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Sample records for active voluntary euthanasia

  1. Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion.

    PubMed

    Amaraskekara, Kumar; Bagaric, Mirko

    2004-09-01

    The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia. PMID:16602214

  2. The legislation of active voluntary euthanasia in Australia: will the slippery slope prove fatal?

    PubMed Central

    Kerridge, I H; Mitchell, K R

    1996-01-01

    At 2.00 am on the morning of May 24, 1995 the Northern Territory Legislative Assembly Australia passed the Rights of the Terminally Ill Act by the narrow margin of 15 votes to 10. The act permits a terminally ill patient of sound mind and over the age of 18 years, and who is either in pain or suffering, or distress, to request a medical practitioner to assist the patient to terminate his or her life. Thus, Australia can lay claim to being the first country in the world to legalise voluntary active euthanasia. The Northern Territory's act has prompted Australia-wide community reaction, particularly in South Australia, Tasmania and the Australian Capital Territory where proposals to legalise euthanasia have already been defeated on the floor of parliament. In New South Wales (NSW) the AIDS Council of NSW has prepared draft euthanasia legislation to be introduced into the Upper House as a Private Member's Bill some time in 1996. In this paper, we focus on a brief description of events as they occurred and on the arguments for and against the legalisation of euthanasia which have appeared in the media. PMID:8910778

  3. Voluntary euthanasia: a utilitarian perspective.

    PubMed

    Singer, Peter

    2003-10-01

    Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia. PMID:14959723

  4. Nurses' attitudes to active voluntary euthanasia: a survey in the ACT.

    PubMed

    Kitchener, B A

    1998-04-01

    National public opinion polls show a large majority of Australians are in favour of active voluntary euthanasia (AVE). However, most members of the public have had only limited direct experience with dying people. For this reason, surveys of the opinions of medical practitioners and nurses on this issue are of great interest. The present study involved a postal survey in late 1996 of 2,000 randomly selected registered nurses from the Australian Capital Territory (ACT). The ACT has had extensive public debate about this issue. The questionnaire included some questions asked in earlier Australian surveys of the general public and health practitioners. Responses were received from 1218 nurses (61%). A majority of nurses who responded supported AVE as 'sometimes right', be it homicide by request (72%) or physician-assisted suicide (71%). A slightly smaller majority believed the law should be changed to allow homicide by request (69%) and physician-assisted suicide (67%). If AVE were legal, 66% of the nurses indicated they were willing to be involved in the procedure. Only 30% were willing to assist patients to give themselves the lethal dose, while 14% were willing to administer the lethal dose to the patient. Comparing these results with previous surveys, it appears that nurses are less in favour of AVE than the public, but more in favour than medical practitioners. PMID:9744194

  5. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    PubMed

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values. PMID:19112873

  6. Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia.

    PubMed

    Quill, T E; Lo, B; Brock, D W

    1997-12-17

    Palliative care is generally agreed to be the standard of care for the dying, but there remain some patients for whom intolerable suffering persists. In the face of ethical and legal controversy about the acceptability of physician-assisted suicide and voluntary active euthanasia, voluntarily stopping eating and drinking and terminal sedation have been proposed as ethically superior responses of last resort that do not require changes in professional standards or the law. The clinical and ethical differences and similarities between these 4 practices are critically compared in light of the doctrine of double effect, the active/passive distinction, patient voluntariness, proportionality between risks and benefits, and the physician's potential conflict of duties. Terminal sedation and voluntarily stopping eating and drinking would allow clinicians to remain responsive to a wide range of patient suffering, but they are ethically and clinically more complex and closer to physician-assisted suicide and voluntary active euthanasia than is ordinarily acknowledged. Safeguards are presented for any medical action that may hasten death, including determining that palliative care is ineffective, obtaining informed consent, ensuring diagnostic and prognostic clarity, obtaining an independent second opinion, and implementing reporting and monitoring processes. Explicit public policy about which of these practices are permissible would reassure the many patients who fear a bad death in their future and allow for a predictable response for the few whose suffering becomes intolerable in spite of optimal palliative care. PMID:9403426

  7. The empirical slippery slope from voluntary to non-voluntary euthanasia.

    PubMed

    Lewis, Penney

    2007-01-01

    This article examines the evidence for the empirical argument that there is a slippery slope between the legalization of voluntary and non-voluntary euthanasia. The main source of evidence in relation to this argument comes from the Netherlands. The argument is only effective against legalization if it is legalization which causes the slippery slope. Moreover, it is only effective if it is used comparatively-to show that the slope is more slippery in jurisdictions which have legalized voluntary euthanasia than it is in jurisdictions which have not done so. Both of these elements are examined comparatively. PMID:17341228

  8. How should Australia regulate voluntary euthanasia and assisted suicide?

    PubMed

    White, Ben; Willmott, Lindy

    2012-12-01

    This article invites consideration of how Australia should regulate voluntary euthanasia and assisted suicide. It attempts to pose this question as neutrally as possible, acknowledging that both prohibition and legalisation of such conduct involve decisions about regulation. It begins by charting the wider field of law at the end of life, before considering the repeated, but ultimately unsuccessful, attempts at law reform in Australia. The situation in Australia is contrasted with permissive jurisdictions overseas where voluntary euthanasia and/or assisted suicide are lawful. The authors consider the arguments for and against legalisation of such conduct along with the available empirical evidence as to what happens in practice both in Australia and overseas. The article concludes by outlining a framework for deliberating on how Australia should regulate voluntary euthanasia and assisted suicide. It asks a threshold question of whether such conduct should be criminal acts (as they presently are), the answer to which then leads to a range of possible regulatory options. PMID:23431857

  9. Euthanasia: A National Survey of Attitudes toward Voluntary Termination of Life.

    ERIC Educational Resources Information Center

    Jorgenson, David E.; Neubecker, Ron C.

    1980-01-01

    A study on the attitudes of adults related to the voluntary termination of life showed that those persons with favorable attitudes toward suicide were also favorable toward euthanasia. Religiosity was negatively associated with pro-euthanasia attitudes. Whites and males were more favorable toward euthanasia than Blacks and females. (Author)

  10. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    PubMed

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia. PMID:23156656

  11. [Euthanasia].

    PubMed

    Hänninen, Juha

    2011-01-01

    Clinical practice may pose an ethical dilemma: is it better to actively kill a patient or let her/him die naturally and more slowly? The former may be considered to involve less suffering than a slow death possibly full of suffering. The central problem in respect of euthanasia is how to define, which level of suffering is intolerable. In practice, persons suffering particularly from degenerative and chronic neurological diseases experience helplessness and powerlessness as a burden. The scope of suffering is changing over time, whereby the establishment of permanent guidelines for euthanasia is difficult. PMID:21568107

  12. Motivations of physicians and nurses to practice voluntary euthanasia: a systematic review

    PubMed Central

    2014-01-01

    Background While a number of reviews have explored the attitude of health professionals toward euthanasia, none of them documented their motivations to practice euthanasia. The objective of the present systematic review was to identify physicians’ and nurses’ motives for having the intention or for performing an act of voluntary euthanasia and compare findings from countries where the practice is legalized to those where it is not. Methods The following databases were investigated: MEDLINE/PubMed (1950+), PsycINFO (1806+), CINAHL (1982+), EMBASE (1974+) and FRANCIS (1984+). Proquest Dissertations and Theses (1861+) was also investigated for gray literature. Additional studies were included by checking the references of the articles included in the systematic review as well as by looking at our personal collection of articles on euthanasia. Results This paper reviews a total of 27 empirical quantitative studies out of the 1 703 articles identified at the beginning. Five studies were in countries where euthanasia is legal and 22 in countries where it is not. Seventeen studies were targeting physicians, 9 targeted nurses and 1 both health professionals. Six studies identified the motivations underlying the intention to practice euthanasia, 16 the behavior itself and 5 both intention and behavior. The category of variables most consistently associated with euthanasia is psychological variables. All categories collapsed, the four variables most frequently associated with euthanasia are past behavior, medical specialty, whether the patient is depressed and the patient’s life expectancy. Conclusions The present review suggests that physicians and nurses are motivated to practice voluntary euthanasia especially when they are familiar with the act of euthanasia, when the patient does not have depressive symptoms and has a short life expectancy and their motivation varies according to their medical specialty. Additional studies among nurses and in countries where

  13. Assisted suicide and voluntary euthanasia: role contradictions for physicians.

    PubMed

    Randall, Fiona; Downie, Robin

    2010-08-01

    It is widely assumed by the general public that if assisted suicide (AS) or euthanasia (VE) were legalised doctors must be essentially involved in the whole process including prescribing the medication and (in euthanasia) administering it. This paper explores some reasons for this assumption and argues that it flatly contradicts what it means to be a doctor. The paper is thus not mainly concerned with the ethics of AS/VE but rather with the concept of a doctor that has evolved since the time of Hippocrates to current professional guidance reflected in healthcare law. The paper argues that the most common recent argument for AS/VE--that patients have a right to control when and how they die--in fact points to the involvement not of doctors but of legal agencies as decision makers plus technicians as agents. PMID:20849002

  14. Difficult Decisions: Euthanasia.

    ERIC Educational Resources Information Center

    Parakh, Jal S.; Slesnick, Irwin L.

    1992-01-01

    Focuses on the moral arguments for and against the controversial topic of voluntary active euthanasia. Discusses the question of legalization and decriminalization of the practice. Provides a student worksheet with questions to stimulate discussion on the issue. (MDH)

  15. A case against Dutch euthanasia.

    PubMed

    Fenigsen, Richard

    1989-01-01

    The growing acceptance of voluntary active euthanasia by the Dutch is examined in relation to the plastic cards requesting active euthanasia carried by many people in The Netherlands, public opinion polls, and support by leading medical figures of the movement to legalize euthanasia. The author draws upon his experience as a hospital doctor to condemn the practice of active euthanasia, arguing that its voluntariness is often counterfeit and always questionable, that it is inseparable from overtly involuntary forms of euthanasia, and that its promise of sparing the sick person agony is false. "Voluntary" euthanasia also brings an ominous change in society because of the message it sends to the elderly and sick, the weak and the dependent; because the fallibility of medical judgments are inconsistent with the irreversibility of the act; and because the fallacious reasoning of the philosophy threatens to cause irreparable damage to the medical profession. PMID:11650123

  16. Active euthanasia and forgoing life-sustaining treatment: can we hold the line?

    PubMed

    Jennings, B

    1991-07-01

    Public sentiment in favor of permitting voluntary active euthanasia creates a dilemma for a bioethics rooted in a libertarian notion of autonomy. At stake in the active euthanasia debate is actually a question of power--the individual's assertion of sovereignty over the timing and circumstances of his or her own death. Also at stake is society's unwillingness to impose a conception of the good--and a good dying--on individuals whose personal values and conceptions of the good may differ. In order both to reject voluntary active euthanasia and to affirm the patient's right to forgo life-sustaining treatment, some societal conception of the good must be developed and agreed upon to counter unbridled claims of individual self-sovereignty over dying. Pragmatic arguments alone, such as the need to maintain confidence in the doctor-patient relationship, will not be sufficient. PMID:1856506

  17. Death Anxiety and Voluntary Passive Euthanasia: Influences of Proximity to Death and Experiences with Death in Important Other Persons.

    ERIC Educational Resources Information Center

    Devins, Gerald M.

    1979-01-01

    Identified five sources of death anxiety. Significant relationships were observed between each source and experimental factors. The relationship between death anxiety and attitude toward voluntary passive euthanasia was explored, and a significant correlation was noted among elderly persons. Results were consistent with an idiographic orientation…

  18. The compatibility between Shiite and Kantian approach to passive voluntary euthanasia

    PubMed Central

    Dabbagh, Soroush; Aramesh, Kiarash

    2009-01-01

    Euthanasia is one of the controversial topics in current medical ethics. Among the six well-known types of euthanasia, passive voluntary euthanasia (PVE) seems to be more plausible in comparison with other types, from the moral point of view. According to the Kantian framework, ethical features come from ‘reason’. Maxims are formulated as categorical imperative which has three different versions. Moreover, the second version of categorical imperative which is dubbed ‘principle of ends’ is associated with human dignity. It follows from this that human dignity has an indisputable role in the Kantian story. On the other hand, there are two main theological schools in Islamic tradition which are called: Ash’arite and Mu’tazilite. Moreover, there are two main Islamic branches: Shiite and Sunni. From the theological point of view, Shiite’s theoretical framework is similar to the Mu’tazilite one. According to Shiite and Mu’tazilite perspectives, moral goodness and badness can be discovered by reason, on its own. Accordingly, bioethical judgments can be made based on the very concept of human dignity rather than merely resorting to the Holy Scripture or religious jurisprudential deliberations. As far as PVE is concerned, the majority of Shiite scholars do not recognize a person’s right to die voluntarily. Similarly, on the basis of Kantian ethical themes, PVE is immoral, categorically speaking. According to Shiite framework, however, PVE could be moral in some ethical contexts. In other words, in such contexts, the way in which Shiite scholars deal with PVE is more similar to Rossian ethics rather than the Kantian one. PMID:23908735

  19. The dangers of euthanasia and dementia: how Kantian thinking might be used to support non-voluntary euthanasia in cases of extreme dementia.

    PubMed

    Sharp, Robert

    2012-06-01

    Some writers have argued that a Kantian approach to ethics can be used to justify suicide in cases of extreme dementia, where a patient lacks the rationality required of Kantian moral agents. I worry that this line of thinking may lead to the more extreme claim that euthanasia is a proper Kantian response to severe dementia (and similar afflictions). Such morally treacherous thinking seems to be directly implied by the arguments that lead Dennis Cooley and similar writers to claim that Kant might support suicide. If rationality is the only factor in valuing a human life, then the loss of that rationality (however such loss might be defined) would allow us to use essentially utilitarian thinking in order to support non-voluntary euthanasia, since the patients themselves would no longer be moral agents that demand respect. PMID:22571425

  20. [Active euthanasia in Colombia and assisted suicide in California].

    PubMed

    Julesz, Máté

    2016-01-31

    The institution of active euthanasia has been legal in Colombia since 2015. In California, the regulation on physician-assisted suicide will come into effect on January 1, 2016. The legal institution of active euthanasia is not accepted under the law of the United States of America, however, physician-assisted suicide is accepted in an increasing number of member states. The related regulation in Oregon is imitated in other member states. In South America, Colombia is not the first country to legalize active euthanasia: active euthanasia has been legal in Uruguay since 1932. The North American legal tradition markedly differs from the South American one and both are incompatible with the Central European rule of law. In Hungary and in most European Union countries, solely the passive form of euthanasia is legal. In the Benelux countries, the active form of euthanasia is legal because the supranational law of the European Union does not prohibit it. Notwithstanding, European Union law does not prescribe legalization of either the active form of euthanasia, or the physician-assisted suicide. PMID:26801362

  1. Doctors' and nurses' attitudes towards and experiences of voluntary euthanasia: survey of members of the Japanese Association of Palliative Medicine

    PubMed Central

    Asai, A; Ohnishi, M; Nagata, S K; Tanida, N; Yamazaki, Y

    2001-01-01

    Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire. Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine. Main outcome measure—Doctors' and nurses' attitude towards and practices of VE. Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. Key Words: Euthanasia • Japan • doctors • nurses • palliative care PMID:11579190

  2. Living in the hands of God. English Sunni e-fatwas on (non-)voluntary euthanasia and assisted suicide.

    PubMed

    Van den Branden, Stef; Broeckaert, Bert

    2011-02-01

    Ever since the start of the twentieth century, a growing interest and importance of studying fatwas can be noted, with a focus on Arabic printed fatwas (Wokoeck 2009). The scholarly study of end-of-life ethics in these fatwas is a very recent feature, taking a first start in the 1980s (Anees 1984; Rispler-Chaim 1993). Since the past two decades, we have witnessed the emergence of a multitude of English fatwas that can easily be consulted through the Internet ('e-fatwas'), providing Muslims worldwide with a form of Islamic normative guidance on a huge variety of topics. Although English online fatwas do provide guidance for Muslims and Muslim minorities worldwide on a myriad of topics including end-of-life issues, they have hardly been studied. This study analyses Islamic views on (non-)voluntary euthanasia and assisted suicide as expressed in English Sunni fatwas published on independent--i.e. not created by established organisations--Islamic websites. We use Tyan's definition of a fatwa to distinguish between fatwas and other types of texts offering Islamic guidance through the Internet. The study of e-fatwas is framed in the context of Bunt's typology of Cyber Islamic Environments (Bunt 2009) and in the framework of Roy's view on the virtual umma (Roy 2002). '(Non-)voluntary euthanasia and assisted suicide' are defined using Broeckaert's conceptual framework on treatment decisions at the end of life (Broeckaert 2008). We analysed 32 English Sunni e-fatwas. All of the e-fatwas discussed here firmly speak out against every form of active termination of life. They often bear the same structure, basing themselves solely on Quranic verses and prophetic traditions, leaving aside classical jurisprudential discussions on the subject. In this respect they share the characteristics central in Roy's typology of the fatwa in the virtual umma. On the level of content, they are in line with the international literature on Islamic end-of-life ethics. English Sunni e-fatwas make

  3. The right to live or die? A perspective on voluntary euthanasia.

    PubMed

    Shah, Amber; Mushtaq, Ammara

    2014-09-01

    "It is choice alone that is being honored, without regards for what is chosen." The debate on euthanasia in medical community stays unresolved. In this manuscript, we present arguments for and against euthanasia, review arguments from both the sides and conclude it with our opinion. PMID:25225548

  4. The right to live or die? A perspective on voluntary euthanasia

    PubMed Central

    Shah, Amber; Mushtaq, Ammara

    2014-01-01

    “It is choice alone that is being honored, without regards for what is chosen.” The debate on euthanasia in medical community stays unresolved. In this manuscript, we present arguments for and against euthanasia, review arguments from both the sides and conclude it with our opinion. PMID:25225548

  5. Attitudes toward Euthanasia in Hong Kong--A Comparison between Physicians and the General Public

    ERIC Educational Resources Information Center

    Chong, Alice Ming-lin; Fok, Shiu-yeu

    2005-01-01

    This article reports the findings of a cross-sectional study that compared the attitudes of 618 respondents of a general household survey and a random sample of 1,197 physicians toward different types of euthanasia in Hong Kong. The general public was found to agree with active euthanasia and non-voluntary euthanasia and was neutral about passive…

  6. Euthanasia: agreeing to disagree?

    PubMed Central

    2010-01-01

    In discussions about the legalisation of active, voluntary euthanasia it is sometimes claimed that what should happen in a liberal society is that the two sides in the debate “agree to disagree”. This paper explores what is entailed by agreeing to disagree and shows that this is considerably more complicated than what is usually believed to be the case. Agreeing to disagree is philosophically problematic and will often lead to an unstable compromise. PMID:20676776

  7. A Right to Die?: Ethical Dilemmas of Euthanasia.

    ERIC Educational Resources Information Center

    Albright, Dianne E.; Hazler, Richard J.

    1992-01-01

    Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…

  8. [Euthanasia through history and religion].

    PubMed

    Gajić, Vladimir

    2012-01-01

    INTRODUCTION Euthanasia represents an ethical, social, legal and medical issue, which is being disputed more and more frequently worldwide. In Serbia, it is illegal and punishable by law and subject to a prison sentence. Euthanasia verbatim, meaning "good death", refers to the practice of ending a life in order to relieve pain and suffering. It can be voluntary, when a person knowingly declares the wish to end life, and involuntary, when relatives and family make decisions on behalf of patients in coma. It can be active, when a person applies a medical procedure to end life and passive, when medical procedures which can extend a patient's life are not applied. EUTHANASIA THROUGH HISTORY: The term was known in old Greece, and Hippocrates mentioned it in his oath, which is now taken by all doctors in the world, by which they pledge not to apply a medicine which can lead to death of the patients, nor to give such counsel. Euthanasia had its most vigorous impetus in the mid-20th century when it was being carried out deliberately in Nazi Germany. All leading religions from Christianity, over Buddhism, to Islam, are directly or indirectly against any kind of euthanasia. EUTHANASIA TODAY: At the beginning of the 21st century, euthanasia was legalized in several most developed countries in the world, among them the Netherlands, Belgium, Germany, Switzerland, Japan, India and some American and Mexican federal states. The World Medical Association from 82 countries has condemned euthanasia, and called all medical workers who practice euthanasia to reconsider their attitudes and to stop this practice. PMID:22788070

  9. Factors associated with the rejection of active euthanasia: a survey among the general public in Austria

    PubMed Central

    2013-01-01

    Background In recent decades, the general public has become increasingly receptive toward a legislation that allows active voluntary euthanasia (AVE). The purpose of this study was to survey the current attitude towards AVE within the Austrian population and to identify explanatory factors in the areas of socio-demographics, personal experiences with care, and ideological orientation. A further objective was to examine differences depending on the type of problem formulation (abstract vs. situational) for the purpose of measuring attitude. Methods A representative cross-sectional study was conducted across the Austrian population. Data were acquired from 1,000 individuals aged 16 years and over based on telephone interviews (CATI). For the purpose of measuring attitude toward AVE, two different problem formulations (abstract vs. situational) were juxtaposed. Results The abstract question about active voluntary euthanasia was answered negatively by 28.8%, while 71.2% opted in favour of AVE or were undecided. Regression analyses showed rejection of AVE was positively correlated with number of adults and children in the household, experience with care of seriously ill persons, a conservative worldview, and level of education. Mean or high family income was associated with lower levels of rejection. No independent correlations were found for variables such as sex, age, political orientation, self-rated health, and experiences with care of terminally ill patients. Correlation for the situational problem formulation was weaker and included fewer predictors than for the abstract question. Conclusions Our results suggest that factors relating to an individual’s interpersonal living situation and his/her cognitive convictions might be important determinants of the attitude toward AVE. If and to the extent that personal care experience plays a role, it is rather associated with rejection than with acceptance of AVE. PMID:23826902

  10. Nurses' attitudes to euthanasia: the influence of empirical studies and methodological concerns on nursing practice.

    PubMed

    Holt, Janet

    2008-10-01

    This paper introduces the controversy surrounding active voluntary euthanasia and describes the legal position on euthanasia and assisted suicide in the UK. Findings from studies of the nurses' attitudes to euthanasia from the national and international literature are reviewed. There are acknowledged difficulties in carrying out research into attitudes to euthanasia and hence the review of findings from the published studies is followed by a methodological review. This methodological review examines the research design and data collection methods used in the published studies, problems with understanding definitions of euthanasia and the measurement of attitudes. The paper concludes with a discussion of how research in this area may influence nursing practice. PMID:18798897

  11. Relational responsibility, and not only stewardship, a Roman Catholic view on voluntary euthanasia for dying and non-dying patients.

    PubMed

    Schotsmans, Paul T

    2003-01-01

    The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called "stewardship argument": Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist--and even secular--debate on the legitimacy of euthanasia. PMID:15254997

  12. Euthanasia, virtue ethics and the law.

    PubMed

    van Zyl, Liezl

    2002-02-01

    Following the recent revival of virtue ethics, a number of ethicists have discussed the moral problems surrounding euthanasia by drawing on concepts such as compassion, benevolence, death with dignity, mercy, and by inquiring whether euthanasia is compatible with human flourishing. Most of these writers assert, or simply assume, that their arguments concerning the morality of euthanasia also support their views with regard to legislation. I argue, against these writers, that legislation cannot and should not be based on our moral and religious beliefs concerning whether euthanasia allows a person to die a good death. I then outline an Aristotelian approach to the role of law and government in a good society, according to which the task of the legislator is not to ensure that people actually act virtuously, but is instead to make it possible for them to choose to live (and die) well by ensuring that they have access to the goods that are necessary for flourishing. In the second half of the paper I apply this approach to the question of whether voluntary active euthanasia should be legalised by asking (1) whether euthanasia always deprives people of the necessary conditions for flourishing, and (2) whether the option to request euthanasia is ever necessary for flourishing. PMID:15587484

  13. 75 FR 27563 - Agency Information Collection Activities: Voluntary Customer Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary Customer... Voluntary Customer Survey. This request for comment is being made pursuant to the Paperwork Reduction Act of... following information collection: Title: Voluntary Customer Survey. OMB Number: Will be assigned...

  14. Against euthanasia for children: a response to Bovens.

    PubMed

    Kaczor, Christopher

    2016-01-01

    If we accept euthanasia for adults, should we also accept voluntary euthanasia for children? In 'Child Euthanasia: Should We Just Not Talk about It?', Luc Bovens answers this question affirmatively. Bovens examines five arguments against extending euthanasia to minors, the arguments being weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care. He rejects each of these arguments. In this paper, I provide a rejoinder for each of his responses. I also critique his view that opponents of euthanasia have extra responsibility to promote palliative care. On the contrary, if euthanasia is legalised, advocates of euthanasia have a special obligation to promote improvements in palliative care. PMID:26474602

  15. Neonatal euthanasia: The Groningen Protocol*

    PubMed Central

    Vizcarrondo, Felipe E.

    2014-01-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  16. Neonatal euthanasia: The Groningen Protocol.

    PubMed

    Vizcarrondo, Felipe E

    2014-11-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  17. 77 FR 55487 - Agency Information Collection Activities; Voluntary Customer Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities; Voluntary Customer... approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a proposed... Register (77 FR 36566) on June 19, 2012, allowing for a 60-day comment period. This notice allows for...

  18. Implications of legalising euthanasia in The Netherlands: greater regulatory control?

    PubMed

    Thynne, Kelisiana

    2002-11-01

    Euthanasia has been decriminalised in The Netherlands for the last 30 years, but it was only in April 2001 that the Dutch Parliament legalised voluntary physician-assisted suicide. The legislation incorporates developments in case law, including scope for peer review, and provides common ethical principles for a clear system of control over doctors' actions in regard to patients who request euthanasia. The legalised regulatory system may prove more effective in controlling voluntary and non-voluntary euthanasia in The Netherlands than in countries where euthanasia remains illegal. PMID:12497737

  19. Neonatal euthanasia is unsupportable: the Groningen protocol should be abandoned.

    PubMed

    Kon, Alexander A

    2007-01-01

    The growing support for voluntary active euthanasia (VAE) is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then one may conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child's life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported. PMID:17985108

  20. [Euthanasia outside Europe].

    PubMed

    Julesz, Máté

    2014-08-10

    The passive form of euthanasia is legalized almost in every civilized country. Its active form is not a generally accepted legal institution. In Europe, active euthanasia is legalized only in The Netherlands, Belgium, Luxembourg and Switzerland. In Australia, the Act on the Rights of the Terminally Ill of 1995 legalized the institution of assisted suicide, which is not identical to active euthanasia. The difference lies in the fact that legalized active euthanasia means that the author of a murder is not punishable (under certain circumstances), whilst assisted suicide is not about murder, rather about suicide. In the first case, the patient is killed on his or her request by someone else. In the second case, the patient himself or herself executes the act of self-killing (by the assistance of a healthcare worker). In Australia, the institution of assisted suicide was repealed in 1997. Assisted suicide is legal in four USA member states: in Vermont, Washington, Montana and Oregon. In Uruguay, the active form of euthanasia has been legal since 1932. PMID:25087217

  1. [An inquiry among medical students. No to legalization of euthanasia, but yes to dropped charges or remission of sentence].

    PubMed

    Nilstun, T

    2001-08-01

    In a questionnaire to medical students in Sweden, only 6 out of 135 answered that they wanted voluntary active euthanasia to be legalized. However, most of the students were of the opinion that the charges brought against the physician could be withdrawn pending assessment by a public prosecutor (55), or alternatively, that remission of sentence could be granted pending assessment by a court (45). A somewhat smaller group (26) answered that prison corresponding to the sentence for manslaughter was reasonable. Only 3 students considered voluntary active euthanasia to be murder. Legal monitoring of each case of active euthanasia was very important to these medical students, but many answered that under specific conditions there should be no punishment. PMID:11526661

  2. [Limits to euthanasia].

    PubMed

    de Kort, Susanne J

    2015-01-01

    A recent survey showed that less than half of Dutch physicians would find it conceivable to grant a request for euthanasia from a patient suffering from psychiatric disease or dementia, or who is tired of life. Because of a broader interpretation by the Regional Review Committees of the official criteria for due care, all recent cases of euthanasia in these specific groups of patients had been accepted. In this commentary it is argued that, following recent social developments in the Netherlands (including cuts in provision of care for the elderly and of mental health care, and a narrowed view about end-of-life issues), the official euthanasia criteria for due care are no longer suitable if we are to avoid a 'slippery slope' effect in cases such as those mentioned above. The criteria of a) a voluntary and well-considered request and b) absence of reasonable treatment alternatives are particularly under pressure. A plea is hold for a return to stricter interpretation of the criteria. PMID:25970679

  3. Involuntary euthanasia of severely ill newborns: is the Groningen Protocol really dangerous?

    PubMed

    Voultsos, P; Chatzinikolaou, F

    2014-01-01

    Advances in medicine can reduce active euthanasia of newborns with severe anomalies or unusual prematurity, but they cannot eliminate it. In the Netherlands, voluntary active euthanasia among adults and adolescents has been allowed since 2002, when the so-called Groningen Protocol (GP) was formulated as an extension of the law on extremely premature and severely ill newborns. It is maintained that, at bioethical level, it serves the principle of beneficence. Other European countries do not accept the GP, including Belgium. Admissibility of active euthanasia is a necessary, though inadequate, condition for acceptance of the GP. Greece generally prohibits euthanasia, although the legal doctrine considers some of the forms of euthanasia permissible, but not active or involuntary euthanasia. The wide acceptance of passive newborns euthanasia, especially when the gestational age of the newborns is 22-25 weeks ("grey zone"), admissibility of practices within the limits between active and passive euthanasia (e.g., withholding/withdrawing), of "indirect active euthanasia" and abortion of the late fetus, the tendency to accept after-birth-abortion (infanticide) in the bioethical theory, the lower threshold for application of withdrawing in neonatal intensive care units compared with pediatric intensive care units, all the above advocate wider acceptance of the GP. However, the GP paves the way for a wide application of involuntary (or pseudo-voluntary) euthanasia (slippery slope) and contains some ambiguous concepts and requirements (e.g., "unbearable suffering"). It is suggested that the approach to the sensitive and controversial ethical dilemmas concerning the severely ill newborns is done not through the GP, but rather, through a combination of virtue bioethics (especially in the countries of the so-called "Mediterranean bioethical zone") and of the principles of principlism which is enriched, however, with the "principle of mutuality" (enhancement of all values and

  4. 77 FR 36566 - Agency Information Collection Activities: Voluntary Customer Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... of automated collection techniques or the use of other forms of information technology; and (e... questions about wait times, ease of entry processing, and the level of communication, efficiency and... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary...

  5. The euthanasia debate.

    PubMed

    Seitz, T

    2000-03-01

    Nurses are key players in determining outcomes for nursing and patient care. They treat patients with actual or potential health problems, act as advocates, and educate patients and families. This makes them eminently qualified to become active participants in the debate as to the legalization of euthanasia. PMID:11143663

  6. 16 CFR 1031.4 - Effect of voluntary standards activities on Commission activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Effect of voluntary standards activities on Commission activities. 1031.4 Section 1031.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL... Policies § 1031.4 Effect of voluntary standards activities on Commission activities. (a)(1) The...

  7. 16 CFR 1031.4 - Effect of voluntary standards activities on Commission activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Effect of voluntary standards activities on Commission activities. 1031.4 Section 1031.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL... Policies § 1031.4 Effect of voluntary standards activities on Commission activities. (a)(1) The...

  8. Euthanasia in Belgium, the Netherlands and Luxembourg.

    PubMed

    2013-11-01

    Each of the Benelux countries (Belgium, Luxembourg, Netherlands) has enacted legislation that partially decriminalises euthanasia, defined as an act that intentionally terminates someone's life at their request. In the Netherlands and Luxembourg, but not in Belgium, the legislation partially decriminalised assisted suicide at the same time. In all three countries, euthanasia can only be performed by a doctor, in response to the patient's voluntary and well-considered request, and for patients who have an incurable disease that causes unbearable suffering, without any prospect of relief. In the Netherlands, minors can request euthanasia as of the age of 12 years. In 2011, reported euthanasia accounted for about 1% of deaths in Belgium and 3% in the Netherlands. In 75% of cases, cancer was the disease leading to a request for euthanasia. In the Netherlands, the number of cases of euthanasia reported by doctors in surveys matches the number that is officially declared. In Belgium, it is thought that there are as many unreported as reported cases of euthanasia. Since the enactment of euthanasia legislation, fewer deaths involve the intentional administration of lethal drugs without an explicit request from the patient. PMID:24427846

  9. Neonatal euthanasia.

    PubMed

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate. PMID:19914522

  10. A right to die? Euthanasia and the law in Australia.

    PubMed

    Bartels, Lorana; Otlowski, Margaret

    2010-02-01

    This article examines the legal regulation of active voluntary euthanasia and assisted suicide in Australia. The Dying with Dignity Bill 2009 (Tas), which was recently defeated by the Tasmanian Parliament, is discussed, as well as other jurisdictions' past and present legislative developments in this context. The recent case law is also considered to ascertain how "mercy killing" or assisted suicide cases are dealt with by the criminal justice system, with particular reference to the case of R v Justins [2008] NSWSC 1194. This is followed by a critical evaluation of the key arguments for and against euthanasia. The article concludes by examining the significance of the Tasmanian Bill and the implications of such legislation. PMID:20329456

  11. Euthanasia: An Indian perspective

    PubMed Central

    Sinha, Vinod K.; Basu, S.; Sarkhel, S.

    2012-01-01

    In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or “mercy –killing” of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession. Moreover, undiagnosed depression and possibility of social ‘coercion’ in people asking for euthanasia put a further question mark on the ethical principles underlying such an act. These concerns have led to strict guidelines for implementing PAS. Assessment of the mental state of the person consenting to PAS becomes mandatory and here, the role of the psychiatrist becomes pivotal. Although considered illegal in our country, PAS has several advocates in the form of voluntary organizations like “death with dignity” foundation. This has got a fillip in the recent Honourable Supreme Court Judgment in the Aruna Shaunbag case. What remains to be seen is how long it takes before this sensitive issue rattles the Indian legislature. PMID:22988327

  12. The body as unwarranted life support: a new perspective on euthanasia.

    PubMed

    Shaw, David

    2007-09-01

    It is widely accepted in clinical ethics that removing a patient from a ventilator at the patient's request is ethically permissible. This constitutes voluntary passive euthanasia. However, voluntary active euthanasia, such as giving a patient a lethal overdose with the intention of ending that patient's life, is ethically proscribed, as is assisted suicide, such as providing a patient with lethal pills or a lethal infusion. Proponents of voluntary active euthanasia and assisted suicide have argued that the distinction between killing and letting die is flawed and that there is no real difference between actively ending someone's life and "merely" allowing them to die. This paper shows that, although this view is correct, there is even less of a distinction than is commonly acknowledged in the literature. It does so by suggesting a new perspective that more accurately reflects the moral features of end-of-life situations: if a patient is mentally competent and wants to die, his body itself constitutes unwarranted life support unfairly prolonging his or her mental life. PMID:17761819

  13. Rotation, locomotor activity and individual differences in voluntary ethanol consumption.

    PubMed

    Nielsen, D M; Crosley, K J; Keller, R W; Glick, S D; Carlson, J N

    1999-03-27

    Spontaneous turning behavior and locomotor activity were evaluated for their ability to predict differences in the voluntary consumption of ethanol in male Long-Evans rats. Animals were assessed for their preferred direction of turning behavior and for high vs. low levels of spontaneous locomotor activity, as determined during nocturnal testing in a rotometer. Subsequently, preference for a 10% ethanol solution vs. water was determined in a 24-h two-bottle home-cage free-choice paradigm. Rats exhibiting a right-turning preference consumed more ethanol than rats showing a left-turning preference. While locomotor activity alone did not predict differences in drinking, turning and locomotor activity together predicted differences in ethanol consumption. Low-activity right-turning rats consumed more ethanol than all the other groups of rats. Previous studies from this laboratory have shown that individual differences in turning behavior are accompanied by different asymmetries in dopamine (DA) function in the medial prefrontal cortex (mPFC). Individual differences in locomotor activity are associated with differences in nucleus accumbens (NAS) DA function. The present data suggest that variations in mPFC DA asymmetry and NAS DA function may underlie differences in the voluntary consumption of ethanol. PMID:10095014

  14. Relationship between back muscle endurance and voluntary activation.

    PubMed

    Bottle, Emily; Strutton, Paul H

    2012-06-01

    There is some evidence that the Biering-Sorensen endurance test can discriminate low back pain sufferers from healthy individuals and can predict future back pain. This test relies on the subject's ability to voluntarily drive the back muscles. This neural drive, termed voluntary activation (VA) can be measured using the twitch interpolation technique. The aim of the current study was to investigate the relationship between back muscle endurance and VA. Twenty-one healthy volunteers (10 males) participated. Bilateral electromyographic recordings were obtained from erector spinae and rectus abdominis. Back extensor torque was recorded using a dynamometer. The protocol consisted of measurement of VA (using magnetic stimulation of the brain and assessment of the sizes of the evoked twitches) and measurement of endurance. There was a linear correlation (r(2)=1, P<0.01) between voluntary torque and VA. The mean (SEM) endurance time was 174.9 (12.8)s. There was no correlation between endurance and VA at either 100% MVC (r(2)=0.01, P=0.72) or at 50% MVC (r(2)=0.11, P=0.16). These findings indicate that the endurance of the back muscles, as assessed using this widely utilised test does not appear to be related to a subject's ability to drive their back muscles voluntarily either maximally or submaximally. PMID:22387330

  15. Reduced Maximal Force during Acute Anterior Knee Pain Is Associated with Deficits in Voluntary Muscle Activation

    PubMed Central

    Salomoni, Sauro; Tucker, Kylie; Hug, François; McPhee, Megan; Hodges, Paul

    2016-01-01

    Although maximal voluntary contraction (MVC) force is reduced during pain, studies using interpolated twitch show no consistent reduction of voluntary muscle drive. The present study aimed to test if the reduction in MVC force during acute experimental pain could be explained by increased activation of antagonist muscles, weak voluntary activation at baseline, or changes in force direction. Twenty-two healthy volunteers performed maximal voluntary isometric knee extensions before, during, and after the effects of hypertonic (pain) and isotonic (control) saline injections into the infrapatellar fat pad. The MVC force, voluntary activation, electromyographic (EMG) activity of agonist, antagonist, and auxiliary (hip) muscles, and pain cognition and anxiety scores were recorded. MVC force was 9.3% lower during pain than baseline (p < 0.001), but there was no systematic change in voluntary activation. Reduced MVC force during pain was variable between participants (SD: 14%), and was correlated with reduced voluntary activation (r = 0.90), baseline voluntary activation (r = − 0.62), and reduced EMG amplitude of agonist and antagonist muscles (all r > 0.52), but not with changes in force direction, pain or anxiety scores. Hence, reduced MVC force during acute pain was mainly explained by deficits in maximal voluntary drive. PMID:27559737

  16. On-farm euthanasia of broiler chickens: effects of different gas mixtures on behavior and brain activity.

    PubMed

    Gerritzen, M A; Lambooij, B; Reimert, H; Stegeman, A; Spruijt, B

    2004-08-01

    The purpose of this study was to investigate the suitability of gas mixtures for euthanasia of groups of broilers in their housing by increasing the percentage of CO2. The suitability was assessed by the level of discomfort before loss of consciousness, and the killing rate. The gas mixtures injected into the housing were 1) 100% CO2, 2) 50% N2 + 50% CO2, and 3) 30% O2 + 40% CO2 + 30% N2, followed by 100% CO2. At 2 and 6 wk of age, groups of 20 broiler chickens per trial were exposed to increasing CO2 percentages due to the injection of these gas mixtures. Behavior and killing rate were examined. At the same time, 2 broilers per trial equipped with brain electrodes were observed for behavior and brain activity. Ten percent of the 2-wk-old broilers survived the increasing CO2 percentage due to the injection of 30% O2 + 40% CO2 + 30% N2 mixture, therefore this mixture was excluded for further testing at 6 wk of age. At 6 wk of age, 30% of the broilers survived in the 50% N2 + 50% CO2 group. The highest level of CO2 in the breathing air (42%) was reached by the injection of the 100% CO2 mixture, vs. 25% for the other 2 mixtures. In all 3 gas mixtures, head shaking, gasping, and convulsions were observed before loss of posture. Loss of posture and suppression of electrical activity of the brain (n = 7) occurred almost simultaneously. The results of this experiment indicate that euthanasia of groups of 2- and 6-wk-old broilers by gradually increasing the percentage of CO2 in the breathing air up to 40% is possible. PMID:15339003

  17. Organ procurement after euthanasia: Belgian experience.

    PubMed

    Ysebaert, D; Van Beeumen, G; De Greef, K; Squifflet, J P; Detry, O; De Roover, A; Delbouille, M-H; Van Donink, W; Roeyen, G; Chapelle, T; Bosmans, J-L; Van Raemdonck, D; Faymonville, M E; Laureys, S; Lamy, M; Cras, P

    2009-03-01

    Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident. Between 2005 and 2007, 4 patients (3 in Antwerp and 1 in Liège) expressed their will for organ donation after their request for euthanasia was granted. Patients were aged 43 to 50 years and had a debilitating neurologic disease, either after severe cerebrovascular accident or primary progressive multiple sclerosis. Ethical boards requested complete written scenario with informed consent of donor and relatives, clear separation between euthanasia and organ procurement procedure, and all procedures to be performed by senior staff members and nursing staff on a voluntary basis. The euthanasia procedure was performed by three independent physicians in the operating room. After clinical diagnosis of cardiac death, organ procurement was performed by femoral vessel cannulation or quick laparotomy. In 2 patients, the liver, both kidneys, and pancreatic islets (one case) were procured and transplanted; in the other 2 patients, there was additional lung procurement and transplantation. Transplant centers were informed of the nature of the case and the elements of organ procurement. There was primary function of all organs. The involved physicians and transplant teams had the well-discussed opinion that this strong request for organ donation after euthanasia could not be waived. A clear separation between the euthanasia request, the euthanasia procedure, and the organ procurement procedure is necessary. PMID:19328932

  18. 77 FR 64383 - Agency Information Collection (Application for Voluntary Service) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

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  19. 78 FR 57818 - Commission Participation and Commission Employee Involvement in Voluntary Standards Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... Commission Employee Involvement in Voluntary Standards Activities. 54 FR 6646 (Feb. 14, 1989). In 2006, the Commission amended several provisions of part 1031. 71 FR 38754 (July 10, 2006). Among other things, the 2006... the development of voluntary standards (43 FR 19216 (May 4, 1978)). Acknowledging the...

  20. 16 CFR 1031.5 - Criteria for Commission involvement in voluntary standards activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Criteria for Commission involvement in... COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies § 1031.5 Criteria for Commission involvement in voluntary standards...

  1. 16 CFR 1031.5 - Criteria for Commission involvement in voluntary standards activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Criteria for Commission involvement in... COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies § 1031.5 Criteria for Commission involvement in voluntary standards...

