Kennedy Institute of Ethics journal
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This paper considers whether a physician is criminally liable for administering a dose of painkillers that hastens a patient's death. The common wisdom is that a version of the doctrine of double effect legally protects the physician. That is, a physician is supposedly acting lawfully so long as the physician's primary purpose is to relieve suffering. ⋯ Physician culpability can be based on recklessness, and recklessness hinges on whether a physician has taken an unjustifiable risk of hastening death. The authors identify three conditions of justifiability. Their analysis helps to explain the distinction between euthanasia, which is legally banned, and the use of risky analgesics, which is permitted in limited circumstances.
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Kennedy Inst Ethics J · Dec 1995
ReviewPerish and publish: non-heart-beating organ donation and unduly iterative ethical review.
In the expanding repertoire of practices designed to increase the supply of organs for transplantation, non-heart-beating cadaver organ donation has generated an ongoing debate in the literature. The continuing stream of articles is disquieting in part because it documents a troubling "trial-and-error ethics" approach to the formulation of organ procurement policy, and because it raises serious questions about the reasons that the development of this policy is being mediated by published communication. In the light of concerns about the implicit support and credibility that professional publications give to organ procurement policies, restraint in publishing articles about non-heart-beating organ donation as well as in devising such policies is strongly advocated.
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Kennedy Inst Ethics J · Dec 1994
Historical ArticlePatients' rights in Japan: progress and resistance.
The discussion of patients' rights in Japan began in 1968 when a surgeon was accused of violating a potential organ donor's right to life by arbitrarily employing brain-based criteria in the determination of his death. A proliferation of documents that articulate and endorse patients' rights occurred in the 1980s and early 1990s. The doctrine of informed consent, which has been a central aspect of the movement toward patients' rights, is increasingly recognized in Japan, although importance rarely has been attached to the element of the patient's "appreciation" of the information disclosed by the physician, much less to the "voluntariness" of the patient's decision. Nevertheless, recent court decisions indicate progress both in the acceptance and the understanding of the doctrine in Japan.