Amyotrophic lateral sclerosis: ethical challenges.

نویسندگان

  • Wendy S Johnston
  • Katelin Hoskins
  • Leo McCluskey
چکیده

Claudio Crisci, MD, Private Hospital for Rehabilitation, Naples, Italy: In the February 2011 issue of Neurology: Clinical Practice, Johnston et al. address the ethical issues amyotrophic lateral sclerosis (ALS) raises in a professional and compassionate manner. Nevertheless, some “unethical” thoughts come to mind. Doctors should not behave with an impersonal attitude, should be compassionate, and should not abandon patients even if faced with unacceptable requests. Is assisted suicide an unacceptable request? All of us have experienced assisting a dying patient with ALS and such a request should be addressed in a very thoughtful way. To withdraw a patient from a ventilator under a palliative sedation is more scientific and probably considered more ethical, while assisted suicide is seen as more sudden and dramatic but perhaps less devastating and less financially burdensome to the family. The economic issue sounds outrageous but insurance companies or private health care facilities are greedy. The patient had a previous tragic experience and instinctively asked for a rapid death to avoid a long-lasting agony. He knew that if he had deferred the issue to a surrogate decision-maker, it would have been impossible to respect his wish to die rapidly. The patient identified the right shortcut for him and his family from the economic and emotional point of view.

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عنوان ژورنال:
  • Neurology

دوره 76 7 Suppl 2  شماره 

صفحات  -

تاریخ انتشار 2011