  2. Muscle spindle activity in man during voluntary fast alternating movements.

    PubMed Central

    Hagbarth, K E; Wallen, G; Löfstedt, L

    1975-01-01

    Single unit activity in primary spindle afferent nerve fibres from finger and foot flexors was recorded with tungsten microelectrodes inserted into the median and peroneal nerves of healthy subjects. During voluntary fast alternating finger and foot movements, simulating the tremor of Parkinsonism, two types of discharges were seen in the Ia afferent fibres: (1) stretch responses occurring during the flexor relaxation phases, and (2) discharges occurring during the flexor contraction phases. Contrary to the stretch responses the spindle contraction discharges could be eliminated by a partial lidocaine block of the muscle nerve proximal to the recording site, indicating that they resulted from fusimotor activation of intrafusal fibres. On the basis of the temporal relations between the beginning and end of individual EMG-bursts, the start of the spindle contraction discharges and the latency of the stretch reflex in the muscles concerned, the following conclusions were drawn: the recurrent extrafusal contractions in movements of this type are initiated by the fast direct alpha route, but individual contraction phases generally last long enough to be influenced subsequently by the coactivated fusimotor loop through the spindles. It is postulated that this gamma loop influence during alternating movements helps to keep flexor and extensor muscles working in a regular reciprocal fashion with contractions adjusted in strength to the external loads. Images PMID:125782

  3. Does voluntary hypoventilation during exercise impact EMG activity?

    PubMed

    Kume, Daisuke; Akahoshi, Shogo; Yamagata, Takashi; Wakimoto, Toshihiro; Nagao, Noriki

    2016-01-01

    It has been reported that exercise under hypoxic conditions induces reduced muscle oxygenation, which could be related to enhanced activity on electromyography (EMG). Although it has been demonstrated that exercise under conditions of voluntary hypoventilation (VH) evokes muscle deoxygenation, it is unclear whether VH during exercise impacts EMG. Seven men performed bicycle exercise for 5 min at 65 % of peak oxygen uptake with normal breathing (NB) and VH. Muscle oxygenation; concentration changes in oxyhemoglobin (Oxy-Hb), deoxyhemoglobin (Deoxy-Hb) and total hemoglobin (Total-Hb); and surface EMG in the vastus lateralis muscle were simultaneously measured. In the VH condition, Oxy-Hb was significantly lower and Deoxy-Hb was significantly higher compared to those in the NB condition (P < 0.05 for both), whereas there was no significant difference in Total-Hb between the two conditions. We observed significantly higher values (P < 0.05) on integrated EMG during exercise under VH conditions compared to those under NB conditions. This study suggests that VH during exercise augments EMG activity. PMID:27026846

  4. [Passive euthanasia and living will].

    PubMed

    Julesz, Máté

    2014-07-01

    This article deals with the intentional distinction between murder of first degree and passive euthanasia. In Hungary, active euthanasia is considered to be a murder of first degree, whilst the Netherlands, Belgium, Luxemburg and Switzerland have legalized the active form of mercy killing in Europe. The palliative terminal care, when e.g. giving pain-killer morphine to the patient, might result in decreasing the patient's life-span, and thus causing indirect euthanasia. However, the legal institution of living will exists in several counter-euthanasia countries. The living will allows future patients to express their decision in advance to refuse a life-sustaining treatment, e.g. in case of irreversible coma. The institution of living will exists in Germany and in Hungary too. Nevertheless, the formal criteria of living will make it hardly applicable. The patient ought to express his/her will before a notary public in advance, and he/she should hand it over when being hospitalized. If the patient is not able to present his/her living will to his/her doctor in the hospital, then his/her only hope remains that he/she has given a copy of the living will to the family doctor previously, and the family doctor will notify the hospital. PMID:24974840

  5. Euthanasia: American attitudes toward the physician's role.

    PubMed

    Caddell, D P; Newton, R R

    1995-06-01

    This is a study of American public opinion toward euthanasia and the physician's role in performing it. The authors examine how these attributes are affected by religious affiliation, religious self-perception, political self-perception and education. The data include 8384 American respondents from years 1977, 1978, 1982, 1985 and 1988 of the General Social Survey conducted by the National Opinion Research Center. The findings suggest that highly educated, politically liberal respondents with a less religious self-perception are most likely to accept active euthanasia or suicide in the case of terminally ill patient. The data also show that Americans tend to draw a distinction between the suicide of a terminally ill patient and active euthanasia under the care of a physician, preferring to have the physician perform this role in the dying process. The tendency to see a distinction between active euthanasia and suicide was clearly affected by religious affiliation and education. PMID:7660180

  6. Resources, the family and voluntary euthanasia.

    PubMed Central

    Bliss, M R

    1990-01-01

    Ethnological studies show that the care which societies are able to provide for their old people depends largely on available resources. However, the concept of resource depends on contemporary requirements and expectations. Modern families still try to look after their old people, but increasing longevity is making this more difficult. There is a finite ability of populations, however wealthy, to support dependent members. Resources provided to look after old people must necessarily be subtracted from those available for the other, still more important dependent group, the children, with potentially disastrous results in underfunding of social support and education. The sociobiological theory of inclusive fitness emphasizes the importance of the ways in which family members interact to help each other and try to ensure their genetic survival, even if this involves sacrificing their own interests and occasionally, their lives. Many old people do not wish for further longevity after they have become too disabled to be of service to their families, and would prefer to see limited resources being used for the young. In the USA, loss of autonomy of patients and their families owing to the practice of defensive medicine has resulted in the development of the 'living will', a legal document in which people can specify in advance what treatment they wish to accept in the event of life threatening illness. It is to be hoped that improved understanding of family relationships will make this generally unnecessary in the future and that, unless specified to the contrary, families will be allowed to decide about treatment for members who are unable to decide for themselves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2112015

  7. 76 FR 2124 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

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    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

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  9. Euthanasia: Some Legal Considerations

    ERIC Educational Resources Information Center

    Koza, Pamela

    1976-01-01

    Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)

  10. Professed religious affiliation and the practice of euthanasia.

    PubMed Central

    Baume, P; O'Malley, E; Bauman, A

    1995-01-01

    Attitudes towards active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) among 1,238 doctors on the medical register of New South Wales varied significantly with self-identified religious affiliation. More doctors without formal religious affiliation ('non-theists') were sympathetic to AVE, and acknowledged that they had practised AVE, than were doctors who gave any religious affiliation ('theists'). Of those identifying with a religion, those who reported a Protestant affiliation were intermediate in their attitudes and practices between the agnostic/atheist and the Catholic groups. Catholics recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic medical respondents who had been so requested, recorded that they had taken active steps to bring about the death of patients. PMID:7776349

  11. Differences in motor activation of voluntary and reflex cough in humans

    PubMed Central

    Lasserson, D; Mills, K; Arunachalam, R; Polkey, M; Moxham, J; Kalra, L

    2006-01-01

    Objectives To study motor activation patterns of voluntary and reflex cough adjusted for cough flow rates. Methods Surface electromyography (EMG) and cough flow rate were measured in 10 healthy volunteers. Voluntary cough was assessed for 20 efforts in each quintile of increasing cough flow rate. Reflex cough was assessed for 25 efforts produced by nebulised l‐tartaric acid. EMG was recorded over the expiratory (rectus abdominis, obliques, lower intercostals) and accessory (trapezius, pectoralis major, deltoid, latissimus dorsi) muscles. EMG activity, burst duration and onset were compared for each quintile of voluntary cough, and between voluntary and reflex cough matched for cough flow rate. Results EMG activity and burst duration of expiratory and accessory muscles during voluntary cough increased in proportion to cough flow. Expiratory muscles had longer EMG burst duration (difference 68 ms (95% CI 34 to 102), p<0.01) and earlier onset of EMG activity (difference 44 ms (95% CI 20 to 68), p<0.0001) compared with accessory muscles. EMG activity in all muscles was increased (mean 110.2% v 56.1%, p<0.001) and burst duration (mean 206 ms v 280 ms, p = 0.013) decreased in reflex cough compared with voluntary cough of equal flow rate. There were no differences in EMG onset (difference 8 ms (95% CI 25 to −9) or burst duration (difference 27 ms (95% CI 58 to −4) between expiratory and accessory muscles. Conclusions Functional organisation of motor activity differs between voluntary and reflex cough. Voluntary cough is characterised by sequential activation whereas reflex cough is associated with early and simultaneous activation of expiratory and accessory muscles. PMID:16601089

  12. Measurement of voluntary activation of fresh and fatigued human muscles using transcranial magnetic stimulation

    PubMed Central

    Todd, Gabrielle; Taylor, Janet L; Gandevia, S C

    2003-01-01

    Recently, transcranial magnetic stimulation of the motor cortex (TMS) revealed impaired voluntary activation of muscles during maximal efforts. Hence, we evaluated its use as a measure of voluntary activation over a range of contraction strengths in both fresh and fatigued muscles, and compared it with standard twitch interpolation using nerve stimulation. Subjects contracted the elbow flexors isometrically while force and EMG from biceps and triceps were recorded. In one study, eight subjects made submaximal and maximal test contractions with rests to minimise fatigue. In the second study, eight subjects made sustained maximal contractions to reduce force to 60 % of the initial value, followed by brief test contractions. Force responses were recorded following TMS or electrical stimulation of the biceps motor nerve. In other contractions, EMG responses to TMS (motor evoked potentials, MEPs) or to stimulation at the brachial plexus (maximal M waves, Mmax) were recorded. During contractions of 50 % maximum, TMS elicited large MEPs in biceps (> 90 % Mmax) which decreased in size (to ≈70 % Mmax) with maximal efforts. This suggests that faster firing rates made some motor units effectively refractory. With fatigue, MEPs were also smaller but remained > 70 % Mmax for contractions of 50–100 % maximum. For fresh and fatigued muscle, the superimposed twitch evoked by motor nerve and motor cortex stimulation decreased with increasing contraction strength. For nerve stimulation the relation was curvilinear, and for TMS it was linear for contractions of 50–100 % maximum (r2 = 1.00). Voluntary activation was derived using the expression: (1 – superimposed twitch/resting twitch) × 100. The resting twitch was measured directly for nerve stimulation and for TMS, it was estimated by extrapolation of the linear regression between the twitch and voluntary force. For cortical stimulation, this resulted in a highly linear relation between voluntary activation and force

  13. Voluntary activation of spindle endings in human muscles temporarily paralysed by nerve pressure.

    PubMed Central

    Burke, D; Hagbarth, K E; Skuse, N F

    1979-01-01

    1. In normal human subjects, the afferent activity from muscle spindle endings in the pretibial muscles was recorded while a pressure block was applied to the peroneal nerve proximally in the popliteal fossa. 2. In five of ten blocks, spindle activity increased in attempted isometric voluntary contractions when the receptor-bearing muscles were completely paralysed. In the remaining five blocks, voluntary effort still increased spindle activity when maximum voluntary power was reduced by more than 90%, but the ability to activate spindles voluntarily was lost with or slightly before block of the last motor units. When the ability to activate spindle endings in an attempted voluntary contraction was lost sympathetic efferent fibres remained unblocked. 3. It is concluded that the fusimotor effects seen during a voluntary contraction are mediated by myelinated fibres of small calibre which probably innervate intrafusal structures exclusively (gamma fusimotor fibres). There is no necessity to postulate that skeleto-fusimotor (beta) fibres are responsible for the tight 'alpha-gamma co-activation' seen in man during voluntary contractions. PMID:155158

  14. Neural Activation During Submaximal Contractions Seems More Reflective of Neuromuscular Ageing than Maximal Voluntary Activation

    PubMed Central

    Scaglioni, Gil; Narici, Marco V.; Martin, Alain

    2016-01-01

    This study aimed at testing the hypothesis that differences in neural activation strategy during submaximal but not maximal plantarflexions exist between young and older men. Eleven young men (YM, 26 ± 4 years) and thirteen old men (OM, 76 ± 3 years) volunteered for the investigation. Maximal voluntary torque (MVT) was 38.2%, lower (p < 0.001) in OM than in YM, while voluntary activation was equivalent (~97%). The relationship between the interpolated twitch-torque and the voluntary torque (IT-VT relationship) was composite (curvilinear + exponential) for both age-groups. However, the OM showed accentuated concavity, as attested by the occurrence of the deviation from linearity at a lower contraction intensity (OM: 54.9 vs. YM: 71.9% MVT). In conclusion, ageing does not affect the capacity to fully activate the plantar flexors during maximal performances, but it alters the activation pattern for submaximal levels of effort. The greater age-related concavity of the IT-VT relationship suggests that, during submaximal contractions, OM need to reach a level of activation higher than YM to develop an equivalent relative torque. PMID:26941638

  15. Effect of experimental muscle pain on maximal voluntary activation of human biceps brachii muscle.

    PubMed

    Khan, Serajul I; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2011-09-01

    Muscle pain has widespread effects on motor performance, but the effect of pain on voluntary activation, which is the level of neural drive to contracting muscle, is not known. To determine whether induced muscle pain reduces voluntary activation during maximal voluntary contractions, voluntary activation of elbow flexors was assessed with both motor-point stimulation and transcranial magnetic stimulation over the motor cortex. In addition, we performed a psychophysical experiment to investigate the effect of induced muscle pain across a wide range of submaximal efforts (5-75% maximum). In all studies, elbow flexion torque was recorded before, during, and after experimental muscle pain by injection of 1 ml of 5% hypertonic saline into biceps. Injection of hypertonic saline evoked deep pain in the muscle (pain rating ∼5 on a scale from 0 to 10). Experimental muscle pain caused a small (∼5%) but significant reduction of maximal voluntary torque in the motor-point and motor cortical studies (P < 0.001 and P = 0.045, respectively; n = 7). By contrast, experimental muscle pain had no significant effect on voluntary activation when assessed with motor-point and motor cortical stimulation although voluntary activation tested with motor-point stimulation was reduced by ∼2% in contractions after pain had resolved (P = 0.003). Furthermore, induced muscle pain had no significant effect on torque output during submaximal efforts (P > 0.05; n = 6), which suggests that muscle pain did not alter the relationship between the sense of effort and production of voluntary torque. Hence, the present study suggests that transient experimental muscle pain in biceps brachii has a limited effect on central motor pathways. PMID:21737829

  16. Pavlov's conceptualization of voluntary movements within the framework of the theory of higher nervous activity.

    PubMed

    Windholz, G

    1998-01-01

    Pavlov became interested in the nature of voluntary movements after receiving Konorski and Miller's letter in 1928 describing their experiments on conditioning of motor movements in dogs. Their paradigmatic experiment involved presenting an indifferent stimulus, followed by passive raising of the dog's leg and then reinforcement. If the same stimulus was provided during a number of trials, the animal lifted its corresponding leg. In 1928 Pavlov asked his students to condition motor movements in his laboratory. Although their findings were equivocal, Pavlov incorporated the so-called voluntary movements into his theory of higher nervous activity. Voluntary movements were responses to external environmental contingencies. On the cortical level, the motor analyzer's cells had both afferent and efferent functions. In Pavlov's view, the motor analyzer's cells established connections with the afferent cells of other sensory analyzers. Pavlov held that motor movements, as responses to external and internal environments, give humans the illusion of voluntary behavior. PMID:9805363

  17. Trainability of muscular activity level during maximal voluntary co-contraction: comparison between bodybuilders and nonathletes.

    PubMed

    Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki

    2013-01-01

    Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE). Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes). The electromyograms (EMGs) of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE). The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (P<0.01) than those for nonathletes (biceps brachii: 66±14% in bodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%). There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03). Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction. PMID:24260233

  18. Dementia and assisted suicide and euthanasia.

    PubMed

    de Beaufort, Inez D; van de Vathorst, Suzanne

    2016-07-01

    The number of dementia patients requesting euthanasia in the Netherlands has increased over the past five years. The issue is highly controversial. In this contribution we discuss some of the main arguments: the nature of suffering, the voluntariness of the request and the role of the physician. We argue that society has a duty to care for patients who suffer from dementia and to make their lives as good and comfortable as possible. We also argue that it can be morally acceptable for those who do not want to continue their life with dementia to choose to die. The choice can be based on good reasons. PMID:27017340

  19. Voluntary stand-up physical activity enhances endurance exercise capacity in rats.

    PubMed

    Seo, Dae Yun; Lee, Sung Ryul; Kwak, Hyo-Bum; Seo, Kyo Won; McGregor, Robin A; Yeo, Ji Young; Ko, Tae Hee; Bolorerdene, Saranhuu; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo; Han, Jin

    2016-05-01

    Involuntary physical activity induced by the avoidance of electrical shock leads to improved endurance exercise capacity in animals. However, it remains unknown whether voluntary stand-up physical activity (SPA) without forced simulating factors improves endurance exercise capacity in animals. We examined the eff ects of SPA on body weight, cardiac function, and endurance exercise capacity for 12 weeks. Twelve male Sprague-Dawley rats (aged 8 weeks, n=6 per group) were randomly assigned to a control group (CON) or a voluntary SPA group. The rats were induced to perform voluntary SPA (lifting a load equal to their body weight), while the food height (18.0 cm) in cages was increased progressively by 3.5 every 4 weeks until it reached 28.5 cm for 12 weeks. The SPA group showed a lower body weight compared to the CON group, but voluntary SPA did not affect the skeletal muscle and heart weights, food intake, and echocardiography results. Although the SPA group showed higher grip strength, running time, and distance compared to the CON group, the level of irisin, corticosterone, genetic expression of mitochondrial biogenesis, and nuclei numbers were not affected. These findings show that voluntary SPA without any forced stimuli in rats can eff ectively reduce body weight and enhance endurance exercise capacity, suggesting that it may be an important alternative strategy to enhance endurance exercise capacity. PMID:27162483

  20. Voluntary stand-up physical activity enhances endurance exercise capacity in rats

    PubMed Central

    Seo, Dae Yun; Lee, Sung Ryul; Kwak, Hyo-Bum; Seo, Kyo Won; McGregor, Robin A; Yeo, Ji Young; Ko, Tae Hee; Bolorerdene, Saranhuu; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo

    2016-01-01

    Involuntary physical activity induced by the avoidance of electrical shock leads to improved endurance exercise capacity in animals. However, it remains unknown whether voluntary stand-up physical activity (SPA) without forced simulating factors improves endurance exercise capacity in animals. We examined the eff ects of SPA on body weight, cardiac function, and endurance exercise capacity for 12 weeks. Twelve male Sprague-Dawley rats (aged 8 weeks, n=6 per group) were randomly assigned to a control group (CON) or a voluntary SPA group. The rats were induced to perform voluntary SPA (lifting a load equal to their body weight), while the food height (18.0 cm) in cages was increased progressively by 3.5 every 4 weeks until it reached 28.5 cm for 12 weeks. The SPA group showed a lower body weight compared to the CON group, but voluntary SPA did not affect the skeletal muscle and heart weights, food intake, and echocardiography results. Although the SPA group showed higher grip strength, running time, and distance compared to the CON group, the level of irisin, corticosterone, genetic expression of mitochondrial biogenesis, and nuclei numbers were not affected. These findings show that voluntary SPA without any forced stimuli in rats can eff ectively reduce body weight and enhance endurance exercise capacity, suggesting that it may be an important alternative strategy to enhance endurance exercise capacity. PMID:27162483

  1. [Euthanasia in Belgium].

    PubMed

    Simón Lorda, Pablo; Barrio Cantalejo, Inés M

    2012-01-01

    The experience of the Netherlands in relation with the legalization and practice of euthanasia is better known in Spain than the Belgian experience in this matter. But the historical process of social debate in Belgium has many specific details which should be known by Spanish healthcare professionals, bioethicists, politicians and lawyers. This paper begins with a comparative analysis of both countries: Spain and Belgium and follows with a description of the milestones of the historical process of debating and, finally, passing the Belgian Law on Euthanasia in 2002. The next chapter consists of a description of the main contents of this important Law. The paper continues then with an approach to the epidemiology of the practice of euthanasia in Belgium and finishes with a description of the different positions of the actors of the process. Two positions are described more in depth: the opinion of the specialists in palliative care, and the opinion of the Catholic Church. The paper ends underlining the reason for the incorporation of the Belgian experience on euthanasia to the debate about the possibility of legalizing euthanasia in Spain. PMID:22991026

  2. Voluntary activation deficits of the infraspinatus present as a consequence of pitching-induced fatigue

    PubMed Central

    Gandhi, Jaipal; ElAttrache, Neal S.; Kaufman, Kenton R.; Hurd, Wendy J.

    2014-01-01

    Hypothesis Neuromuscular inhibition of the infraspinatus would be greater and external rotation muscle force would be lower after a simulated game compared with pregame values. Materials and methods The sample included 21 uninjured, asymptomatic high school–aged baseball pitchers. Maximum volitional shoulder external rotation strength was assessed before and after a simulated game with a clinical dynamometer. Voluntary activation of the infraspinatus was assessed during strength testing by a modified burst superimposition technique. Performance-related fatigue was assessed by monitoring pitch velocity, and global fatigue was assessed by subject self-report before and after the game. Statistical testing included paired and independent t tests, with α ≤ 05. Results There was no difference between throwing and non-throwing shoulder external rotation strength (P = .12) or voluntary infraspinatus activation (P = .27) before the game. After the game, voluntary activation was significantly lower in the throwing limb compared with pregame activation levels (P = .01). Lower external rotation strength after the game approached statistical significance (P =.06). Pitch velocity was lower in the final inning compared with first-inning velocity (P = .01), and fatigue was significantly greater after the game (P = .01). Conclusions Voluntary infraspinatus muscle activation is a mechanism contributing to external rotation muscle weakness in the fatigued pitcher. Understanding mechanisms contributing to muscle weakness is necessary to develop effective injury prevention and rehabilitation programs. Treatment techniques that enhance neuromuscular activation may be a useful strategy for enhancing strength in this population. Level of evidence Basic Science Study, Kinesiology Study. PMID:21831667

  3. Firing of antagonist small-diameter muscle afferents reduces voluntary activation and torque of elbow flexors.

    PubMed

    Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2013-07-15

    During muscle fatigue, firing of small-diameter muscle afferents can decrease voluntary activation of the fatigued muscle. However, these afferents may have a more widespread effect on other muscles in the exercising limb. We examined if the firing of fatigue-sensitive afferents from elbow extensor muscles in the same arm reduces torque production and voluntary activation of elbow flexors. In nine subjects we examined voluntary activation of elbow flexors by measuring changes in superimposed twitches evoked by transcranial magnetic stimulation of the motor cortex during brief (2-3 s) maximal voluntary contractions (MVC). Inflation of a blood pressure cuff following a 2-min sustained MVC blocked blood flow to the fatigued muscle and maintained firing of small-diameter afferents. After a fatiguing elbow flexion contraction, maximal flexion torque was lower (26.0 ± 4.4% versus 67.9 ± 5.2% of initial maximal torque; means ± s.d.; P < 0.001) and superimposed twitches were larger (4.1 ± 1.1% versus 1.8 ± 0.2% ongoing MVC, P = 0.01) with than without ischaemia. After a fatiguing elbow extensor contraction, maximal flexion torque was also reduced (82.2 ± 4.9% versus 91.4 ± 2.3% of initial maximal torque; P = 0.007), superimposed twitches were larger (2.7 ± 0.7% versus 1.3 ± 0.2% ongoing MVC; P = 0.02) and voluntary activation lower (81.6 ± 8.2% versus 95.5 ± 6.9%; P = 0.04) with than without ischaemia. After a fatiguing contraction, voluntary drive to the fatigued muscles is reduced with continued input from small-diameter muscle afferents. Furthermore, fatigue of the elbow extensor muscles decreases voluntary drive to unfatigued elbow flexors of the same arm. Therefore, firing of small-diameter muscle afferents from one muscle can affect voluntary activation and hence torque generation of another muscle in the same limb. PMID:23652589

  4. Attitudes towards euthanasia.

    PubMed Central

    Winget, C; Kapp, F T; Yeaworth, R C

    1977-01-01

    There are an infinite variety of attitudes to euthanasia, each individual response to the concept being influenced by many factors. Consequently there is a literature on the subject ranging from the popular article to papers in specialized journals. This study, however, has taken a well defined sample of people, inviting them to answer a questionnaire which was designed to elicit their attitudes to euthanasia in a way which could be analysed statistically. Nor surprisingly attitudes appeared to 'harden' as those answering the questionnaire grew more experienced in dealing with patients and also more professionally established. Thus it was found that of the seven groups questioned practising physicians showed more positive attitudes to euthanasia and their responses did not differ significantly from those of senior medical students. It is these groups which actually or potentially have to resolve the clinical dilemma posed by the dying patient. PMID:859163

  5. [Euthanasia and medical act].

    PubMed

    2011-05-01

    Right to life -as the prohibition of intentionally and arbitrarily taking life, even with authorization of the concerned one- is an internationally recognized right. In many countries, debate regarding euthanasia is more centered in its convenience, social acceptability and how it is regulated, than in its substantial legitimacy. Some argue that euthanasia should be included as part of clinical practice of health professionals, grounded on individual's autonomy claims-everyone having the liberty to choose how to live and how to die. Against this, others sustain that life has a higher value than autonomy, exercising autonomy without respecting the right to life would become a serious moral and social problem. Likewise, euthanasia supporters some-times claim a 'right to live with dignity', which must be understood as a personal obligation, referred more to the ethical than to the strictly legal sphere. In countries where it is already legalized, euthanasia practice has extended to cases where it is not the patient who requests this but the family or some healthcare professional, or even the legal system-when they think that the patient is living in a condition which is not worthy to live. Generalization of euthanasia possibly will end in affecting those who need more care, such as elder, chronically ill or dying people, damaging severely personal basic rights. Nature, purpose and tradition of medicine rule out the practice of euthanasia, which ought not be considered a medical act or legitimately compulsory for physicians. Today's medicine counts with effective treatments for pain and suffering, such as palliative care, including sedative therapy, which best preserves persons dignity and keeps safe the ethos of the medical profession. PMID:22051717

  6. 77 FR 27779 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... Register of May 28, 2010 (75 FR 30033) (the May 2010 notice) during the most recent request for extension... HUMAN SERVICES Food and Drug Administration Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary Submission of Food/Feed Facility Profile Information AGENCY: Food...

  7. Feedlot Euthanasia and Necropsy.

    PubMed

    Griffin, Dee

    2015-11-01

    Timely euthanasia of feeder cattle can minimize suffering of cattle that have little hope of recovery or pain abatement. Euthanasia techniques are described, including primary and secondary steps to ensure humane death. Considerations are discussed to ensure rendered product from euthanized cattle will be safe. A necropsy technique that is time efficient and thorough is outlined. An important aspect is minimizing the number of detached body organs, thereby making it easier to remove the necropsied animal. A necropsy data collection system is discussed that uses check-boxes to record findings. A link to a database that can be downloaded is included. PMID:26188549

  8. Caffeine-induced increase in voluntary activation and strength of the quadriceps muscle during isometric, concentric and eccentric contractions.

    PubMed

    Behrens, Martin; Mau-Moeller, Anett; Weippert, Matthias; Fuhrmann, Josefin; Wegner, Katharina; Skripitz, Ralf; Bader, Rainer; Bruhn, Sven

    2015-01-01

    This study investigated effects of caffeine ingestion (8 mg/kg) on maximum voluntary torque (MVT) and voluntary activation of the quadriceps during isometric, concentric and eccentric contractions. Fourteen subjects ingested caffeine and placebo in a randomized, controlled, counterbalanced, double-blind crossover design. Neuromuscular tests were performed before and 1 h after oral caffeine and placebo intake. MVTs were measured and the interpolated twitch technique was applied during isometric, concentric and eccentric contractions to assess voluntary activation. Furthermore, normalized root mean square of the EMG signal was calculated and evoked spinal reflex responses (H-reflex evoked at rest and during weak isometric voluntary contraction) as well as twitch torques were analyzed. Caffeine increased MVT by 26.4 N m (95%CI: 9.3-43.5 N m, P = 0.004), 22.5 N m (95%CI: 3.1-42.0 N m, P = 0.025) and 22.5 N m (95%CI: 2.2-42.7 N m, P = 0.032) for isometric, concentric and eccentric contractions. Strength enhancements were associated with increases in voluntary activation. Explosive voluntary strength and voluntary activation at the onset of contraction were significantly increased following caffeine ingestion. Changes in spinal reflex responses and at the muscle level were not observed. Data suggest that caffeine ingestion induced an acute increase in voluntary activation that was responsible for the increased strength regardless of the contraction mode. PMID:25969895

  9. Dutch euthanasia revisited.

    PubMed

    Fenigsen, R

    1997-01-01

    The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom. PMID:9479883

  10. The view of religions toward euthanasia and extraordinary treatments in Japan.

    PubMed

    Tanida, N

    2000-01-01

    388 Japanese religious groups--143 Shinto, 157 Buddhist, 58 Christian and 30 others--were asked to answer questions regarding several forms of euthanasia and extraordinary treatment during the dying process. Passive euthanasia and indirect euthanasia were accepted by around 70% of the respondents. Active euthanasia was favored by less than 20% of them. Christians were less supportive of euthanasia than practitioners of other religions. Shinto and Buddhist corporations advocated "being natural," when medical treatment became futile at the terminal stage. Religionists' views may deepen the discussion of end-of-life issues. PMID:11933972

  11. Expanding Voluntary Active-learning Opportunities for Pharmacy Students in a Respiratory Physiology Module

    PubMed Central

    Ernst, Hardy; Colthorpe, Kay

    2008-01-01

    Objectives To expand voluntary active-learning opportunities for bachelor of pharmacy students enrolled in a third-year human physiology and pharmacology course and determine whether the additional course components improved learning outcomes. Design Additional voluntary active-learning opportunities including a large-class tutorial, additional formative assessment, and an online discussion were added to the Respiratory Physiology Module of the course. Examination scores were compared with those from previous years. A questionnaire was administered to assess students' perception of the active-learning components. Assessment Mean examination scores increased from 69.3% ± 24.4% in 2003 to 88.9% ± 13.4% in 2004 and 86.9% ± 17.6% in 2005, after the addition of the active-learning components. Students' overall perception of the value of the active-learning activities was positive. Summary The addition of voluntary active-learning course components to a required pharmacy course resulted in improved student examination scores, and decreased failure rate, and were accomplished at low cost and with little additional staff time. PMID:18483596

  12. Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb.

    PubMed

    Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2014-02-15

    With fatiguing exercise, firing of group III/IV muscle afferents reduces voluntary activation and force of the exercised muscles. These afferents can also act across agonist/antagonist pairs, reducing voluntary activation and force in nonfatigued muscles. We hypothesized that maintained firing of group III/IV muscle afferents after a fatiguing adductor pollicis (AP) contraction would decrease voluntary activation and force of AP and ipsilateral elbow flexors. In two experiments (n = 10) we examined voluntary activation of AP and elbow flexors by measuring changes in superimposed twitches evoked by ulnar nerve stimulation and transcranial magnetic stimulation of the motor cortex, respectively. Inflation of a sphygmomanometer cuff after a 2-min AP maximal voluntary contraction (MVC) blocked circulation of the hand for 2 min and maintained firing of group III/IV muscle afferents. After a 2-min AP MVC, maximal AP voluntary activation was lower with than without ischemia (56.2 ± 17.7% vs. 76.3 ± 14.6%; mean ± SD; P < 0.05) as was force (40.3 ± 12.8% vs. 57.1 ± 13.8% peak MVC; P < 0.05). Likewise, after a 2-min AP MVC, elbow flexion voluntary activation was lower with than without ischemia (88.3 ± 7.5% vs. 93.6 ± 3.9%; P < 0.05) as was torque (80.2 ± 4.6% vs. 86.6 ± 1.0% peak MVC; P < 0.05). Pain during ischemia was reported as Moderate to Very Strong. Postfatigue firing of group III/IV muscle afferents from the hand decreased voluntary drive and force of AP. Moreover, this effect decreased voluntary drive and torque of proximal unfatigued muscles, the elbow flexors. Fatigue-sensitive group III/IV muscle nociceptors act to limit voluntary drive not only to fatigued muscles but also to unfatigued muscles within the same limb. PMID:24356522

  13. [Euthanasia--a moral choice?].

    PubMed

    Sveinsson, Olafur Arni

    2007-01-01

    Euthanasia has been heatedly discussed in Western countries over the last years. Only a few nations have legalized euthanasia or physician assisted suicide with the Dutch at the forefront of that field. Proponents of euthanasia mostly argue for euthanasia on two grounds. Firstly, that the patient has a right to die and secondly, that there is no substantial difference between euthanasia and palliative care. In this paper I will argue against both of the above. I discuss the arguments against euthanasia which are in principle four. Firstly, it is held by many that taking a human life is wrong under all circumstances. Secondly, that it is an unjustifiable demand to ask a person to take another person's life. In relation to that argument, euthanasia is not in accordance with the basic principles of medicine and nursing as they have evolved over the years and could therefore easily disrupt the therapeutic relationship. Thirdly, as shown from Holland there is empirical evidence that euthanasia is not under good enough surveillance and therefore invites misuse. Fourthly, even though euthanasia might possibly be justifiable under certain circumstances, legalisation might well invite abuse because of the message and pressure that the option places on both patients and professionals in terminal care. My answer to the euthanasia demand is palliative care, where dialogue between the patient and doctor is central. But the dialogue cannot be effective, unless both partners are willing and able to engage in sincere and frank conversations. PMID:17823497

  14. Effect of Hypohydration on Peripheral and Corticospinal Excitability and Voluntary Activation

    PubMed Central

    Bowtell, Joanna L.; Avenell, Gareth; Hunter, Steven P.; Mileva, Katya N.

    2013-01-01

    We investigated whether altered peripheral and/or corticospinal excitatory output and voluntary activation are implicated in hypohydration-induced reductions in muscle isometric and isokinetic (90°.s−1) strength. Nine male athletes completed two trials (hypohydrated, euhydrated) comprising 90 min cycling at 40°C, with body weight losses replaced in euhydrated trial. Peripheral nerve and transcranial magnetic stimulations were applied during voluntary contractions pre- and 40 min post-exercise to quantify voluntary activation and peripheral (M-wave) and corticospinal (motor evoked potential) evoked responses in m. vastus medialis. Both maximum isometric (−15.3±3.1 vs −5.4±3.5%) and isokinetic eccentric (−24.8±4.6 vs −7.3±7.2%) torque decreased to a greater extent in hypohydrated than euhydrated trials (p<0.05). Half relaxation time of the twitch evoked by peripheral nerve stimulation during maximal contractions increased after exercise in the hypohydrated (21.8±9.3%) but stayed constant in the euhydrated (1.6±10.7%; p = 0.017) condition. M-wave amplitude during maximum voluntary contraction increased after exercise in the heat in hypohydrated (10.7±18.0%) but decreased in euhydrated condition (−17.4±16.9%; p = 0.067). Neither peripheral nor cortical voluntary activation were significantly different between conditions. Motor evoked potential amplitude increased similarly in both conditions (hypohydrated: 25.7±28.5%; euhydrated: 52.9±33.5%) and was accompanied by lengthening of the cortical silent period in euhydrated but not hypohydrated condition (p = 0.019). Different neural strategies seem to be adopted to regulate neural drive in the two conditions, with increases in inhibitory input of either intracortical or corticospinal origin during the euhydrated trial. Such changes were absent in the hypohydrated condition, yet voluntary activation was similar to the euhydrated condition, perhaps due to smaller increases in excitatory

  15. Attitudes of medical students towards euthanasia in a multicultural setting.

    PubMed

    Adchalingam, K; Kong, W H; Zakiah, M A; Zaini, M; Wong, Y L; Lang, C C

    2005-03-01

    A cross-sectional survey of 400 medical students of multicultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes, and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease while 48% of them were against it. Seventy-one percent of the students involved in the study were against the idea of active euthanasia i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. Thirty-two percent of the respondents favoured the legalization of euthanasia in Malaysia while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities. PMID:16250279

  16. The relationships among sprint performance, voluntary swimming activity, and social dominance in juvenile rainbow trout.

    PubMed

    McDonald, D G; Keeler, R A; McFarlane, W J

    2007-01-01

    The specific objectives of this study were to determine whether sprint performance in juvenile rainbow trout is correlated with either voluntary swimming activity or aggressive behaviors and to determine the reciprocal: the effect of swimming activity and aggression on sprint performance. Sprint performance was assessed by rapidly accelerating trout (5-7-cm fork length) to a fixed velocity (40, 42, or 45 cm s(-1)) and then holding them at that velocity until fatigue. There was considerable interindividual variation in sprint performance not explained by variations in body size, but intraindividual performance was highly repeatable over at least 2 mo. Voluntary swimming was measured as the frequency of transits (voluntary transit activity, VTA) between two identical tanks via a connecting channel with two different flow regimes: zero or minimum velocity (0 or 2.5 cm s(-1)) and high velocity (84 cm s(-1)). There was a strong correlation between sprint performance and VTA in minimal current but no correlation in high current. Furthermore, sprint performance did not predict the outcome of dominance encounters. Experience with rapid acceleration, especially when voluntary, led to a pronounced improvement in sprint performance in proportion to the number of acceleration events. Social dominance encounters had a more complex effect: a significant reduction in sprint performance in previously high-performance sprinters and the reverse for low performers. We propose that there are four independent axes of interindividual variation in juvenile rainbow trout: spontaneous and rheotaxis-stimulated locomotor activity, aggressive activity, and the trainability of sprint performance. The independence of these axes has the potential to produce a much larger diversity in behavioral and ultimately physiological phenotypes than would be produced if the axes were linked. PMID:17909998

  17. Voluntary physical activity prevents insulin resistance in a tissue specific manner

    PubMed Central

    Sarvas, Jessica L; Otis, Jeffrey S; Khaper, Neelam; Lees, Simon J

    2015-01-01

    Physical inactivity and a sedentary lifestyle are risk factors for the development of type 2 diabetes. Here, we identified the effects 8 weeks of voluntary physical activity had on the prevention of insulin resistance in mouse skeletal muscles and liver (a hallmark of T2D). To do this, 8 week old C57BL/6J mice with (RUN) and without (SED) voluntary access to running wheels were fed a standard rodent chow ad libitum for 8 weeks. In the liver, there was a 2.5-fold increase in insulin stimulated AktSER473 phosphorylation, and a threefold increase in insulin-stimulated (0.5 U/kg) GSK3βSER9 phosphorylation in RUN compared to SED mice. Although not induced in skeletal muscles, there was a twofold increase in SOCS3 expression in SED compared to RUN mice in the liver. There was no difference in the glucose tolerance test between groups. This study was the first to show differences in liver insulin sensitivity after 8 weeks of voluntary physical activity, and increased SOCS3 expression in the liver of sedentary mice compared to active mice. These findings demonstrate that even in young mice that would normally be considered healthy, the lack of physical activity leads to insulin resistance representing the initial pathogenesis of impaired glucose metabolism leading to type 2 diabetes. PMID:25713323

  18. Euthanasia and eudaimonia.

    PubMed

    Shaw, D M

    2009-09-01

    This paper re-evaluates euthanasia and assisted suicide from the perspective of eudaimonia, the ancient Greek conception of happiness across one's whole life. It is argued that one cannot be said to have fully flourished or had a truly happy life if one's death is preceded by a period of unbearable pain or suffering that one cannot avoid without assistance in ending one's life. While death is to be accepted as part of life, it should not be left to nature to dictate the way we die, and it is fundamentally unjust to grant people liberal latitude in how they live their lives while granting them little control over the conclusion of their life narratives. Three objections to this position are considered and rejected; the paper also offers an explanation of why we think killing can be a benefit. Ultimately, euthanasia may be necessary in some cases in order to achieve eudaimonia. PMID:19717690

  19. [EUTHANASIA AND ASSISTED SUICIDE].

    PubMed

    Lantero, Caroline

    2015-07-01

    Euthanasia and assisted suicide are not part of French laws of bioethics and lack, for the time being, definition and normative framework other than their criminal prosecution. To transform them into a right, these concepts certainly call for an ethical and legal debate. This paper aims to question the ideas to be considered, the conceptual bases and normative tools that may be useful to the discussion. PMID:27356358

  20. From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance.

    PubMed

    Enke, Martin; Meyer, Patric; Flor, Herta

    2016-01-01

    Numerous questionnaire studies on attitudes towards euthanasia produced conflicting results, precluding any general conclusion. This might be due to the fact that human behavior can be influenced by automatically triggered attitudes, which represent ingrained associations in memory and cannot be assessed by standard questionnaires, but require indirect measures such as reaction times (RT) or electroencephalographic recording (EEG). Event related potentials (ERPs) of the EEG and RT during an affective priming task were assessed to investigate the impact of automatically triggered attitudes and were compared to results of an explicit questionnaire. Explicit attitudes were ambivalent. Reaction time data showed neither positive nor negative associations towards euthanasia. ERP analyses revealed an N400 priming effect with lower mean amplitudes when euthanasia was associated with negative words. The euthanasia-related modulation of the N400 component shows an integration of the euthanasia object in negatively valenced associative neural networks. The integration of all measures suggests a bottom-up process of attitude activation, where automatically triggered negative euthanasia-relevant associations can become more ambiguous with increasing time in order to regulate the bias arising from automatic processes. These data suggest that implicit measures may make an important contribution to the understanding of euthanasia-related attitudes. PMID:27088244

  1. From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance

    PubMed Central

    Enke, Martin; Meyer, Patric; Flor, Herta

    2016-01-01

    Numerous questionnaire studies on attitudes towards euthanasia produced conflicting results, precluding any general conclusion. This might be due to the fact that human behavior can be influenced by automatically triggered attitudes, which represent ingrained associations in memory and cannot be assessed by standard questionnaires, but require indirect measures such as reaction times (RT) or electroencephalographic recording (EEG). Event related potentials (ERPs) of the EEG and RT during an affective priming task were assessed to investigate the impact of automatically triggered attitudes and were compared to results of an explicit questionnaire. Explicit attitudes were ambivalent. Reaction time data showed neither positive nor negative associations towards euthanasia. ERP analyses revealed an N400 priming effect with lower mean amplitudes when euthanasia was associated with negative words. The euthanasia-related modulation of the N400 component shows an integration of the euthanasia object in negatively valenced associative neural networks. The integration of all measures suggests a bottom-up process of attitude activation, where automatically triggered negative euthanasia-relevant associations can become more ambiguous with increasing time in order to regulate the bias arising from automatic processes. These data suggest that implicit measures may make an important contribution to the understanding of euthanasia-related attitudes. PMID:27088244

  2. Changes in Voluntary Activation Assessed by Transcranial Magnetic Stimulation during Prolonged Cycling Exercise

    PubMed Central

    Perrey, Stephane; Temesi, John; Wuyam, Bernard; Levy, Patrick; Verges, Samuel; Millet, Guillaume Y.

    2014-01-01

    Maximal central motor drive is known to decrease during prolonged exercise although it remains to be determined whether a supraspinal deficit exists, and if so, when it appears. The purpose of this study was to evaluate corticospinal excitability and muscle voluntary activation before, during and after a 4-h cycling exercise. Ten healthy subjects performed three 80-min bouts on an ergocycle at 45% of their maximal aerobic power. Before exercise and immediately after each bout, neuromuscular function was evaluated in the quadriceps femoris muscles under isometric conditions. Transcranial magnetic stimulation was used to assess voluntary activation at the cortical level (VATMS), corticospinal excitability via motor-evoked potential (MEP) and intracortical inhibition by cortical silent period (CSP). Electrical stimulation of the femoral nerve was used to measure voluntary activation at the peripheral level (VAFNES) and muscle contractile properties. Maximal voluntary force was significantly reduced after the first bout (13±9%, P<0.01) and was further decreased (25±11%, P<0.001) at the end of exercise. CSP remained unchanged throughout the protocol. Rectus femoris and vastus lateralis but not vastus medialis MEP normalized to maximal M-wave amplitude significantly increased during cycling. Finally, significant decreases in both VATMS and VAFNES (∼8%, P<0.05 and ∼14%, P<0.001 post-exercise, respectively) were observed. In conclusion, reductions in VAFNES after a prolonged cycling exercise are partly explained by a deficit at the cortical level accompanied by increased corticospinal excitability and unchanged intracortical inhibition. When comparing the present results with the literature, this study highlights that changes at the cortical and/or motoneuronal levels depend not only on the type of exercise (single-joint vs. whole-body) but also on exercise intensity and/or duration. PMID:24586559

  3. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    PubMed

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. PMID:25525208

  4. Age and Acceptance of Euthanasia.

    ERIC Educational Resources Information Center

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  5. Euthanasia for Detainees in Belgium.

