As medical technologies evolve and assume greater importance in health care, individuals are confronted by situations that involve difficult ethical issues.
Autonomy, beneficence, and justice are ethical principles that apply to decision making in health care.
Informed consent requires that the patient is competent, understands the treatment options, and freely and voluntarily makes choices.
Health care institutions are increasingly oriented toward providing "total" or "whole-person" care (physical, emotional, and spiritual) and social support.
In the context of health care, a covenantal relationship implies a mutuality of interest between health care providers and patients; it encourages clear communication and promotes sharing of decision-making.
Euthanasia (a "good" or gentle and painless death) encompasses a range of medical decisions: choosing to withhold a particular treatment; withdrawing artificial life support or nutrition and hydration; administering high doses of pain medication that have the "double effect" of hastening death; providing a terminally ill person with the means to end his or her own life; and actively assisting in causing death (as in the case of a lethal injection administered by a physician).
Right-to-die advocates view euthanasia as a basic human right, an alternative to needless suffering. Opponents argue that it is often difficult or impossible to obtain a patient's clear consent to euthanasia, that there is always a risk of faulty diagnosis, that a timely cure may be found, that palliative care can ease pain and discomfort, and that opening the door to euthanasia will inevitably lead down a "slippery slope" toward inhumane and unethical practices.
The high-profile cases of Karen Ann Quinlan and Nancy Cruzan have provoked public debate about dying in an era of sophisticated medical technology.
Neonatal intensive care frequently involves painful decisions with respect to life-sustaining medical interventions.
Advance directives such as living wills and durable powers of attorney for health care provide a means for individuals to express their wishes about the use of life-sustaining treatment.
The Patient Self-Determination Act, enacted into law by Congress in 1990, requires health care providers who receive federal funds to give information to patients concerning advance directives.
Physician-assisted suicide, as exemplified in the highly publicized actions of Dr. Jack Kevorkian, is increasingly an issue for national debate and legislative initiatives. In 1994, Oregon voters passed the Oregon Death with Dignity Act, making that state the first to legalize aid-in-dying. In March 1998, an elderly woman with breast cancer became the first known person to die under the law, having taken a lethal dose of barbiturates prescribed by her doctor.
A will is a legal document expressing an individual's wishes and intentions with respect to the disposition of his or her property after death.
Probate is the legal process whereby a will is proved valid and an estate is distributed to its beneficiaries; it is conducted by an administrator or executor under supervision of a court.
Life insurance and other death benefits provide funds to survivors who have been named by the decedent as beneficiaries or who are otherwise entitled to the proceeds from such benefits.
