| ISSUE SUMMARY |
| Disabilities Ethical History International Medical Psychological Religious |
Euthanasia Examined: Ethical, Clinical and Legal Perspectives Euthanasia: Opposing Viewpoints Language and Reality at the End of Life Suicide and Euthanasia, Are They Ever Right? The Case Against Assisted Suicide: For the Right to End-of-Life Care The Slippery Slope of Assisted Suicide When Killing is Wrong: Physician-Assisted Suicide and the Courts |
Language and Reality at the End of Life Raphael Cohen-Almagor, Language and Reality at the End of Life, 28 J. LAW, MED. & ETHICS 267 (2000).To find adequate answers to a changing reality heavily influenced by advances in technology, medical professionals have developed an array of terms that have brought new concepts into the profession. "Dignity," "vegetative state," "futility," "double effect," and "brain death" have become indispensable words in the medical setting. In this article the attention is on terminology. Every profession has its concepts, phrases, and key words that are important to help categorize phenomena, save time, and provide a framework for working together. The question is whether these concepts and terms are designed chiefly to serve the physicians or patients. The thesis of this article is that language in the medical setting serves primarily the physicians, sometimes at the expense of the patients' best interests. This language and the concepts it describes have generated an unhealthy atmosphere for patients, which may lead to undesirable actions at the end of patients' lives. Some terms have a clear meaning, like "pro-life" or "pro-choice." Other terms are not clear, however, and careful reading is needed before making up one's mind as to the intentions of the speaker or writer. For instance, one who speaks of "double effect" or "death with dignity" may be an advocate of active euthanasia, mercy killings, and physician-assisted suicide, or might side with those who are against these practices. Some terms may be transient, i.e., once they had a dubious meaning, but increasingly became loaded, and today are associated with one school of thought. This is the case with the phrase, "quality of life." In the past, the term was used by persons holding differing viewpoints, but increasingly became associated with active euthanasia advocates, and now contrasts with the notion of "sanctity of life." The author analyzes the meanings and uses of the phrases: "death with dignity," "persistent vegetative state," "futility," "double effect," and "brain death." He concludes that doctors must strive to use only simple, non-technical language to insure that patients and their loved ones not only understand the information disclosed but are also not offended by it. Dehumanizing terminology like "persistent vegetative state" should be excluded from medical discussions for ethical reasons. Thoughtful and sensitive explanations should replace the concise and brutal terms that fall like an axe on patients and their loved ones. Terms like "double effect" and "futility" should be explained in detail and with sincerity. The motivation for using these terms and others, like "brain death," needs to be clarified. Doctors, patients, public leaders and religious figures, ethicists and intellectuals of social and philosophical backgrounds, psychologists, social workers, and others who care about patients should all take part in these discussions. Posted on June 26, 2004. |