    PubMed

    Devolder, Katrien

    2016-07-01

    In 2011, Frank Van Den Bleeken became the first detainee to request euthanasia under Belgium's Euthanasia Act of 2002. This article investigates whether it would be lawful and morally permissible for a doctor to accede to this request. Though Van Den Bleeken has not been held accountable for the crimes he committed, he has been detained in an ordinary prison, without appropriate psychiatric care, for more than 30 years. It is first established that Van Den Bleeken's euthanasia request plausibly meets the relevant conditions of the Euthanasia Act and that, consequently, a doctor could lawfully fulfill it. Next, it is argued that autonomy-based reasons for euthanizing him outweigh complicity-based reasons against doing so, and that, therefore, it is also morally permissible for a doctor to carry out the euthanasia request. PMID:27348823

  6. Caffeine-induced increase in voluntary activation and strength of the quadriceps muscle during isometric, concentric and eccentric contractions

    PubMed Central

    Behrens, Martin; Mau-Moeller, Anett; Weippert, Matthias; Fuhrmann, Josefin; Wegner, Katharina; Skripitz, Ralf; Bader, Rainer; Bruhn, Sven

    2015-01-01

    This study investigated effects of caffeine ingestion (8 mg/kg) on maximum voluntary torque (MVT) and voluntary activation of the quadriceps during isometric, concentric and eccentric contractions. Fourteen subjects ingested caffeine and placebo in a randomized, controlled, counterbalanced, double-blind crossover design. Neuromuscular tests were performed before and 1 h after oral caffeine and placebo intake. MVTs were measured and the interpolated twitch technique was applied during isometric, concentric and eccentric contractions to assess voluntary activation. Furthermore, normalized root mean square of the EMG signal was calculated and evoked spinal reflex responses (H-reflex evoked at rest and during weak isometric voluntary contraction) as well as twitch torques were analyzed. Caffeine increased MVT by 26.4 N m (95%CI: 9.3-43.5 N m, P = 0.004), 22.5 N m (95%CI: 3.1-42.0 N m, P = 0.025) and 22.5 N m (95%CI: 2.2-42.7 N m, P = 0.032) for isometric, concentric and eccentric contractions. Strength enhancements were associated with increases in voluntary activation. Explosive voluntary strength and voluntary activation at the onset of contraction were significantly increased following caffeine ingestion. Changes in spinal reflex responses and at the muscle level were not observed. Data suggest that caffeine ingestion induced an acute increase in voluntary activation that was responsible for the increased strength regardless of the contraction mode. PMID:25969895

  7. Suppression of voluntary motor activity revealed using transcranial magnetic stimulation of the motor cortex in man.

    PubMed Central

    Davey, N J; Romaiguère, P; Maskill, D W; Ellaway, P H

    1994-01-01

    1. Suppression of voluntary muscle activity of hand and arm muscles in response to transcranial magnetic stimulation (TMS) of the motor cortex has been investigated in man. 2. Suppression could be elicited by low levels of TMS without any prior excitatory response. The latency of the suppression was 3-8 ms longer than the excitation observed at a higher stimulus intensity. The duration of the suppression ranged from 8 to 26 ms. 3. A circular stimulating coil was used to determine threshold intensity for excitation and suppression of contraction of thenar muscles in response to TMS at different locations over the motor cortex. The locations for lowest threshold excitation coincided with those for lowest threshold suppression. Suppression was elicited at a lower threshold than excitation at all locations. 4. A figure-of-eight stimulating coil was positioned over the left motor cortex at the lowest threshold point for excitation of the right thenar muscles. The orientation for the lowest threshold excitatory and inhibitory responses was the same for all subjects. That orientation induced a stimulating current travelling in an antero-medial direction. Suppression was invariably elicited at lower thresholds than excitation. 5. When antagonistic muscles (second and third dorsal interosseus) were co-contracted, TMS evoked coincident suppression of voluntary EMG in the two muscles without prior excitation of either muscle. This suggests that the suppression is not mediated via corticospinal activation of spinal interneurones. 6. Test responses to electrical stimulation of the cervical spinal cord were evoked in both relaxed and activated thenar muscles. In the relaxed muscle, prior TMS at an intensity that would suppress voluntary activity failed to influence the test responses, suggesting absence of inhibition at a spinal level. However, in the activated muscle, prior TMS could reduce the test response. This may be explained by disfacilitation of motoneurones due to

  8. Effects of early-onset voluntary exercise on adult physical activity and associated phenotypes in mice.

    PubMed

    Acosta, Wendy; Meek, Thomas H; Schutz, Heidi; Dlugosz, Elizabeth M; Vu, Kim T; Garland, Theodore

    2015-10-01

    The purpose of this study was to evaluate the effects of early-life exercise on adult physical activity (wheel running, home-cage activity), body mass, food consumption, and circulating leptin levels in males from four replicate lines of mice selectively bred for high voluntary wheel running (High Runner or HR) and their four non-selected control (C) lines. Half of the mice were given wheel access shortly after weaning for three consecutive weeks. Wheel access was then removed for 52 days, followed by two weeks of adult wheel access for all mice. A blood sample taken prior to adult wheel testing was analyzed for circulating leptin concentration. Early-life wheel access significantly increased adult voluntary exercise on wheels during the first week of the second period of wheel access, for both HR and C mice, and HR ran more than C mice. During this same time period, activity in the home cages was not affected by early-age wheel access, and did not differ statistically between HR and C mice. Throughout the study, all mice with early wheel access had lower body masses than their sedentary counterparts, and HR mice had lower body masses than C mice. With wheel access, HR mice also ate significantly more than C mice. Early-life wheel access increased plasma leptin levels (adjusted statistically for fat-pad mass as a covariate) in C mice, but decreased them in HR mice. At sacrifice, early-life exercise had no statistically significant effects on visceral fat pad, heart (ventricle), liver or spleen masses (all adjusted statistically for variation in body mass). Results support the hypothesis that early-age exercise in mice can have at least transitory positive effects on adult levels of voluntary exercise, in addition to reducing body mass, and may be relevant for the public policy debates concerning the importance of physical education for children. PMID:26079567

  9. Voluntary Exercise Preconditioning Activates Multiple Antiapoptotic Mechanisms and Improves Neurological Recovery after Experimental Traumatic Brain Injury

    PubMed Central

    Zhao, Zaorui; Sabirzhanov, Boris; Wu, Junfang; Faden, Alan I.

    2015-01-01

    Abstract Physical activity can attenuate neuronal loss, reduce neuroinflammation, and facilitate recovery after brain injury. However, little is known about the mechanisms of exercise-induced neuroprotection after traumatic brain injury (TBI) or its modulation of post-traumatic neuronal cell death. Voluntary exercise, using a running wheel, was conducted for 4 weeks immediately preceding (preconditioning) moderate-level controlled cortical impact (CCI), a well-established experimental TBI model in mice. Compared to nonexercised controls, exercise preconditioning (pre-exercise) improved recovery of sensorimotor performance in the beam walk task, as well as cognitive/affective functions in the Morris water maze, novel object recognition, and tail-suspension tests. Further, pre-exercise reduced lesion size, attenuated neuronal loss in the hippocampus, cortex, and thalamus, and decreased microglial activation in the cortex. In addition, exercise preconditioning activated the brain-derived neurotrophic factor pathway before trauma and amplified the injury-dependent increase in heat shock protein 70 expression, thus attenuating key apoptotic pathways. The latter include reduction in CCI-induced up-regulation of proapoptotic B-cell lymphoma 2 (Bcl-2)-homology 3–only Bcl-2 family molecules (Bid, Puma), decreased mitochondria permeabilization with attenuated release of cytochrome c and apoptosis-inducing factor (AIF), reduced AIF translocation to the nucleus, and attenuated caspase activation. Given these neuroprotective actions, voluntary physical exercise may serve to limit the consequences of TBI. PMID:25419789

  10. Physician assisted suicide: the great Canadian euthanasia debate.

    PubMed

    Schafer, Arthur

    2013-01-01

    A substantial majority of Canadians favours a change to the Criminal Code which would make it legally permissible, subject to careful regulation, for patients suffering from incurable physical illness to opt for either physician assisted suicide (PAS) or voluntary active euthanasia (VAE). This discussion will focus primarily on the arguments for and against decriminalizing physician assisted suicide, with special reference to the British Columbia case of Lee Carter vs. Attorney General of Canada. The aim is to critique the arguments and at the same time to describe the contours of the current Canadian debate. Both ethical and legal issues raised by PAS are clarified. Empirical evidence available from jurisdictions which have followed the regulatory route is presented and its relevance to the slippery slope argument is considered. The arguments presented by both sides are critically assessed. The conclusion suggested is that evidence of harms to vulnerable individuals or to society, consequent upon legalization, is insufficient to support continued denial of freedom to those competent adults who seek physician assistance in hastening their death. PMID:23856180

  11. Compensatory elevation of voluntary activity in mouse mutants with impaired mitochondrial energy metabolism

    PubMed Central

    Lapointe, Jérôme; G. Hughes, Bryan; Bigras, Eve; Hekimi, Siegfried

    2014-01-01

    Abstract Mitochondria play a crucial role in determining whole‐body metabolism and exercise capacity. Genetic mouse models of mild mitochondrial dysfunction provide an opportunity to understand how mitochondrial function affects these parameters. MCLK1 (a.k.a. Coq7) is an enzyme implicated in the biosynthesis of ubiquinone (UQ; Coenzyme Q). Low levels of MCLK1 in Mclk1+/− heterozygous mutants lead to abnormal sub‐mitochondrial distribution of UQ, impaired mitochondrial function, elevated mitochondrial oxidative stress, and increased lifespan. Here, we report that young Mclk1+/− males, but not females, show a significant decrease in whole‐body metabolic rate as measured by indirect calorimetry. Such a sex‐specific effect of mitochondrial dysfunction on energy metabolism has also been reported for heterozygous mice carrying a mutation for the gene encoding the “Rieske” protein of mitochondrial complex III (RISP+/P224S). We find that both Mclk1+/− and RISP+/P224S males are capable of restoring their defective metabolic rates by making significantly more voluntary use of a running wheel compared to wild type. However, this increase in voluntary activity does not reflect their exercise capacity, which we found to be impaired as revealed by a shorter treadmill distance run before exhaustion. In contrast to what is observed in Mclk1+/− and RISP+/P224S mutants, Sod2+/− mice with elevated oxidative stress and major mitochondrial dysfunction did not increase voluntary activity. Our study reveals a sex‐specific effect on how impaired mitochondrial function impacts whole‐body energy metabolism and locomotory behavior, and contributes to the understanding of the metabolic and behavioral consequences of mitochondrial disorders. PMID:25413331

  12. Voluntary access to a warm plate reduces hyperactivity in activity-based anorexia.

    PubMed

    Hillebrand, Jacquelien J G; de Rijke, Corine E; Brakkee, Jan H; Kas, Martien J H; Adan, Roger A H

    2005-06-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa. In ABA, scheduled feeding in combination with voluntary wheel running leads to hyperactivity, reduced food intake, severe body weight loss and hypothermia. In this study it was investigated whether hyperactivity in ABA could be reduced by introducing a warm plate (which was voluntary accessible and did not influence ambient temperature) into a part of the cage. In ad libitum fed rats, the presence of the warm plate did not influence body temperature, running wheel activity (RWA), body weight or food intake. During ABA, however, rats preferred the warm plate and hypothermia was prevented, while hyperactivity and body weight loss were significantly reduced when compared to ABA rats without a plate. Correlation analysis revealed a significant association between basal body temperature and RWA during the light phase in ABA rats. However, there was no evidence that initiation of light phase RWA was a result of hypothermia. These data suggest that ABA rats prefer to prevent hypothermia passively by choosing a warm plate rather than actively regulating body temperature by hyperactivity. PMID:15924912

  13. A wheelchair modified for leg propulsion using voluntary activity or electrical stimulation.

    PubMed

    Stein, R B; Roetenberg, D; Chong, S L; James, K B

    2003-01-01

    A commercially available wheelchair has been modified for propulsion by movements of the lower legs. The feet are attached securely to a foot rest that can rotate around the knee joint. Movement is generated either with residual voluntary activation of the quadriceps (knee extensor) and hamstring (knee flexor) muscles, or with electrical stimulation of these muscles, if voluntary control is absent. Either a chain or a lever can couple the movements through a gearbox to the wheel to propel the wheelchair forward. Control of a wheelchair with the legs is more efficient than using the arms and has the potential to increase the mobility and whole-body fitness of many wheelchair users, but there is considerable variability between subjects. To address this variability, we measured for individual subjects the passive properties of the legs and foot at rest (effective stiffness and viscosity), the length-tension (torque-angle) properties of the active muscle groups, as well as their force-velocity curve and their activation and fatigue rates. The measured values were then inserted into a model of the leg-propelled wheelchair. The purpose of this paper is to test whether the model could predict the performance of individual subjects accurately and could be used, for example, to optimize the speed of the wheelchair for a given subject. PMID:12485782

  14. Effects of voluntary activity and genetic selection on muscle metabolic capacities in house mice Mus domesticus.

    PubMed

    Houle-Leroy, P; Garland, T; Swallow, J G; Guderley, H

    2000-10-01

    Selective breeding is an important tool in behavioral genetics and evolutionary physiology, but it has rarely been applied to the study of exercise physiology. We are using artificial selection for increased wheel-running behavior to study the correlated evolution of locomotor activity and physiological determinants of exercise capacity in house mice. We studied enzyme activities and their response to voluntary wheel running in mixed hindlimb muscles of mice from generation 14, at which time individuals from selected lines ran more than twice as many revolutions per day as those from control (unselected) lines. Beginning at weaning and for 8 wk, we housed mice from each of four replicate selected lines and four replicate control lines with access to wheels that were free to rotate (wheel-access group) or locked (sedentary group). Among sedentary animals, mice from selected lines did not exhibit a general increase in aerobic capacities: no mitochondrial [except pyruvate dehydrogenase (PDH)] or glycolytic enzyme activity was significantly (P < 0.05) higher than in control mice. Sedentary mice from the selected lines exhibited a trend for higher muscle aerobic capacities, as indicated by higher levels of mitochondrial (cytochrome-c oxidase, carnitine palmitoyltransferase, citrate synthase, and PDH) and glycolytic (hexokinase and phosphofructokinase) enzymes, with concomitant lower anaerobic capacities, as indicated by lactate dehydrogenase (especially in male mice). Consistent with previous studies of endurance training in rats via voluntary wheel running or forced treadmill exercise, cytochrome-c oxidase, citrate synthase, and carnitine palmitoyltransferase activity increased in the wheel-access groups for both genders; hexokinase also increased in both genders. Some enzymes showed gender-specific responses: PDH and lactate dehydrogenase increased in wheel-access male but not female mice, and glycogen phosphorylase decreased in female but not in male mice. Two

  15. Modulation of cortical activity as a result of voluntary postural sway direction: an EEG study

    PubMed Central

    Slobounov, Semyon; Hallett, Mark; Cao, Cheng; Newell, Karl

    2008-01-01

    There is increasing evidence demonstrating the role of the cerebral cortex in human postural control. Modulation of EEG both in voltage and frequency domains has been observed preceding and following self-paced postural movements and those induced by external perturbations. The current study set out to provide additional evidence regarding the role of cerebral cortex in human postural control by specifically examining modulation of EEG as a function of postural sway direction. Twelve neurologically normal subjects were instructed to produce self-paced voluntary postural sways in the anterior-posterior (AP) and medial-lateral (ML) directions. The center of pressure dynamics and EEG both in voltage and frequency domains were extracted by averaging and Morlet wavelet techniques, respectively. The amplitude of movement-related cortical potentials (MRCP) was significantly higher preceding ML sways. Also, time-frequency wavelet coefficients (TF) indicated differential modulation of EEG within alpha, beta and gamma bands as a function of voluntary postural sway direction. Thus, ML sway appear to be more difficult and energy demanding tasks than the AP sway as reflected in differential modulation of EEG. These results are discussed within the conceptual framework of differential patterns of brain activation as a result of postural task complexity. PMID:18639613

  16. Voluntary participation in an active learning exercise leads to a better understanding of physiology.

    PubMed

    Carvalho, Helena; West, Crystal A

    2011-03-01

    Students learn best when they are focused and thinking about the subject at hand. To teach physiology, we must offer opportunities for students to actively participate in class. This approach aids in focusing their attention on the topic and thus generating genuine interest in the mechanisms involved. This study was conducted to determine if offering voluntary active learning exercises would improve student understanding and application of the material covered. To compare performance, an anonymous cardiorespiratory evaluation was distributed to two groups of students during the fall (control, n = 168) and spring (treatment, n = 176) semesters. Students in both groups were taught by traditional methods, and students in the treatment group had the option to voluntary participate in two additional active learning exercises: 1) a small group discussion, where students would discuss a physiology topic with their Teaching Assistant before running BIOPAC software for the laboratory exercise and 2) a free response question, where students anonymously responded to one short essay question after the laboratory exercise. In these formative assessments, students received feedback about their present state of learning from the discussion with their peers and also from the instructor comments regarding perceived misconceptions. As a result of the participation in these activities, students in the treatment group had a better overall performance [χ(2) (degree of freedom = 1) = 31.2, P < 0.001] on the evaluation (treatment group: 62% of responses correct and control group: 49%) with an observed difference of 13% (95% confidence interval: 8, 17). In conclusion, this study presents sufficient evidence that when the opportunity presents itself, students become active participants in the learning process, which translates into an improvement in their understanding and application of physiological concepts. PMID:21386002

  17. Relationship between stretch reflex thresholds and voluntary arm muscle activation in patients with spasticity.

    PubMed

    Musampa, Nadine K; Mathieu, Pierre A; Levin, Mindy F

    2007-08-01

    Previous studies have shown that deficits in agonist-antagonist muscle activation in the single-joint elbow system in patients with spastic hemiparesis are directly related to limitations in the range of regulation of the thresholds of muscle activation. We extended these findings to the double-joint, shoulder-elbow system in these patients. Ten non-disabled individuals and 11 stroke survivors with spasticity in upper limb muscles participated. Stroke survivors had sustained a single unilateral stroke 6-36 months previously, had full pain-free passive range of motion of the affected shoulder and elbow and had some voluntary control of the arm. EMG activity from four elbow and two shoulder muscles was recorded during quasi-static (<5 degrees /s) stretching of elbow flexors/extensors and during slow voluntary elbow flexion/extension movement through full range. Stretches and active movements were initiated from full elbow flexion or extension with the shoulder in three different initial positions (60 degrees , 90 degrees , 145 degrees horizontal abduction). SRTs were defined as the elbow angle at which EMG signals began to exceed 2SD of background noise. SRT angles obtained by passive muscle stretch were compared with the angles at which the respective muscles became activated during voluntary elbow movements. SRTs in elbow flexors were correlated with clinical spasticity scores. SRTs of elbow flexors and extensors were within the biomechanical range of the joint and varied with changes in the shoulder angle in all subjects with hemiparesis but could not be reached in this range in all healthy subjects when muscles were initially relaxed. In patients, limitations in the regulation of SRTs resulted in a subdivision of all-possible shoulder-elbow arm configurations into two areas, one in which spasticity was present ("spatial spasticity zone") and another in which it was absent. Spatial spasticity zones were different for different muscles in different patients but

  18. Feeding frequency, but not dietary water content, affects voluntary physical activity in young lean adult female cats.

    PubMed

    de Godoy, M R C; Ochi, K; de Oliveira Mateus, L F; de Justino, A C C; Swanson, K S

    2015-05-01

    The objective of this study was to investigate whether increased dietary water content and feeding frequency increased voluntary physical activity of young, lean adult female cats. A replicated 4 × 4 Latin square design with a 2 × 2 factorial treatment arrangement (feeding frequency and water content) was used. The 4 treatments consisted of 1 meal daily dry pet food without added water (1D; 12% moisture as is), 1 meal daily dry pet food with added water (1W; 70% total water content), 4 meals daily dry pet food without added water (4D; 12% moisture as is), and 4 meals daily dry pet food with added water (4W; 70% total water content). Eight healthy adult, lean, intact, young, female domestic shorthair cats were used in this experiment. Voluntary physical activity was evaluated using Actical activity monitors placed on collars and worn around the cats' necks for the last 7 d of each experimental period of 14 d. Food anticipatory activity (FAA) was calculated based on 2 h prior to feeding periods and expressed as a percentage of total daily voluntary physical activity. Increased feeding frequency (4 vs. 1 meal daily) resulted in greater average daily activity (P = 0.0147), activity during the light period (P = 0.0023), and light:dark activity ratio (P = 0.0002). In contrast, physical activity during the dark period was not altered by feeding frequency (P > 0.05). Cats fed 4 meals daily had increased afternoon FAA (P= 0.0029) compared with cats fed once daily. Dietary water content did not affect any measure of voluntary physical activity. Increased feeding frequency is an effective strategy to increase the voluntary physical activity of cats. Thus, it may assist in the prevention and management of obesity. PMID:26020354

  19. What people close to death say about euthanasia and assisted suicide: a qualitative study

    PubMed Central

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-01-01

    Objective To explore the experiences of people with a “terminal illness”, focusing on the patients' perspective of euthanasia and assisted suicide. Method A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non‐malignant. Results That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Conclusion Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. PMID:17145910

  20. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity...

  1. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity...

  2. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity...

  3. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity...

  4. 42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes entering into a compact with the IHS under Title V? 137... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity...

  5. Asymmetrical Brain Activity Induced by Voluntary Spatial Attention Depends on the Visual Hemifield: A Functional Near-Infrared Spectroscopy Study

    ERIC Educational Resources Information Center

    Harasawa, Masamitsu; Shioiri, Satoshi

    2011-01-01

    The effect of the visual hemifield to which spatial attention was oriented on the activities of the posterior parietal and occipital visual cortices was examined using functional near-infrared spectroscopy in order to investigate the neural substrates of voluntary visuospatial attention. Our brain imaging data support the theory put forth in a…

  6. 21 CFR 522.900 - Euthanasia solution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  7. 21 CFR 522.900 - Euthanasia solution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  8. 21 CFR 522.900 - Euthanasia solution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  9. 21 CFR 522.900 - Euthanasia solution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  10. 21 CFR 522.900 - Euthanasia solution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight....

  11. Killing people: what Kant could have said about suicide and euthanasia but did not

    PubMed Central

    Brassington, I

    2006-01-01

    An agent who takes his own life acts in violation of the moral law, according to Kant; suicide, and, by extension, assisted suicide are therefore wrong. By a similar argument, and with a few important exceptions, killing is wrong; implicitly, then, voluntary euthanasia is also wrong. Kant's conclusions are uncompelling and his argument in these matters is undermined on considering other areas of his thought. Kant, in forbidding suicide and euthanasia, is conflating respect for persons and respect for people, and assuming that, in killing a person (either oneself or another), we are thereby undermining personhood. But an argument along these lines is faulty according to Kant's own standards. There is no reason why Kantians have to accept that self‐killing and euthanasia are contrary to the moral law. Even if some Kantians adhere to this doctrine, others can reject it. PMID:17012496

  12. [Euthanasia--experiences from Norwegian pain clinics].

    PubMed

    Meidell, N K; Naess, A C

    1998-10-10

    This survey focuses on the subject of euthanasia. A questionnaire was sent to 90 doctors working in pain clinics in Norwegian hospitals. 60 doctors (67%) returned the questionnaire. Only 18 doctors (30%) had ever received a request for euthanasia. The patients who requested euthanasia suffered from refractory pain, depression, fear of pain and fear of becoming helpless. 67% of the doctors were satisfied with the present Norwegian law, while 13% favoured a liberalization of the law. Only 5% were willing to comply with the patient's request for euthanasia under today's law. One third of the doctors would leave the decision to an officially appointed "board" if euthanasia were to become legalized. A majority wanted a doctor to commit the actual procedure, but there were also suggestions that a lawyer or other lay person should carry out the act of euthanasia. Our conclusion is that the closer the patient-doctor relationship is, the more opposed the doctor is to euthanasia. PMID:9816949

  13. [Modifications induced on thrombin and plasmin activity by voluntary interruption of pregnancy].

    PubMed

    Manoni, F; Gessoni, G; Antico, A; Finesso, P; Rossito, G; Sartori, R

    1993-05-01

    Pregnancy is characterized by plasmatic variations of coagulative factors' concentration and by different haemostatic-fibrinolytic balance. At present it is possible, with EIA methods, to measure fibrinogen (FgDP) and fibrin (FbDP) degradation products with precision and accuracy, as direct indexes of fibrinolysis and the thrombin-antithrombin III complex (TAT) as indirect index of thrombophilia. We have considered the course of those indexes in 61 pregnant women within the tenth week of gestation, before and after voluntary pregnancy interruption (VPI) resulted without complications. The results don't show any peculiar variation of the examined parameters between the pregnant women before VPI and a control group. Comparing the basal data with those obtained three hours after VPI, all indexes are increased, particularly FbDP. After 24 hours the concentration of FgDP, FbDP and TDP decreased in comparison with the three hours control drawing, nevertheless staying higher than the values obtained in the basal drawing. The evolution of FDP and of TAT, in our study, points out that, in the first weeks of pregnancy, the haemostatic-fibrinolytic balance does not differ significantly from the physiological balance. Three hours after VPI fibrinolytic mechanisms prevail as regards the fibrinogenolytic ones. TAT increases after 3 hours and returns to the rules after 24 hours, proposing itself as an indirect index of thrombinic activation and as a direct index of antithrombinic activity. PMID:8351063

  14. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey

    PubMed Central

    Stolz, Erwin; Burkert, Nathalie; Großschädl, Franziska; Rásky, Éva; Stronegger, Willibald J.; Freidl, Wolfgang

    2015-01-01

    Background Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. Methods A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. Results Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. Conclusion Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates. PMID:25906265

  15. Killing, letting die and euthanasia.

    PubMed

    Husak, D N

    1979-12-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible. PMID:541821

  16. Euthanasia Acceptance: An Attitudinal Inquiry.

    ERIC Educational Resources Information Center

    Klopfer, Fredrick J.; Price, William F.

    The study presented was conducted to examine potential relationships between attitudes regarding the dying process, including acceptance of euthanasia, and other attitudinal or demographic attributes. The data of the survey was comprised of responses given by 331 respondents to a door-to-door interview. Results are discussed in terms of preferred…

  17. Use of mouth pressure twitches induced by cervical magnetic stimulation to assess voluntary activation of the diaphragm.

    PubMed

    de Bruin, P F; Watson, R A; Khalil, N; Pride, N B

    1998-09-01

    There is a need for a simple method to assess the adequacy of diaphragm activation during voluntary inspiratory efforts in patients with suspected respiratory muscle weakness. We have compared mouth (Pmo,t), oesophageal (Poes,t) and transdiaphragmatic (Pdi,t) twitch pressure elicited by cervical magnetic stimulation (CMS) in five normal men (mean (SD) age 32.2 (1.8) yrs) on two separate study days. Single magnetic stimuli were delivered at functional residual capacity during relaxation and during graded voluntary inspiratory efforts against a closed airway. As voluntary-effort transdiaphragmatic and oesophageal pressure increased, Pdi,t and Poes,t decreased linearly (r range, respectively, 0.82-0.98 and 0.87-0.95). During relaxation, Pmo,t was unreliable due to the poor transmission of intrathoracic pressure, but during inspiratory efforts, the relation between voluntary mouth pressure and Pmo,t was also linear (r range 0.84-0.95). On average, our subjects voluntarily generated 99, 100 and 102% of the maximum transdiaphragmatic, oesophageal and mouth pressures predicted by the respective linear regression equations. Pmo,t was correlated to both Poes,t and Pdi,t during inspiratory efforts, but not during relaxation. These studies confirm that twitch pressures induced by CMS during inspiratory efforts can be assessed at the mouth in normal subjects, providing a simple and non-invasive technique for assessing diaphragm activation during voluntary inspiratory efforts. Potentially, this technique could be made more sensitive and accurate and applied to detect submaximal efforts in patients. PMID:9762798

  18. Time course of human motoneuron recovery after sustained low-level voluntary activity.

    PubMed

    Héroux, Martin E; Butler, Annie A; Gandevia, Simon C; Taylor, Janet L; Butler, Jane E

    2016-02-01

    Motoneurons often fire repetitively and for long periods. In sustained voluntary contractions the excitability of motoneurons declines. We provide the first detailed description of the time course of human motoneuron recovery after sustained activity at a constant discharge rate. We recorded the discharge of single motor units (MUs, n = 30) with intramuscular wire electrodes inserted in triceps brachii during weak isometric contractions. Subjects (n = 15) discharged single MUs at a constant frequency (∼10 Hz) with visual feedback for prolonged durations (3-7 min) until rectified surface electromyogram (sEMG) of triceps brachii increased by ∼100%. After a rest of 1-2, 15, 30, 60, 120, or 240 s, subjects briefly resumed the contraction with the target MU at the same discharge rate. Each MU was tested with three to four rest periods. The magnitude of sEMG was increased when contractions were resumed, and the target motoneuron discharged at the test frequency following rest intervals of 2-60 s (P = 0.001-0.038). The increased sEMG indicates that greater excitatory drive was needed to discharge the motoneuron at the test rate. The increase in EMG recovered exponentially with a time constant of 28 s but did not return to baseline even after a rest period of ∼240 s. Thus the decline in motoneuron excitability from a weak contraction takes several minutes to recover fully. PMID:26609117

  19. Within- and between-session reliability of the maximal voluntary knee extension torque and activation.

    PubMed

    Park, Jihong; Hopkins, J Ty

    2013-01-01

    A ratio between the torque generated by maximal voluntary isometric contraction (MVIC) and exogenous electrical stimulus, central activation ratio (CAR), has been widely used to assess quadriceps function. To date, no data exist regarding between-session reliability of this measurement. Thirteen neurologically sound volunteers underwent three testing sessions (three trials per session) with 48 hours between-session. Subjects performed MVICs of the quadriceps with the knee locked at 90° flexion and the hip at 85°. Once the MVIC reached a plateau, an electrical stimulation from superimposed burst technique (SIB: 125 V with peak output current 450 mA) was manually delivered and transmitted directly to the quadriceps via stimulating electrodes. CAR was calculated by using the following equation: CAR = MVIC torque/MVIC + SIB torque. Intraclass correlation coefficients (ICC) were calculated within- (ICC((2,1))) and between-session (ICC((2,k))) for MVIC torques and CAR values. Our data show that quadriceps MVIC and CAR are very reliable both within- (ICC((2,1)) = 0.99 for MVIC; 0.94 for CAR) and between-measurement sessions (ICC((2,k)) = 0.92 for MVIC; 0.86 for CAR) in healthy young adults. For clinical research, more data of the patients with pathological conditions are required to ensure reproducibility of calculation of CAR. PMID:23009562

  20. Euthanasia and assisted suicide in the post-Rodriguez era: lessons from foreign jurisdictions.

    PubMed

    Cormack, M

    2000-01-01

    Euthanasia and assisted suicide are highly controversial subjects that have drawn much attention in Canada over the last two decades. This paper outlines how the Netherlands, the United States, Australia, and Canada have approached the practices. Jurisprudence, public opinion polls, legislative developments, and the positions of medical organizations and their members are included in the analysis. A number of arguments for and against the continued prohibition of the practices in Canada are evaluated. As well, information regarding the extent to which euthanasia and assisted suicide are performed in these countries is assessed. It will be shown that Canadians currently enjoy significant control over decisions concerning end of life. The principles of autonomy and beneficence provide the foundation necessary to justify lifting the prohibition of voluntary euthanasia and assisted suicide in Canada. With regard to the development of safeguards, the way in which foreign jurisdictions have dealt with both procedures is highly instructive. A qualified system of pre-authorization, unlike those adopted elsewhere, would prevent abuses from occurring and maintaining the prohibition of non-voluntary and involuntary euthanasia. Since legislators are in the best position to deal with the issues, change in the law should be made by the government, not the judiciary. Practical legislation is feasible and a proposal of what this should entail is presented. PMID:12611410

  1. Beyond Baby Doe: Does Infant Transplantation Justify Euthanasia?

    ERIC Educational Resources Information Center

    Coulter, David L.

    1988-01-01

    The paper examines ethical issues in the transplantation of organs from infants with anencephaly into infants with severe heart and kidney disease. It argues that active euthanasia of infants with anencephaly should be prohibited to safeguard the rights of all persons with severe neurological disabilities. (Author/DB)

  2. Euthanasia attitude; A comparison of two scales

    PubMed Central

    Aghababaei, Naser; Farahani, Hojjatollah; Hatami, Javad

    2011-01-01

    The main purposes of the present study were to see how the term “euthanasia” influences people’s support for or opposition to euthanasia; and to see how euthanasia attitude relates to religious orientation and personality factors. In this study two different euthanasia attitude scales were compared. 197 students were selected to fill out either the Euthanasia Attitude Scale (EAS) or Wasserman’s Attitude Towards Euthanasia scale (ATE scale). The former scale includes the term “euthanasia”, the latter does not. All participants filled out 50 items of International Personality Item Pool, 16 items of the the HEXACO openness, and 14 items of Religious Orientation Scale-Revised. Results indicated that even though the two groups were not different in terms of gender, age, education, religiosity and personality, mean score on the ATE scale was significantly higher than that of the EAS. Euthanasia attitude was negatively correlated with religiosity and conscientiousness and it was positively correlated with psychoticism and openness. It can be concluded that analyzing the attitude towards euthanasia with the use of EAS rather than the ATE scale results in lower levels of opposition against euthanasia. This study raises the question of whether euthanasia attitude scales should contain definitions and concepts of euthanasia or they should describe cases of it. PMID:23908751

  3. Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

    PubMed

    Khan, Farooq; Tadros, George

    2013-01-01

    Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients' wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time. PMID:23833354

  4. Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

    PubMed Central

    Khan, Farooq; Tadros, George

    2013-01-01

    Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients’ wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time. PMID:23833354

  5. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans.

    PubMed

    Kox, Matthijs; van Eijk, Lucas T; Zwaag, Jelle; van den Wildenberg, Joanne; Sweep, Fred C G J; van der Hoeven, Johannes G; Pickkers, Peter

    2014-05-20

    Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases. PMID:24799686

  6. Responses of Male C57BL/6N Mice to Observing the Euthanasia of Other Mice.

    PubMed

    Boivin, Gregory P; Bottomley, Michael A; Grobe, Nadja

    2016-01-01

    The AVMA Panel on Euthanasia recommends that sensitive animals should not be present during the euthanasia of others, especially of their own species, but does not provide guidelines on how to identify a sensitive species. To determine if mice are a sensitive species we reviewed literature on empathy in mice, and measured the cardiovascular and activity response of mice observing euthanasia of conspecifics. We studied male 16-wk-old C57BL/6N mice and found no increase in cardiovascular parameters or activity in the response of the mice to observing CO2 euthanasia. Mice observing decapitation had an increase in all values, but this was paralleled by a similar increase during mock decapitations in which no animals were handled or euthanized. We conclude that CO2 euthanasia of mice does not have an impact on other mice in the room, and that euthanasia by decapitation likely only has an effect due to the noise of the guillotine. We support the conceptual idea that mice are both a sensitive species and display empathy, but under the controlled circumstances of the euthanasia procedures used in this study there was no signaling of stress to witnessing inhabitants in the room. PMID:27423146

  7. Euthanasia: the perceptions of nurses in India.

    PubMed

    Poreddi, Vijayalakshmi; Nagarajaiah; Konduru, Reddemma; Math, Suresh Bada

    2013-04-01

    Euthanasia provokes controversies in various domains, such as the moral, ethical, legal, religious, scientific, and economic. India legalised passive euthanasia (withdrawal of life support) for patients with brain death or who are in a permanent vegetative state in 2011, but research on perceptions of euthanasia among people in India is limited. This study aimed to examine nurses' perceptions of the practice of euthanasia as well as factors influencing those perceptions. A non-probability quantitative, cross-sectional design was adopted for a sample of 214 nurses working at a tertiary care centre. Data was collected through self-reported questionnaires at the nurses workplace.The findings revealed mixed opinions on euthanasia among the nurses. However, the majority of the participants did not agree with the practice of euthanasia. Nonetheless, further research is needed on this issue across the country among various health professionals in the context of current legislation. PMID:23967773

  8. Legal Standards for Brain Death and Undue Influence in Euthanasia Laws.

    PubMed

    Pope, Thaddeus Mason; Okninski, Michaela E

    2016-06-01

    A major appellate court decision from the United States seriously questions the legal sufficiency of prevailing medical criteria for the determination of death by neurological criteria. There may be a mismatch between legal and medical standards for brain death, requiring the amendment of either or both. In South Australia, a Bill seeks to establish a legal right for a defined category of persons suffering unbearably to request voluntary euthanasia. However, an essential criterion of a voluntary decision is that it is not tainted by undue influence, and this Bill falls short of providing adequate guidance to assess for undue influence. PMID:27048423

  9. [Legal issues of physician-assisted euthanasia part I--terminology and historical overview].

    PubMed

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2012-01-01

    Under German criminal law, euthanasia assisted by the attending physician involves the risk of criminal prosecution. However, in the absence of clear legal provisions, the law concerning euthanasia has been primarily developed by court rulings and jurisprudential literature in the last 30 years. According to a traditional classification there are four categories of euthanasia: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. However, there is still no generally accepted definition for the general term "euthanasia". The development of the law on the permissibility of euthanasia was strongly influenced by the conflict between the right of self-determination of every human being guaranteed by the Constitution and the constitutional mandate of the state to protect and maintain human life. The decisions of the German Federal Court of Justice on euthanasia in the criminal trials "Wittig" (1984), "Kempten" (1994) and "Putz" (2010) as well as the ruling of the 12th Division for Civil Matters of the Federal Court of Justice (2003) are of special importance. Some of these decisions were significantly influenced by the discussions in the jurisprudential literature. However, the German Bundestag became active for the first time as late as in 2009 when it adopted the 3rd Guardianship Amendment Act, which also contains provisions on the legal validity of a living will independent of the nature and stage of an illness. In spite of the new law, an analysis of the "Putz" case makes it especially clear that the criminal aspects of legal issues at the end of a person's life still remain controversial. It is to be expected that this issue will remain the subject of intensive discussion also in the next few years. PMID:23367790

  10. Neurobiology of Mice Selected for High Voluntary Wheel-running Activity.

    PubMed

    Rhodes, Justin S; Gammie, Stephen C; Garland, Theodore

    2005-06-01

    Selective breeding of house mice has been used to study the evolution of locomotor behavior. Our model consists of 4 replicate lines selectively bred for high voluntary wheel running (High-Runner) and 4 bred randomly (Control). The major changes in High-Runner lines appear to have taken place in the brain rather than in capacities for exercise. Their neurobiological profile resembles features of human Attention Deficit Hyperactivity Disorder (ADHD) and is also consistent with high motivation for exercise as a natural reward. Both ADHD and motivation for natural rewards (such as food and sex), as well as drugs of abuse, have been associated with alterations in function of the neuromodulator dopamine, and High-Runner mice respond differently to dopamine drugs. In particular, drugs that block the dopamine transporter protein (such as Ritalin and cocaine) reduce the high-intensity running of High-Runner mice but have little effect on Control mice. In preliminary studies of mice exercised on a treadmill, brain dopamine concentrations did not differ, suggesting that changes in the dopamine system may have occurred downstream of dopamine production (e.g., receptor expression or transduction). Brain imaging by immunohistochemical detection of c-Fos identified several key regions (prefrontal cortex, nucleus accumbens, caudate-putamen, lateral hypothalamus) that appear to play a role in the differential response to Ritalin and in the increased motivation for running in High-Runner mice. The activation of other brain regions, such as the hippocampus, was closely associated with wheel running itself. Chronic wheel running (several weeks) also increased the production of new neurons to apparently maximal levels in the hippocampus, but impaired learning in High-Runner mice. We discuss the biomedical implications of these findings. PMID:21676789

  11. A Survey of Special Educators' Attitudes toward Euthanasia for Infants with Severe Handicaps.

    ERIC Educational Resources Information Center

    Wood, Diane M.; May, Deborah C.

    1994-01-01

    This paper describes findings from a survey of the attitudes of 188 special education teachers toward ethical dilemmas surrounding surgery, active and passive euthanasia and the right to die. (Author/PB)

  12. Transcranial magnetic stimulation intensity affects exercise-induced changes in corticomotoneuronal excitability and inhibition and voluntary activation.

    PubMed

    Bachasson, D; Temesi, J; Gruet, M; Yokoyama, K; Rupp, T; Millet, G Y; Verges, Samuel

    2016-02-01

    Transcranial magnetic stimulation (TMS) of the motor cortex during voluntary contractions elicits electrophysiological and mechanical responses in the target muscle. The effect of different TMS intensities on exercise-induced changes in TMS-elicited variables is unknown, impairing data interpretation. This study aimed to investigate TMS intensity effects on maximal voluntary activation (VATMS), motor-evoked potentials (MEPs), and silent periods (SPs) in the quadriceps muscles before, during, and after exhaustive isometric exercise. Eleven subjects performed sets of ten 5-s submaximal isometric quadriceps contractions at 40% of maximal voluntary contraction (MVC) strength until task failure. Three different TMS intensities (I100, I75, I50) eliciting MEPs of 53 ± 6%, 38 ± 5% and 25 ± 3% of maximal compound action potential (Mmax) at 20% MVC were used. MEPs and SPs were assessed at both absolute (40% baseline MVC) and relative (50%, 75%, and 100% MVC) force levels. VATMS was assessed with I100 and I75. When measured at absolute force level, MEP/Mmax increased during exercise at I50, decreased at I100 and remained unchanged at I75. No TMS intensity effect was observed at relative force levels. At both absolute and relative force levels, SPs increased at I100 and remained stable at I75 and I50. VATMS assessed at I75 tended to be lower than at I100. TMS intensity affects exercise-induced changes in MEP/Mmax (only when measured at absolute force level), SPs, and VATMS. These results indicate a single TMS intensity assessing maximal voluntary activation and exercise-induced changes in corticomotoneuronal excitability/inhibition may be inappropriate. PMID:26642805

  13. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults - A randomized controlled trial.

