberalising endangers great many
\npatients
\n– physicians should withstand any attempts to
\nintroduce such practices in their respective
\ncountries
\nSahm Ketteler-Krankenhaus 2017
\nThank you for
\nyour attention<\/p>\n"},"caption":{"rendered":"

Sahm Ketteler-Krankenhaus 2017 DKD \u00d8 Clinic for Gastroenterology\/ Oncology, Palliative Care Ketteler Hospital Offenbach, University Center for Tumour Diseases (UCT) and \u00d8 Institute of History and Ethics in Medicine, Frankfurt University On Death and Dying \u2013 Medical Concepts and Ethics in Palliative Care Prof. Dr. med. Stephan Sahm Sahm Ketteler-Krankenhaus 2017 I: The philosophy behind: […]<\/p>\n"},"alt_text":"","media_type":"file","mime_type":"application\/pdf","media_details":{"sizes":{"thumbnail":{"file":"Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-106x150.jpg","width":106,"height":150,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-106x150.jpg"},"medium":{"file":"Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-212x300.jpg","width":212,"height":300,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-212x300.jpg"},"large":{"file":"Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-724x1024.jpg","width":724,"height":1024,"mime_type":"image\/jpeg","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf-724x1024.jpg"},"full":{"file":"Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf.jpg","width":1058,"height":1497,"mime_type":"application\/pdf","source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017-pdf.jpg"}}},"post":null,"source_url":"https:\/\/www.wma.net\/wp-content\/uploads\/2017\/05\/Sahm-WMA-EoL-Presentation-Vatican-Nov2017.pdf","_links":{"self":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media\/9603"}],"collection":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/media"}],"about":[{"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/types\/attachment"}],"author":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wma.net\/fr\/wp-json\/wp\/v2\/comments?post=9603"}]}}