    PubMed

    Hvid, Lars G; Strotmeyer, Elsa S; Skjødt, Mathias; Magnussen, Line V; Andersen, Marianne; Caserotti, Paolo

    2016-07-01

    Incomplete voluntary muscle activation may contribute to impaired muscle mechanical function and physical function in older adults. Exercise interventions have been shown to increase voluntary muscle activation, although the evidence is sparse for mobility-limited older adults, particularly in association with physical function. This study examined the effects of 12weeks of power training on outcomes of voluntary muscle activation and gait speed in mobility-limited older adults from the Healthy Ageing Network of Competence (HANC) study. We included 37 older men and women with a usual gait speed of <0.9m/s in the per-protocol analysis: n=16 in the training group (TG: 12weeks of progressive high-load power training, 2 sessions per week; age: 82.3±1.3years, 56% women) and n=21 in the control group (CG: no interventions; age: 81.6±1.1years, 67% women). Knee extensor muscle thickness (ultrasonography), strength (isokinetic dynamometry), voluntary activation (interpolated twitch technique), and gait speed (2-min maximal walking test) were assessed at baseline and post-intervention. At baseline, TG and CG were comparable for all measures. Post-intervention, significant between-group changes (TG vs. CG; p<0.05) were observed for voluntary muscle activation (+6.2%), muscle strength (+13.4Nm), and gait speed (+0.12m/s), whereas the between-group change in muscle thickness was non-significant (+0.08cm). Improvements in voluntary muscle activation were associated with improvements in gait speed in TG (r=0.67, p<0.05). Importantly, voluntary muscle activation is improved in mobility-limited older adults following 12-weeks of progressive power training, and is associated with improved maximal gait speed. Incomplete voluntary muscle activation should be considered one of the key mechanisms influencing muscle mechanical function and gait speed in older adults. PMID:27090485

  14. Running behavior and its energy cost in mice selectively bred for high voluntary locomotor activity.

    PubMed

    Rezende, Enrico L; Gomes, Fernando R; Chappell, Mark A; Garland, Theodore

    2009-01-01

    Locomotion is central to behavior and intrinsic to many fitness-critical activities (e.g., migration, foraging), and it competes with other life-history components for energy. However, detailed analyses of how changes in locomotor activity and running behavior affect energy budgets are scarce. We quantified these effects in four replicate lines of house mice that have been selectively bred for high voluntary wheel running (S lines) and in their four nonselected control lines (C lines). We monitored wheel speeds and oxygen consumption for 24-48 h to determine daily energy expenditure (DEE), resting metabolic rate (RMR), locomotor costs, and running behavior (bout characteristics). Daily running distances increased roughly 50%-90% in S lines in response to selection. After we controlled for body mass effects, selection resulted in a 23% increase in DEE in males and a 6% increase in females. Total activity costs (DEE - RMR) accounted for 50%-60% of DEE in both S and C lines and were 29% higher in S males and 5% higher in S females compared with their C counterparts. Energetic costs of increased daily running distances differed between sexes because S females evolved higher running distances by running faster with little change in time spent running, while S males also spent 40% more time running than C males. This increase in time spent running impinged on high energy costs because the majority of running costs stemmed from "postural costs" (the difference between RMR and the zero-speed intercept of the speed vs. metabolic rate relationship). No statistical differences in these traits were detected between S and C females, suggesting that large changes in locomotor behavior do not necessarily effect overall energy budgets. Running behavior also differed between sexes: within S lines, males ran with more but shorter bouts than females. Our results indicate that selection effects on energy budgets can differ dramatically between sexes and that energetic constraints in S

  15. Dilemmas surrounding passive euthanasia--a Malaysian perspective.

    PubMed

    Talib, Norchaya

    2005-09-01

    In western societies where the principle of autonomy is jealously guarded, perhaps active euthanasia is more often the focus of public concern and debates rather than any other forms of euthanasia. However due to the advance in technology and its corresponding ability in prolonging life, in Malaysia passive euthanasia presents more of a dilemma. For those concerned and involved with end of life decision-making, it is generally agreed that this is an area fraught with not only medical but legal and ethical issues. In Malaysia where the society is not homogenous but is multi-cultural and multi-religious, in addition to medical, legal and ethical issues, religious principles and cultural norms further impact and play significant roles in end of life decision-making. This paper seeks to identify the issues surrounding the practice of passive euthanasia in Malaysia. It will be shown that despite applicable legal provisions, current practice of the medical profession combined with religious and cultural values together affect decision-making which involves the withholding and/or withdrawing of life-saving treatment. PMID:16229394

  16. [The new euthanasia-discussion from the psychiatric viewpoint].

    PubMed

    Lauter, H; Meyer, J E

    1992-11-01

    The practice to kill terminally ill patients on their own demand has resulted in the Netherlands in a decriminalisation of active euthanasia which thus has fundamentally changed the way to deal with dying patients. Sooner or later this development will extend to other European countries as well as to the USA. Involuntary euthanasia of severely handicapped newborn children or of demented persons is propagated by the practical ethics of P. Singer and other representatives of utilitarianistic philosophy. According to the standpoint of utilitarianism a human being should only have the right to live as long as he or she is a person, i. e. has rationality and self-consciousness. The next step toward the elimination of elderly people can easily be predicted. For economical reasons these persons may be withheld from life-saving medical treatment or may be supposed to commit suicide. A moral pressure is created to make a decision for suicide as soon as severe invalidity occurs. The consideration of such ideas shows that in today's debate on euthanasia the issue is no longer the right of a few severely and terminally ill human beings to their "own death". Instead, the right to live of a large group of handicapped and "socially useless" or "unproductive" persons is at stake. This is the danger of today's discussion of euthanasia. PMID:1468747

  17. Molecular and metabolomic effects of voluntary running wheel activity on skeletal muscle in late middle-aged rats

    PubMed Central

    Garvey, Sean M; Russ, David W; Skelding, Mary B; Dugle, Janis E; Edens, Neile K

    2015-01-01

    We examined the molecular and metabolomic effects of voluntary running wheel activity in late middle-aged male Sprague Dawley rats (16–17 months). Rats were assigned either continuous voluntary running wheel access for 8 weeks (RW+) or cage-matched without running wheel access (RW−). The 9 RW+ rats averaged 83 m/day (range: 8–163 m), yet exhibited both 84% reduced individual body weight gain (4.3 g vs. 26.3 g, P = 0.02) and 6.5% reduced individual average daily food intake (20.6 g vs. 22.0 g, P = 0.09) over the 8 weeks. Hindlimb muscles were harvested following an overnight fast. Muscle weights and myofiber cross-sectional area showed no difference between groups. Western blots of gastrocnemius muscle lysates with a panel of antibodies suggest that running wheel activity improved oxidative metabolism (53% increase in PGC1α, P = 0.03), increased autophagy (36% increase in LC3B-II/-I ratio, P = 0.03), and modulated growth signaling (26% increase in myostatin, P = 0.04). RW+ muscle also showed 43% increased glycogen phosphorylase expression (P = 0.04) and 45% increased glycogen content (P = 0.04). Metabolomic profiling of plantaris and soleus muscles indicated that even low-volume voluntary running wheel activity is associated with decreases in many long-chain fatty acids (e.g., palmitoleate, myristoleate, and eicosatrienoate) relative to RW− rats. Relative increases in acylcarnitines and acyl glycerophospholipids were also observed in RW+ plantaris. These data establish that even modest amounts of physical activity during late middle-age promote extensive metabolic remodeling of skeletal muscle. PMID:25716928

  18. [Euthanasia in advanced dementia: a moral impossibility].

    PubMed

    Keizer, A A Bert

    2013-01-01

    Advance directives containing a request for euthanasia in cases of severely debilitating dementia are of no use. In such an advanced stage of the disease, the doctor would have to administer lethal medication to a patient who does not realise what is happening to him/her. The Dutch Euthanasia Act is ambivalent about this possibility. PMID:23777970

  19. Euthanasia and Mental Retardation: Suggesting the Unthinkable.

    ERIC Educational Resources Information Center

    Hollander, Russell

    1989-01-01

    The article examines current opinions toward euthanasia of persons with mental retardation in light of the history of public and professional attitudes. It also discusses the rejection of euthanasia on moral and religious grounds, and notes the use of lifelong incarceration, based on eugenics principles, to accomplish similar ends. (DB)

  20. [Euthanasia: what the pharmacist should know].

    PubMed

    Schaus, Valérie

    2015-06-01

    It is not unusual for a pharmacist to get a prescription to deliver a "kit for euthanasia", without further explanation. However, such a kit is not available. Which products and materials are necessary to perform euthanasia? What are the conditions to which the prescription and delivery has to comply? This article summarizes what you need to know. PMID:26466504

  1. Techniques to Pass on: Technology and Euthanasia

    ERIC Educational Resources Information Center

    Martin, Brian

    2010-01-01

    Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the mid-1990s, following the world's first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search for do-it-yourself technological means of dying with dignity. The Australian government has opposed…

  2. [Physician practice patterns and attitudes to euthanasia in Germany. A representative survey of physicians].

    PubMed

    Kirschner, R; Elkeles, T

    1998-04-01

    Growing life expectancy and increasing pharmaceutical and technical methods in medicine are leading to more and more discussions among the general population and among physicians as to whether methods to shorten the sufferings of mortally ill persons should be legalised further. In Australia 60% of physicians wish to be able to perform active euthanasia if this would be legal. In the Netherlands physicians do not commit an offence if they perform euthanasia on the basis of ethically consented rules. In the FRG the National Board of Physicians (Bundesärztekammer) still rejects any liberalisation concerning active euthanasia. However, little is known of the attitudes and behaviour of physicians concerning the questions of active and passive euthanasia. Sponsored by Gruner and Jahr publishers for a magazine "Stern" publication we conducted a representative study among physicians working in hospitals and their colleagues in free practices concerning this topic. Beginning with qualitative interviews with 50 physicians we tested the questionnaire developed and looked for the data production method best fitting for this difficult matter resulting in telephone interviews or a self-administered questionnaire. In the main study a representative sample of n = 282 physicians in free practices and n = 191 physicians in hospitals were interviewed. The response rates were 94% and 51% respectively. Analysis of non-responses did not indicate any bias. Half of the physicians think that a broader discussion on euthanasia is necessary, 34% disagree and 17% consider even a discussion already dangerous. 6% of the physicians in hospitals and 11% in free practices have already experienced methods of active euthanasia. Half of the physicians have seen patients who strongly wished euthanasia, a situation which happens once in every two years. The majority of physicians feel a deep understanding but only a minority of 4% comply with the wish. The vast majority of physicians advocate

  3. [Euthanasia in advanced dementia: directive is useful].

    PubMed

    Wijsbek, Henri

    2013-01-01

    The Dutch Euthanasia Act states that an advance directive can replace an actual request for euthanasia in cases in which a patient has become unable to make autonomous decisions. In Euthanasia and the Severely Demented, I agree with Keizer that the severely demented can suffer unbearably, but contrary to Keizer I do not believe that it is impossible to state in advance the conditions under which one would not wish to go on living any longer. Consequently, euthanasia can be permissible even in patients with late-stage dementia, provided that the other due-care criteria are met. Permissibility by itself, however, will not settle disputes about borderline cases. Due to the erratic course of the disease, the right moment for euthanasia may very well be impossible to determine. PMID:23777971

  4. A minimalist legislative solution to the problem of euthanasia.

    PubMed

    Komesaroff, Paul A; Charles, Stephen

    2015-05-18

    Intense debate has continued for many years about whether voluntary euthanasia or assisted suicide should be permitted by law. The community is bitterly divided and there has been vigorous opposition from medical practitioners and the Australian Medical Association. Despite differences of religious and philosophical convictions and ethical values, there is widespread community agreement that people with terminal illnesses are entitled to adequate treatment, and should also be allowed to make basic choices about when and how they die. A problem with the current law is that doctors who follow current best practice cannot be confident that they will be protected from criminal prosecution. We propose simple changes to Commonwealth and state legislation that recognise community concerns and protect doctors acting in accordance with best current practice. This minimalist solution should be widely acceptable to the community, including both the medical profession and those who object to euthanasia for religious reasons. Important areas of disagreement will persist that can be addressed in future debates. PMID:25971571

  5. Role of the Dorsal Medial Habenula in the Regulation of Voluntary Activity, Motor Function, Hedonic State, and Primary Reinforcement

    PubMed Central

    Hsu, Yun-Wei A.; Wang, Si D.; Wang, Shirong; Morton, Glenn; Zariwala, Hatim A.; de la Iglesia, Horacio O.

    2014-01-01

    The habenular complex in the epithalamus consists of distinct regions with diverse neuronal populations. Past studies have suggested a role for the habenula in voluntary exercise motivation and reinforcement of intracranial self-stimulation but have not assigned these effects to specific habenula subnuclei. Here, we have developed a genetic model in which neurons of the dorsal medial habenula (dMHb) are developmentally eliminated, via tissue-specific deletion of the transcription factor Pou4f1 (Brn3a). Mice with dMHb lesions perform poorly in motivation-based locomotor behaviors, such as voluntary wheel running and the accelerating rotarod, but show only minor abnormalities in gait and balance and exhibit normal levels of basal locomotion. These mice also show deficits in sucrose preference, but not in the forced swim test, two measures of depression-related phenotypes in rodents. We have also used Cre recombinase-mediated expression of channelrhodopsin-2 and halorhodopsin to activate dMHb neurons or silence their output in freely moving mice, respectively. Optical activation of the dMHb in vivo supports intracranial self-stimulation, showing that dMHb activity is intrinsically reinforcing, whereas optical silencing of dMHb outputs is aversive. Together, our findings demonstrate that the dMHb is involved in exercise motivation and the regulation of hedonic state, and is part of an intrinsic reinforcement circuit. PMID:25143617

  6. Rates of euthanasia and adoption for dogs and cats in Michigan animal shelters.

    PubMed

    Bartlett, Paul C; Bartlett, Andrew; Walshaw, Sally; Halstead, Stephen

    2005-01-01

    Estimates of canine and feline euthanasia at U.S. animal shelters--largely based on voluntary surveys with low response rates--make it difficult to estimate the population from which the euthanized animals derive. Estimates of euthanasia rates (animals euthanized per unit of population) have varied widely and been available only sporadically. This study used requirements of Michigan state law (Pet Shops, Dog Pounds, and Animal Shelters Act, 1969) for animal shelters to collect admission and discharge data for all 176 Michigan-licensed animal shelters. In 2003, Michigan shelters discharged 140,653 dogs: Of these, 56,972 (40%) were euthanized; 40,005 (28%) were adopted. This annual euthanasia rate is 2.6% of the estimated 2003 Michigan dog population. Michigan shelters discharged 134,405 cats in 2003: 76,321 (57%) by euthanasia and (24%) by adoption. The estimated ratio of euthanized cats to cats who had owners was 3.1%. Small shelters and privately owned shelters were associated with higher adoption rates. Comparison with historical information from the past 10 to 20 years suggests the number of companion animals being euthanized in shelters has decreased and that progress has been made in reducing the companion animal overpopulation problem. PMID:16277593

  7. Neonatal euthanasia: A claim for an immoral law

    PubMed Central

    Martinovici, Dana

    2013-01-01

    Active ending of the life of a newborn baby is a crime. Yet its clandestine practise is a reality in several European countries. In this paper, we defend the necessity to institute a proper legal frame for what we define as active neonatal euthanasia. The only legal attempt so far, the Dutch Groningen protocol, is not satisfactory. We critically analyse this protocol, as well as several other clinical practises and philosophical stances. Furthermore, we have tried to integrate our opinions as clinicians into a law project, with the purpose of pinpointing several issues, specific of perinatality that should be addressed by such a law. In conclusion, we argue that the legalisation of neonatal euthanasia under exceptional circumstances is the only way to avoid all the “well-intentioned” malpractices associated with ending life at the very dawn of it. PMID:24068880

  8. [Good death: euthanasia in the eyes of medical students].

    PubMed

    Kuře, Josef; Vaňharová, Michaela

    2014-01-01

    Both in the general public and in the professional communities, very diverse notions of euthanasia can be found. At the same time determining of the precise semantics of euthanasia is one of the crucial prerequisites for subsequent meaningful ethical discussion of euthanasia. The paper analyzes an empirical study investigating the understanding of euthanasia by medical students. The aim of the conducted research was to identify the semantic definitions of euthanasia used by the first-year medical students. PMID:24968293

  9. Chinese concepts of euthanasia and health care.

    PubMed

    Sleeboom-Faulkner, Margaret

    2006-08-01

    This article argues that taking concepts of euthanasia out of their political and economic contexts leads to violations of the premises on which the Stoic ideal of euthanasia is based: 'a quick, gentle and honourable death.' For instance, the transplantation of the narrowly defined concept of euthanasia developed under the Dutch welfare system into a developing country, such as the People's Republic of China (PRC), seems inadequate. For it cannot deal with questions of anxiety about degrading forms of dying and suffering without reference to its economic rationale, demanded by a scarcity (unequal distribution) of health care resources. The weakness of health care provisions for the terminally ill in Mainland China has become increasingly poignant since the collapse of collective health care institutions in the countryside since the reforms of the late-1980s. As in most cases where health care facilities are wanting, it is difficult to apply the criteria of gentleness and dignity at reaching death. Its solution lies not in a faster relief from suffering by euthanasia, but in extending the quality of life through distributive justice within Chinese healthcare policy-making. This paper begins with a brief description of the Dutch euthanasia law, after which it discusses Chinese conceptions of euthanasia in biomedical textbooks, the media and in surveys. It concludes by pointing out the need for a transnational framework in which both the specifics and generalities of euthanasia can be discussed. PMID:17044154

  10. Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

    PubMed

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

    2014-05-01

    As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice. PMID:24420744

  11. Investigation of perceived environment, perceived outcome, and person variables in relationship to voluntary development activity by employees.

    PubMed

    Maurer, T J; Tarulli, B A

    1994-02-01

    The authors examined perceived environment, perceived incentive and outcome, and person constructs for relationships with interest and participation in voluntary learning and development activity by nonmanagement employees. All 3 groups of constructs were related to development activity. In relationships with development activity, perceived outcome and environment variables interacted with workers' personal values relevant to aspects of a development setting, illustrating the potentially important role that differences in values may play in a development setting, illustrating the potentially important role that differences in values may play in a development context. Additionally, small relationships were observed between several demographic variables and values within a development setting. Results provide implications for the design and implementation of successful development programs and highlight the need to carefully consider individual differences in this context when targeting many different types of employees for participation. PMID:8200872

  12. Nurses and the management of death, dying and euthanasia.

    PubMed

    Stevens, C A; Hassan, R

    1994-01-01

    This article is one of two which report findings of research which examined the attitudes and practices of health professionals in South Australia towards the management of death, dying and euthanasia. The focus in this article is on findings related to nurses. Conducted in August 1991, mail-back, self-administered questionnaires were posted to a sample of 500 nurses on the general nurses register held by the Nurses Board of South Australia. A total response rate of 57.8% was obtained, and 55% (278) were usable returns. The survey found that 47% of the respondents had received requests from patients to hasten their deaths by withdrawing treatment, and 30% had received request from patients for active euthanasia. 'Persistent and irrelievable pain' was the main reason for such requests. The majority either would or did discuss such requests with relatives, other medical practitioners and nursing staff. Nineteen per cent had taken active steps which had brought about the death of a patient. Eighty-two per cent thought that guidelines for withholding and withdrawal of treatment should be established. Sixty per cent were in favour of legalization of active euthanasia under certain circumstances. PMID:7845184

  13. Should euthanasia be legal? An international survey of neonatal intensive care units staff

    PubMed Central

    Cuttini, M; Casotto, V; Kaminski, M; de Beaufort, I; Berbik, I; Hansen, G; Kollee, L; Kucinskas, A; Lenoir, S; Levin, A; Orzalesi, M; Persson, J; Rebagliato, M; Reid, M; Saracci, R

    2004-01-01

    Objective: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. Design: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom); 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). Main outcome measure: The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Results: Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Conclusions: Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation. PMID:14711848

  14. Strength Training to Contraction Failure Increases Voluntary Activation of the Quadriceps Muscle Shortly After Total Knee Arthroplasty

    PubMed Central

    Mikkelsen, Elin Karin; Jakobsen, Thomas Linding; Holsgaard-Larsen, Anders; Andersen, Lars Louis; Bandholm, Thomas

    2016-01-01

    ABSTRACT Objective The objective of this study was to investigate voluntary activation of the quadriceps muscle during one set of knee extensions performed until contraction failure in patients shortly after total knee arthroplasty. Design This was a cross-sectional study of 24 patients with total knee arthroplasty. One set of knee extensions was performed until contraction failure, using a predetermined 10 repetition maximum loading. In the operated leg, electromyographic (EMG) activity of the lateral and medial vastus, semitendinosus, and biceps femoris muscles was recorded during the set. Muscle activity (%EMGmax) and median power frequency of the EMG power spectrum were calculated for each repetition decile (10%–100% contraction failure). Results Muscle activity increased significantly over contractions from a mean of 90.0 and 93.6 %EMGmax (lateral vastus and medial vastus, respectively) at 10% contraction failure to 99.3 and 105.5 %EMGmax at 100% contraction failure (P = 0.009 and 0.004). Median power frequency decreased significantly over contractions from a mean of 66.8 and 64.2 Hz (lateral vastus and medial vastus, respectively) at 10% contraction failure to 59.9 and 60.1 Hz at 100% contraction failure (P = 0.0006 and 0.0187). Conclusion In patients shortly after total knee arthroplasty, 10 repetition maximum–loaded knee extensions performed in one set until contraction failure increases voluntary activation of the quadriceps muscle during the set. Clinical Trials Gov-identifier: NCT01713140 to the abstract to increase trial transparency. PMID:26339729

  15. Medial prefrontal cortical activity reflects dynamic re-evaluation during voluntary persistence.

    PubMed

    McGuire, Joseph T; Kable, Joseph W

    2015-05-01

    Deciding how long to keep waiting for future rewards is a nontrivial problem, especially when the timing of rewards is uncertain. We carried out an experiment in which human decision makers waited for rewards in two environments in which reward-timing statistics favored either a greater or lesser degree of behavioral persistence. We found that decision makers adaptively calibrated their level of persistence for each environment. Functional neuroimaging revealed signals that evolved differently during physically identical delays in the two environments, consistent with a dynamic and context-sensitive reappraisal of subjective value. This effect was observed in a region of ventromedial prefrontal cortex that is sensitive to subjective value in other contexts, demonstrating continuity between valuation mechanisms involved in discrete choice and in temporally extended decisions analogous to foraging. Our findings support a model in which voluntary persistence emerges from dynamic cost/benefit evaluation rather than from a control process that overrides valuation mechanisms. PMID:25849988

  16. Medial prefrontal cortical activity reflects dynamic re-evaluation during voluntary persistence

    PubMed Central

    McGuire, Joseph T.; Kable, Joseph W.

    2015-01-01

    Deciding how long to keep waiting for future rewards is a nontrivial problem, especially when the timing of rewards is uncertain. We report an experiment in which human decision makers waited for rewards in two environments, in which reward-timing statistics favored either a greater or lesser degree of behavioral persistence. We found that decision makers adaptively calibrated their level of persistence for each environment. Functional neuroimaging revealed signals that evolved differently during physically identical delays in the two environments, consistent with a dynamic and context-sensitive reappraisal of subjective value. This effect was observed in a region of ventromedial prefrontal cortex that is sensitive to subjective value in other contexts, demonstrating continuity between valuation mechanisms involved in discrete choice and in temporally extended decisions analogous to foraging. Our findings support a model in which voluntary persistence emerges from dynamic cost/benefit evaluation rather than from a control process that overrides valuation mechanisms. PMID:25849988

  17. Informal Learning and the Voluntary Arts

    ERIC Educational Resources Information Center

    Simpson, Robin

    2011-01-01

    While people might not be familiar with the term "voluntary arts", they are probably either involved with some voluntary arts activity themselves or they know someone who is. They use "voluntary arts" to mean any situation in which someone is voluntarily participating in an art form for pleasure, social reasons, skills development, and so on, but…

  18. Pulling up the runaway: the effect of new evidence on euthanasia's slippery slope.

    PubMed Central

    Ryan, C J

    1998-01-01

    The slippery slope argument has been the mainstay of many of those opposed to the legalisation of physician-assisted suicide and euthanasia. In this paper I re-examine the slippery slope in the light of two recent studies that examined the prevalence of medical decisions concerning the end of life in the Netherlands and in Australia. I argue that these two studies have robbed the slippery slope of the source of its power--its intuitive obviousness. Finally I propose that, contrary to the warnings of the slippery slope, the available evidence suggests that the legalisation of physician-assisted suicide might actually decrease the prevalence of non-voluntary and involuntary euthanasia. PMID:9800591

  19. Effect of voluntary periodic muscular activity on nonlinearity in the apparent mass of the seated human body during vertical random whole-body vibration

    NASA Astrophysics Data System (ADS)

    Huang, Ya; Griffin, Michael J.

    2006-12-01

    The principal resonance frequency in the driving-point impedance of the human body decreases with increasing vibration magnitude—a nonlinear response. An understanding of the nonlinearities may advance understanding of the mechanisms controlling body movement and improve anthropodynamic modelling of responses to vibration at various magnitudes. This study investigated the effects of vibration magnitude and voluntary periodic muscle activity on the apparent mass resonance frequency using vertical random vibration in the frequency range 0.5-20 Hz. Each of 14 subjects was exposed to 14 combinations of two vibration magnitudes (0.25 and 2.0 m s -2 root-mean square (rms)) in seven sitting conditions: two without voluntary periodic movement (A: upright; B: upper-body tensed), and five with voluntary periodic movement (C: back-abdomen bending; D: folding-stretching arms from back to front; E: stretching arms from rest to front; F: folding arms from elbow; G: deep breathing). Three conditions with voluntary periodic movement significantly reduced the difference in resonance frequency at the two vibration magnitudes compared with the difference in a static sitting condition. Without voluntary periodic movement (condition A: upright), the median apparent mass resonance frequency was 5.47 Hz at the low vibration magnitude and 4.39 Hz at the high vibration magnitude. With voluntary periodic movement (C: back-abdomen bending), the resonance frequency was 4.69 Hz at the low vibration magnitude and 4.59 Hz at the high vibration magnitude. It is concluded that back muscles, or other muscles or tissues in the upper body, influence biodynamic responses of the human body to vibration and that voluntary muscular activity or involuntary movement of these parts can alter their equivalent stiffness.

  20. Neonatal euthanasia: lessons from the Groningen Protocol.

    PubMed

    Eduard Verhagen, A A

    2014-10-01

    Decisions about neonatal end-of-life care have been studied intensely over the last 20 years in The Netherlands. Nationwide surveys were done to quantify these decisions, provide details and monitor the effect of guidelines, new regulations and other interventions. One of those interventions was the Groningen Protocol for newborn euthanasia in severely ill newborns, published in 2005. Before publication, an estimated 20 cases of euthanasia per year were performed. After publication, only two cases in five years were reported. Studies suggested that this might be partly caused by the lack of consensus about the dividing line between euthanasia and palliative care. New recommendations about paralytic medication use in dying newborns were issued to increase transparency and to improve reporting of euthanasia. New surveys will be needed to measure the effects of these interventions. This cycle of interventions and measurements seems useful for continuous improvement of end-of-life care in newborns. PMID:25150794

  1. Neonatal euthanasia: moral considerations and criminal liability.

    PubMed

    Sklansky, M

    2001-02-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice. PMID:11233379

  2. Controversial issues: euthanasia - a guide to resources.

    PubMed

    Polacek, Kelly Myer

    2007-01-01

    The purpose of this resource guide is to provide health sciences, medical, and large libraries a description of the content and features of the most popular Web sites on euthanasia. The redundancy in results of searches of the term "euthanasia" in multiple search engines indicates the high likelihood that information seekers will be directed to one or more of these sites. The eight most frequently retrieved sites are discussed here with attention paid to position (i.e., pro- or anti-euthanasia), authority, degree and quality of linkage, and uniqueness of information provided. These descriptions should help librarians direct their users to appropriate sources of information about euthanasia on the Web. PMID:17522009

  3. Passive euthanasia in India: a critique.

    PubMed

    Shukla, Rohini

    2016-01-01

    Given its preoccupation with the doctor's agency in administering euthanasia, the legal discourse on euthanasia in India has neglected the moral relevance of the patient's suffering in determining the legitimate types of euthanasia. In this paper, I begin by explicating the condition for the possibility of euthanasia in terms of the following moral principle: the doctor ought to give priority to the patient's suffering over the patient's life. I argue that the form of passive euthanasia legally permissible in India is inconsistent with this moral principle, owing to the consequences it entails for the patient. Inevitably, it is acts of commission on the part of the doctor that can provide the best possible death, which is the moral objective of euthanasia. To meet this objective, doctors must be seen as agents who possess the moral integrity and technical expertise to judge when and how the patient’s life ought to be terminated, depending on the patient’s medical condition. They are not bound to save lives and provide care unconditionally. PMID:26323062

  4. Voluntary physical activity abolishes the proliferative tumor growth microenvironment created by adipose tissue in animals fed a high fat diet.

    PubMed

    Theriau, Christopher F; Shpilberg, Yaniv; Riddell, Michael C; Connor, Michael K

    2016-07-01

    The molecular mechanisms behind the obesity-breast cancer association may be regulated via adipokine secretion by white adipose tissue. Specifically, adiponectin and leptin are altered with adiposity and exert antagonistic effects on cancer cell proliferation. We set out to determine whether altering adiposity in vivo via high fat diet (HFD) feeding changed the tumor growth supporting nature of adipose tissue and whether voluntary physical activity (PA) could ameliorate these HFD-dependent effects. We show that conditioned media (CM) created from the adipose tissue of HFD fed animals caused an increase in the proliferation of MCF7 cells compared with cells exposed to CM prepared from the adipose of lean chow diet fed counterparts. This increased proliferation was driven within the MCF7 cells by an HFD-dependent antagonism between AMP-activated protein kinase (AMPK) and protein kinase B (Akt) signaling pathways, decreasing p27 protein levels via reduced phosphorylation at T198 and downregulation of adiponectin receptor 1 (AdipoR1). PA can ameliorate these proliferative effects of HFD-CM on MCF7 cells, increasing p27(T198) by AMPK, reducing pAkt(T308), and increasing AdipoR1, resulting in cell cycle withdrawal in a manner that depends on the PA intensity. High physical activity (>3 km/day) completely abolished the effects of HFD feeding. In addition, AdipoR1 overexpression mimics the effects of exercise, abolishing the proliferative effects of the HFD-CM on MCF7 cells and further enhancing the antiproliferative effects of PA on the HFD-CM. Thus voluntary PA represents a means to counteract the proliferative effects of adipose tissue on breast cancers in obese patients. PMID:27150834

  5. [Euthanasia/assisted suicide. Ethical and socio-religious aspects].

    PubMed

    Chiriţă, V; Chiriţă, Roxana; Duică, Lavinia; Talau, Gh

    2009-01-01

    Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001). PMID:20191812

  6. Analgesic Activity of Tramadol and Buprenorphine after Voluntary Ingestion by Rats (Rattus norvegicus)

    PubMed Central

    Taylor, Bryan F; Ramirez, Harvey E; Battles, August H; Andrutis, Karl A; Neubert, John K

    2016-01-01

    Effective pain management for rats and mice is crucial due to the continuing increase in the use of these species in biomedical research. Here we used a recently validated operant orofacial pain assay to determine dose–response curves for buprenorphine and tramadol when mixed in nut paste and administered to male and female rats. Statistically significant analgesic doses of tramadol in nut paste included doses of 20, 30, and 40 mg/kg for female rats but only 40 mg/kg for male rats. For male rats receiving buprenorphine mixed in nut paste, a significant analgesic response was observed at 0.5 and 0.6 mg/kg. None of the doses tested produced a significant analgesic response in female rats. Our results indicate that at the doses tested, tramadol and buprenorphine produced an analgesic response in male rats. In female rats, tramadol shows a higher analgesic effect than buprenorphine. The analgesic effects observed 60 min after administration of the statistically significant oral doses of both drugs were similar to the analgesic effects of 0.03 mg/kg subcutaneous buprenorphine 30 min after administration. The method of voluntary ingestion could be effective, is easy to use, and would minimize stress to the rats during the immediate postoperative period. PMID:26817983

  7. Voluntary medical male circumcision for HIV prevention and early resumption of sexual activity: a literature review.

    PubMed

    Kamath, Veena; Limaye, Rupali J

    2015-01-01

    A number of programs have focused on scale-up and implementation research regarding voluntary medical male circumcision; however, there is limited research with regard to factors and strategies related to abstinence compliance and the effects of resuming sex during the wound healing period (42-day post-circumcision). We searched the literature for peer-reviewed articles examining early resumption of sex during this period. This review identifies factors that may predispose a client to engage in sex during the 42-day postoperative period, examines how early resumption of sex can inhibit wound healing and increase seroconversion, and reviews strategies that may increase adherence to abstinence during the wound healing period. We found that the most common factor that may predispose a client to engage in sex before the end of the postoperative period is marriage or cohabitation with a sexual partner. With regard to the effect of sex during the postoperative period on wound healing and seroconversion, we found that adverse events incurred were mild, and there was an increased risk of seroconversion. The only strategy studied to increase compliance to abstinence during the postoperative period utilized text messaging, and the trial results indicate that text messaging did not increase abstinence compliance. PMID:25738780

  8. Voluntary Activities and Online Education for Digital Heritage Inventory Development after the Great East Japan Earthquake

    NASA Astrophysics Data System (ADS)

    Kondo, Y.; Uozu, T.; Seino, Y.; Ako, T.; Goda, Y.; Fujimoto, Y.; Yamaguchi, H.

    2013-07-01

    Consortium for Earthquake-Damaged Cultural Heritage (CEDACH) is a voluntary initiative launched just after the Great East Japan Earthquake on 11 March 2011. The consortium is developing a social network between local cultural resource managers restoring disaster-damaged cultural heritage on one side and remote researchers including historians, archaeologists and specialists of cultural information studies on the other side, in order to facilitate collaborative projects. This paper presents three projects in which CEDACH contributed to the development of a digital inventory for disaster-damaged heritage management through web-based collaborations by self-motivated workers. The first project, CEDACH GIS, developed an online archaeological site inventory for the disaster area. Although a number of individuals voluntarily participated in the project at the beginning, it gradually stagnated due to limited need for local rescue archaeology. However, the experience of online-based collaborations worked well for the second project proposed by local specialists, in which CEDACH restored the book catalogue of a tsunami-devastated research library. This experience highlighted the need for online education to improve information and communication technologies (ICT) skills of data builders. Therefore, in the third project called CEDACHeLi, an e-Learning management system was developed to facilitate learning the fundamental knowledge and techniques required for information processing in rescue operations of disaster-damaged cultural heritage. This system will contribute to improved skills and motivation of potential workers for further developments in digital heritage inventory.

  9. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

    PubMed Central

    van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

    2010-01-01

    Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

  10. Voluntary exercise prevents colonic inflammation in high-fat diet-induced obese mice by up-regulating PPAR-γ activity

    SciTech Connect

    Liu, Wei-Xin; Wang, Ting; Zhou, Feng; Wang, Ying; Xing, Jun-Wei; Zhang, Shen; Gu, Shou-Zhi; Sang, Li-Xuan; Dai, Cong; Wang, Hai-Lan

    2015-04-10

    Obesity is associated with increased colonic inflammation, which elevates the risk of colon cancer. Although exercise exerts anti-inflammatory actions in multiple chronic diseases associated with inflammation, it is unknown whether this strategy prevents colonic inflammation in obesity. We hypothesized that voluntary exercise would suppress colonic inflammation in high-fat diet (HFD)-induced obesity by modulation of peroxisome proliferator-activated receptor (PPAR)-γ. Male C57Bl/6J mice fed either a control diet (6.5% fat, CON) or a high-fat diet (24% fat, HFD) were divided into sedentary, voluntary exercise or voluntary exercise with PPAR-γ antagonist GW9662 (10 mg/kg/day). All interventions took place for 12 weeks. Compared with CON-sedentary group, HFD-sedentary mice gained significantly more body weight and exhibited metabolic disorders. Molecular studies revealed that HFD-sedentary mice had increased expression of inflammatory mediators and activation of nuclear factor (NF)-κB in the colons, which were associated with decreased expression and activity of PPAR-γ. Voluntary exercise markedly attenuated body weight gain, improved metabolic disorders, and normalized the expression of inflammatory mediators and activation of NF-κB in the colons in HFD-mice while having no effects in CON-animals. Moreover, voluntary exercise significantly increased expression and activity of PPAR-γ in the colons in both HFD- and CON-animals. However, all of these beneficial effects induced by voluntary exercise were abolished by GW9662, which inhibited expression and activity of PPAR-γ. The results suggest that decreased PPAR-γ activity in the colon of HFD-induced obesity may facilitate the inflammatory response and colon carcinogenesis. Voluntary exercise prevents colonic inflammation in HFD-induced obesity by up-regulating PPAR-γ activity. - Highlights: • Obesity down-regulates PPAR-γ in the colon. • Down-regulated colonic PPAR-γ may facilitate inflammatory

  11. Euthanasia using gaseous agents in laboratory rodents.

    PubMed

    Valentim, A M; Guedes, S R; Pereira, A M; Antunes, L M

    2016-08-01

    Several questions have been raised in recent years about the euthanasia of laboratory rodents. Euthanasia using inhaled agents is considered to be a suitable aesthetic method for use with a large number of animals simultaneously. Nevertheless, its aversive potential has been criticized in terms of animal welfare. The data available regarding the use of carbon dioxide (CO2), inhaled anaesthetics (such as isoflurane, sevoflurane, halothane and enflurane), as well as carbon monoxide and inert gases are discussed throughout this review. Euthanasia of fetuses and neonates is also addressed. A table listing currently available information to ease access to data regarding euthanasia techniques using gaseous agents in laboratory rodents was compiled. Regarding better animal welfare, there is currently insufficient evidence to advocate banning or replacing CO2 in the euthanasia of rodents; however, there are hints that alternative gases are more humane. The exposure to a volatile anaesthetic gas before loss of consciousness has been proposed by some scientific studies to minimize distress; however, the impact of such a measure is not clear. Areas of inconsistency within the euthanasia literature have been highlighted recently and stem from insufficient knowledge, especially regarding the advantages of the administration of isoflurane or sevoflurane over CO2, or other methods, before loss of consciousness. Alternative methods to minimize distress may include the development of techniques aimed at inducing death in the home cage of animals. Scientific outcomes have to be considered before choosing the most suitable euthanasia method to obtain the best results and accomplish the 3Rs (replacement, reduction and refinement). PMID:26609130

  12. Co-Activity during Maximum Voluntary Contraction: A Study of Four Lower-Extremity Muscles in Children with and without Cerebral Palsy

    ERIC Educational Resources Information Center

    Tedroff, Kristina; Knutson, Loretta M.; Soderberg, Gary L.

    2008-01-01

    This study was designed to determine whether children with cerebral palsy (CP) showed more co-activity than comparison children in non-prime mover muscles with regard to the prime mover during maximum voluntary isometric contraction (MVIC) of four lower-extremity muscles. Fourteen children with spastic diplegic CP (10 males, four females; age…

  13. GPs' views on changing the law on physician-assisted suicide and euthanasia, and willingness to prescribe or inject lethal drugs: a survey from Wales

    PubMed Central

    Pasterfield, Diana; Wilkinson, Clare; Finlay, Ilora G; Neal, Richard D; Hulbert, Nicholas J

    2006-01-01

    If physician-assisted suicide/euthanasia is legalised in the UK, this may be the work of GPs. In the absence of recent or comprehensive evidence about GPs' views on either legalisation or willingness to take part, a questionnaire survey of all Welsh GPs was conducted of whom 1202 (65%) responded. Seven hundred and fifty (62.4% of responders) and 671 (55.8% of responders) said that they did not favour a change in the law to allow physician-assisted suicide/voluntary euthanasia respectively. These data provide a rational basis for determining the position of primary care on this contentious issue. PMID:16762127

  14. GPs' views on changing the law on physician-assisted suicide and euthanasia, and willingness to prescribe or inject lethal drugs: a survey from Wales.

    PubMed

    Pasterfield, Diana; Wilkinson, Clare; Finlay, Ilora G; Neal, Richard D; Hulbert, Nicholas J

    2006-06-01

    If physician-assisted suicide/euthanasia is legalised in the UK, this may be the work of GPs. In the absence of recent or comprehensive evidence about GPs' views on either legalisation or willingness to take part, a questionnaire survey of all Welsh GPs was conducted of whom 1202 (65%) responded. Seven hundred and fifty (62.4% of responders) and 671 (55.8% of responders) said that they did not favour a change in the law to allow physician-assisted suicide/voluntary euthanasia respectively. These data provide a rational basis for determining the position of primary care on this contentious issue. PMID:16762127

  15. Why Palliative Care for Children is Preferable to Euthanasia.

    PubMed

    Carter, Brian S

    2016-02-01

    Recent laws in Europe now allow for pediatric euthanasia. The author reviews some rationale for caution, and addresses why ensuring the availability of pediatric palliative care is an important step before allowing pediatric euthanasia. PMID:25007796

  16. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    ERIC Educational Resources Information Center

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  17. Exploring the effect of repeated-day familiarization on the ability to generate reliable maximum voluntary muscle activation.

    PubMed

    Frost, Lydia R; Gerling, Michael E; Markic, Jessica L; Brown, Stephen H M

    2012-12-01

    Maximum voluntary isometric contractions (MVCs) are commonly used to normalize electromyography (EMG) data and must be reliable even if the individual has no prior experience performing MVCs. This study explored the effect of familiarization over three testing sessions on MVC performance and reliability by comparing muscle activation during standardized maximal and sub-maximal muscle contractions. Participants were recruited into two groups: (1) individuals who regularly engaged in upper body resistance training; (2) individuals with little or no prior experience in upper body resistance training. EMG was collected from two pairs of muscles; biceps brachii and triceps brachii from the arm, and erector spinae and external oblique from the trunk. The trunk muscles were chosen as muscles that are less frequently activated in isolation in day-to-day life. It was found that there were no significant improvements in MVC performance or within-day reliability over the three testing sessions for both resistance trained and non-resistance trained groups. Resistance-trained individuals showed a trend to be more reliable within-day than non-resistance trained participants. Day-to-day MVC reliability, particularly of the erector spinae muscle, was limited in some participants. This suggests that further efforts are needed to improve our capability of reliably eliciting muscle activation MVCs for EMG normalization, especially for muscles that are less frequently activated in isolation. PMID:22726611

  18. Attitudes on euthanasia and physician-assisted suicide among medical students in Athens.

    PubMed

    Kontaxakis, Vp; Paplos, K G; Havaki-Kontaxaki, B J; Ferentinos, P; Kontaxaki, M-I V; Kollias, C T; Lykouras, E

    2009-10-01

    Attitudes towards assisted death activities among medical students, the future health gatekeepers, are scarce and controversial. The aims of this study were to explore attitudes on euthanasia and physician-assisted suicide among final year medical students in Athens, to investigate potential differences in attitudes between male and female medical students and to review worldwide attitudes of medical students regarding assisted death activities. A 20- item questionnaire was used. The total number of participants was 251 (mean age 24.7±1.8 years). 52.0% and 69.7% of the respondents were for the acceptance of euthanasia and physician-assisted suicide, respectively. Women's attitudes were more often influenced by religious convictions as well as by the fact that there is a risk that physician-assisted suicide might be misused with certain disadvantaged groups. On the other hand, men more often believed that a request for physician-assisted suicide from a terminally ill patient is prima-facie evidence of a mental disorder, usually depression. Concerning attitudes towards euthanasia among medical students in various countries there are contradictory results. In USA, the Netherlands, Hungary and Switzerland most of the students supported euthanasia and physician-assisted suicide. However, in many other countries such as Norway, Sweden, Yugoslavia, Italy, Germany, Sudan, Malaysia and Puerto Rico most students expressed negative positions regarding euthanasia and physician assisted suicide. PMID:22218231

  19. Euthanasia: Murder or Not: A Comparative Approach.

    PubMed

    Banović, Božidar; Turanjanin, Veljko

    2014-10-01

    Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public to its supporters and opponents. It also appears as one of the points where all three major religions (Catholic, Orthodox, and Islamic) have the same view. They are strongly against legalizing mercy killing, emphasizing the holiness of life as a primary criterion by which the countries should start in their considerations. Studying criminal justice systems in the world, the authors concluded that the issue of deprivation of life from compassion is solved on three ways. On the first place, we have countries where euthanasia is murder like any other murder from the criminal codes. Second, the most numerous are states where euthanasia is murder committed under privilege circumstances. On the third place, in the Western Europe we have countries where euthanasia is a legal medical procedure, under requirements prescribed by the law. In this paper, authors have made a brief comparison of the solutions that exist in some Islamic countries, where euthanasia is a murder, with Western countries, where it represents completely decriminalized medical procedure. PMID:26056652

  20. Euthanasia: Murder or Not: A Comparative Approach

    PubMed Central

    BANOVIĆ, Božidar; TURANJANIN, Veljko

    2014-01-01

    Abstract Background Euthanasia is one of the most intriguing ethical, medical and law issues that marked whole XX century and beginning of the XXI century, sharply dividing scientific and unscientific public to its supporters and opponents. It also appears as one of the points where all three major religions (Catholic, Orthodox, and Islamic) have the same view. They are strongly against legalizing mercy killing, emphasizing the holiness of life as a primary criterion by which the countries should start in their considerations. Studying criminal justice systems in the world, the authors concluded that the issue of deprivation of life from compassion is solved on three ways. On the first place, we have countries where euthanasia is murder like any other murder from the criminal codes. Second, the most numerous are states where euthanasia is murder committed under privilege circumstances. On the third place, in the Western Europe we have countries where euthanasia is a legal medical procedure, under requirements prescribed by the law. In this paper, authors have made a brief comparison of the solutions that exist in some Islamic countries, where euthanasia is a murder, with Western countries, where it represents completely decriminalized medical procedure. PMID:26056652

  1. Euthanasia tactics: patterns of injustice and outrage.

    PubMed

    Martin, Brian

    2013-12-01

    Struggles over euthanasia can be examined in terms of tactics used by players on each side of the issue to reduce outrage from actions potentially perceived as unjust. From one perspective, the key injustice is euthanasia itself, especially when the person or relatives oppose death. From a different perspective, the key injustice is denial of euthanasia, seen as a person's right to die. Five types of methods are commonly used to reduce outrage from something potentially seen as unjust: covering up the action; devaluing the target; reinterpreting the action, including using lying, minimising consequences, blaming others and benign framing; using official channels to give an appearance of justice; and using intimidation. Case studies considered include the Nazi T4 programme, euthanasia in contemporary jurisdictions in which it is legal, and censorship of Exit International by the Australian government. By examining euthanasia struggles for evidence of the five types of tactics, it is possible to judge whether one or both sides use tactics characteristic of perpetrators of injustice. This analysis provides a framework for examining tactics used in controversial health issues. PMID:23807915

  2. Euthanasia Acceptance as Related to Afterlife and Other Attitudes.

    ERIC Educational Resources Information Center

    Klopfer, Frederick J.; Price, William F.

    1978-01-01

    Information on euthanasia attitudes was obtained from fixed-schedule interviews gathered from 331 respondents. It was found that a favorable attitude toward euthanasia coincided with (1) belief in an afterlife; (2) a less favorable attitude toward euthanasia if relatives make the decision; and (3) younger respondents. (Author)

  3. Social reward improves the voluntary control over localized brain activity in fMRI-based neurofeedback training

    PubMed Central

    Mathiak, Krystyna A.; Alawi, Eliza M.; Koush, Yury; Dyck, Miriam; Cordes, Julia S.; Gaber, Tilman J.; Zepf, Florian D.; Palomero-Gallagher, Nicola; Sarkheil, Pegah; Bergert, Susanne; Zvyagintsev, Mikhail; Mathiak, Klaus

    2015-01-01

    Neurofeedback (NF) based on real-time functional magnetic resonance imaging (rt-fMRI) allows voluntary regulation of the activity in a selected brain region. For the training of this regulation, a well-designed feedback system is required. Social reward may serve as an effective incentive in NF paradigms, but its efficiency has not yet been tested. Therefore, we developed a social reward NF paradigm and assessed it in comparison with a typical visual NF paradigm (moving bar). We trained twenty-four healthy participants, on three consecutive days, to control activation in dorsal anterior cingulate cortex (ACC) with fMRI-based NF. In the social feedback group, an avatar gradually smiled when ACC activity increased, whereas in the standard feedback group, a moving bar indicated the activation level. In order to assess a transfer of the NF training both groups were asked to up-regulate their brain activity without receiving feedback immediately before and after the NF training (pre- and post-test). Finally, the effect of the acquired NF training on ACC function was evaluated in a cognitive interference task (Simon task) during the pre- and post-test. Social reward led to stronger activity in the ACC and reward-related areas during the NF training when compared to standard feedback. After the training, both groups were able to regulate ACC without receiving feedback, with a trend for stronger responses in the social feedback group. Moreover, despite a lack of behavioral differences, significant higher ACC activations emerged in the cognitive interference task, reflecting a stronger generalization of the NF training on cognitive interference processing after social feedback. Social reward can increase self-regulation in fMRI-based NF and strengthen its effects on neural processing in related tasks, such as cognitive interference. A particular advantage of social feedback is that a direct external reward is provided as in natural social interactions, opening perspectives

  4. Increased spinal reflex excitability is associated with enhanced central activation during voluntary lengthening contractions in human spinal cord injury.

    PubMed

    Kim, Hyosub E; Corcos, Daniel M; Hornby, T George

    2015-07-01

    This study of chronic incomplete spinal cord injury (SCI) subjects investigated patterns of central motor drive (i.e., central activation) of the plantar flexors using interpolated twitches, and modulation of soleus H-reflexes during lengthening, isometric, and shortening muscle actions. In a recent study of the knee extensors, SCI subjects demonstrated greater central activation ratio (CAR) values during lengthening (i.e., eccentric) maximal voluntary contractions (MVCs), compared with during isometric or shortening (i.e., concentric) MVCs. In contrast, healthy controls demonstrated lower lengthening CAR values compared with their isometric and shortening CARs. For the present investigation, we hypothesized SCI subjects would again produce their highest CAR values during lengthening MVCs, and that these increases in central activation were partially attributable to greater efficacy of Ia-α motoneuron transmission during muscle lengthening following SCI. Results show SCI subjects produced higher CAR values during lengthening vs. isometric or shortening MVCs (all P < 0.001). H-reflex testing revealed normalized H-reflexes (maximal SOL H-reflex-to-maximal M-wave ratios) were greater for SCI than controls during passive (P = 0.023) and active (i.e., 75% MVC; P = 0.017) lengthening, suggesting facilitation of Ia transmission post-SCI. Additionally, measures of spinal reflex excitability (passive lengthening maximal SOL H-reflex-to-maximal M-wave ratio) in SCI were positively correlated with soleus electromyographic activity and CAR values during lengthening MVCs (both P < 0.05). The present study presents evidence that patterns of dynamic muscle activation are altered following SCI, and that greater central activation during lengthening contractions is partly due to enhanced efficacy of Ia-α motoneuron transmission. PMID:25972590

  5. Euthanasia, assisted suicide, and cessation of life support: Japan's policy, law, and an analysis of whistle blowing in two recent mercy killing cases.

    PubMed

    Akabayashi, Akira

    2002-08-01

    Issues pertaining to euthanasia, assisted suicide, and cessation of life support continue to be a subject of worldwide interest. Euthanasia- particularly "active" euthanasia- is not considered legally or socially acceptable in most countries. In Japan, the first judgment of a case involving euthanasia took place in 1949. Since then there have been another five cases that reached the point of sentencing in 1990. All six cases were examples of so called "active euthanasia", in which the termination of life was performed by family members. However, the focus of discussion has been changed dramatically in recent years, owing to two prominent cases of mercy killing in 1995 (Yokohama) and 1996 (Kyoto), respectively. Medical doctors were involved in both of these cases, and euthanasia moved from being a theoretical problem to a practical dilemma. These cases also drew attention to the fact that assisted suicide could be distinguished from euthanasia. The first part of this paper will summarize the current status of euthanasia and the cessation of life support in Japan, focusing on its historical background and policy. The second part will briefly sketch the characteristics of Japanese law and then will examine the two recent cases of mercy killing mentioned above to try and determine the roles of whistle blowing in the medical practice arena, with particular reference to Japanese culture. This analysis is a challenge to elucidate how ethics and the law interact, and influence medical practice in a specific cultural context. PMID:12188460

  6. An effective method for terrestrial arthropod euthanasia.

    PubMed

    Bennie, Neil A C; Loaring, Christopher D; Bennie, Mikaella M G; Trim, Steven A

    2012-12-15

    As scientific understanding of invertebrate life increases, so does the concern for how to end that life in an effective way that minimises (potential) suffering and is also safe for those carrying out the procedure. There is increasing debate on the most appropriate euthanasia methods for invertebrates as their use in experimental research and zoological institutions grows. Their popularity as pet species has also led to an increase in the need for greater veterinary understanding. Through the use of a local injection of potassium chloride (KCl) initially developed for use in American lobsters, this paper describes a safe and effective method for euthanasia in terrestrial invertebrates. Initial work focused on empirically determining the dose for cockroaches, which was then extrapolated to other arthropod species. For this method of euthanasia, we propose the term 'targeted hyperkalosis' to describe death through terminal depolarisation of the thoracic ganglia as a result of high potassium concentration. PMID:22996446

  7. [Walter Creutz and "euthanasia" in the rhein province: between resistance and collaboration].

    PubMed

    Schmuhl, H-W

    2013-09-01

    Over many decades Walter Creutz, medical officer in the provincial administration of Rhine Province from 1935 to 1945, was held to be one of the few psychiatrists who had actively opposed the Nazi "Euthanasia" program. In the famous "Euthanasia trial" in Düsseldorf from 1948 to 1950, Creutz was acquitted of complicity in murder; the court attested that he had done his best to sabotage the "Euthanasia" program and in so doing had saved up to 3,000 patients in the Rhineland. This rendering was circulated further in the history of science literature, so that the Rhine Province was considered to be a center of resistance to the "Euthanasia" program. Doubts about this portrayal have arisen since the 1980s. Various authors attempted to prove that Walter Creutz collaborated with the "Euthanasia" apparatus claiming there was no evidence of opposition or resistance or only to a very limited degree. However, this new perspective is based on an equally one-sided, at times grossly distorted analysis of the sources. The article provides building blocks for a more differentiated interpretation. PMID:23995339

  8. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  9. [Euthanasia and general practice in Belgium].

    PubMed

    Thomas, J M

    2014-09-01

    In Belgium, the GP can perform euthanasia or be called as a consultant. He must know the laws concerning the end of life and be able to explain his rights to his patients. He will know the best practices and techniques for euthanasia. If necessary, he will call help or refer to a more competent colleague. He negotiates with the patient an advanced care planning following the evolution of its pathologies and will witness its wishes regarding end of life against other institutions and doctors. PMID:25675647

  10. Misconstrual of EAPC's position paper on euthanasia.

    PubMed

    Materstvedt, Lars Johan

    2015-08-01

    This is a response to Barutta and Vollmann's article 'Physician-assisted death with limited access to palliative care.' I show how they misconstrue a key empirical statement made by the European Association for Palliative Care regarding legalisation of euthanasia and physician-assisted suicide. Additionally, I include some further remarks on the relationship between euthanasia and palliative care. I read with interest the article, which delineate well several positions and gives a nice overview of arguments presented on either side. I also found the line of argument unprejudiced and clear, and am sure people working within palliative care would benefit from reading it. PMID:25948759

  11. Buddhism, euthanasia and the sanctity of life.

    PubMed Central

    Perrett, R W

    1996-01-01

    Damien and John Keown claim that there is important common ground between Buddhism and Christianity on the issue of euthanasia and that both traditions oppose it for similar reasons in order to espouse a "sanctity of life" position. I argue that the appearance of consensus is partly created by their failure to specify clearly enough certain key notions in the argument: particularly Buddhism, euthanasia and the sanctity of life. Once this is done, the Keowns' central claims can be seen to be either false or only restrictedly true. PMID:8910785

  12. Euthanasia: the role of the psychiatrist.

    PubMed

    Naudts, Kris; Ducatelle, Caroline; Kovacs, Jozsef; Laurens, Kristin; van den Eynde, Frederique; van Heeringen, Cornelis

    2006-05-01

    Belgium has become one of the few countries in the world where euthanasia is legally allowed within a specific juridical framework. Even more unique is the inclusion of grounds for requesting euthanasia on the basis of mental suffering. Further refinement of the legal, medical and psychiatric approach to the issue is required in order to clear up essential practical and ethical matters. Psychiatrists and their professional organisations need to play a greater role in this ongoing debate and contribute from a clinical, scientific and ethical point of view. PMID:16648525

  13. Buddhism, euthanasia and the sanctity of life.

    PubMed

    Perrett, R W

    1996-10-01

    Damien and John Keown claim that there is important common ground between Buddhism and Christianity on the issue of euthanasia and that both traditions oppose it for similar reasons in order to espouse a "sanctity of life" position. I argue that the appearance of consensus is partly created by their failure to specify clearly enough certain key notions in the argument: particularly Buddhism, euthanasia and the sanctity of life. Once this is done, the Keowns' central claims can be seen to be either false or only restrictedly true. PMID:8910785

  14. Fluvoxamine moderates reduced voluntary activity following chronic dexamethasone infusion in mice via recovery of BDNF signal cascades.

    PubMed

    Terada, Kazuki; Izumo, Nobuo; Suzuki, Biora; Karube, Yoshiharu; Morikawa, Tomomi; Ishibashi, Yukiko; Kameyama, Toshiki; Chiba, Koji; Sasaki, Noriko; Iwata, Keiko; Matsuzaki, Hideo; Manabe, Takayuki

    2014-04-01

    Major depression is a complex disorder characterized by genetic and environmental interactions. Selective serotonin reuptake inhibitors (SSRIs) effectively treat depression. Neurogenesis following chronic antidepressant treatment activates brain derived neurotrophic factor (BDNF) signaling. In this study, we analyzed the effects of the SSRI fluvoxamine (Flu) on locomotor activity and forced-swim behavior using chronic dexamethasone (cDEX) infusions in mice, which engenders depression-like behavior. Infusion of cDEX decreased body weight and produced a trend towards lower locomotor activity during darkness. In the forced-swim test, cDEX-mice exhibited increased immobility times compared with mice administered saline. Flu treatment reversed decreased locomotor activity and mitigated forced-swim test immobility. Real-time polymerase chain reactions using brain RNA samples yielded significantly lower BDNF mRNA levels in cDEX-mice compared with the saline group. Endoplasmic reticulum stress-associated X-box binding protein-1 (XBP1) gene expression was lower in cDEX-mice compared with the saline group. However, marked expression of the XBP1 gene was observed in cDEX-mice treated with Flu compared with mice given saline and untreated cDEX-mice. Expression of 5-HT2A and Sigma-1 receptors decreased after cDEX infusion compared with the saline group, and these decreases normalized to control levels upon Flu treatment. Our results indicate that the Flu moderates reductions in voluntary activity following chronic dexamethasone infusions in mice via recovery of BDNF signal cascades. PMID:24582626

  15. In favour or against euthanasia--dentistry students' opinion.

    PubMed

    Matthews-Brzozowska, M; Filipowski, H; Musielak, M; Matthews-Brzozowska, T

    2003-01-01

    Euthanasia and a doctor-assisted suicide are not only practiced worldwide, but also legalized in some countries. In Poland they are broadly discussed. The purpose of this paper was to define dentistry students attitude towards human right to ask for death and euthanasia. In the research 148 students of both sexes were questioned. Generally students were against euthanasia in the world as well as in Poland, although men were in majority for euthanasia. Believers were against it due to ethically-religious reasons, while non-believers were for euthanasia motivating it by rational reasons. PMID:15148876

  16. Young People's Voluntary and Campaigning Activities as Sources of Political Education.

    ERIC Educational Resources Information Center

    Roker, Debi; Player, Katie; Coleman, John

    1999-01-01

    Discusses political apathy and alienation among youth, challenging this negative image. Describes empirical research that demonstrates a high level of engagement by young people in social activism and community activities, focuses on factors influencing young people's participation, and demonstrates that volunteering and campaigning affect young…

  17. Dying well? A colloquy on euthanasia and assisted suicide.

    PubMed

    Crigger, Bette-Jane

    1992-01-01

    With this special issue the Report once again joins the debate on what patients, physicians, and society can -- and cannot -- live with at the end of life. The articles gathered here address in various ways, from various perspectives, the questions that inform the debate on euthanasia and assisted suicide. Do the canons of self-determination and respect for persons compel us to honor the choices of those who request active assistance in dying? Can we coherently argue that physicians' professional obligations to alleviate suffering extend so far as to taking life on request? To what extent ought our policy decisions rest on consideration of possible consequences? PMID:11642997

  18. 16 CFR 1031.7 - Commission support of voluntary standards activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... or subsidizing technical assistance, including research, health science data, and engineering support... standards development activities may include any one or a combination of the following actions: (1) Providing epidemiological and health science information and explanations of hazards for consumer...

  19. 16 CFR 1031.7 - Commission support of voluntary standards activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... or subsidizing technical assistance, including research, health science data, and engineering support... standards development activities may include any one or a combination of the following actions: (1) Providing epidemiological and health science information and explanations of hazards for consumer...

  20. 77 FR 10572 - Agency Information Collection Activities; Existing Collection, Comments Requested: the Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Federal Bureau of Investigation Agency Information Collection Activities; Existing Collection, Comments... comment until March 23, 2012. This process is conducted in accordance with Title 5, Code of...

  1. Pediatric Euthanasia and Palliative Care Can Work Together.

    PubMed

    Hanson, Stephen S

    2016-06-01

    Since the Netherlands produced the Groningen protocol describing the methods to be used for pediatric euthanasia and Belgium passed laws authorizing euthanasia for children who consent to it, the issue of pediatric euthanasia has become a relevant topic to discuss. Most rejections of pediatric euthanasia fall into 1 or more of 3 categories, each of which has problems. This article shows how several recent arguments against pediatric euthanasia fail to prove that pediatric euthanasia is unacceptable. It does not follow from this that the practice is permissible but rather that if one is to reject such a practice, stronger arguments will need to be made, especially in countries where adult euthanasia or assisted suicide is already permitted. PMID:25667147

  2. Regional activation within the vastus medialis in stimulated and voluntary contractions.

    PubMed

    Gallina, Alessio; Ivanova, Tanya D; Garland, S Jayne

    2016-08-01

    This study examined the contribution of muscle fiber orientation at different knee angles to regional activation identified with high-density surface electromyography (HDsEMG). Monopolar HDsEMG signals were collected using a grid of 13 × 5 electrodes placed over the vastus medialis (VM). Intramuscular electrical stimulation was used to selectively activate two regions within VM. The distribution of EMG responses to stimulation was obtained by calculating the amplitude of the compound action potential for each channel; the position of the peak amplitude was tracked across knee angles to describe shifts of the active muscle regions under the electrodes. In a separate experiment, regional activation was investigated in 10 knee flexion-extension movements against a fixed resistance. Intramuscular stimulation of different VM regions resulted in clear differences in amplitude distribution along the columns of the electrode grid (P < 0.001); changes in knee angle resulted in consistent shifts along the rows (P < 0.01) and negligible shifts along the columns of the electrode grid. Regional VM activation was identified in dynamic movement, with distal shifts of the EMG distribution in the eccentric phase of the movement (P < 0.05) and at more flexed knee angles (P < 0.05). HDsEMG was used to describe regional activation across the VM that was not attributable to anatomic factors. Changes in muscle fiber orientation associated with knee joint angle mainly influence the amplitude distribution along the fiber direction. Future studies are needed to understand possible functional roles for regional activation within the VM in dynamic tasks. PMID:27365281

  3. Cerebellar brain inhibition in the target and surround muscles during voluntary tonic activation.

    PubMed

    Panyakaew, Pattamon; Cho, Hyun Joo; Srivanitchapoom, Prachaya; Popa, Traian; Wu, Tianxia; Hallett, Mark

    2016-04-01

    Motor surround inhibition is the neural mechanism that selectively favours the contraction of target muscles and inhibits nearby muscles to prevent unwanted movements. This inhibition was previously reported at the onset of a movement, but not during a tonic contraction. Cerebellar brain inhibition (CBI) is reduced in active muscles during tonic activation; however, it has not been studied in the surround muscles. CBI was evaluated in the first dorsal interosseus (FDI) muscle as the target muscle, and the abductor digiti minimi, flexor carpi radialis and extensor carpi radialis muscles as surround muscles, during rest and tonic activation of the FDI muscle in 21 subjects. Cerebellar stimulation was performed under magnetic resonance imaging-guided neuronavigation targeting lobule VIII of the cerebellar hemisphere. Stimulus intensities for cerebellar stimulation were based on the resting motor cortex threshold (RMT) and adjusted for the depth difference between the cerebellar and motor cortices. We used 90-120% of the adjusted RMT as the conditioning stimulus intensity during rest. The intensity that generated the best CBI at rest in the FDI muscle was selected for use during tonic activation. During selective tonic activation of the FDI muscle, CBI was significantly reduced only for the FDI muscle, and not for the surround muscles. Unconditioned motor evoked potential sizes were increased in all muscles during FDI muscle tonic activation as compared with rest, despite background electromyography activity increasing only for the FDI muscle. Our study suggests that the cerebellum may play an important role in selective tonic finger movement by reducing its inhibition in the motor cortex only for the relevant agonist muscle. PMID:26900871

  4. Voluntary locomotor activity mitigates oxidative damage associated with isolation stress in the prairie vole (Microtus ochrogaster)

    PubMed Central

    Fletcher, Kelsey L.; Whitley, Brittany N.; Treidel, Lisa A.; Thompson, David; Williams, Annie; Noguera, Jose C.; Stevenson, Jennie R.; Haussmann, Mark F.

    2015-01-01

    Organismal performance directly depends on an individual's ability to cope with a wide array of physiological challenges. For social animals, social isolation is a stressor that has been shown to increase oxidative stress. Another physiological challenge, routine locomotor activity, has been found to decrease oxidative stress levels. Because we currently do not have a good understanding of how diverse physiological systems like stress and locomotion interact to affect oxidative balance, we studied this interaction in the prairie vole (Microtus ochrogaster). Voles were either pair housed or isolated and within the isolation group, voles either had access to a moving wheel or a stationary wheel. We found that chronic periodic isolation caused increased levels of oxidative stress. However, within the vole group that was able to run voluntarily, longer durations of locomotor activity were associated with less oxidative stress. Our work suggests that individuals who demonstrate increased locomotor activity may be better able to cope with the social stressor of isolation. PMID:26179798

  5. Voluntary locomotor activity mitigates oxidative damage associated with isolation stress in the prairie vole (Microtus ochrogaster).

    PubMed

    Fletcher, Kelsey L; Whitley, Brittany N; Treidel, Lisa A; Thompson, David; Williams, Annie; Noguera, Jose C; Stevenson, Jennie R; Haussmann, Mark F

    2015-07-01

    Organismal performance directly depends on an individual's ability to cope with a wide array of physiological challenges. For social animals, social isolation is a stressor that has been shown to increase oxidative stress. Another physiological challenge, routine locomotor activity, has been found to decrease oxidative stress levels. Because we currently do not have a good understanding of how diverse physiological systems like stress and locomotion interact to affect oxidative balance, we studied this interaction in the prairie vole (Microtus ochrogaster). Voles were either pair housed or isolated and within the isolation group, voles either had access to a moving wheel or a stationary wheel. We found that chronic periodic isolation caused increased levels of oxidative stress. However, within the vole group that was able to run voluntarily, longer durations of locomotor activity were associated with less oxidative stress. Our work suggests that individuals who demonstrate increased locomotor activity may be better able to cope with the social stressor of isolation. PMID:26179798

  6. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    ERIC Educational Resources Information Center

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  7. A Bibliography on Euthanasia, 1958-1978.

    ERIC Educational Resources Information Center

    Hilker, Christine; And Others

    This collection of materials represents a 20-year span (1958-1978) of references on euthanasia found through select indexes and abstracting services. The contents are organized into two general reference sections, periodicals and books, with citations listed alphabetically by author. The last two sections focus on the locations of these materials…

  8. Six Approaches to Post-16 Citizenship: 4. Citizenship through Voluntary and Community-Based Activities

    ERIC Educational Resources Information Center

    Fettes, Trisha

    2007-01-01

    Citizenship enables young people to learn about their rights and responsibilities, to understand how society works, and develop knowledge and understanding of social and political issues. Through citizenship education young people are encouraged to take action on issues of concern to themselves and to play an active part in the democratic process,…

  9. 77 FR 68130 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary Hazard...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... food industry nationally. The primary objective of the Retail Food Protection Program is to prevent foodborne illness at the retail level of the food industry by directing activities toward promotion of... service operators implement the recommendations outlined in the two manuals, as estimated in 2009 (73...

  10. 77 FR 59665 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... of Alcohol, Tobacco, Firearms and Explosives Agency Information Collection Activities; Proposed... ACTION: 30-day notice. ] The Department of Justice (DOJ), Bureau of Alcohol, Tobacco, Firearms and... Alcohol, Tobacco, Firearms and Explosives. (4) Affected public who will be asked or required to...

  11. Voluntary Participation in an Active Learning Exercise Leads to a Better Understanding of Physiology

    ERIC Educational Resources Information Center

    Carvalho, Helena; West, Crystal A.

    2011-01-01

    Students learn best when they are focused and thinking about the subject at hand. To teach physiology, we must offer opportunities for students to actively participate in class. This approach aids in focusing their attention on the topic and thus generating genuine interest in the mechanisms involved. This study was conducted to determine if…

  12. Activation of the trigeminal medullary dorsal horn during voluntary diving in rats.

    PubMed

    McCulloch, Paul F

    2005-07-27

    Fos immunohistochemistry was used to indicate whether activation of trigeminal neurons occurs in voluntarily diving rats. In rats trained to dive underwater, significant increases in Fos labeling were found within the ventral superficial MDH and paratrigeminal nucleus, 100-150 microm caudal to the obex compared to control rats. The conclusion is that the ventral superficial MDH is the initial brainstem afferent relay of diving response in voluntarily diving rats. PMID:15978555

  13. Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

    PubMed Central

    2009-01-01

    Background The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN) and Life End Information Forum (LEIF) in Belgium. The aim of this study is to describe and compare these initiatives. Methods We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols). Results In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions. Conclusion In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a consultation provision could also

  14. Adipose tissue and vascular phenotypic modulation by voluntary physical activity and dietary restriction in obese insulin-resistant OLETF rats

    PubMed Central

    Crissey, Jacqueline M.; Jenkins, Nathan T.; Lansford, Kasey A.; Thorne, Pamela K.; Bayless, David S.; Vieira-Potter, Victoria J.; Rector, R. Scott; Thyfault, John P.; Laughlin, M. Harold

    2014-01-01

    Adipose tissue (AT)-derived cytokines are proposed to contribute to obesity-associated vascular insulin resistance. We tested the hypothesis that voluntary physical activity and diet restriction-induced maintenance of body weight would both result in decreased AT inflammation and concomitant improvements in insulin-stimulated vascular relaxation in the hyperphagic, obese Otsuka Long-Evans Tokushima fatty (OLETF) rat. Rats (aged 12 wk) were randomly assigned to sedentary (SED; n = 10), wheel running (WR; n = 10), or diet restriction (DR; n = 10; fed 70% of SED) for 8 wk. WR and DR rats exhibited markedly lower adiposity (7.1 ± 0.4 and 15.7 ± 1.1% body fat, respectively) relative to SED (27 ± 1.2% body fat), as well as improved blood lipid profiles and systemic markers of insulin resistance. Reduced adiposity in both WR and DR was associated with decreased AT mRNA expression of inflammatory genes (e.g., MCP-1, TNF-α, and IL-6) and markers of immune cell infiltration (e.g., CD8, CD11c, and F4/80). The extent of these effects were most pronounced in visceral AT compared with subcutaneous and periaortic AT. Markers of inflammation in brown AT were upregulated with WR but not DR. In periaortic AT, WR- and DR-induced reductions in expression and secretion of cytokines were accompanied with a more atheroprotective gene expression profile in the adjacent aortic wall. WR, but not DR, resulted in greater insulin-stimulated relaxation in the aorta; an effect that was, in part, mediated by a decrease in insulin-induced endothelin-1 activation in WR aorta. Collectively, we show in OLETF rats that lower adiposity leads to less AT and aortic inflammation, as well as an exercise-specific improvement in insulin-stimulated vasorelaxation. PMID:24523340

  15. "You're not going to dehydrate mom, are you?": Euthanasia, versterving, and good death in the Netherlands.

    PubMed

    Pool, Robert

    2004-03-01

    In 1996, a debate erupted in the Netherlands about versterven: dying as a result of abstaining from eating and drinking. This discussion initially appeared to be one of the many side-shows to the wider Dutch euthanasia debate, but it continued to dominate the debate for the next few years, with newspaper headlines reporting "involuntary dehydration" in nursing homes. Part of the reason for this was the term itself. Introduced to refer to terminal dehydration, the word versterven had peculiar connotations and this, together with the way in which it was used, caused much confusion and controversy. Was versterven related to euthanasia? Did it denote dying naturally and peacefully or a horrible death imposed on helpless psychogeriatric patients? Was it (could it be) voluntary? Was the patient in control? Was it good death? This paper examines the discussion about, and the media representations of, versterven, focusing on its ambiguity and its relationship to good death. PMID:14732608

  16. The proprioceptive reflex control of the intercostal muscles during their voluntary activation

    PubMed Central

    Davis, J. Newsom; Sears, T. A.

    1970-01-01

    1. A quantitative study has been made of the reflex effects of sudden changes in mechanical load on contracting human intercostal muscles during willed breathing movements involving the chest wall. Averaging techniques were applied to recordings of electromyogram (EMG) and lung volume, and to other parameters of breathing. 2. Load changes were effected for brief periods (10-150 msec) at any predetermined lung volume by sudden connexion of the airway to a pressure source variable between ± 80 cm H2O so that respiratory movement could be either assisted or opposed. In some experiments airway resistance was suddenly reduced by porting from a high to a low resistance external airway. 3. Contracting inspiratory and expiratory intercostal muscles showed a `silent period' with unloading which is attributed to the sudden withdrawal from intercostal motoneurones of monosynaptic excitation of muscle spindle origin. 4. For both inspiratory and expiratory intercostal muscles the typical immediate effect of an increase in load was an inhibitory response (IR) with a latency of about 22 msec followed by an excitatory response (ER) with a latency of 50-60 msec. 5. It was established using brief duration stimuli (< 40 msec) that the IR depended on mechanical events associated with the onset of stimulation, whereas stimuli greater than 40 msec in duration were required to evoke the ER. 6. For constant expiratory flow rate and a constant load, the ER of expiratory intercostal muscles increased as lung volume decreased within the limits set by maximal activation of the motoneurone pool as residual volume was approached. 7. The ER to a constant load increased directly with the expiratory flow rate at which the load applied, also within limits set by maximal activation of the motoneurone pool. 8. For a given load, the ER during phonation was greater than that occurring at a similar expiratory flow rate without phonation when the resistance of the phonating larynx was mimicked by an

  17. Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program

    PubMed Central

    Thorndike, Anne N.; Healey, Erica; Sonnenberg, Lillian; Regan, Susan

    2010-01-01

    Objective In a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index. Methods In 2007, 774 employees enrolled in a 10 week program at a hospital in Boston, MA. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (BMI≥30), overweight (BMI=25–29.9), and normal weight (BMI<25) participants. Results At baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by BMI. Mean weight loss was 1.9 kg at end of program (p<0.001) and 0.4 kg at 1 year (p=0.002). At end of program, participants with BMI≥30 lost 3.0% body weight vs. 2.7% for BMI=25–29.9 and 1.7% for BMI<25 (p<0.001), but weight loss at 1 year did not differ by BMI. Mean cholesterol and blood pressure were lower at end of program and 1 year (p all <0.005) but did not differ by BMI. Conclusions Worksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees. PMID:21130804

  18. [Legal issues of physician-assisted euthanasia. Part III--Passive euthanasia, comparison of international legislation, conclusions for medical practice].

    PubMed

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2013-01-01

    The generic term "passive euthanasia" includes different issues dealing with the omission, discontinuation or termination of life-sustaining or life-prolonging medical treatments. The debate around passive euthanasia focuses on the constitutional right of self-determination of every human being on the one hand and the constitutional mandate of the State to protect human life on the other. Issues of passive euthanasia always require a differentiated approach. Essentially, it comes down to the following: In Germany, the human right of self-determination includes the right to prohibit the performance of life-sustaining treatments, even if this leads to the death of the patient. A physician who does not take life-sustaining treatment measures because this is the free will expressed by the patient is not subject to prosecution. On the other hand, if the physician treats the patient against his will, this can be deemed a punishable act of bodily injury. The patient's will is decisive even if his concrete state of health does no longer allow him to freely express his will. In the Patient's Living Will Act of 2009, the German legislator clarified the juridical assessment of such constellations being of particular relevance in practice. A written living will of a person in which he requests to take or not to take certain medical treatment measures in case that he is no longer able to make the decision himself shall be binding for the people involved in the process of medical treatment. If there is no living will, the supposed will of the patient shall be relevant. In its judgment in the "Putz case", the German Federal Court of Justice ruled in 2010 that actions terminating a life-sustaining treatment that does not correspond to the patient's will must be limited to letting an already ongoing disease process run its course. In this context it is not important, however, whether treatment is discontinued by an active act or by omission. Under certain circumstances, the

  19. Exposure of Research Personnel to Carbon Dioxide during Euthanasia Procedures

    PubMed Central

    Amparan, Ashlee A; Djoufack-Momo, Shelly M; Grunden, Beverly; Boivin, Gregory P

    2014-01-01

    CO2 is one of the most commonly used euthanasia agents for laboratory animals. Considerable research has gone into the effect of the agent on animals, but little has been done to examine potential human exposure during these procedures. In this study, we examine the CO2 concentrations to which personnel are exposed while euthanizing rodents with CO2. To examine the environmental levels of CO2 generated during euthanasia, we examined several variables including flow rate, inclusion of a cage in the euthanasia chamber, inversion of the euthanasia chamber, chamber size, distance from the euthanasia chamber, and room size. Under all conditions, CO2 concentrations in the room temporarily increased significantly to 600 to 4000 ppm. The results of this study show that, under several testing scenarios, occupational levels of CO2 did not exceed governmentally mandated allowable exposure limits during routine rodent euthanasia procedures. PMID:25199093

  20. Treatment limitation decisions under uncertainty: the value of subsequent euthanasia.

    PubMed

    Savulescu, Julian

    1994-01-01

    This paper examines how decisions to limit treatment to critically ill patients under uncertainty can be made rationally. Expected utility theory offers one way of making rational decisions under uncertainty. One problem with using this approach is that we may not know the value of each option. One rational course open is to treat until further information becomes available. However, treatment can limit the range of options open. With treatment, a patient may recover such that he no longer requires life-supporting treatment. However, his life may be not worth living. If active euthanasia of 'non-terminal' conditions is prohibited, the option of dying will no longer be available. Taking a rational 'wait and see' course may result in being trapped within an unbearable life. On the other hand, sometimes present practice 'lets nature take its course'. Critically ill patients are allowed to die because it is believed that their lives will be not worth living. It is likely that some patients are allowed to die when there is some objective chance of worthwhile future life. This paper argues that a policy of treating critically ill patients until the nature of future options can be better evaluated, in company with an offer of subsequent euthanasia where appropriate, allows a more rational and humane approach to treatment limitation decisions under uncertainty. PMID:11657375

  1. [Paul Nitsche: psychiatric reformer and main protagonist of Nazi euthanasia].

    PubMed

    Böhm, B

    2012-03-01

    The professional career of Paul Nitsche reflects the contradictory path taken by a German institutional psychiatrist who was a leader in the field at the time. During the Weimar Republic he advocated improving the institutional system based on principles of psychiatric reform, but was already receptive to concepts of racial hygiene. Shortly after the National Socialists seized power, Nitsche was already an influential proponent and participant in eugenic measures in Saxony and actively involved in implementing the "Law for the Prevention of Genetically Diseased Offspring." He increasingly appraised the value of a patient according to the person's economic performance. It was also Nitsche's opinion that the consequence of this extreme rationalization of human life was to exterminate "life unworthy of life." As a T4 appointed head assessor he decided in the last instance whether thousands of people would live or die. As the Medical Director of the T4 program, he was later directly responsible for continuing the massacre as "decentralized euthanasia." At the euthanasia trial in Dresden he was condemned to death and executed in 1948. PMID:22399059

  2. Methods of euthanasia in poultry and food-producing animals.

    PubMed

    Trapp, A L; Taylor, R F

    1986-03-01

    This article summarizes the methods of euthanasia in poultry and food-producing animals and details some of the advantages and disadvantages of specific methods. Specific recommendations are made for each type of animal, with alternative methods for special circumstances. Reasons are given for recommending methods that are not "first-choice methods" of the AVMA Panel on Euthanasia. Detailed descriptions are included for selected methods of euthanasia. PMID:2936436

  3. Mitigating Greenhouse Gas Emissions: Voluntary Reporting 1996

    EIA Publications

    1997-01-01

    Presents information on voluntary actions to reduce greenhouse gases or remove such gases from the atmosphere in 1995. It provides an overview of participation in the Voluntary Reporting Program, a perspective on the composition of activities reported, and a review of some key issues in interpreting and evaluating achievements associated with reported emissions mitigation initiatives.

  4. [Organ donation after euthanasia. Handle with great care].

    PubMed

    Abdo, W F Farid

    2014-01-01

    Recently, organ donation after euthanasia has been a topic of discussion in the Dutch media and scientific literature. Unfortunately, both the articles in question and the media interviews contained several unsubstantiated statements. This article describes the background of organ donation after euthanasia and refutes some of the recent statements. It discusses why it is expected that organ donation after euthanasia will result in a far fewer additional organ donors that originally stated. In conclusion, euthanasia is a topic that should be handled with great care. PMID:25492739

  5. QALYs, euthanasia and the puzzle of death.

    PubMed

    Barrie, Stephen

    2015-08-01

    This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be 'better off dead'. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an 'anchor' for the surveyed preferences on which QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. PMID:25082901

  6. Reflections on the state of current debate over physician-assisted suicide and euthanasia.

    PubMed

    Winkler, Earl

    1995-07-01

    This paper is part of a larger project. My overall aim is to argue that the evolution of familiar forms of termination of life sustaining treatment, constituting so called passive euthanasia, has severely undercut the logic of every form of reasoning that has traditionally been used to oppose active euthanasia and assistance in suicide. Basically, there are two such forms of traditional opposition, each represented in a range of different versions. There is the inevitable argument concerning social utilities -- that permitting euthanasia and assisted suicide will have bad social consequences. But more fundamentally, the idea persists that killing is intrinsically worse than letting-die in some sense that justifies the current practice of prohibiting the first while allowing the latter. In this paper, I first consider this latter claim. My ultimate strategy, as I have said, is to show that the nature of certain things we have all come to approve regarding termination of treatment makes it next to impossible to convincingly explain, in either of these ways, what is wrong with certain forms of assistance in suicide and euthanasia. In the second part of this paper I take another step in this direction by discussing, in a preliminary way, a special case of the argument from social risks. PMID:11653048

  7. Excitability of spinal motor neurons during motor imagery of thenar muscle activity under maximal voluntary contractions of 50% and 100%

    PubMed Central

    Bunno, Yoshibumi; Onigata, Chieko; Suzuki, Toshiaki

    2015-01-01

    [Purpose] We often perform physical therapy using motor imagery of muscle contraction to improve motor function for healthy subjects and central nerve disorders. This study aimed to determine the differences in the excitability of spinal motor neurons during motor imagery of a muscle contraction at different contraction strengths. [Subjects] We recorded the F-wave in 15 healthy subjects. [Methods] In resting trial, the muscle was relaxed during F-wave recording. For motor imagery trial, subjects were instructed to imagine maximal voluntary contractions of 50% and 100% while holding the sensor of a pinch meter, and F-waves were recorded for each contraction. The F-wave was recorded immediately after motor imagery. [Results] Persistence and F/M amplitude ratio during motor imagery under maximal voluntary contractions of 50% and 100% were significantly higher than that at rest. In addition, the relative values of persistence, F/M amplitude ratio, and latency were similar during motor imagery under the two muscle contraction strengths. [Conclusion] Motor imagery under maximal voluntary contractions of 50% and 100% can increase the excitability of spinal motor neurons. Differences in the imagined muscle contraction strengths are not involved in changes in the excitability of spinal motor neurons. PMID:26504291

  8. Association of changes in self-efficacy, voluntary physical activity, and risk factors for type 2 diabetes in a behavioral treatment for obese preadolescents: a pilot study.

    PubMed

    Smith, Alice E; Annesi, James J; Walsh, Ann M; Lennon, Vivian; Bell, Ruth A

    2010-10-01

    Childhood obesity is increasing in the United States; thus, physicians, nurses, and other health care professionals seek to refer patients to interventions that will reliably improve physical activity and nutrition behaviors. The present 12-week, two-session-per-week protocol, based on social cognitive theory, was given preliminary testing with 23 obese children (M(age) = 11.7 years) with risk factors for Type 2 diabetes. A significant within-group improvement in number of days per week of 60 or more minutes of voluntary physical activity was reported. Changes in measures of both task self-efficacy (beta = .39) and self-regulatory efficacy (beta = .44) significantly contributed to the significant portion of the variance explained in change in voluntary physical activity (R(2) = .40). Significant improvements in total cholesterol and body mass index (kg/m(2)) were also found. Correlations between changes in physical activity and changes in each physiological factor tested were each in the expected direction but did not reach statistical significance. Results suggest that replications and extensions of this pilot study, with greater experimental power, are warranted. PMID:20816562

  9. Death Education and Attitudes toward Euthanasia and Terminal Illness.

    ERIC Educational Resources Information Center

    Nagi, Mostafa H.; Lazerine, Neil G.

    1982-01-01

    Analyzed attitudes of 614 Protestant and Catholic Cleveland clergy toward terminal illness and euthanasia. Clergy responses revealed that, although eager to prolong life, terminally ill patients feared prolonged illness more than death. The controversial nature of euthanasia became more apparent with clergy who had more training in death…

  10. Suicide and Euthanasia - Special Types of Partner Relationships.

    ERIC Educational Resources Information Center

    Pohlmeier, Hermann

    1985-01-01

    Concentrates on the joint issues of suicide and euthanasia in the context of the doctor-patient relationship. A new evaluation of suicide prevention and euthanasia, especially as they relate to the training of medical students and doctors, is advocated. (Author/BL)

  11. "Euthanasia" of Persons with Severe Handicaps: Refuting the Rationalizations.

    ERIC Educational Resources Information Center

    Lusthaus, Evelyn

    1985-01-01

    The article examines two common rationalizations for euthanasia of persons with severe handicaps and presents arguments to refute them. The article calls for parents, professionals, and friends of persons with severe handicaps to be vocal in refuting euthanasia and its rationales. (Author/CL)

  12. Voluntary exercise enhances activity rhythms and ameliorates anxiety- and depression-like behaviors in the sand rat model of circadian rhythm-related mood changes.

    PubMed

    Tal-Krivisky, Katy; Kronfeld-Schor, Noga; Einat, Haim

    2015-11-01

    Physical exercise is a non-pharmacological treatment for affective disorders. The mechanisms of its effects are unknown although some suggest a relationship to synchronization of circadian rhythms. One way to explore mechanisms is to utilize animal models. We previously demonstrated that the diurnal fat sand rat is an advantageous model for studying the interactions between photoperiods and mood. The current study was designed to evaluate the effects of voluntary exercise on activity rhythms and anxiety and depression-like behaviors in sand rats as a step towards better understanding of the underlying mechanisms. Male sand rats were housed in short photoperiod (SP; 5h light/19 h dark) or neutral light (NP; 12h light/12h dark) regimens for 3 weeks and divided into subgroups with or without running wheels. Activity was monitored for 3 additional weeks and then animals were tested in the elevated plus-maze, the forced swim test and the social interaction test. Activity rhythms were enhanced by the running wheels. As hypothesized, voluntary exercise had significant effects on SP animals' anxiety- and depression-like behaviors but not on NP animals. Results are discussed in the context of interactions between physical exercise, circadian rhythms and mood. We suggest that the sand rat model can be used to explore the underlying mechanism of the effects of physical exercise for mood disorders. PMID:26253214

  13. Beliefs about euthanasia among university students: perspectives from Pakistan.

    PubMed

    Shaikh, M A; Kamal, A

    2011-10-01

    Opinions of university students about euthanasia were studied in 4 cities in Pakistan using convenience sampling. A total of 836 students (316 males and 520 females) completed a questionnaire in which euthanasia was defined as deliberate administration of an overdose of a drug by a doctor to relieve pain and suffering of a dying patient at his/her explicit request to end his/her life. Only 25.6% of students agreed that euthanasia should be legalized in Pakistan. The most common reason cited for legalization of euthanasia was to relieve patient's suffering but only when a committee of physicians agreed to recommend it. Students who opposed legalization (74.4%) cited impediments to future medical research as the most common reason, followed by the risk of misuse by physicians or family members. Only 8.9% of students cited religious beliefs as a reason against legalization. There is a need in Pakistan for more debate about euthanasia. PMID:22256415

  14. Child euthanasia: should we just not talk about it?

    PubMed

    Bovens, Luc

    2015-08-01

    Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults--viz, arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care--and show that these arguments are wanting. Second, there is another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman's 'Against the Right to Die' and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors. PMID:25757464

  15. The Dutch Euthanasia Act: recent legal developments.

    PubMed

    Legemaate, Johan; Bolt, Ineke

    2013-12-01

    The Dutch Termination of Life on Request and Assisted Suicide Act [Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding (Wtl)] came into force in 2002. Its aim is to increase the degree of due care exercised by physicians when terminating a patient's life and to provide a legal framework within which physicians account for their actions in such cases. On the basis of the second evaluation of the Act, published in December 2012, this article provides an overview of the most recent legal developments regarding the Dutch Euthanasia Act. Special attention is given to patients with dementia, psychiatric patients and patient who are "weary of life". PMID:24437331

  16. Kant on euthanasia and the duty to die: clearing the air.

    PubMed

    Cholbi, Michael

    2015-08-01

    Thanks to recent scholarship, Kant is no longer seen as the dogmatic opponent of suicide that he appears to be at first glance. However, some interpreters have recently argued for a Kantian view of the morality of suicide with surprising, even radical, implications. More specifically, they have argued that Kantianism (1) requires that those with dementia or other rationality-eroding conditions end their lives before their condition results in their loss of identity as moral agents and (2) requires subjecting the fully demented or those confronting future dementia to non-voluntary euthanasia. Properly understood, Kant's ethics have neither of these implications (1) wrongly assumes that rational agents' duty of self-preservation entails a duty of self-destruction when they become non-rational, (2) further neglects Kant's distinction between duties to self and duties to others and wrongly assumes that duties can be owed to rational agents only during the time of their existence. PMID:25246636

  17. Role and Involvement of Life End Information Forum Physicians in Euthanasia and Other End-of-Life Care Decisions in Flanders, Belgium

    PubMed Central

    Van Wesemael, Yanna; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D; Bilsen, Johan; Distelmans, Wim; Deliens, Luc

    2009-01-01

    Objective To describe role and involvement of Life End Information Forum (LEIF) physicians in end-of-life care decisions and euthanasia in Flanders. Study Design All 132 LEIF physicians in Belgium received a questionnaire inquiring about their activities in the past year, and their end-of-life care training and experience. Principal Findings Response rate was 75 percent. Most respondents followed substantive training in end-of-life care. In 1 year, LEIF physicians were contacted 612 times for consultations in end-of-life decisions, of which 355 concerned euthanasia requests eventually resulting in 221 euthanasia cases. LEIF physicians also gave information about various end-of-life issues (including palliative care) to patients and colleagues. Conclusions LEIF physicians provide a forum for information and advice for physicians and patients. A similar health service providing support to physicians for all end-of-life decisions could also be beneficial for countries without a euthanasia law. PMID:19780854

  18. Neural Activity during Voluntary Movements in Each Body Representation of the Intracortical Microstimulation-Derived Map in the Macaque Motor Cortex

    PubMed Central

    Kunori, Nobuo; Murata, Yumi

    2016-01-01

    In order to accurately interpret experimental data using the topographic body map identified by conventional intracortical microstimulation (ICMS), it is important to know how neurons in each division of the map respond during voluntary movements. Here we systematically investigated neuronal responses in each body representation of the ICMS map during a reach-grasp-retrieval task that involves the movements of multiple body parts. The topographic body map in the primary motor cortex (M1) generally corresponds to functional divisions of voluntary movements; neurons at the recording sites in each body representation with movement thresholds of 10 μA or less were differentially activated during the task, and the timing of responses was consistent with the movements of the body part represented. Moreover, neurons in the digit representation responded differently for the different types of grasping. In addition, the present study showed that neural activity depends on the ICMS current threshold required to elicit body movements and the location of the recording on the cortical surface. In the ventral premotor cortex (PMv), no correlation was found between the response properties of neurons and the body representation in the ICMS map. Neural responses specific to forelimb movements were often observed in the rostral part of PMv, including the lateral bank of the lower arcuate limb, in which ICMS up to 100 μA evoked no detectable movement. These results indicate that the physiological significance of the ICMS-derived maps is different between, and even within, areas M1 and PMv. PMID:27494282

  19. [Is it necessary to legislate euthanasia?].

    PubMed

    Michaud, J

    1999-01-01

    There are no specific articles on the end of life in French law. Thus an act of euthanasia can be qualified as murder, murder with premeditation or non-assistance to a person in danger. Recent events and debates have raised the question of enacting new legislation to deal with this problem. Two contrary positions could be considered: either create a special offence or explicitly authorize acts of euthanasia. There are major objections to both these propositions. The first one would require taking account of various situations, --unbearable suffering, loss of dignity, and precise requests,--that would be impossible to specify in legislative terms. The second proposition would be open to the same objection; it would also derogate from the major principle of respect for the life of persons and thus risk setting a precedent that could be used in other circumstances to evade this principle. Finally, if a law were enacted to this effect, it would constitute a threat for the development of palliative care. PMID:10464995

  20. [Euthanasia and palliative care in the Netherlands].

    PubMed

    Boisseau, Nicolas

    2004-03-27

    THE BIRTH OF THE DUTCH LAW: Euthanasia has been recently legalized in the Netherlands (since April 1, 2002). In this Article, we present the various cultural and historical factors that contributed to the law, the guidelines for the procedure and the resulting controversy. THE INTERVENING FACTORS: Internationally, the attitude concerning end of life care are heterogenic and also directly depend on religious and cultural factors. In the Netherlands, the health system promotes the maintenance at home of the terminally ill. However, the financial aspects (private health insurance) interact with the management of these patients. The rules for euthanasia are very strict and a declaration must be registered. Dedicated commissions are organised to control that the rules are applied. The current debate concerns the pertinence of the regulations, the attitude towards handicapped people and children, and the need to develop palliative care. The latter have only recently been developed in the country. The priority is focusing on old peoples' homes. The Netherlands is slow in this regard, but a new draft law is soon to be presented to the Authorities, and will most probably enable the gaps to be bridged. PMID:15105777

  1. Welfare, Quality of Life, and Euthanasia of Aged Horses.

    PubMed

    McGowan, Catherine M; Ireland, Joanne L

    2016-08-01

    Duration of ownership strengthens the human-horse bond, affecting decision-making about the horse's welfare, quality of life (QoL), and euthanasia. Most owners consider their geriatric horses to have good or excellent QoL; however, increasing age is negatively associated with QoL. Management factors are important. The most common reasons for euthanasia include musculoskeletal disorders or lameness, colic, and nonspecific chronic diseases. The decision to euthanize is difficult, so the advice of the veterinarian and QoL are important. This article focuses on the human-horse bond, assessment of QoL, reasons for euthanasia, and owner experiences of mortality. PMID:27449393

  2. [Bioethics of Sigmund Freud´s death: euthanasia or appropriation?].

    PubMed

    Figueroa, Gustavo

    2011-04-01

    The death of Freud raises the ethical dilemma about euthanasia. It can be characterized as indirect active euthanasia according to the rule of double effect, or terminal sedation, or palliated death. The primacy of the principle of autonomy over non maleficence, conditioned the physician's attitude toward his patient Freud. The physician assisted death was and remains punishable in western medicine. Therefore, a fundamental tradition was infringed. In contrast, the present study attempts to characterize the final position of Freud himself to his death and called it appropriation of his finitude; he assumes his being-unto-death, that is, he now projects his being not as a being-at-his-end but as a being-unto-end, indicating thereby that he understood that the end always penetrated his whole existence. PMID:21879194

  3. Individual differences in voluntary ethanol consumption lead to differential activation of the central amygdala in rats: relationship to the anxiolytic and stimulant effects of low dose ethanol

    PubMed Central

    Sharko, Amanda C.; Kaigler, Kris F.; Fadel, Jim R.; Wilson, Marlene A.

    2016-01-01

    Background Although alcohol use disorders and anxiety disorders are highly comorbid, the relationship between these two disorders is not fully understood. Previous work from our laboratory shows that anxiety-like behavior is highly variable in outbred Long-Evans rats and is related to the level of voluntary ethanol consumption, suggesting that basal anxiety state influences ethanol intake. To further examine the relationship between the acquisition of ethanol consumption and anxiety phenotype, Long-Evans rats were assessed for anxiety-like behavior and neuronal activation following voluntary ethanol consumption in a limited access drinking paradigm. Methods Rats were allowed to self-administer ethanol (6%v/v) for four days using a limited access drinking in the dark (DID) paradigm and divided into high and low drinking groups based on a median split of average daily ethanol intake. Immediately following the fourth drinking session, animals were tested on the elevated plus maze and evaluated for anxiety-like behaviors. Fos immunoreactivity was assessed in the central and basolateral amygdala, as well as the bed nucleus of the stria terminalis. Results High ethanol drinkers spent significantly more time on the open arms of the plus maze than low ethanol drinkers. High ethanol drinkers also had increased locomotor activity as compared to both low ethanol drinkers and water drinkers. Fos immunoreactivity was positively correlated with ethanol consumption in all brain regions examined, although Fos positive cell counts were only significantly different between high and low ethanol drinkers in the central amygdala. Conclusions Our findings demonstrate that outbred rats will voluntarily consume behaviorally effective doses of ethanol in a short-term access model and ethanol consumption is positively correlated with increased neuronal activation in the central amygdala. PMID:22834974

  4. Pathologic changes induced by an euthanasia agent.

    PubMed

    Port, C D; Garvin, P J; Ganote, C E; Sawyer, D C

    1978-08-01

    Dogs and cats killed by intravenous injection of either 0.3 ml/kg body weight T-61 or 100 mg/kg body weight pentoarbital and necropsied at less than 5 minutes or at 15 minutes after injection did not have gross or microscopic pathological changes. However, dogs and cats killed with T-61 at a dose of 1.0--1.5 ml/kg body weight and necropsied at 15 minutes after injection had significant gross and microscopic pathological lesions. Grossly, the lungs were severely edematous, did not collapse, and were deep red. Microscopically, the lungs had severe pulmonary edema and endothelial necrosis. Endothelial swelling of glomerular tuft vessels was also present. These lung and kidney lesions are classified as an euthanasia artefact. PMID:703253

  5. Euthanasia--the twenty-sixth specialty?

    PubMed

    Capanna, A H; Capanna, D M; Bianco, R Y

    1998-08-01

    Twenty-five medical specialties currently offer board certification in the United States. The question is, should there be a 26th specialty--that of euthanasia? Physician-assisted suicide has clearly been brought to the forefront of public debate by Dr. Jack Kevorkian, the retired Michigan pathologist, and the passage of the Oregon Proposition. The concern becomes multifold; should physician-assisted suicide be allowed? On whom should it be allowed? Should all physicians be allowed to participate, or only a select few? All physicians take either the Hippocratic Oath or World Health Organization Oath (or both) at medical school commencement, which forbids the taking of a life. How then are we to reconcile physician-assisted suicide? The Dutch have extensive experience with euthanasia assisted by physicians. It has become increasingly clear that a great deal of pressure will be directly or indirectly exerted on physicians to withhold or minimize treatment with terminally ill patients at both spectrums of life. The need to face these decisions will be pushed by economic interests. It is well documented historically that Nazi doctors conducted numerous experiments on concentration camp inmates in the name of research and scientific truth. How did these doctors become part of Hitler's killing machine in the 1940s? By 1942, the Nazified physicians were ready to cure the nation by killing off "useless eaters," and Jews, the "cancer" of the Nordic race. If we are taught that history repeats itself, how can we condone the helping of one patient and assisting another with ending his life? Perhaps it is fitting that Dr. Kevorkian was a pathologist, not directly involved in caring for patients and families. Perhaps we will need the 26th specialty, but the real questions is "Should those of us who took the Hippocratic Oath take the first step?" PMID:9701114

  6. Hospital social workers' attitudes toward euthanasia and assisted suicide.

    PubMed

    Csikai, E L

    1999-01-01

    Euthanasia and assisted suicide are the subjects of increasing controversy in the health care setting. In this study of 122 hospital social workers' attitudes toward euthanasia and assisted suicide, many respondents reported agreement that both practices may be ethical, should be legal in some situations, and that they would be willing to participate in the practices. Almost one-fourth of the respondents have been asked by patients and families during their careers to discuss euthanasia and assisted suicide. The social workers also identified situations in which euthanasia and assisted suicide may be appropriate and safeguards that should apply if practices are legalized. Preparation for requests to discuss these practices, through awareness of their own beliefs and attitudes and becoming knowledgeable about current controversies, policies, and practices, is essential. By doing so, social workers will be ready to seize the opportunity to emerge as leaders of multidisciplinary discussion of complex ethical issues in health care. PMID:10855802

  7. The Dutch experience with euthanasia: lessons for Canada?

    PubMed

    Mullens, A

    1995-06-01

    Anne Mullens used a recent fellowship provided by the Atkinson Foundation to take an in-depth look at euthanasia in the Netherlands. During her time in Holland, she discussed the issue with doctors who support and oppose euthanasia. She accompanied a doctor as he visited a patient who was dying of cancer and was beginning to consider the possibility of euthanasia. She talked to a nonphysician who is adamantly opposed to euthanasia and carries a card stating that. She visited a hospital in Amsterdam that has received requests from foreigners seeking euthansia. Mullens offers a comprehensive look at an issue that continues to provoke strong feelings among Canadian physicians and patients. PMID:7773901

  8. Euthanasia and death with dignity in Japanese law.

    PubMed

    Kai, Katsunori

    2010-12-01

    In Japan, there are no acts and, specific provisions or official guidelines on euthanasia, but recently, as I will mention below, an official guideline on "death with dignity" has been made. Nevertheless in fact, this guideline provides only a few rules of process on terminal care. Therefore the problems of euthanasia and "death with dignity" are mainly left to the legal interpretation by literatures and judicial precedents of homicide (Article 199 of the Criminal Code; where there is no distinction between murder and manslaughter) and of homicide with consent (Article 202 of the Criminal Code). Furthermore, there are several cases on euthanasia or "death with dignity" as well as borderline cases in Japan. In this paper I will present the situation of the latest discussions on euthanasia and "death with dignity" in Japan from the viewpoint of medical law. Especially, "death with dignity" is seriously discussed in Japan, therefore I focus on it. PMID:21766728

  9. Metaphors, stigma and the 'Alzheimerization' of the euthanasia debate.

    PubMed

    Johnstone, Megan-Jane

    2013-07-01

    This paper reports the findings of an unobtrusive research inquiry investigating the possible use and misuse of Alzheimer's disease in public policy debate on the legalization of euthanasia. The component of the study being reported identified the problematic use of five key metaphors: the Alzheimer metaphor, which in turn was reinforced by three additional metaphors--the epidemic metaphor, the military metaphor, and the predatory thief metaphor; and the euthanasia metaphor. All metaphors were found to be morally loaded and used influentially to stigmatize Alzheimer's disease and mediate public opinion supporting the legalization of euthanasia as an end-of-life 'solution' for people with the disease. It is contended that, in the interests of promoting intellectual honesty and giving proper recognition to the extraordinary complexity of the issue, the problematic use and influence of metaphoric thinking in the public debate about Alzheimer's disease and euthanasia needs to be made transparent, questioned and challenged. PMID:24336950

  10. The Dutch experience with euthanasia: lessons for Canada?

    PubMed Central

    Mullens, A

    1995-01-01

    Anne Mullens used a recent fellowship provided by the Atkinson Foundation to take an in-depth look at euthanasia in the Netherlands. During her time in Holland, she discussed the issue with doctors who support and oppose euthanasia. She accompanied a doctor as he visited a patient who was dying of cancer and was beginning to consider the possibility of euthanasia. She talked to a nonphysician who is adamantly opposed to euthanasia and carries a card stating that. She visited a hospital in Amsterdam that has received requests from foreigners seeking euthansia. Mullens offers a comprehensive look at an issue that continues to provoke strong feelings among Canadian physicians and patients. Images p1846-a p1849-a p1850-a p1852-a PMID:7773901

  11. Acceptance of Conditional Suicide and Euthanasia among Adult Americans.

    ERIC Educational Resources Information Center

    Johnson, David; And Others

    1980-01-01

    Analysis indicates that religious intensity, sex, age, and education are important associational variables regarding attitudes toward suicide and euthanasia. Males are more accepting than females. Females are influenced by family life conditions. Males are influenced by health status. (JMF)

  12. Tibialis Anterior muscle coherence during controlled voluntary activation in patients with spinal cord injury: diagnostic potential for muscle strength, gait and spasticity

    PubMed Central

    2014-01-01

    Background Coherence estimation has been used as an indirect measure of voluntary neurocontrol of residual motor activity following spinal cord injury (SCI). Here intramuscular Tibialis Anterior (TA) coherence estimation was performed within specific frequency bands for the 10-60 Hz bandwidth during controlled ankle dorsiflexion in subjects with incomplete SCI with and without spasticity. Methods In the first cohort study 15 non-injured and 14 motor incomplete SCI subjects were recruited to evaluate TA coherence during controlled movement. Specifically 15-30 Hz EMG was recorded during dorsiflexion with: i) isometric activation at 50, 75 and 100% of maximal voluntary torque (MVT), ii) isokinetic activation at 60 and 120°/s and iii) isotonic dorsiflexion at 50% MVT. Following identification of the motor tasks necessary for measurement of optimal TA coherence a second cohort was analyzed within the 10-16 Hz, 15-30 Hz, 24-40 Hz and 40-60 Hz bandwidths from 22 incomplete SCI subjects, with and without spasticity. Results Intramuscular 40-60 Hz, but not 15-30 Hz TA, coherence calculated in SCI subjects during isometric activation at 100% of MVT was lower than the control group. In contrast only isometric activation at 100% of MVT 15-30 Hz TA coherence was higher in subjects with less severe SCI (AIS D vs. AIS C), and correlated functionally with dorsiflexion MVT. Higher TA coherence was observed for the SCI group during 120°/s isokinetic movement. In addition 15-30 Hz TA coherence calculated during isometric activation at 100% MVT or 120°/s isokinetic movement correlated moderately with walking function and time from SCI, respectively. Spasticity symptoms correlated negatively with coherence during isometric activation at 100% of MVT in all tested frequency bands, except for 15-30 Hz. Specifically, 10-16 Hz coherence correlated inversely with passive resistive torque to ankle dorsiflexion, while clinical measures of muscle hypertonia and spasm severity correlated

  13. The "Endura" of The Cathars' Heresy: Medieval Concept of Ritual Euthanasia or Suicide?

    PubMed

    Tsiamis, Costas; Tounta, Eleni; Poulakou-Rebelakou, Effie

    2016-02-01

    The aim of the study is to explore the medieval concepts on the voluntary death of severely sick people, as they emerge through the endura (endurance) of the heresy of the Cathars in France (twelfth to fourteenth centuries). The endura was the prerequisite act of repentance that would allow the fallen soul to return to heaven. The endura was a necessary act of repentance, after the performance of a ceremonial purification of the soul (consolamentum), and consisted of the patients' voluntary abstention from vital food. The consolamentum and endura could be performed in the final stage of a disease with the consent of the patients or their relatives. The role of the Cathar physician was only to determine the severity of the disease and the forthcoming death of the patient. The physician was not allowed to take steps that would deprive the life of the patient, and the performance of the ritual endura was duty of the spiritual leaders of the community. The modern ethical approach to this subject is dictated by the medieval belief on the salvation of the soul and tries to answer the question of whether the endura could be seen as a medieval concept of a ritual euthanasia or fell within the theological sin of suicide. PMID:25716628

  14. Attitudes towards euthanasia among final-year Khartoum University medical students.

    PubMed

    Ahmed, A M; Kheir, M M

    2006-01-01

    To investigate the attitudes of final-year medical students at Khartoum University towards euthanasia an anonymous questionnaire was answered by 141 students. Most were familiar with the concept of euthanasia. The majority, 108 (76.6%) opposed euthanasia and their reasons included religious beliefs, belief that euthanasia was unethical and fear of misuse. The supporters of euthanasia (23.4%) stated reasons such as preventing the suffering of patients and respecting their autonomy and dignity. More students who described themselves as strongly religious were opponents of euthanasia (83/87, 95.4%) than those who were moderately religious (25/54, 46.3%). PMID:17037708

  15. Effects of voluntary exercise and genetic selection for high activity levels on HSP72 expression in house mice.

    PubMed

    Belter, Jason G; Carey, Hannah V; Garland, Theodore

    2004-04-01

    We studied expression of heat shock protein 72 (HSP72) in female mice from four replicate lines that had been selectively bred for high voluntary wheel running (S) and from four random-bred control lines (C). Mice from generation 23 were sampled after 6 days of wheel access, and those from generation 14 were sampled after 8 wk of access to wheels either free to rotate or locked. Mice from S lines ran approximately 2.6 times as many revolutions per day as did those from C lines. Western blotting of tissues from generation 23 mice indicated that S mice had elevated HSP72 expression in triceps surae muscle, but levels in spleen, kidney, heart, and lung were similar in S and C mice. HSP72 expression in triceps surae from generation 14 mice was measured by ELISA and analyzed with a two-way analysis of covariance. The interaction between wheel type and line type (S vs. C) was statistically significant, and subsequent analyses indicated that S mice had significantly elevated HSP72 expression only when housed with free wheels. Mice with the previously described mini-muscle phenotype (Houle-Leroy P, Guderley H, Swallow JG, and Garland T Jr. Am J Physiol Regul Integr Comp Physiol 284: R433-R443, 2003) occurred in both generations and had elevated HSP72 expression in triceps surae. For the generation 23 sample, wheel running as a covariate had a significant negative association with HSP72 expression, and the effect of line type was still statistically significant. Therefore, the increased HSP72 expression of S mice is not a simple proximate effect of their increased wheel running. PMID:14672969

  16. Voluntary Euthanasia and the Right to Die: A Dialogue with Derek Humphry.

    ERIC Educational Resources Information Center

    Sinnett, E. Robert; And Others

    1989-01-01

    Presents interview with Derek Humphry, founder of the Hemlock Society (an international right-to-die organization), who shares his personal experiences, as well as his efforts to educate the public and stimulate legal reform. Notes Humphry has dedicated more than a decade to this highly charged universal problem. (Author/ABL)

  17. Effects of transcranial magnetic stimulation during voluntary and non-voluntary stepping movements in humans.

    PubMed

    Solopova, I A; Selionov, V A; Kazennikov, O V; Ivanenko, Y P

    2014-09-01

    Here, we compared motor evoked potentials (MEP) in response to transcranial magnetic stimulation of the motor cortex and the H-reflex during voluntary and vibration-induced air-stepping movements in humans. Both the MEPs (in mm biceps femoris, rectus femoris and tibialis anterior) and H-reflex (in m soleus) were significantly smaller during vibration-induced cyclic leg movements at matched amplitudes of angular motion and muscle activity. These findings highlight differences between voluntary and non-voluntary activation of the spinal pattern generator circuitry in humans, presumably due to an extra facilitatory effect of voluntary control/triggering of stepping on spinal motoneurons and interneurons. The results support the idea of active engagement of supraspinal motor areas in developing central pattern generator-modulating therapies. PMID:25038416

  18. Attitudes toward Euthanasia and Related Issues among Physicians and Patients in a Multi-cultural Society of Malaysia

    PubMed Central

    Rathor, Mohammad Yousuf; Abdul Rani, Mohammad Fauzi; Shahar, Mohammad Arif; Jamalludin, A. Rehman; Che Abdullah, Shahrin Tarmizi Bin; Omar, Ahmad Marzuki Bin; Mohamad Shah, Azarisman Shah Bin

    2014-01-01

    Introduction: Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public toward greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As euthanasia has gained world-wide prominence, the objectives of our study therefore were to explore the attitude of physicians and chronically ill patients toward euthanasia and related issues. Concomitantly, we wanted to ascertain the frequency of requests for assistance in active euthanasia. Materials and Methods: Questionnaire based survey among consenting patients and physicians. Results: The majority of our physicians and patients did not support active euthanasia or physician-assisted suicide (EAS), no matter what the circumstances may be P < 0.001. Both opposed to its legalization P < 0.001. Just 15% of physicians reported that they were asked by patients for assistance in dying. Both physicians 29.2% and patients 61.5% were in favor of withdrawing or withholding life-sustaining treatment to a patient with no chances of survival. Among patients no significant differences were observed for age, marital status, or underlying health status. Conclusions: A significant percentage of surveyed respondents were against EAS or its legalization. Patient views were primarily determined by religious beliefs rather than the disease severity. More debates on the matter are crucial in the ever-evolving world of clinical medicine. PMID:25374860

  19. Involuntary Euthanasia and Current Attempts to Define Persons with Mental Retardation as Less Than Human.

    ERIC Educational Resources Information Center

    Lusthaus, Evelyn W.

    1985-01-01

    The author examines current attempts to define mentally retarded persons as less than human and suggests that these ideologies are being used to justify euthanasia practices and to formulate euthanasia policies. (CL)

  20. A template for non-religious-based discussions against euthanasia.

    PubMed

    Bloodworth, Melissa; Bloodworth, Nathaniel; Ely, E Wesley

    2015-02-01

    We submit this manuscript as part of the ongoing conversation in society at large about physician-assisted death (PAD) and euthanasia. This outlines an approach used by lay healthcare professionals in arguing against PAD/euthanasia during a 1-hour debate conducted on a secular medical school campus. We have included the elements chosen for the "con" side of the argument (i.e., against PAD) by the medical students and attending physician. The goal of this manuscript is to provide a focused and pithy template upon which to build an approach that honors the dignity of life in all circumstances. Lay summary: The discussion over physician assisted death and euthanasia remains ongoing in secular academic medical institutions across the United States and much of the western world. These debates have incentivized efforts to develop a framework for arguments against Euthanasia that will find traction in an environment generally hostile to religion and religious thought. In this essay, we present arguments given by the "con" side in a student-led debate over physician assisted death and euthanasia at Vanderbilt University with the hope that they will provide a foundation for future discussions promoting truth and life without alienating our secular colleagues. PMID:25698842

  1. Guidelines for legalized euthanasia in Canada: a proposal.

    PubMed

    Nielsen, T O

    1998-10-01

    Arguments for liberty, mercy, and dignity support the legalization of euthanasia, but there remains a possibility of undesirable social consequences should this occur. Accordingly, proposals must prevent involuntary euthanasia, prevent unconscious coercion of the terminally ill to request euthanasia, protect and enshrine the availability of first-class palliative care, ensure documentation for purposes of enforcement and study, and spell out enforceable consequences for violations. Guidelines set by the Royal Dutch Medical Association have largely failed to meet these requirements. In North America, proposals for legalization, such as Oregon's Measure 16 and the minority opinion in Canada's Rodriguez case, also have flaws in meeting these criteria. Legislation in the Northern Territory of Australia came closest to meeting the requirements outlined, but was overruled after a brief period in effect. In Canada, a comprehensive survey of current euthanasia practices and improved availability of palliative care must precede attempts at legalization. A specific proposal is made for ethics committees operating at a regional health board level to approve legal euthanasia fitting within careful guidelines. Composition, procedures and mandate are described. If a set of guidelines, balancing any right there is "to die with dignity" with a responsibility to protect the weakest in society, is proposed first by the medical community, Parliament may have the courage to enact legislation. PMID:12382660

  2. A template for non-religious-based discussions against euthanasia

    PubMed Central

    Bloodworth, Melissa; Bloodworth, Nathaniel; Ely, E. Wesley

    2015-01-01

    We submit this manuscript as part of the ongoing conversation in society at large about physician-assisted death (PAD) and euthanasia. This outlines an approach used by lay healthcare professionals in arguing against PAD/euthanasia during a 1-hour debate conducted on a secular medical school campus. We have included the elements chosen for the “con” side of the argument (i.e., against PAD) by the medical students and attending physician. The goal of this manuscript is to provide a focused and pithy template upon which to build an approach that honors the dignity of life in all circumstances. Lay summary: The discussion over physician assisted death and euthanasia remains ongoing in secular academic medical institutions across the United States and much of the western world. These debates have incentivized efforts to develop a framework for arguments against Euthanasia that will find traction in an environment generally hostile to religion and religious thought. In this essay, we present arguments given by the “con” side in a student-led debate over physician assisted death and euthanasia at Vanderbilt University with the hope that they will provide a foundation for future discussions promoting truth and life without alienating our secular colleagues. PMID:25698842

  3. Attitudes toward Euthanasia as a Function of Death Fears and Demographic Variables.

    ERIC Educational Resources Information Center

    Slezak, Michael E.

    1982-01-01

    Studied the relationship of attitudes toward euthanasia to death fears and demographic variables in a sample of 100 adults. Found the strongest predictors of euthanasia attitude were age and amount of education. Suggests individuals who are more experienced with life and death have a more positive attitude toward euthanasia. (Author)

  4. Effect of tongue position on masseter and temporalis electromyographic activity during swallowing and maximal voluntary clenching: a cross-sectional study.

    PubMed

    Valdés, C; Astaburuaga, F; Falace, D; Ramirez, V; Manns, A

    2014-12-01

    The purpose of this study was to measure and compare the tonic electromyographic (EMG) activity of the temporalis and masseter muscles following placement of the tongue either on the palate or in the floor of the mouth during swallowing and maximal voluntary clenching (MVC). Thirty healthy dental students with natural dentition and bilateral molar support, between the ages of 18 and 22, with no prior history of oro-facial injury, or current or past pain in the jaw, mouth or tongue participated in the study. Tonic masseter and temporalis EMG activities were recorded using surface electrodes. Subjects were instructed to passively place the tongue either on the anterior hard palate or in the floor of the mouth during swallowing and MVC. At each tongue position, the resulting EMG was recorded. During swallowing, no significant difference in EMG activity was found either for the masseter (P-value = 0.1592) or the temporalis (P-value = 0.0546) muscles, regardless of the tongue position. During MVC, there was a statistically significant difference for both the masseter (P-value = 0.0016) and the temporalis (P-value = 0.0277) muscles with lower levels recorded with the tongue in the floor of the mouth. This study found that in normal, pain-free subjects, placing the tongue in the floor of the mouth significantly reduces masticatory muscle activity during MVC. Thus, it may be considered as a possible therapeutic option to decrease masticatory muscle activity; however, further research is needed in patients with oro-facial pain. PMID:25040648

  5. The voluntary health sector: some reflections.

    PubMed

    Narayan, R; Narayan, T

    1993-06-01

    All India Peoples Science Network. One of the questions posed was whether the government was purposefully obscuring the differences between the profit and not-for-profit sectors. The Policy Delphi analysis in 1992 forecasted the need for a new philosophical framework and identified 11 basic goals, such as preferential treatment for the poor and marginalized. An overview is given of how the voluntary sector operates, and its activities are indicated. PMID:12318296

  6. Quarantine stressing voluntary compliance.

    PubMed

    DiGiovanni, Cleto; Bowen, Nancy; Ginsberg, Michele; Giles, Gregory

    2005-11-01

    A 1-day table-top exercise in San Diego, California, in December 2004 emphasized voluntary compliance with home quarantine to control an emerging infectious disease outbreak. The exercise heightened local civilian-military collaboration in public health emergency management. Addressing concerns about lost income by residents in quarantine was particularly challenging. PMID:16318738

  7. Survey of euthanasia practices in animal shelters in Canada

    PubMed Central

    Caffrey, Niamh; Mounchili, Aboubakar; McConkey, Sandra; Cockram, Michael S.

    2011-01-01

    Questionnaires on methods of euthanasia used in Canadian animal shelters were sent to 196 Canadian animal shelters yielding 67 responses. Sodium pentobarbital injection was the only method of euthanasia used by 61% of establishments that euthanized dogs and 53% of the establishments that euthanized cats. Many of these establishments used pre-medication. Sodium pentobarbital was mostly administered intravenously but some establishments also used intracardiac and intraperitoneal routes, and some only used intracardiac administration for cats. T-61 injection was the only method of euthanasia used by 23% of the establishments that euthanized dogs and 35% of the establishments that euthanized cats. All of these establishments used pre-medication, but the percentages of establishments that only used the intravenous route for administration of T-61 in dogs and cats were 45% and 7%, respectively. Further studies on the use of T-61, and the training and provision of counselling services for staff are recommended. PMID:21461208

  8. Intermittent Theta Burst Over M1 May Increase Peak Power of a Wingate Anaerobic Test and Prevent the Reduction of Voluntary Activation Measured with Transcranial Magnetic Stimulation

    PubMed Central

    Giboin, Louis-Solal; Thumm, Patrick; Bertschinger, Raphael; Gruber, Markus

    2016-01-01

    Despite the potential of repetitive transcranial magnetic stimulation (rTMS) to improve performances in patients suffering from motor neuronal afflictions, its effect on motor performance enhancement in healthy subjects during a specific sport task is still unknown. We hypothesized that after an intermittent theta burst (iTBS) treatment, performance during the Wingate Anaerobic Test (WAnT) will increase and supraspinal fatigue following the exercise will be lower in comparison to a control treatment. Ten subjects participated in two randomized experiments consisting of a WAnT 5 min after either an iTBS or a control treatment. We determined voluntary activation (VA) of the right knee extensors with TMS (VATMS) and with peripheral nerve stimulation (VAPNS) of the femoral nerve, before and after the WAnT. T-tests were applied to the WAnT results and a two way within subject ANOVA was applied to VA results. The iTBS treatment increased the peak power and the maximum pedalling cadence and suppressed the reduction of VATMS following the WAnT compared to the control treatment. No behavioral changes related to fatigue (mean power and fatigue index) were observed. These results indicate for the first time that iTBS could be used as a potential intervention to improve anaerobic performance in a sport specific task. PMID:27486391

  9. Euthanasia in patients dying at home in Belgium: interview study on adherence to legal safeguards

    PubMed Central

    Smets, Tinne; Bilsen, Johan; Van den Block, Lieve; Cohen, Joachim; Van Casteren, Viviane; Deliens, Luc

    2010-01-01

    Background Euthanasia became legal in Belgium in 2002. Physicians must adhere to legal due care requirements when performing euthanasia; for example, consulting a second physician and reporting each euthanasia case to the Federal Review Committee. Aim To study the adherence and non-adherence of GPs to legal due care requirements for euthanasia among patients dying at home in Belgium and to explore possible reasons for non-adherence. Design of study Large scale, retrospective study. Setting General practice in Belgium. Method A retrospective mortality study was performed in 2005–2006 using the nationwide Belgian Sentinel Network of General Practitioners. Each week GPs reported medical end-of-life decisions taken in all non-sudden deaths of patients in their practice. GP interviews were conducted for each euthanasia case occurring at home. Results Interviews were conducted for nine of the 11 identified euthanasia cases. Requirements concerning the patient's medical condition were met in all cases. Procedural requirements such as consultation of a second physician were sometimes ignored. Euthanasia cases were least often reported (n = 4) when the physician did not regard the decision as euthanasia, when only opioids were used to perform euthanasia, or when no second physician was consulted. Factors that may contribute to explaining non-adherence to the euthanasia law included: being unaware of which practices are considered to be euthanasia; insufficient knowledge of the euthanasia law; and the fact that certain procedures are deemed burdensome. Conclusion Substantive legal due care requirements for euthanasia concerning the patient's request for euthanasia and medical situation were almost always met by GPs in euthanasia cases. Procedural consultation and reporting requirements were not always met. PMID:20353662

  10. Ethics policies on euthanasia in nursing homes: a survey in Flanders, Belgium.

    PubMed

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Verbeke, Geert; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris

    2008-01-01

    In many European countries there is a public debate about the acceptability and regulation of euthanasia. In 2002, Belgium became the second country after the Netherlands to enact a law on euthanasia. Although euthanasia rarely occurs, the complexity of the clinical-ethical decision making surrounding euthanasia requests and the need for adequate support reported by caregivers, means that healthcare institutions increasingly need to consider how to responsibly handle euthanasia requests. The development of written ethics policies on euthanasia may be important to guarantee and maintain the quality of care for patients requesting euthanasia. The aim of this study was to determine the prevalence, development, position, and communication of written ethics policies on euthanasia in Flemish nursing homes. Data were obtained through a cross-sectional mail survey of general directors of all Catholic nursing homes in Flanders, Belgium. Of the 737 nursing homes invited to participate, 612 (83%) completed the questionnaire. Of these, only 15% had a written ethics policy on euthanasia. Presence of an ethics committee and membership of an umbrella organization were independent predictors of whether a nursing home had such a written ethics policy. The Act on Euthanasia and euthanasia guidelines advanced by professional organizations were the most frequent reasons (76% and 56%, respectively) and reference sources (92% and 64%, respectively) for developing ethics policies on euthanasia. Development of ethics policies occurred within a multidisciplinary context. In general, Flemish nursing homes applied the Act on Euthanasia restrictively by introducing palliative procedures in addition to legal due care criteria. The policy was communicated to the consulting general practitioner and nurses in 74% and 89% of nursing homes, respectively. Although the overall prevalence of ethics policies on euthanasia was low in Flemish nursing homes, institution administrators displayed growing

  11. Meseritz-Obrawalde: a 'wild euthanasia' hospital of Nazi Germany.

    PubMed

    Benedict, Susan; Chelouche, Tessa

    2008-03-01

    In 1939, Hitler authorized a programme of 'euthanasia' of children and adults with physical and psychiatric disorders. Initially, gas chambers were established at six psychiatric institutions in Germany and Austria. This programme was discontinued in August 1941 but the killings continued on an individual basis. Physicians selected patients who were unable to work or who required extensive care, and ordered the nurses to administer lethal doses of sedatives. Meseritz-Obrawalde was a site for 10,000 of these killings. Using documents from the trial of one of Obrawalde's physicians, Hilde Wernicke, the era of 'wild euthanasia' is described and her rationale for participating in the killings is explored. PMID:19127829

  12. Euthanasia: how proponents justify it and provide models for regulation.

    PubMed

    Daruwala, Anhaita

    2002-01-01

    Life prolonging advances in medicine have raised debate about the concept and clinical practice of euthanasia for terminally ill patients. This debate involves the need for protection of patients' rights in their delicate condition, while providing them with the right to end their own life, if they choose to do so. This paper addresses how proponents justify euthanasia in societies that have legalized it, while ensuring that patients asking for a merciful death do not get exploited by the system. Regulation models are thus adapted from the Dutch and Oregon medical systems. PMID:12755102

  13. 16 CFR 1031.8 - Voluntary Standards Coordinator.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Voluntary Standards Coordinator. 1031.8 Section 1031.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  14. 16 CFR 1031.8 - Voluntary Standards Coordinator.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Voluntary Standards Coordinator. 1031.8 Section 1031.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  15. 16 CFR 1031.8 - Voluntary Standards Coordinator.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Voluntary Standards Coordinator. 1031.8 Section 1031.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  16. Assessment of voluntary exercise behavior and active video gaming among adolescent and young adult patients during hematopoietic stem cell transplantation.

    PubMed

    Rosipal, Nicole C; Mingle, Lindsay; Smith, Janet; Morris, G Stephen

    2013-01-01

    This pilot study sought to examine the exercise behavior and preferences among adolescent and young adult (AYA) hematopoietic stem cell transplant (HSCT) recipients. Eighteen patients aged 19 to 25 years were recruited to engage in unsupervised exercise activities lasting at least 60 minutes/week during hospitalization for HSCT. Enrolled patients had access to standard exercise activities (walking, resistance training, and basketball) and active video gaming equipment. Physical function (6-Minute Walk Test and Timed-Up-and-Go test) and quality of life (Behavioral, Affective, and Somatic Experiences Scale) were assessed at different time points during admission. Participants exercised an average of 76% of the days during admission and spent an average of 36.5 minutes per day exercising. The Nintendo Wii was the preferred active video gaming equipment, but standard exercises accounted for 73% of all exercise time. Neither functional capacity nor quality of life improved. Results suggest that AYAs voluntarily exercise during HSCT admission, prefer to use standard exercise activities, and may require supervision in order to derive maximum benefits from their efforts. These results provide guidance for developing rehabilitation interventions for AYA HSCT recipients. PMID:23160792

  17. Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

    PubMed

    Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

    2014-11-01

    Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian

  18. Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

    PubMed Central

    Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

    2014-01-01

    Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian

  19. The complexity of nurses' attitudes toward euthanasia: a review of the literature

    PubMed Central

    Berghs, M; d Dierckx; Gastmans, C

    2005-01-01

    In this literature review, a picture is given of the complexity of nursing attitudes toward euthanasia. The myriad of data found in empirical literature is mostly framed within a polarised debate and inconclusive about the complex reality behind attitudes toward euthanasia. Yet, a further examination of the content as well as the context of attitudes is more revealing. The arguments for euthanasia have to do with quality of life and respect for autonomy. Arguments against euthanasia have to do with non-maleficence, sanctity of life, and the notion of the slippery slope. When the context of attitudes is examined a number of positive correlates for euthanasia such as age, nursing specialty, and religion appear. In a further analysis of nurses' comments on euthanasia, it is revealed that part of the complexity of nursing attitudes toward euthanasia arises because of the needs of nurses at the levels of clinical practice, communication, emotions, decision making, and ethics. PMID:16076966

  20. Euthanasia Method for Mice in Rapid Time-Course Pulmonary Pharmacokinetic Studies

    PubMed Central

    Schoell, Adam R; Heyde, Bruce R; Weir, Dana E; Chiang, Po-Chang; Hu, Yiding; Tung, David K

    2009-01-01

    To develop a means of euthanasia to support rapid time-course pharmacokinetic studies in mice, we compared retroorbital and intravenous lateral tail vein injection of ketamine–xylazine with regard to preparation time, utility, tissue distribution, and time to onset of euthanasia. Tissue distribution and time to onset of euthanasia did not differ between administration methods. However, retroorbital injection could be performed more rapidly than intravenous injection and was considered to be a technically simple and superior alternative for mouse euthanasia. Retroorbital ketamine–xylazine, CO2 gas, and intraperitoneal pentobarbital then were compared as euthanasia agents in a rapid time-point pharmacokinetic study. Retroorbital ketamine–xylazine was the most efficient and consistent of the 3 methods, with an average time to death of approximately 5 s after injection. In addition, euthanasia by retroorbital ketamine–xylazine enabled accurate sample collection at closely spaced time points and satisfied established criteria for acceptable euthanasia technique. PMID:19807971

  1. Euthanasia method for mice in rapid time-course pulmonary pharmacokinetic studies.

    PubMed

    Schoell, Adam R; Heyde, Bruce R; Weir, Dana E; Chiang, Po-Chang; Hu, Yiding; Tung, David K

    2009-09-01

    To develop a means of euthanasia to support rapid time-course pharmacokinetic studies in mice, we compared retroorbital and intravenous lateral tail vein injection of ketamine-xylazine with regard to preparation time, utility, tissue distribution, and time to onset of euthanasia. Tissue distribution and time to onset of euthanasia did not differ between administration methods. However, retroorbital injection could be performed more rapidly than intravenous injection and was considered to be a technically simple and superior alternative for mouse euthanasia. Retroorbital ketamine-xylazine, CO(2) gas, and intraperitoneal pentobarbital then were compared as euthanasia agents in a rapid time-point pharmacokinetic study. Retroorbital ketamine-xylazine was the most efficient and consistent of the 3 methods, with an average time to death of approximately 5 s after injection. In addition, euthanasia by retroorbital ketamine-xylazine enabled accurate sample collection at closely spaced time points and satisfied established criteria for acceptable euthanasia technique. PMID:19807971

  2. 25 CFR 38.14 - Voluntary services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services on behalf of Bureau schools from the private sector, including individuals, groups, or students. Voluntary service shall be for all non-hazardous activities where public services, special projects, or school operations are improved and enhanced. Volunteer service is limited to personal services...

  3. Voluntary pollution reduction programs

    SciTech Connect

    Sears, E.B.

    1997-08-01

    Despite claims that the government is reducing the amount of environmental regulation, the sheer amount of regulatory language has actually increased yearly. Yet based on media reports and citizen claims, pollution appears to go unchecked. Citizens condemn a perceived lack of government regulation of industrial pollution, while industries find themselves mired in increasingly complex regulatory programs that are sometimes far removed from real world situations. US Environmental Protection Agency (EPA) decision-makers have responded to these concerns by designing regulatory programs that abandon traditional command-and-control regulatory schemes as ill-suited to today`s pollution problems and the interests of these stakeholders. This paper analyzes the use of voluntary pollution control programs in place of command-and-control regulation. It is proposed that voluntary programs may serve as carrots to entice regulated entities to reduce pollution, but that there are a number of hurdles to their effective implementation that preclude them from being embraced as effective environmental regulatory tools. This paper reviews why agencies have moved from command-and-control regulation and examines current voluntary pollution control programs. This paper also contemplates the future of such programs.

  4. The prospects for nursing if euthanasia is legalized.

    PubMed

    Banaszak, A

    As the debate about the legalization of euthanasia continues, Antoni Banaszak examines the professional and legal implications for nurses. He argues that the case of the Netherlands could be a model for a possible way forward for the UK, but that nurses would need to be appropriately trained and protected. PMID:10633706

  5. The "Lethal Chamber": Further Evidence of the Euthanasia Option.

    ERIC Educational Resources Information Center

    Elks, Martin A.

    1993-01-01

    Historical discussions of the euthanasia or "lethal chamber" option in relation to people with mental retardation are presented. The paper concludes that eugenic beliefs in the primacy of heredity over environment and the positive role of natural selection may have condoned the poor conditions characteristic of large, segregated institutions and…

  6. Validation of the Chinese Expanded Euthanasia Attitude Scale

    ERIC Educational Resources Information Center

    Chong, Alice Ming-Lin; Fok, Shiu-Yeu

    2013-01-01

    This article reports the validation of the Chinese version of an expanded 31-item Euthanasia Attitude Scale. A 4-stage validation process included a pilot survey of 119 college students and a randomized household survey with 618 adults in Hong Kong. Confirmatory factor analysis confirmed a 4-factor structure of the scale, which can therefore be…

  7. Euthanasia in Greece: Greek nurses' involvement and beliefs.

    PubMed

    Patelarou, Evridiki; Vardavas, Constantine I; Fioraki, Ioanna; Alegakis, Thanasis; Dafermou, Maria; Ntzilepi, Penelope

    2009-05-01

    Euthanasia has become a prominent social and ethical issue in which nurses play an important role. This study evaluated, for the first time in Greece, the acceptance and enactment of passive euthanasia among Greek nursing staff, measured in relation to the type of patients cared for. Passive euthanasia, illegal in Greece, is defined as either withdrawing or withholding life-sustaining treatment. Fifty-one per cent responded that they would not be willing to withhold life-sustaining treatment if legalized, while almost 30% responded that they had withheld life-sustaining treatment from a patient at least once in the past; specifically 47.7% of intensive care unit nurses (OR 8.2; 95% CI: 1.6-41.3), 20% of cancer ward nurses (OR 2.7; 95% CI: 0.5-15.6) and 8.3% of other nurses from other wards (P = 0.001). Age, gender and self-reported levels of religiosity among Greek nurses were not found to affect statistically any variable regarding euthanasia and its enactment. PMID:19491750

  8. Gas alternatives to carbon dioxide for euthanasia: A piglet perspective

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The identification and validation of a humane method to euthanize piglets is critical to address concern that current methods are not acceptable. This research sought to: 1) identify a method of scientifically determining if pigs find a specific euthanasia method aversive, and 2) develop an innovati...

  9. Attitudes of Catholic and Protestant Clergy Toward Euthanasia

    ERIC Educational Resources Information Center

    Nagi, Mostafa H.; And Others

    1977-01-01

    Even though Catholic and Protestant clergymen, in about the same proportions, tend to see the terminal patient as competent to make decisions concerning euthanasia, the two groups, strongly agree that neither the individual patient nor the state should be allowed sole responsibility for the decision. (Author)

  10. Using voluntary motor commands to inhibit involuntary arm movements.

    PubMed

    Ghosh, Arko; Rothwell, John; Haggard, Patrick

    2014-11-01

    A hallmark of voluntary motor control is the ability to stop an ongoing movement. Is voluntary motor inhibition a general neural mechanism that can be focused on any movement, including involuntary movements, or is it mere termination of a positive voluntary motor command? The involuntary arm lift, or 'floating arm trick', is a distinctive long-lasting reflex of the deltoid muscle. We investigated how a voluntary motor network inhibits this form of involuntary motor control. Transcranial magnetic stimulation of the motor cortex during the floating arm trick produced a silent period in the reflexively contracting deltoid muscle, followed by a rebound of muscle activity. This pattern suggests a persistent generator of involuntary motor commands. Instructions to bring the arm down voluntarily reduced activity of deltoid muscle. When this voluntary effort was withdrawn, the involuntary arm lift resumed. Further, voluntary motor inhibition produced a strange illusion of physical resistance to bringing the arm down, as if ongoing involuntarily generated commands were located in a 'sensory blind-spot', inaccessible to conscious perception. Our results suggest that voluntary motor inhibition may be a specific neural function, distinct from absence of positive voluntary motor commands. PMID:25253453

  11. The Extension of Belgium's Euthanasia Law to Include Competent Minors.

    PubMed

    Raus, Kasper

    2016-06-01

    Following considerable debate, the practice of euthanasia was legalized in Belgium in 2002, thereby making Belgium one of the few places in the world where this practice is legal. In 2014 the law was amended for the first time. The 2014 amendment makes euthanasia legally possible for all minors who repeatedly and voluntarily request euthanasia and who are judged to possess "capacity of discernment" (regardless of their biological age), as well as fulfil a number of other criteria of due care. This extension of the 2002 euthanasia law generated a lot of national and international debate and has been applauded by many and heavily criticized by others. This evolution is clearly of interest to end-of-life debates in the entire world. This paper will therefore describe how this amendment came to get passed using official documents from Belgium's Senate and Chamber of Representatives where this amendment was discussed and subsequently passed. Next, some of the most commonly given arguments in favour of the law are identified, as well as the arguments most often voiced against the amendment. All these arguments will be expanded upon and it will be examined whether they hold up to ethical scrutiny. Analysing the official documents and identifying the most commonly voiced arguments gives valuable insight into how Belgium came to amend its euthanasia law and why it did so in 2014. It also becomes clear that although the current amendment is often seen as far-reaching, more radical ideas were proposed during the drafting of the law. Also, in analysing those arguments in favour of the amendment and those against, it is clear that the validity of some of these is questionable. PMID:26842904

  12. Health promotion: private voluntary organisations in action.

    PubMed

    Arnold, J P

    1998-01-01

    Since the country's independence in 1947, India has come a long way in its efforts to improve health services. One initiative taken by the Government is the involvement of private voluntary organizations (PVOs) in the health promotion activity. Several grant-in-aid schemes have been initiated, whereby PVOs obtain government funding for the provision of services and the promotion of health and family welfare activities. The US Agency for International Development has supported the government in this endeavor. Keeping these in mind, Tamil Nadu Voluntary Health Association, a state-level association of voluntary health organizations such as hospitals, dispensaries and community-based health organizations, worked out a proposal for support and collaboration with the Government of India. This association aims to promote health through networking and coordinating with voluntary organizations, strengthening of nongovernmental organization activities, collection and dissemination of relevant information, lobbying, campaigning and liaisoning for health issues. This article highlights the experience of the Association in conceiving and carrying out its proposal/project. In particular, it describes the planning and implementation of the Integrated Project for Development of Primary Health Care and Women's Welfare in Tamil Nadu as well as the achievements of the project. The main goal of this project is to coordinate with various levels of health services to improve the health status of rural Tamil Nadu. PMID:12349576

  13. Voluntary palliated starvation: a lawful and ethical way to die?

    PubMed

    White, Ben; Willmott, Lindy; Savulescu, Julian

    2014-12-01

    Increasingly, individuals want control over their own destiny. This includes the way in which they die and the timing of their death. The desire for self-determination at the end of life is one of the drivers for the ever-increasing number of jurisdictions overseas that are legalising voluntary euthanasia and/or assisted suicide, and for the continuous attempts to reform State and Territory law in Australia. Despite public support for law reform in this field, legislative change in Australia is unlikely in the near future given the current political landscape. This article argues that there may be another solution which provides competent adults with control over their death and to have any pain and symptoms managed by doctors, but which is currently lawful and consistent with prevailing ethical principles. "Voluntary palliated starvation" refers to the process which occurs when a competent individual chooses to stop eating and drinking, and receives palliative care to address pain, suffering and symptoms that may be experienced by the individual as he or she approaches death. The article argues that, at least in some circumstances, such a death would be lawful for the individual and doctors involved, and consistent with principles of medical ethics. PMID:25715538

  14. Management of death, dying and euthanasia: attitudes and practices of medical practitioners in South Australia.

    PubMed

    Stevens, C A; Hassan, R

    1994-03-01

    This article presents the first results of a study of the decisions made by health professionals in South Australia concerning the management of death, dying, and euthanasia, and focuses on the findings concerning the attitudes and practices of medical practitioners. Mail-back, self-administered questionnaires were posted in August 1991 to a ten per cent sample of 494 medical practitioners in South Australia randomly selected from the list published by the Medical Board of South Australia. A total response rate of 68 per cent was obtained, 60 per cent of which (298) were usable returns. It was found that forty-seven per cent had received requests from patients to hasten their deaths. Nineteen per cent had taken active steps which had brought about the death of a patient. Sixty-eight per cent thought that guidelines for withholding and withdrawal of treatment should be established. Forty-five per cent were in favour of legalisation of active euthanasia under certain circumstances. PMID:8035439

  15. Voluntary motor commands reveal awareness and control of involuntary movement.

    PubMed

    De Havas, Jack; Ghosh, Arko; Gomi, Hiroaki; Haggard, Patrick

    2016-10-01

    The capacity to inhibit actions is central to voluntary motor control. However, the control mechanisms and subjective experience involved in voluntarily stopping an involuntary movement remain poorly understood. Here we examined, in humans, the voluntary inhibition of the Kohnstamm phenomenon, in which sustained voluntary contraction of shoulder abductors is followed by involuntary arm raising. Participants were instructed to stop the involuntary movement, hold the arm in a constant position, and 'release' the inhibition after ∼2s. Participants achieved this by modulating agonist muscle activity, rather than by antagonist contraction. Specifically, agonist muscle activity plateaued during this voluntary inhibition, and resumed its previous increase thereafter. There was no discernible antagonist activation. Thus, some central signal appeared to temporarily counter the involuntary motor drive, without directly affecting the Kohnstamm generator itself. We hypothesise a form of "negative motor command" to account for this novel finding. We next tested the specificity of the negative motor command, by inducing bilateral Kohnstamm movements, and instructing voluntary inhibition for one arm only. The results suggested negative motor commands responsible for inhibition are initially broad, affecting both arms, and then become focused. Finally, a psychophysical investigation found that the perceived force of the aftercontraction was significantly overestimated, relative to voluntary contractions with similar EMG levels. This finding is consistent with the hypothesis that the Kohnstamm generator does not provide an efference copy signal. Our results shed new light on this interesting class of involuntary movement, and provide new information about voluntary inhibition of action. PMID:27399155

  16. Family planning and voluntary workers.

    PubMed

    Bhende, A

    1968-01-01

    The Family Planning Communication Action Research Projects at the Demographic Training and Research Centre, DTRC, Bombay, and the Planning Research and Action Institute (PRAI) Lucknow, provide guidelines for implementation of a program in which voluntary workers play an important role. DTRC has concentrated on urban areas and PRAI on rural areas. In selecting the volunteers, emphasis is on involving those who are already active in community affairs, or those who wield some degree of influence. In rural areas, the literacy level of the leaders is an important factor, as well as those who have a wide circle of acquaintances. The training programs conducted by the DTRC are for 3-5 days, covering 6-10 hours, and the involvement of some local association is always sought. It is found that an informal, permissive atmosphere, the use of visual aids, the distribution of reference material, and the lecture and group discussion methods are effective in orienting the participants to family planning educational activities. The PRAI trains the workers 1st through individual visits, and then when a good number have participated for 3 or 4 months, a training camp is organized. When high officials attend and address these camps, and when certificates and badges are distributed, it serves to keep up the enthusiasm. The main problem in both urban and rural area are sustaining the interest of the volunteer and involving men as volunteers. Where cash incentives are not feasible, newspaper and radio publicity is effective, and words of recognition and appreciation also help. Where male volunteers are involved, it is found that they can work well in their places of employment rather than in residential communities. In highly cosmopolitan areas, various linquestic groups live side by side, and it is necessary to enroll voluntary workers from the individual groups. PMID:12338667

  17. [Similarities and differences between the euthanasia laws in Belgium and the Netherlands].

    PubMed

    Deliens, L; van der Wal, G

    2003-01-25

    Recently, a law on euthanasia has been adopted in both the Netherlands and Belgium. In both countries euthanasia has been legalized under strict conditions and after confirmation with a notification procedure. Although both laws are similar, the Belgian law is more extensive on the requirements of prudent practice. On the other hand, in Dutch society the norm-setting on euthanasia has been more widely developed through jurisprudence. Nevertheless, we expect that the implementation of the new law and the notification procedure in Belgium will be more difficult than in the Netherlands. In order to promote, safeguard and guarantee the quality of the euthanasia practice, the present euthanasia notification procedure in the Netherlands is supplemented with feedback to the physicians. The strict anonymous procedure in the Belgian notification procedure prevents this possibility. Therefore, Belgian physicians will not be supported by the notification procedure to improve their knowledge and skills in euthanasia. PMID:12635551

  18. Operant Variability and Voluntary Action

    ERIC Educational Resources Information Center

    Neuringer, Allen; Jensen, Greg

    2010-01-01

    A behavior-based theory identified 2 characteristics of voluntary acts. The first, extensively explored in operant-conditioning experiments, is that voluntary responses produce the reinforcers that control them. This bidirectional relationship--in which reinforcer depends on response and response on reinforcer--demonstrates the functional nature…

  19. Voluntary Simplicity: A Lifestyle Option.

    ERIC Educational Resources Information Center

    Pestle, Ruth E.

    This guide provides practical ideas for incorporating the concept of voluntary simplicity into home economics classes. Discussed in the first chapter are the need to study voluntary simplicity, its potential contributions to home economics, and techniques and a questionnaire for measuring student attitudes toward the concept. The remaining…

  20. Benefits of voluntary industry standards: The triumph of experience over regulation

    SciTech Connect

    O`Leary, J.T.

    1996-12-31

    Voluntary international standards for mining machinery may gradually replace many national regulations. The days of establishing voluntary standards nation by nation, inhibiting the important flow of international trade, could be numbered. This does not mean that nations will cease domestic regulatory activities within their boundaries, but rulemaking will pay considerable attention to voluntary international standards and will likely strive for compatibility with voluntary international standards. International standards setting bodies are developing standards for machine safety. When these standards are complete and adopted, some nations will require machinery to comport with them. International commerce in products that do not conform to these voluntary international standards may be discouraged.

  1. Nurses' views on their involvement in euthanasia: a qualitative study in Flanders (Belgium)

    PubMed Central

    de Casterlé, B Dierckx; Verpoort, C; De Bal, N; Gastmans, C

    2006-01-01

    Background Although nurses worldwide are confronted with euthanasia requests from patients, the views of palliative care nurses on their involvement in euthanasia remain unclear. Objectives In depth exploration of the views of palliative care nurses on their involvement in the entire care process surrounding euthanasia. Design A qualitative Grounded Theory strategy was used. Setting and participants In anticipation of new Belgian legislation on euthanasia, we conducted semistructured interviews with 12 nurses working in a palliative care setting in the province of Vlaams‐Brabant (Belgium). Results Palliative care nurses believed unanimously that they have an important role in the process of caring for a patient who requests euthanasia, a role that is not limited to assisting the physician when he is administering life terminating drugs. Nurses' involvement starts when the patient requests euthanasia and ends with supporting the patient's relatives and healthcare colleagues after the potential life terminating act. Nurses stressed the importance of having an open mind and of using palliative techniques, also offering a contextual understanding of the patient's request in the decision making process. Concerning the actual act of performing euthanasia, palliative care nurses saw their role primarily as assisting the patient, the patient's family, and the physician by being present, even if they could not reconcile themselves with actually performing euthanasia. Conclusions Based on their professional nursing expertise and unique relationship with the patient, nurses participating as full members of the interdisciplinary expert team are in a key position to provide valuable care to patients requesting euthanasia. PMID:16574869

  2. Euthanasia assessment in ebola virus infected nonhuman primates.

    PubMed

    Warren, Travis K; Trefry, John C; Marko, Shannon T; Chance, Taylor B; Wells, Jay B; Pratt, William D; Johnson, Joshua C; Mucker, Eric M; Norris, Sarah L; Chappell, Mark; Dye, John M; Honko, Anna N

    2014-11-01

    Multiple products are being developed for use against filoviral infections. Efficacy for these products will likely be demonstrated in nonhuman primate models of filoviral disease to satisfy licensure requirements under the Animal Rule, or to supplement human data. Typically, the endpoint for efficacy assessment will be survival following challenge; however, there exists no standardized approach for assessing the health or euthanasia criteria for filovirus-exposed nonhuman primates. Consideration of objective criteria is important to (a) ensure test subjects are euthanized without unnecessary distress; (b) enhance the likelihood that animals exhibiting mild or moderate signs of disease are not prematurely euthanized; (c) minimize the occurrence of spontaneous deaths and loss of end-stage samples; (d) enhance the reproducibility of experiments between different researchers; and (e) provide a defensible rationale for euthanasia decisions that withstands regulatory scrutiny. Historic records were compiled for 58 surviving and non-surviving monkeys exposed to Ebola virus at the US Army Medical Research Institute of Infectious Diseases. Clinical pathology parameters were statistically analyzed and those exhibiting predicative value for survival are reported. These findings may be useful for standardization of objective euthanasia assessments in rhesus monkeys exposed to Ebola virus and may serve as a useful approach for other standardization efforts. PMID:25421892

  3. Organ Donation After Euthanasia: A Dutch Practical Manual.

    PubMed

    Bollen, J; de Jongh, W; Hagenaars, J; van Dijk, G; Ten Hoopen, R; Ysebaert, D; Ijzermans, J; van Heurn, E; van Mook, W

    2016-07-01

    Many physicians and patients do not realize that it is legally and medically possible to donate organs after euthanasia. The combination of euthanasia and organ donation is not a common practice, often limited by the patient's underlying pathology, but nevertheless has been performed >40 times in Belgium and the Netherlands since 2005. In anticipation of patients' requests for organ donation after euthanasia and contributing to awareness of the possibility of this combination among general practitioners and medical specialists, the Maastricht University Medical Center and the Erasmus University Medical Center Rotterdam have developed a multidisciplinary practical manual in which the organizational steps regarding this combined procedure are described and explained. This practical manual lists the various criteria to fulfill and the rules and regulations the different stakeholders involved need to comply with to meet all due diligence requirements. Although an ethicist was involved in writing this paper, this report is not specifically meant to comprehensively address the ethical issues surrounding the topic. This paper is focused on the operational aspects of the protocol. PMID:26842128

  4. 27 CFR 19.691 - Voluntary destruction.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., State, and local environmental laws and regulations. (e) Record of destruction. The proprietor shall... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Voluntary destruction. 19... Voluntary Destruction Voluntary Destruction § 19.691 Voluntary destruction. (a) General. Spirits,...

  5. 12 CFR 627.2795 - Voluntary liquidation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Voluntary liquidation. 627.2795 Section 627.2795 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM TITLE IV CONSERVATORS, RECEIVERS, AND VOLUNTARY LIQUIDATIONS Voluntary Liquidation § 627.2795 Voluntary liquidation. (a) A Farm...

  6. Voluntary Support of Education 1987-1988.

    ERIC Educational Resources Information Center

    Council for Aid to Education, New York, NY.

    The 29th edition of a publication featuring statistics on voluntary support of education is presented. Three sections have the following titles: (1) "Colleges and Universities" (including national estimates of expenditures and voluntary support, and survey results noting voluntary support by type of institution, voluntary support by source,…

  7. The Notion of Voluntary Unemployment.

    ERIC Educational Resources Information Center

    Standing, Guy

    1981-01-01

    Considers the distinction between voluntary and involuntary unemployment by analyzing six behavioral characteristics attributed to groups of workers suspected of indulging in the former, and the labor market mechanisms supposedly encouraging them. (Author/CT)

  8. Organization position statements and the stance of "studied neutrality" on euthanasia in palliative care.

    PubMed

    Johnstone, Megan-Jane

    2012-12-01

    In recent years, palliative care and related organizations have increasingly adopted a stance of "studied neutrality" on the question of whether euthanasia should be legalized as a bona fide medical regimen in palliative care contexts. This stance, however, has attracted criticism from both opponents and proponents of euthanasia. Pro-euthanasia activists see the stance as an official position of indecision that is fundamentally disrespectful of a patient's right to "choose death" when life has become unbearable. Some palliative care constituents, in turn, are opposed to the stance, contending that it reflects an attitude of "going soft" on euthanasia and as weakening the political resistance that has hitherto been successful in preventing euthanasia from becoming more widely legalized. In this article, attention is given to examining critically the notion and possible unintended consequences of adopting a stance of studied neutrality on euthanasia in palliative care. It is argued that although palliative care and related organizations have an obvious stake in the outcome of the euthanasia debate, it is neither unreasonable nor inconsistent for such organizations to be unwilling to take a definitive stance on the issue. It is further contended that, given the long-standing tenets of palliative care, palliative care organizations have both a right and a responsibility to defend the integrity of the principles and practice of palliative care and to resist demands for euthanasia to be positioned either as an integral part or logical extension of palliative care. PMID:22771130

  9. The Debreather: A Report on Euthanasia and Suicide Assistance Using Adapted Scuba Technology

    ERIC Educational Resources Information Center

    Ogden, Russel D.

    2010-01-01

    In response to the general prohibition of euthanasia and assisted suicide, some right-to-die activists have developed non-medical methods to covertly hasten death. One such method is a "debreather," a closed system breathing device that laypersons can use to induce hypoxia for persons seeking euthanasia or assisted suicide. This article presents…

  10. The distinct role of performing euthanasia on depression and suicide in veterinarians.

    PubMed

    Tran, Lily; Crane, Monique F; Phillips, Jacqueline K

    2014-04-01

    Veterinarians are more likely to experience mood disorders and suicide than other occupational groups (Fritschi, Morrison, Shirangi & Day, 2009; Platt, Hawton, Simkin, & Mellanby, 2010). The performance of euthanasia has been implicated as contributing determinately to the prevalence of suicide risk and psychological distress in veterinarians (Bartram & Baldwin, 2008, 2010). In contrast, the application of psychological approaches would suggest a possible protective role for euthanasia administration. This paper is the first to investigate the association between euthanasia-administration frequency and depressed mood and suicide risk. A cross-sectional survey sampled 540 Australia-registered veterinarians (63.8% women), ranging in age from 23 to 74. Results revealed that the administration of objectionable euthanasia (i.e., euthanasia that the veterinarian disagreed with) was not related to our mental health variables. In contrast, overall euthanasia frequency had a weak positive linear relationship with depression. Moreover, overall euthanasia frequency moderated the impact of depression on suicide risk. The nature of this moderation suggested that average frequency per week of performing euthanasia attenuated the relationship between depressed mood and suicide risk. The implications of these findings and directions for further research are discussed. PMID:24635739

  11. Treatment or Involuntary Euthanasia for Severely Handicapped Newborns: Issues of Philosophy and Public Policy.

    ERIC Educational Resources Information Center

    Powell, T. Hennessy; And Others

    1982-01-01

    Recent reports have indicated that parents and/or physicians occasionally decide not to provide life-sustaining treatment (referred to as involuntary euthanasia), thus ensuring that the severely handicapped newborn will die. The issues involved relative to treatment or involuntary euthanasia are reviewed from two opposing perspectives…

  12. The spinal reflex cannot be perceptually separated from voluntary movements.

    PubMed

    Ghosh, Arko; Haggard, Patrick

    2014-01-01

    Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions. Volunteers reported the reflexive contribution in leg movements that were partly driven by the knee-jerk reflex induced by a patellar tendon tap and partly by voluntary motor control. In one condition, participants were instructed to kick back in response to a tendon tap. The results were compared to reflexes in a resting baseline condition without voluntary movement. In a further condition, participants were instructed to kick forwards after a tap. Volunteers reported the perceived reflex contribution by repositioning the leg to the perceived maximum displacement to which the reflex moved the leg after each tendon tap. In the resting baseline condition, the reflex was accurately perceived. We found a near-unity slope of linear regressions of perceived on actual reflexive displacement. Both the slope value and the quality of regression fit in individual volunteers were significantly reduced when volunteers were instructed to generate voluntary backward kicks as soon as they detected the tap. In the kick forward condition, kinematic analysis showed continuity of reflex and voluntary movements, but the reflex contribution could be estimated from electromyography (EMG) recording on each trial. Again, participants' judgements of reflexes showed a poor relation to reflex EMG, in contrast to the baseline condition. In sum, we show that reflexes can be accurately perceived from afferent information. However

  13. Voluntary GHG reduction in the US electric industry

    SciTech Connect

    2005-11-15

    The report is a study of efforts by members of the industry to voluntarily reduce their greenhouse gas emission. Dozens of US utilities are leveraging voluntary greenhouse gas (GHG) emissions reduction programs to help develop cost-effective plans for responding to future potential regulation. Many of these utilities are taking aggressive steps to reduce their GHG emissions and positioning themselves as leaders. They are participating in voluntary programs for reasons ranging from pressure by environmental groups and investors to a desire for a stronger voice in shaping climate change policy. The report takes a comprehensive look at what is driving these voluntary efforts, what government and industry help is available to support them, and what specific activities are being undertaken to reduce GHG emissions. It explains the features of the most prominent voluntary utility programs to help companies determine which might best suit their needs. 1 app.

  14. Prevalence of Formal Accusations of Murder and Euthanasia against Physicians

    PubMed Central

    Cohen, Lewis M.; Arnold, Robert M.; Goy, Elizabeth; Arons, Stephen; Ganzini, Linda

    2012-01-01

    Abstract Background Little is known about how often physicians are formally accused of hastening patient deaths while practicing palliative care. Methods We conducted an Internet-based survey on a random 50% sample of physician-members of a national hospice and palliative medicine society. Results The final sample consisted of 663 physicians (response rate 53%). Over half of the respondents had had at least one experience in the last 5 years in which a patient's family, another physician, or another health care professional had characterized palliative treatments as being euthanasia, murder, or killing. One in four stated that at least one friend or family member, or a patient had similarly characterized their treatments. Respondents rated palliative sedation and stopping artificial hydration/nutrition as treatments most likely to be misconstrued as euthanasia. Overall, 25 physicians (4%) had been formally investigated for hastening a patient's death when that had not been their intention—13 while using opiates for symptom relief and six for using medications while discontinuing mechanical ventilation. In eight (32%) cases, another member of the health care team had initiated the charges. At the time of the survey, none had been found guilty, but they reported experiencing substantial anger and worry. Conclusions Commonly used palliative care practices continue to be misconstrued as euthanasia or murder, despite this not being the intention of the treating physician. Further efforts are needed to explain to the health care community and the public that treatments often used to relieve patient suffering at the end of life are ethical and legal. PMID:22401355

  15. Euthanasia, moral stress, and chronic illness in veterinary medicine.

    PubMed

    Rollin, Bernard E

    2011-05-01

    Euthanasia is a double-edged sword in veterinary medicine. It is a powerful and ultimately the most powerful tool for ending the pain and suffering. Demand for its use for client convenience is morally reprehensible and creates major moral stress for ethically conscious practitioners. But equally reprehensible and stressful to veterinarians is the failure to use it when an animal faces only misery, pain, distress, and suffering. Finding the correct path through this minefield may well be the most important ethical task facing the conscientious veterinarian. PMID:21601753

  16. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study

    PubMed Central

    Kamath, Sneha; Bhate, Priya; Mathew, Ginu; Sashidharan, Srijith; Daniel, Anjali B

    2011-01-01

    Context: Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. Aim: This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. Settings and Design: A cross-sectional survey of 213 doctors working at a tertiary care hospital was conducted to determine their attitudes toward euthanasia. Materials and Methods: A self-administered questionnaire was used to assess attitudes and personal perceptions about euthanasia. Statistical Analysis Used: The Chi square test was used to assess factors influencing attitudes toward euthanasia. Results: A majority of the respondents (69.3%) supported the concept of euthanasia. Relief from unbearable pain and suffering was the most commonly (80.3%) cited reason for being willing to consider the option of euthanasia. Majority of those who were against euthanasia (66.2%) felt that the freedom to perform euthanasia could easily be misused. Disapproval of euthanasia was associated with religious affiliation (P<0.001) and speciality (P<0.001). Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia. PMID:22346044

  17. Cardiovascular effects of thoracic compression in horses subjected to euthanasia.

    PubMed

    Hubbell, J A; Muir, W W; Gaynor, J S

    1993-07-01

    Six horses scheduled for euthanasia were instrumented for the measurement of blood flow by thermodilution, pulmonary arterial, right atrial and arterial blood pressures and collection of arterial blood for pH and blood gas analysis. The horses were anaesthetised with intravenous (iv) thiamylal sodium (10 mg/kg) and placed in right lateral recumbency. After euthanasia with an overdose of pentobarbitone sodium (100 mg/kg, iv) and loss of the electrocardiogram and arterial pulse pressure, thoracic compression at rates of 40, 60 and 80 compressions/min was instituted. Thoracic compression was accomplished by an investigator who delivered a blow to the chest wall with his knee while dropping from a standing or crouching position. Compression rates of 40, 60 and 80/min produced blood flows of 5.65 +/- 0.5, 6.33 +/- 1.11 and 8.28 +/- 2.16 litres/min, respectively. Compression rates of 80/min produced significantly (P < 0.05) greater blood flows and mean arterial blood pressures than did slower rates. The blood flows produced by 80 thoracic compressions/min were approximately 50% of those reported for deeply anaesthetised horses and while not sufficient to sustain life might be used to prolong life in order to facilitate distribution of resuscitative drugs to vital tissues. PMID:8354212

  18. Evaluation of Isoflurane Overdose for Euthanasia of Neonatal Mice.

    PubMed

    Seymour, Travis L; Nagamine, Claude M

    2016-01-01

    Neonatal mice (that is, pups younger than 6 d) must be exposed to CO2 for as long as 50 min to achieve euthanasia. Alternatively, other inhalant anesthetic agents have been used to euthanize laboratory rodent species. We investigated the efficacy of isoflurane at saturated vapor pressure to euthanize neonatal mice. Neonatal mice (n = 76; age, 1 or 2 d) were exposed to isoflurane in a sealed, quart-size (0.95-L) plastic bag at room temperature. Righting and withdrawal reflexes were absent in less than 2 min. After 30 min of exposure to isoflurane, pups were removed and monitored for recovery. All pups were cyanotic and showed no detectable signs of life when they were removed from the bag. However, after 30 to 120 min after removal from the bag, 24% of isoflurane-overexposed pups began gasping and then resumed normal respiration and regained a normal pink coloration. These results demonstrate that isoflurane overexposure at saturated vapor pressure for 30 min is insufficient to euthanize neonatal mice and that isoflurane overexposure must be followed by a secondary means of euthanasia. PMID:27177567

  19. "It's intense, you know." Nurses' experiences in caring for patients requesting euthanasia.

    PubMed

    Denier, Yvonne; Dierckx de Casterlé, Bernadette; De Bal, Nele; Gastmans, Chris

    2010-02-01

    The Belgian Act on Euthanasia came into force on 23 September 2002, making Belgium the second country--after the Netherlands--to decriminalize euthanasia under certain due-care conditions. Since then, Belgian nurses have been increasingly involved in euthanasia care. In this paper, we report a qualitative study based on in-depth interviews with 18 nurses from Flanders (the Dutch-speaking part of Belgium) who have had experience in caring for patients requesting euthanasia since May 2002 (the approval of the Act). We found that the care process for patients requesting euthanasia is a complex and dynamic process, consisting of several stages, starting from the period preceding the euthanasia request and ending with the aftercare stage. When asked after the way in which they experience their involvement in the euthanasia care process, all nurses described it as a grave and difficult process, not only on an organizational and practical level, but also on an emotional level. "Intense" is the dominant feeling experienced by nurses. This is compounded by the presence of other feelings such as great concern and responsibility on the one hand, being content in truly helping the patient to die serenely, and doing everything in one's power to contribute to this; but also feeling unreal and ambivalent on the other hand, because death is arranged. Nurses feel a discrepancy, because although it is a nice death, which happens in dignity and with respect, it is also an unnatural death. The clinical ethical implications of these findings are discussed. PMID:19381871

  20. Euthanasia, assisted dying and the right to die in Ghana: a socio-legal analysis.

    PubMed

    Owusu-Dapaa, Ernest

    2013-12-01

    There is unanimity among states to protect the continuation of life of the individual as a safeguard against their collective extinction. The right to life is accordingly guaranteed but its antithesis, the right to die is the subject of an unending debate. The controversy over the right to die is deepened by rapid advances in medicine, creating the capability for prolongation of life beyond the span which one's natural strength can endure. Ghana's supreme law explicitly guarantees the right to life but remains ambiguous on right to die, particularly euthanasia and assisted dying. Thus, some of the other rights, such as the right to dignity and not to be tortured, can creatively be exploited to justify some instances of euthanasia. Ghana's criminal code largely proscribes euthanasia. Notwithstanding, proscription of euthanasia and assisted dying by the law, in Ghana's empirical work undertaken in some of the communities in Ghana, suggests that euthanasia is quietly practisedin health facilities and private homes, especially in the rural areas. Contrary to the popular reasons assigned in the literature of the Western world, with respect to the practice or quest for legalization of euthanasia as being a necessity for providing relief from pain or hopeless quality of life, empirical data from social and anthropological studies conducted in Ghana reveal that poverty is the motivation for informal euthanasia practice in Ghana rather than genuine desire on part of patients to die or their relatives to see to their accelerated death. Apart from poverty, traditional cultural values of African societies consider non-natural death as a taboo and ignominy to the victim and his family. Thus, any move by the government to legalize euthanasia will need to be informed by widely held consultations and a possible referendum; otherwise the law may be just a mere transplant of Western models of legislation on euthanasia without reflecting the ethos of the African people. PMID:24552118

  1. Voluntary self-touch increases body ownership

    PubMed Central

    Hara, Masayuki; Pozeg, Polona; Rognini, Giulio; Higuchi, Takahiro; Fukuhara, Kazunobu; Yamamoto, Akio; Higuchi, Toshiro; Blanke, Olaf; Salomon, Roy

    2015-01-01

    Experimental manipulations of body ownership have indicated that multisensory integration is central to forming bodily self-representation. Voluntary self-touch is a unique multisensory situation involving corresponding motor, tactile and proprioceptive signals. Yet, even though self-touch is frequent in everyday life, its contribution to the formation of body ownership is not well understood. Here we investigated the role of voluntary self-touch in body ownership using a novel adaptation of the rubber hand illusion (RHI), in which a robotic system and virtual reality allowed participants self-touch of real and virtual hands. In the first experiment, active and passive self-touch were applied in the absence of visual feedback. In the second experiment, we tested the role of visual feedback in this bodily illusion. Finally, in the third experiment, we compared active and passive self-touch to the classical RHI in which the touch is administered by the experimenter. We hypothesized that active self-touch would increase ownership over the virtual hand through the addition of motor signals strengthening the bodily illusion. The results indicated that active self-touch elicited stronger illusory ownership compared to passive self-touch and sensory only stimulation, and show an important role for active self-touch in the formation of bodily self. PMID:26617534

  2. Voluntary self-touch increases body ownership.

    PubMed

    Hara, Masayuki; Pozeg, Polona; Rognini, Giulio; Higuchi, Takahiro; Fukuhara, Kazunobu; Yamamoto, Akio; Higuchi, Toshiro; Blanke, Olaf; Salomon, Roy

    2015-01-01

    Experimental manipulations of body ownership have indicated that multisensory integration is central to forming bodily self-representation. Voluntary self-touch is a unique multisensory situation involving corresponding motor, tactile and proprioceptive signals. Yet, even though self-touch is frequent in everyday life, its contribution to the formation of body ownership is not well understood. Here we investigated the role of voluntary self-touch in body ownership using a novel adaptation of the rubber hand illusion (RHI), in which a robotic system and virtual reality allowed participants self-touch of real and virtual hands. In the first experiment, active and passive self-touch were applied in the absence of visual feedback. In the second experiment, we tested the role of visual feedback in this bodily illusion. Finally, in the third experiment, we compared active and passive self-touch to the classical RHI in which the touch is administered by the experimenter. We hypothesized that active self-touch would increase ownership over the virtual hand through the addition of motor signals strengthening the bodily illusion. The results indicated that active self-touch elicited stronger illusory ownership compared to passive self-touch and sensory only stimulation, and show an important role for active self-touch in the formation of bodily self. PMID:26617534

  3. Effects of size, sex, and voluntary running speeds on costs of locomotion in lines of laboratory mice selectively bred for high wheel-running activity.

    PubMed

    Rezende, Enrico L; Kelly, Scott A; Gomes, Fernando R; Chappell, Mark A; Garland, Theodore

    2006-01-01

    Selective breeding for over 35 generations has led to four replicate (S) lines of laboratory house mice (Mus domesticus) that run voluntarily on wheels about 170% more than four random-bred control (C) lines. We tested whether S lines have evolved higher running performance by increasing running economy (i.e., decreasing energy spent per unit of distance) as a correlated response to selection, using a recently developed method that allows for nearly continuous measurements of oxygen consumption (VO2) and running speed in freely behaving animals. We estimated slope (incremental cost of transport [COT]) and intercept for regressions of power (the dependent variable, VO2/min) on speed for 49 males and 47 females, as well as their maximum VO2 and speeds during wheel running, under conditions mimicking those that these lines face during the selection protocol. For comparison, we also measured COT and maximum aerobic capacity (VO2max) during forced exercise on a motorized treadmill. As in previous studies, the increased wheel running of S lines was mainly attributable to increased average speed, with males also showing a tendency for increased time spent running. On a whole-animal basis, combined analysis of males and females indicated that COT during voluntary wheel running was significantly lower in the S lines (one-tailed P=0.015). However, mice from S lines are significantly smaller and attain higher maximum speeds on the wheels; with either body mass or maximum speed (or both) entered as a covariate, the statistical significance of the difference in COT is lost (one-tailed P> or =0.2). Thus, both body size and behavior are key components of the reduction in COT. Several statistically significant sex differences were observed, including lower COT and higher resting metabolic rate in females. In addition, maximum voluntary running speeds were negatively correlated with COT in females but not in males. Moreover, males (but not females) from the S lines exhibited

  4. First Do No Harm: Euthanasia of Patients with Dementia in Belgium.

    PubMed

    Cohen-Almagor, Raphael

    2016-02-01

    In Memory of Ed Pellegrino. Euthanasia in Belgium is not limited to terminally ill patients. It may be applied to patients with chronic degenerative diseases. Currently, people in Belgium wish to make it possible to euthanize incompetent patients who suffer from dementia. This article explains the Belgian law and then explores arguments for and against euthanasia of patients with dementia. It probes the dementia paradox by elucidating Dworkin's distinction between critical and experiential interests, arguing that at the end-of-life this distinction is not clearcut. It argues against euthanasia for patients with dementia, for respecting patients' humanity and for providing them with more care, compassion, and good doctoring. PMID:26661050

  5. A Taxonomy of Voluntary Associations in Atlantic Canada.

    ERIC Educational Resources Information Center

    Dobson, John R. A.

    A study isolated and examined the words most frequently used by voluntary organizations in Atlantic Canada to describe their goals (what), learning objectives and activities (how), and conditions (who/for whom). Research methodology involved (1) administering a questionnaire for identification of goals, learning objectives and activities, and…

  6. 75 FR 75471 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act... organizations whose mission and primary activity is to conduct activities to improve patient safety and...

  7. 75 FR 75472 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Group, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... or component organizations whose mission and primary activity is to conduct activities to...

  8. 75 FR 75473 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Medical, Inc., of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... or component organizations whose mission and primary activity is to conduct activities to...

  9. Effect of food toxicants on voluntary wheel running in rats.

    PubMed

    Squibb, R E; Squibb, R L

    1979-05-01

    Voluntary wheel running in rats in reaction to a dietary deficiency of iron or food toxicants of natural (dioscin) and environmental (cadmium) origins was used to develop a behavioral model by which rapid detection of food contaminants was accomplished following induction of spontaneous activity by techniques of feed restriction. High levels of voluntary wheel running in reference controls were followed by significant depressions in running activity in animals fed the dietary toxicants. Analyses of blood and liver tissues and depressions of testes size confirmed the presence of the insults to metabolism. PMID:438894

  10. Voluntary Associations and Community Structure.

    ERIC Educational Resources Information Center

    Dillman, Don A.; And Others

    This study examined overlapping membership of voluntary associations as the basis of a statistical technique for analyzing community structure. An underlying assumption was that organizations select certain membership linkages in preference to others within a community. Thus one would expect to find points of integration and cleavage among…

  11. Social Cohesion and Voluntary Associations

    ERIC Educational Resources Information Center

    Heuser, Brian L.

    2005-01-01

    Voluntary organizations exert great influence over how social norms and ethical codes are guided into action. As such, they have a significant impact on societal levels of social cohesion. Although social capital involves generalized trust becoming manifest as spontaneous sociability, social cohesion is determined by how that sociability is…

  12. Reliability and validity of the Euthanasia Attitude Scale (EAS) for Hong Kong medical doctors.

    PubMed

    Tang, Wai-Kiu; Mak, Kwok-Kei; Kam, Philip Ming-Ho; Ho, Joanna Wing-Kiu; Chan, Denise Che-Ying; Suen, To-Lam; Lau, Michael Chak-Kwan; Cheng, Adrian Ka-Chun; Wan, Yuen-Ting; Wan, Ho-Yan; Hussain, Assad

    2010-08-01

    This study aimed to examine the reliability and validity of the Euthanasia Attitude Scale (EAS) in Hong Kong medical doctors. A total of 107 medical doctors (61.7% men) participated in a survey at clinical settings in 2008. The 21-item EAS was used to assess their attitudes toward euthanasia. The mean (standard deviation) and median of the EAS were 63.60 (60.31) and 63.00. Total EAS scores correlated well with ''Ethical Considerations,'' ''Practical Considerations,'' and ''Treasuring Life'' (Spearman rho =.37-.96, P < .001) but not ''Naturalistic Beliefs.'' The construct validity of the 3-factor model was appropriate (Kaiser-Meyer-Olkin [KMO] value = 0.90) and showed high internal consistency (Cronbach alpha =.79-.92). Euthanasia Attitude Scale may be a reliable and valid measure for assessing the attitudes toward euthanasia in medical professionals. PMID:20167833

  13. Discourses of the body in euthanasia: symptomatic, dependent, shameful and temporal.

    PubMed

    Street, A F; Kissane, D W

    2001-09-01

    This theoretical paper is derived from a discourse analysis of the textual material from a study of the seven deaths associated with legalised euthanasia in the Northern Territory, Australia. The textual analysis utilises evidence from interviews, letters written by people seeking euthanasia, medical reports, coroner's records and media reports concerning the social experiment of legalised euthanasia in Australia. The paper does not discuss the euthanasia debate. It argues that the body is a neglected concern in the debates and offers a construction of the discourses of the body as symptomatic, dependent, shameful and temporal. Medical discourses frame the body as symptomatic but these people were also concerned with the loss of autonomy associated with dependence, with shame connected with loss of bodily functions and the embodied experience of determining a 'time to die'. PMID:11882215

  14. Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands.

    PubMed

    Bollen, Jan; Ten Hoopen, Rankie; Ysebaert, Dirk; van Mook, Walther; van Heurn, Ernst

    2016-08-01

    Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs. PMID:27012736

  15. Murder-suicide involving BC doctor raises troubling questions about euthanasia.

    PubMed Central

    Wilson, V

    1995-01-01

    The deaths last September of a British Columbia physician and his wife have raised troubling questions about euthanasia and Alzheimer's disease. Police described the deaths of Dr. Tom Powell and his wife Dr. Lorraine Miles, a retired dentist, as a murder-suicide. Friends of the couple wonder if more lenient laws concerning euthanasia and assisted suicide might have saved Miles' life. Images p1856-a PMID:7773902

  16. 31 CFR 103.110 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Voluntary information sharing among... Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 103.110 Voluntary information sharing among financial institutions. (a) Definitions. For purposes of this section: (1)...

  17. 22 CFR 142.6 - Remedial action, voluntary action, and self-evaluation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Remedial action, voluntary action, and self-evaluation. 142.6 Section 142.6 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General Provisions § 142.6 Remedial action, voluntary...

  18. 29 CFR 32.6 - Remedial action, voluntary action, and self-evaluation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Remedial action, voluntary action, and self-evaluation. 32.6 Section 32.6 Labor Office of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General Provisions § 32.6 Remedial action, voluntary action, and self-evaluation....

  19. 31 CFR 1024.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MUTUAL FUNDS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1024.540 Voluntary information sharing among financial institutions. (a) Refer to § 1010.540 of this... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Voluntary information sharing...

  20. 31 CFR 1024.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MUTUAL FUNDS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1024.540 Voluntary information sharing among financial institutions. (a) Refer to § 1010.540 of this... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Voluntary information sharing...

  1. 31 CFR 1024.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MUTUAL FUNDS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1024.540 Voluntary information sharing among financial institutions. (a) Refer to § 1010.540 of this... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Voluntary information sharing...

  2. 31 CFR 1024.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MUTUAL FUNDS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1024.540 Voluntary information sharing among financial institutions. (a) Refer to § 1010.540 of this... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Voluntary information sharing...

  3. 31 CFR 1021.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CASINOS AND CARD CLUBS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity for Casinos and Card Clubs § 1021.540 Voluntary information sharing among financial institutions... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Voluntary information sharing...

  4. 31 CFR 1021.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CASINOS AND CARD CLUBS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity for Casinos and Card Clubs § 1021.540 Voluntary information sharing among financial institutions... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Voluntary information sharing...

  5. 31 CFR 1028.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... OPERATORS OF CREDIT CARD SYSTEMS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1028.540 Voluntary information sharing among financial institutions. (a) Refer to... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Voluntary information sharing...

  6. 31 CFR 1028.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... OPERATORS OF CREDIT CARD SYSTEMS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1028.540 Voluntary information sharing among financial institutions. (a) Refer to... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Voluntary information sharing...

  7. 31 CFR 1021.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CASINOS AND CARD CLUBS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity for Casinos and Card Clubs § 1021.540 Voluntary information sharing among financial institutions... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Voluntary information sharing...

  8. 31 CFR 1028.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... OPERATORS OF CREDIT CARD SYSTEMS Special Information Sharing Procedures To Deter Money Laundering and Terrorist Activity § 1028.540 Voluntary information sharing among financial institutions. (a) Refer to... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Voluntary information sharing...

  9. The history of euthanasia debates in the United States and Britain.

    PubMed

    Emanuel, E J

    1994-11-15

    Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pains of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about the ethics of euthanasia raged in the United States and Britain, culminating in 1906 in an Ohio bill to legalize euthanasia, a bill that was ultimately defeated. The arguments propounded for and against euthanasia in the 19th century are identical to contemporary arguments. Such similarities suggest four conclusions: Public interest in euthanasia 1) is not linked with advances in biomedical technology; 2) it flourishes in times of economic recession, in which individualism and social Darwinism are invoked to justify public policy; 3) it arises when physician authority over medical decision making is challenged; and 4) it occurs when terminating life-sustaining medical interventions become standard medical practice and interest develops in extending such practices to include euthanasia. PMID:7944057

  10. Euthanasia and physician-assisted suicide: knowledge, attitudes and experiences of nurses in Andalusia (Spain).

    PubMed

    Tamayo-Velázquez, María-Isabel; Simón-Lorda, Pablo; Cruz-Piqueras, Maite

    2012-09-01

    The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken. PMID:22990427

  11. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls

    PubMed Central

    Pereira, J.

    2011-01-01

    Euthanasia or assisted suicide—and sometimes both—have been legalized in a small number of countries and states. In all jurisdictions, laws and safeguards were put in place to prevent abuse and misuse of these practices. Prevention measures have included, among others, explicit consent by the person requesting euthanasia, mandatory reporting of all cases, administration only by physicians (with the exception of Switzerland), and consultation by a second physician. The present paper provides evidence that these laws and safeguards are regularly ignored and transgressed in all the jurisdictions and that transgressions are not prosecuted. For example, about 900 people annually are administered lethal substances without having given explicit consent, and in one jurisdiction, almost 50% of cases of euthanasia are not reported. Increased tolerance of transgressions in societies with such laws represents a social “slippery slope,” as do changes to the laws and criteria that followed legalization. Although the initial intent was to limit euthanasia and assisted suicide to a last-resort option for a very small number of terminally ill people, some jurisdictions now extend the practice to newborns, children, and people with dementia. A terminal illness is no longer a prerequisite. In the Netherlands, euthanasia for anyone over the age of 70 who is “tired of living” is now being considered. Legalizing euthanasia and assisted suicide therefore places many people at risk, affects the values of society over time, and does not provide controls and safeguards. PMID:21505588

  12. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls.

    PubMed

    Pereira, J

    2011-04-01

    Euthanasia or assisted suicide-and sometimes both-have been legalized in a small number of countries and states. In all jurisdictions, laws and safeguards were put in place to prevent abuse and misuse of these practices. Prevention measures have included, among others, explicit consent by the person requesting euthanasia, mandatory reporting of all cases, administration only by physicians (with the exception of Switzerland), and consultation by a second physician.The present paper provides evidence that these laws and safeguards are regularly ignored and transgressed in all the jurisdictions and that transgressions are not prosecuted. For example, about 900 people annually are administered lethal substances without having given explicit consent, and in one jurisdiction, almost 50% of cases of euthanasia are not reported. Increased tolerance of transgressions in societies with such laws represents a social "slippery slope," as do changes to the laws and criteria that followed legalization. Although the initial intent was to limit euthanasia and assisted suicide to a last-resort option for a very small number of terminally ill people, some jurisdictions now extend the practice to newborns, children, and people with dementia. A terminal illness is no longer a prerequisite. In the Netherlands, euthanasia for anyone over the age of 70 who is "tired of living" is now being considered. Legalizing euthanasia and assisted suicide therefore places many people at risk, affects the values of society over time, and does not provide controls and safeguards. PMID:21505588

  13. International Voluntary Renewable Energy Markets (Presentation)

    SciTech Connect

    Heeter, J.

    2012-06-01

    This presentation provides an overview of international voluntary renewable energy markets, with a focus on the United States and Europe. The voluntary renewable energy market is the market in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. In 2010, the U.S. voluntary market was estimated at 35 terawatt-hours (TWh) compared to 300 TWh in the European market, though key differences exist. On a customer basis, Australia has historically had the largest number of customers, pricing for voluntary certificates remains low, at less than $1 megawatt-hour, though prices depend on technology.

  14. Voluntary Truck and Bus Fuel-Economy-Program marketing plan. Final technical report, September 29, 1980-January 29, 1982

    SciTech Connect

    1982-01-01

    The aim of the program is to improve the utilization of fuel by commercial trucks and buses by updating and implementing specific approaches for educating and monitoring the trucking industry on methods and means of conserving fuels. The following outlines the marketing plan projects: increase use of program logo by voluntary program members and others; solicit trade publication membership and support; brief Congressional delegations on fuel conservation efforts; increase voluntary program presence before trade groups; increase voluntary program presence at truck and trade shows; create a voluntary program display for use at trade shows and in other areas; review voluntary program graphics; increase voluntary program membership; and produce placemats carrying fuel conservation messages; produce a special edition of Fuel Economy News, emphasizing the driver's involvement in fuel conservation; produce posters carrying voluntary program fuel conservation message. Project objectives, activities, and results for each project are summarized.

  15. Redefining RECs: Additionality in the voluntary Renewable Energy Certificate market

    NASA Astrophysics Data System (ADS)

    Gillenwater, Michael Wayne

    In the United States, electricity consumers are told that they can "buy" electricity from renewable energy projects, versus fossil fuel-fired facilities, through participation in a voluntary green power program. The marketing messages communicate to consumers that their participation and premium payments for a green label will cause additional renewable energy generation and thereby allow them to claim they consume electricity that is absent pollution as well as reduce pollutant emissions. Renewable Energy Certificates (RECs) and wind energy are the basis for the majority of the voluntary green power market in the United States. This dissertation addresses the question: Do project developers respond to the voluntary REC market in the United States by altering their decisions to invest in wind turbines? This question is investigated by modeling and probabilistically quantifying the effect of the voluntary REC market on a representative wind power investor in the United States using data from formal expert elicitations of active participants in the industry. It is further explored by comparing the distribution of a sample of wind power projects supplying the voluntary green power market in the United States against an economic viability model that incorporates geographic factors. This dissertation contributes the first quantitative analysis of the effect of the voluntary REC market on project investment. It is found that 1) RECs should be not treated as equivalent to emission offset credits, 2) there is no clearly credible role for voluntary market RECs in emissions trading markets without dramatic restructuring of one or both markets and the environmental commodities they trade, and 3) the use of RECs in entity-level GHG emissions accounting (i.e., "carbon footprinting") leads to double counting of emissions and therefore is not justified. The impotence of the voluntary REC market was, at least in part, due to the small magnitude of the REC price signal and lack of

  16. An empirical evaluation of private landowner participation in voluntary forest conservation programs.

    PubMed

    Kauneckis, Derek; York, Abigail M

    2009-09-01

    The use of voluntary programs targeting resource conservation on private land has become increasingly prevalent in environmental policy. Voluntary programs potentially offer significant benefits over regulatory and market-based approaches. This article examines the factors affecting landowner participation in voluntary forest conservation programs using a combination of parcel-level GIS and remotely sensed data and semi-structured interviews of landowners in Monroe County, Indiana. A logistic regression model is applied to determine the probability of participation based on landowner education, membership in other non-forest voluntary programs, dominant land use activity, parcel size, distance from urban center, land resource portfolios, and forest cover. Both land use activity and the spatial configuration of a landholder's resource portfolio are found to be statistically significant with important implications for the design and implementation of voluntary programs. PMID:19629580

  17. Attitudes of belgian students of medicine, philosophy, and law toward euthanasia and the conditions for its acceptance.

    PubMed

    Roelands, Marc; Van den Block, Lieve; Geurts, Sylvie; Deliens, Luc; Cohen, Joachim

    2015-01-01

    Euthanasia is legal in Belgium if due care criteria are met, which is judged by committees including physicians, ethicists, and jurists. We examined whether students in these disciplines differ in how they judge euthanasia as an acceptable act. A cross-sectional, anonymous e-mail survey revealed that they have similar attitudes and accept its legalization. Therefore, joint decision-making of physicians, ethicists, and lawyers regarding euthanasia seems to have a common attitudinal base in Belgium. However, they differ to some extent regarding the conditions they put forward for euthanasia being acceptable. Philosophy of life (religion) was an independent predictor of these attitudes. PMID:25255845

  18. The role of advance euthanasia directives as an aid to communication and shared decision-making in dementia.

    PubMed

    Hertogh, C M P M

    2009-02-01

    Recent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don't, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, "reciprocity" is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making. PMID:19181882

  19. Development and Operation of a Voluntary Audit Program.

    ERIC Educational Resources Information Center

    Murphy, Jerome R.

    This report describes a voluntary audit program implemented by the Educational Testing Service (ETS). The comprehensive audit program was developed to assure that all corporate programs adhere to the ETS Standards for Quality and Fairness. The standards address issues which relate to all ETS activities such as accountability, confidentiality of…

  20. Early Experiences Implementing Voluntary School District Mergers in Vermont

    ERIC Educational Resources Information Center

    Rogers, John D.; Glesner, Talia J.; Meyers, Herman W.

    2014-01-01

    This article describes the implementation of an initiative to encourage voluntary school district mergers in Vermont. The law was intended to increase educational opportunities for Vermont students while reducing costs. Three research activities were conducted to understand how districts and supervisory unions around the state responded to the new…

  1. What we think before a voluntary movement

    PubMed Central

    Schneider, L.; Houdayer, E.; Bai, O.; Hallett, M.

    2016-01-01

    A central feature of voluntary movement is the sense of volition, but when this sense arises in the course of movement formulation and execution is not clear. Many studies have explored how the brain might be actively preparing movement prior to the sense of volition, however, because the timing of the sense of volition has depended on subjective and retrospective judgements these findings are still regarded with a degree of scepticism. Electroencephalographic (EEG) events such as beta event-related desynchronization (βERD) and movement-related cortical potentials (MRCPs) are associated with the brain’s programming of movement. Using an optimized EEG signal derived from multiple variables we were able to make real-time predictions of movements in advance of their occurrence with a low false positive rate. We asked subjects what they were thinking at the time of prediction: sometimes they were thinking about movement, and other times they were not. Our results indicate that the brain can be preparing to make voluntary movements while subjects are thinking about something else. PMID:23363409

  2. Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives

    PubMed Central

    Wright, David Kenneth; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

    2015-01-01

    Background Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. Methods We conducted a discourse analysis of print media on physicians’ perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician’s perspective. Results We identified 3 predominant discourses about physicians’ public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Interpretation Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies. PMID:26389090

  3. Concerns about end-of-life care and support for euthanasia.

    PubMed

    Givens, Jane L; Mitchell, Susan L

    2009-08-01

    Popular support for euthanasia is known to vary according to sociodemographic characteristics. However, little is known about whether support is associated with concerns regarding the emotional, physical, and economic burdens of end-of-life care. This study used data from the 1998 General Social Survey, a national survey of community-dwelling adults. The outcome variable assessed the respondents' support for a doctor's right to end life in the setting of terminal illness. Independent variables assessed the following concerns: 1) concern about the emotional burden of end-of-life decision making for family members; 2) worry about the economic burden of terminal illness; 3) concern about pain at the end of life; 4) worry that lack of money or insurance will result in second-class end-of-life care; and 5) belief that their religious community will be helpful at the end of life. Multivariable logistic regression estimated the independent effect of these concerns on support for euthanasia, adjusting for sociodemographic characteristics. Of 786 respondents, 70.6% approved of euthanasia in the setting of terminal illness. In adjusted analyses, respondents with concerns about the emotional toll of decision making on family members, economic burden, and poor health care because of lack of insurance were significantly more likely to support euthanasia. Respondents with faith in the helpfulness of their religious community were less likely to support euthanasia. In conclusion, emotional and economic concerns about end-of-life care were associated with support for the right to euthanasia. Future work can evaluate whether alleviating these concerns may reduce the perceived desire for euthanasia by patients near the end of life. PMID:19345554

  4. Final voluntary release assessment/corrective action report

    SciTech Connect

    1996-11-12

    The US Department of Energy, Carlsbad Area Office (DOE-CAO) has completed a voluntary release assessment sampling program at selected Solid Waste Management Units (SWMUs) at the Waste Isolation Pilot Plant (WIPP). This Voluntary Release Assessment/Corrective Action (RA/CA) report has been prepared for final submittal to the Environmental protection Agency (EPA) Region 6, Hazardous Waste Management Division and the New Mexico Environment Department (NMED) Hazardous and Radioactive Materials Bureau to describe the results of voluntary release assessment sampling and proposed corrective actions at the SWMU sites. The Voluntary RA/CA Program is intended to be the first phase in implementing the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) and corrective action process at the WIPP. Data generated as part of this sampling program are intended to update the RCRA Facility Assessment (RFA) for the WIPP (Assessment of Solid Waste Management Units at the Waste Isolation Pilot Plant), NMED/DOE/AIP 94/1. This Final Voluntary RA/CA Report documents the results of release assessment sampling at 11 SWMUs identified in the RFA. With this submittal, DOE formally requests a No Further Action determination for these SWMUs. Additionally, this report provides information to support DOE`s request for No Further Action at the Brinderson and Construction landfill SWMUs, and to support DOE`s request for approval of proposed corrective actions at three other SWMUs (the Badger Unit Drill Pad, the Cotton Baby Drill Pad, and the DOE-1 Drill Pad). This information is provided to document the results of the Voluntary RA/CA activities submitted to the EPA and NMED in August 1995.

  5. Evaluation of the foetal time to death in mice after application of direct and indirect euthanasia methods.

    PubMed

    Muñoz-Mediavilla, C; Cámara, J A; Salazar, S; Segui, B; Sanguino, D; Mulero, F; de la Cueva, E; Blanco, I

    2016-04-01

    Directive 2010/63/EU on the protection of animals used for scientific purposes requires that the killing of mammal foetuses during the last third of their gestational period should be accomplished through effective and humane methods. The fact that murine foetuses are resistant to hypoxia-mediated euthanasia renders the current euthanasia methods ineffective or humane for the foetuses when these methods are applied to pregnant female mice. We have assessed the time to death of foetuses after performing either indirect (dam euthanasia) or direct (via intraplacental injection - a new approach to euthanasia) euthanasia methods in order to determine a euthanasia method that is appropriate, ethical and efficient for the killing of mouse foetuses. The respective times to death of foetuses after performing the three most commonly used euthanasia methods (namely cervical dislocation, CO2inhalation and intraperitoneal sodium pentobarbital administration) were recorded. Absence of foetal heartbeat was monitored via ultrasound. We consider that the most effective and humane method of foetal euthanasia was the one able to achieve foetal death within the shortest possible period of time. Among the indirect euthanasia methods assessed, the administration of a sodium pentobarbital overdose to pregnant female mice was found to be the fastest for foetuses, with an average post-treatment foetal death of approximately 29.8 min. As for the direct euthanasia method assessed, foetal time to death after intraplacental injection of sodium pentobarbital was approximately 14 min. Significant differences among the different mouse strains employed were found. Based on the results obtained in our study, we consider that the administration of a sodium pentobarbital overdose by intraplacental injection to be an effective euthanasia method for murine foetuses. PMID:26265244

  6. Culturally sanctioned suicide: Euthanasia, seppuku, and terrorist martyrdom.

    PubMed

    Pierre, Joseph M

    2015-03-22

    Suicide is one of the greatest concerns in psychiatric practice, with considerable efforts devoted to prevention. The psychiatric view of suicide tends to equate it with depression or other forms of mental illness. However, some forms of suicide occur independently of mental illness and within a framework of cultural sanctioning such that they aren't regarded as suicide at all. Despite persistent taboos against suicide, euthanasia and physician-assisted suicide in the context of terminal illness is increasingly accepted as a way to preserve autonomy and dignity in the West. Seppuku, the ancient samurai ritual of suicide by self-stabbing, was long considered an honorable act of self-resolve such that despite the removal of cultural sanctioning, the rate of suicide in Japan remains high with suicide masquerading as seppuku still carried out both there and abroad. Suicide as an act of murder and terrorism is a practice currently popular with Islamic militants who regard it as martyrdom in the context of war. The absence of mental illness and the presence of cultural sanctioning do not mean that suicide should not be prevented. Culturally sanctioned suicide must be understood in terms of the specific motivations that underlie the choice of death over life. Efforts to prevent culturally sanctioned suicide must focus on alternatives to achieve similar ends and must ultimately be implemented within cultures to remove the sanctioning of self-destructive acts. PMID:25815251

  7. Culturally sanctioned suicide: Euthanasia, seppuku, and terrorist martyrdom

    PubMed Central

    Pierre, Joseph M

    2015-01-01

    Suicide is one of the greatest concerns in psychiatric practice, with considerable efforts devoted to prevention. The psychiatric view of suicide tends to equate it with depression or other forms of mental illness. However, some forms of suicide occur independently of mental illness and within a framework of cultural sanctioning such that they aren’t regarded as suicide at all. Despite persistent taboos against suicide, euthanasia and physician-assisted suicide in the context of terminal illness is increasingly accepted as a way to preserve autonomy and dignity in the West. Seppuku, the ancient samurai ritual of suicide by self-stabbing, was long considered an honorable act of self-resolve such that despite the removal of cultural sanctioning, the rate of suicide in Japan remains high with suicide masquerading as seppuku still carried out both there and abroad. Suicide as an act of murder and terrorism is a practice currently popular with Islamic militants who regard it as martyrdom in the context of war. The absence of mental illness and the presence of cultural sanctioning do not mean that suicide should not be prevented. Culturally sanctioned suicide must be understood in terms of the specific motivations that underlie the choice of death over life. Efforts to prevent culturally sanctioned suicide must focus on alternatives to achieve similar ends and must ultimately be implemented within cultures to remove the sanctioning of self-destructive acts. PMID:25815251

  8. Voluntary Exercise Protects Heart from Oxidative Stress in Diabetic Rats

    PubMed Central

    Naderi, Roya; Mohaddes, Gisou; Mohammadi, Mustafa; Ghaznavi, Rana; Ghyasi, Rafigheh; Vatankhah, Amir Mansour

    2015-01-01

    Purpose: Oxidative stress plays a key role in the onset and development of diabetes complications. In this study, we evaluated whether voluntary exercise could alleviate oxidative stress in the heart and blood of streptozotocin - induced diabetic rats. Methods: 28 male Wistar rats were randomly divided into four groups (n=7): control, exercise, diabetes and exercise + diabetes. Diabetes was induced by injection of streptozotocin in male rats. Rats in the trained groups were subjected to voluntary running wheel exercise for 6 weeks. At the end of six weeks blood and heart tissue samples were collected and used for determination of antioxidant enzymes (including SOD, GPX and CAT activities) and MDA level. Results: Exercise significantly reduced MDA levels both in the heart tissue (p<0.01) and blood samples (p<0.05). In addition, exercise significantly increased SOD (p<0.05), GPX (p<0.001) and CAT (p<0.05) in the heart tissue. Voluntary exercise also significantly increased SOD (p<0.01), GPX (p<0.05) and CAT (p<0.001) in the blood. Conclusion: Voluntary exercise diminishes the MDA level in blood and heart tissue of diabetic rats. It also accentuates activities of SOD, GPX and CAT. Therefore, it may be considered a useful tool for the reduction of oxidative stress in diabetes. PMID:26236662

  9. Mahātmā Gandhi's view on euthanasia and assisted suicide.

    PubMed

    Gielen, Joris

    2012-07-01

    To many in India and elsewhere, the life and thoughts of Mohandas Karamchand Gandhi are a source of inspiration. The idea of non-violence was pivotal in his thinking. In this context, Gandhi reflected upon the possibility of what is now called 'euthanasia' and 'assisted suicide'. So far, his views on these practices have not been properly studied. In his reflections on euthanasia and assisted suicide, Gandhi shows himself to be a contextually flexible thinker. In spite of being a staunch defender of non-violence, Gandhi was aware that violence may sometimes be unavoidable. Under certain conditions, killing a living being could even be an expression of non-violence. He argued that in a few rare cases it may be better to kill people who are suffering unbearably at the end of life. In this way, he seems to support euthanasia and assisted suicide. Yet, Gandhi also thought that as long as care can be extended to a dying patient, his or her suffering could be relieved. Since in most cases relief was thus possible, euthanasia and assisted suicide were in fact redundant. By stressing the importance of care and nursing as an alternative to euthanasia and assisted suicide, Gandhi unconsciously made himself an early advocate of palliative care in India. This observation could be used to strengthen and promote the further development of palliative care in India. PMID:22375080

  10. Voluntary control of a phantom limb.

    PubMed

    Walsh, E; Long, C; Haggard, P

    2015-08-01

    Voluntary actions are often accompanied by a conscious experience of intention. The content of this experience, and its neural basis, remain controversial. On one view, the mind just retrospectively ascribes intentions to explain the occurrence of actions that lack obvious triggering stimuli. Here, we use EEG frequency analysis of sensorimotor rhythms to investigate brain activity when a participant (CL, co-author of this paper) with congenital absence of the left hand and arm, prepared and made a voluntary action with the right or the phantom "left hand". CL reported the moment she experienced the intention to press a key. This timepoint was then used as a marker for aligning and averaging EEG. In a second condition, CL was asked to prepare the action on all trials, but then, on some trials, to cancel the action at the last moment. For the right hand, we observed a typical reduction in beta-band spectral power prior to movement, followed by beta rebound after movement. When CL prepared but then cancelled a movement, we found a characteristic EEG pattern reported previously, namely a left frontal increase in spectral power close to the time of the perceived intention to move. Interestingly, the same neural signatures of positive and inhibitory volition were also present when CL prepared and inhibited movements with her phantom left hand. These EEG signals were all similar to those reported previously in a group of 14 healthy volunteers. Our results suggest that conscious intention may depend on preparatory brain activity, and not on making, or ever having made, the corresponding physical body movement. Accounts that reduce conscious volition to mere retrospective confabulation cannot easily explain our participant's neurophenomenology of action and inhibition. In contrast, the results are consistent with the view that specific neural events prior to movement may generate conscious experiences of positive and negative volition. PMID:26116910

  11. Prior voluntary wheel running attenuates neuropathic pain.

    PubMed

    Grace, Peter M; Fabisiak, Timothy J; Green-Fulgham, Suzanne M; Anderson, Nathan D; Strand, Keith A; Kwilasz, Andrew J; Galer, Erika L; Walker, Frederick Rohan; Greenwood, Benjamin N; Maier, Steven F; Fleshner, Monika; Watkins, Linda R

    2016-09-01

    Exercise is known to exert a systemic anti-inflammatory influence, but whether its effects are sufficient to protect against subsequent neuropathic pain is underinvestigated. We report that 6 weeks of voluntary wheel running terminating before chronic constriction injury (CCI) prevented the full development of allodynia for the ∼3-month duration of the injury. Neuroimmune signaling was assessed at 3 and 14 days after CCI. Prior exercise normalized ipsilateral dorsal spinal cord expression of neuroexcitatory interleukin (IL)-1β production and the attendant glutamate transporter GLT-1 decrease, as well as expression of the disinhibitory P2X4R-BDNF axis. The expression of the macrophage marker Iba1 and the chemokine CCL2 (MCP-1), and a neuronal injury marker (activating transcription factor 3), was attenuated by prior running in the ipsilateral lumbar dorsal root ganglia. Prior exercise suppressed macrophage infiltration and/or injury site proliferation, given decreased presence of macrophage markers Iba1, iNOS (M1), and Arg-1 (M2; expression was time dependent). Chronic constriction injury-driven increases in serum proinflammatory chemokines were suppressed by prior running, whereas IL-10 was increased. Peripheral blood mononuclear cells were also stimulated with lipopolysaccharide ex vivo, wherein CCI-induced increases in IL-1β, nitrite, and IL-10 were suppressed by prior exercise. Last, unrestricted voluntary wheel running, beginning either the day of, or 2 weeks after, CCI, progressively reversed neuropathic pain. This study is the first to investigate the behavioral and neuroimmune consequences of regular exercise terminating before nerve injury. This study suggests that chronic pain should be considered a component of "the diseasome of physical inactivity," and that an active lifestyle may prevent neuropathic pain. PMID:27355182

  12. Dynamics of Voluntary Cough Maneuvers

    NASA Astrophysics Data System (ADS)

    Naire, Shailesh

    2008-11-01

    Voluntary cough maneuvers are characterized by transient peak expiratory flows (PEF) exceeding the maximum expiratory flow-volume (MEFV) curve. In some cases, these flows can be well in excess of the MEFV, generally referred to as supramaximal flows. Understanding the flow-structure interaction involved in these maneuvers is the main goal of this work. We present a simple theoretical model for investigating the dynamics of voluntary cough and forced expiratory maneuvers. The core modeling idea is based on a 1-D model of high Reynolds number flow through flexible-walled tubes. The model incorporates key ingredients involved in these maneuvers: the expiratory effort generated by the abdominal and expiratory muscles, the glottis and the flexibility and compliance of the lung airways. Variations in these allow investigation of the expiratory flows generated by a variety of single cough maneuvers. The model successfully reproduces PEF which is shown to depend on the cough generation protocol, the glottis reopening time and the compliance of the airways. The particular highlight is in simulating supramaximal PEF for very compliant tubes. The flow-structure interaction mechanisms behind these are discussed. The wave speed theory of flow limitation is used to characterize the PEF. Existing hypotheses of the origin of PEF, from cough and forced expiration experiments, are also tested using this model.

  13. Method of Euthanasia Influences the Oocyte Fertilization Rate with Fresh Mouse Sperm

    PubMed Central

    Hazzard, Karen C; Watkins-Chow, Dawn E; Garrett, Lisa J

    2014-01-01

    In vitro fertilization (IVF) is used to produce mouse embryos for a variety of reasons. We evaluated the effect of the method of euthanasia on the fertilization rate in 2 different IVF protocols. Oocytes collected from C57BL/6J female mice euthanized by CO2 inhalation or cervical dislocation were used in IVF with fresh sperm from either wild-type or genetically engineered C57BL/6J. Compared with CO2 inhalation, cervical dislocation improved the resulting rate of fertilization by 18% in an IVF method using Cook media and by 13% in an IVF method using methyl-B cyclodextrin and reduced glutathione. The lower fertilization rate due to euthanasia by CO2 inhalation was accompanied by changes in blood pH and body temperature despite efforts to minimize temperature drops. In our hands, euthanasia by cervical dislocation improved fertilization rates and consequently reduced the number of egg-donor mice required. PMID:25650969

  14. Euthanasia by CO₂ inhalation affects potassium levels in mice.

    PubMed

    Traslavina, Ryan P; King, Edward J; Loar, Andrew S; Riedel, Elyn R; Garvey, Michael S; Ricart-Arbona, Rodolfo; Wolf, Felix R; Couto, Suzana S

    2010-05-01

    We and others frequently have noted serum potassium levels of 8.0 +/- 0.85 mEq/L or greater in laboratory mice; this concentration has even been published as the upper limit of a 'normal' reference range. However, if bone fide, this potassium concentration would be incompatible with life in all species. We investigated conditions frequently encountered in the research setting to distinguish artifactual from true hyperkalemia. Variables evaluated included site of collection, time allowed for clot formation before serum separation, time elapsed between collection and analysis of samples collected in a serum separator tube, precollection method of anesthesia, and euthanasia technique. Serum potassium was measured from 75 C57BL/6NTac 10-wk-old female mice and divided into at least 5 mice per variable. Animals were euthanized by exsanguination immediately after terminal CO₂ or ketamine-xylazine (KX) administration. Mice euthanized with CO₂ had higher mean serum potassium (7.0 +/- 0.5 mEq/L) and range serum potassium (6.0 to 8.1 mEq/L) than did KX-treated mice. CO₂ inhalation resulted in significantly lower blood pH (6.9 +/- 0.1), higher pCO₂ (153.3 +/- 38.8 mm Hg), and higher lactate levels (3.9 +/- 0.9 mmol/L) than did KX anesthesia followed by exsanguination. These results suggest that antemortem respiratory acidosis from CO₂ administration causes artifactual hyperkalemia in mice. Therefore, blood collection under KX anesthesia is preferable over CO₂ inhalation to obtain accurate potassium values from mice. PMID:20587163

  15. Survey of U.S. zoo and aquarium animal care staff attitudes regarding humane euthanasia for population management.

    PubMed

    Powell, David M; Ardaiolo, Matthew

    2016-05-01

    The humane euthanasia of animals for population management, or culling, has been suggested as one possible tool for managing animal populations for sustainability, and recent, highly publicized euthanasia of zoo animals in Copenhagen has stimulated global conversation about population management in zoos. We conducted a nationwide survey of U.S. zoo and aquarium personnel, including keepers, managers, and leaders of AZA animal programs, to assess their overall attitudes regarding population management euthanasia. The surveyed populations were generally very aware of the concept of population management euthanasia. Managers and animal program leaders were more supportive of euthanasia than keepers. We found that regardless of role, men were more supportive of euthanasia than women. Those personnel who were aware of instances of population management euthanasia at their institutions before were more supportive of it than those who were not. Support for culling varied with the kind of animal being considered for it, with three general taxon acceptability groupings emerging. Education, tenure in the profession, taxonomic expertise, and whether or not the responder took the survey before or after the Copenhagen events were not strong predictors of attitudes. Overall, the surveyed populations were approximately evenly split in terms of being in favor of euthanasia, not supporting euthanasia, or being unsure. Most responders indicated that they would be more likely to accept culling if more information was provided on its rationale. These results will form the basis for further discussions on the role of humane euthanasia for population management. Zoo Biol. 35:187-200, 2016. © 2016 Wiley Periodicals, Inc. PMID:26934585

  16. Extending experiences of voluntary action by association.

    PubMed

    Khalighinejad, Nima; Haggard, Patrick

    2016-08-01

    "Sense of agency" refers to the experience that links one's voluntary actions to their external outcomes. It remains unclear whether this ubiquitous experience is hardwired, arising from specific signals within the brain's motor systems, or rather depends on associative learning, through repeated cooccurrence of voluntary movements and their outcomes. To distinguish these two models, we asked participants to trigger a tone by a voluntary keypress action. The voluntary action was always associated with an involuntary movement of the other hand. We then tested whether the combination of the involuntary movement and tone alone might now suffice to produce a sense of agency, even when the voluntary action was omitted. Sense of agency was measured using an implicit marker based on time perception, namely a shift in the perceived time of the outcome toward the action that caused it. Across two experiments, repeatedly pairing an involuntary movement with a voluntary action induced key temporal features of agency, with the outcome now perceived as shifted toward the involuntary movement. This shift required involuntary movements to have been previously associated with voluntary actions. We show that some key aspects of agency may be transferred from voluntary actions to involuntary movements. An internal volitional signal is required for the primary acquisition of agency but, with repeated association, the involuntary movement in itself comes to produce some key temporal features of agency over the subsequent outcome. This finding may explain how humans can develop an enduring sense of agency in nonnatural cases, like brain-machine interfaces. PMID:27436902

  17. 12 CFR 650.10 - Voluntary liquidation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Voluntary liquidation. 650.10 Section 650.10 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FEDERAL AGRICULTURAL MORTGAGE CORPORATION GENERAL PROVISIONS § 650.10 Voluntary liquidation. (a) The Corporation may voluntarily...

  18. 14 CFR 234.7 - Voluntary reporting.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Voluntary reporting. 234.7 Section 234.7 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.7 Voluntary reporting. (a) In addition to...

  19. 14 CFR 234.7 - Voluntary reporting.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Voluntary reporting. 234.7 Section 234.7 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.7 Voluntary reporting. (a) In addition to...

  20. 22 CFR 127.12 - Voluntary disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Voluntary disclosures. 127.12 Section 127.12 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS VIOLATIONS AND PENALTIES § 127.12 Voluntary disclosures. (a) General policy. The Department strongly encourages the disclosure of information to the Directorate of...

  1. Voluntary Support of Education, 1982-1983.

    ERIC Educational Resources Information Center

    Council for Financial Aid to Education, New York, NY.

    Results of the 1982-1983 Survey of Voluntary Support of Education are presented, including a narrative summary and detailed statistical tables. Reports of voluntary support are presented for 1,137 institutions, and support patterns over the past decade are examined, along with patterns for a core group participating in two successive surveys.…

  2. Voluntary Support of Education, 1980-1981.

    ERIC Educational Resources Information Center

    Council for Financial Aid to Education, New York, NY.

    Results of the 1980-1981 Survey of Voluntary Support of Education are presented, including a narrative summary and detailed statistical tables. Reports of voluntary support are presented for 928 institutions, and support patterns over the last decade are examined, along with patterns for a core group participating in two successive surveys.…

  3. 75 FR 47504 - Voluntary Education Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... America. TTT helps relieve teacher shortages, especially in math, science, special education, and other...) Support the off-duty, voluntary education programs of DoD and conduct special projects and developmental... of the Secretary 32 CFR Part 68 RIN 0790-AI50 Voluntary Education Programs AGENCY: Office of...

  4. Changing Dynamics in the Voluntary Market (Presentation)

    SciTech Connect

    Heeter, J.

    2014-12-01

    Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This presentation, presented at the Renewable Energy Markets Conference in December 2014, outlines the voluntary market in 2013, including community choice aggregation and community solar.

  5. 78 FR 51678 - Voluntary Education Programs; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-21

    ... 14, 2013 (78 FR 49382-49400), the Department of Defense published a proposed rule titled Voluntary Education Programs. Subsequent to the publication of the proposed rule in the Federal Register, DoD... Part 68 RIN 0790-AJ06 Voluntary Education Programs; Correction AGENCY: Office of the Under Secretary...

  6. 78 FR 6208 - Voluntary Education Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ...: On Friday, December 7, 2012 (77 FR 72941-72956), the Department of Defense published a final rule in the Federal Register titled Voluntary Education Programs. Subsequent to the publication of that rule... of the Secretary 32 CFR Part 68 RIN 0790-AI50 Voluntary Education Programs AGENCY: Office of...

  7. Ohio's Resource Guide for Voluntary Skill Standards.

    ERIC Educational Resources Information Center

    Springfield-Clark Joint Vocational School, Springfield, OH.

    Voluntary skill standards are industry-based, industry-verified performance specifications that identify the knowledge, skills, and abilities individuals need for success in an industry. This resource guide is designed to raise awareness of voluntary skill standards, identify their benefits, and encourage stakeholder involvement in implementation…

  8. Voluntary Task Switching: Chasing the Elusive Homunculus

    ERIC Educational Resources Information Center

    Arrington, Catherine M.; Logan, Gordon D.

    2005-01-01

    In the voluntary task switching procedure, subjects choose the task to perform on a series of bivalent stimuli, requiring top-down control of task switching. Experiments 1-3 contrasted voluntary task switching and explicit task cuing. Choice behavior showed small, inconsistent effects of external stimulus characteristics, supporting the assumption…

  9. The Opinions of GP's Patients About Suicide, Assisted Suicide, Euthanasia, and Suicide Prevention: An Italian Survey.

    PubMed

    Poma, Stefano Zanone; Vicentini, Silvia; Siviero, Francesca; Grossi, Antonello; Toniolo, Emanuele; Baldo, Vincenzo; De Leo, Diego

    2015-08-01

    A survey about opinions on end-of-life issues of a population represented by 1,171 people in the waiting room of general practitioners' surgeries was conducted in a province of northern Italy. Most subjects did not consider suicide as a reasonable option even in cases of a serious and incurable disease. Moreover, subjects did not consider euthanasia as a possible option either; however, they did express an opposite attitude when considering euthanasia in a third-person perspective. People with a personal history of suicidal behavior appear to present as a different population, overall expressing more open attitudes. PMID:25382548

  10. Voluntary exercise during extinction of auditory fear conditioning reduces the relapse of fear associated with potentiated activity of striatal direct pathway neurons.

    PubMed

    Mika, Agnieszka; Bouchet, Courtney A; Bunker, Preston; Hellwinkel, Justin E; Spence, Katie G; Day, Heidi E W; Campeau, Serge; Fleshner, Monika; Greenwood, Benjamin N

    2015-11-01

    Relapse of previously extinguished fear presents a significant, pervasive obstacle to the successful long-term treatment of anxiety and trauma-related disorders. Thus, identification of a novel means to enhance fear extinction to stand the passage of time and generalize across contexts is of the utmost importance. Acute bouts of exercise can be used as inexpensive, noninvasive treatment strategies to reduce anxiety, and have been shown to enhance memory for extinction when performed in close temporal proximity to the extinction session. However, it is unclear whether acute exercise can be used to prevent relapse of fear, and the neural mechanisms underlying this potential effect are unknown. The current study therefore examined whether acute exercise during extinction of auditory fear can protect against the later relapse of fear. Male F344 rats lacking an extended history of wheel running were conditioned to fear a tone CS and subsequently extinguished within either a freely mobile running wheel, a locked wheel, or a control context lacking a wheel. Rats exposed to fear extinction within a freely mobile wheel ran during fear extinction, and demonstrated reduced fear as well as attenuated corticosterone levels during re-exposure to the extinguished CS during the relapse test in a novel context 1week later. Examination of cfos mRNA patterns elicited by re-exposure to the extinguished CS during the relapse test revealed that acute exercise during extinction decreased activation of brain circuits classically involved in driving fear expression and interestingly, increased activity within neurons of the direct striatal pathway involved in reward signaling. These data suggest that exercise during extinction reduces relapse through a mechanism involving the direct pathway of the striatum. It is suggested that a positive affective state could become associated with the CS during exercise during extinction, thus resulting in a relapse-resistant extinction memory. PMID

  11. A decision-tree model to detect post-calving diseases based on rumination, activity, milk yield, BW and voluntary visits to the milking robot.

    PubMed

    Steensels, M; Antler, A; Bahr, C; Berckmans, D; Maltz, E; Halachmi, I

    2016-09-01

    Early detection of post-calving health problems is critical for dairy operations. Separating sick cows from the herd is important, especially in robotic-milking dairy farms, where searching for a sick cow can disturb the other cows' routine. The objectives of this study were to develop and apply a behaviour- and performance-based health-detection model to post-calving cows in a robotic-milking dairy farm, with the aim of detecting sick cows based on available commercial sensors. The study was conducted in an Israeli robotic-milking dairy farm with 250 Israeli-Holstein cows. All cows were equipped with rumination- and neck-activity sensors. Milk yield, visits to the milking robot and BW were recorded in the milking robot. A decision-tree model was developed on a calibration data set (historical data of the 10 months before the study) and was validated on the new data set. The decision model generated a probability of being sick for each cow. The model was applied once a week just before the veterinarian performed the weekly routine post-calving health check. The veterinarian's diagnosis served as a binary reference for the model (healthy-sick). The overall accuracy of the model was 78%, with a specificity of 87% and a sensitivity of 69%, suggesting its practical value. PMID:27221983

  12. To protect or to publish: confidentiality and the fate of the mentally ill victims of Nazi euthanasia.

    PubMed

    Strous, R D

    2009-06-01

    In Nazi Germany, approximately 200 000 mentally ill people were murdered under the guise of euthanasia. Relatively little is known regarding the fate of the Jewish mentally ill patients targeted in this process, long before the Holocaust officially began. For the Nazis, Jewish mentally ill patients were doubly cursed since they embodied both "precarious genes" and "racial toxin". To preserve the memory of the victims, Yad Vashem, the leading institution dedicated to documentation of the Holocaust, actively collects information and documents the fate of victims in an open online database. Recently, a list of approximately 1200 names of Jewish mentally ill euthanasia victims has been compiled from hospital archives. Their fate remains unknown to surviving family members. Given the duty to preserve medical confidentiality, can this list be publicised for public interest and for notifying families-publicising names and death circumstances, including where "killed" would immediately indicate that the person had had a mental illness? Does the right to medical confidentiality lapse upon death? Is time elapsed since death a factor? Can opposing obligations of preserving victims' memory over-ride medical confidentiality? What if a family member objects to a grandparent's name being exposed on the list of mentally ill patients? This article considers these issues as well as the "rational" and "non-rational" factors in ethical decisional making surrounding this unique dilemma. Several possible solutions are proposed including preserving the list in a locked database for access by families and researchers, publicising in the media that such a list exists, publishing the information online without any identifiers and submitting the information to historians, allowing them to process the data as they see fit. PMID:19482979

  13. Emotion biases voluntary vertical action only with visible cues.

    PubMed

    Sasaki, Kyoshiro; Yamada, Yuki; Miura, Kayo

    2016-01-01

    Emotional information influences our bodily experiences according to the space-valence metaphor (positive/negative is up/down). In the present study, we examined whether visible and invisible emotional stimuli could also modulate voluntary action. After observing an emotional image (e.g., positive, neutral, or negative), participants used a joystick to arbitrarily position a dot stimulus in a display. The emotional image was either masked (masked condition) or not (unmasked condition) via a continuous flash suppression technique, i.e., dynamic interocular masking. We found that in the unmasked condition, the placed position of the dot was significantly higher after observing the positive image compared with the negative image, but this difference was not present in the masked condition. Our findings suggest that conscious emotional information is necessary for activating sensorimotor representations of vertical directions, and voluntary action is performed based on these activations. PMID:26637931

  14. 16 CFR 1031.6 - Extent and form of Commission involvement in the development of voluntary standards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Extent and form of Commission involvement in the development of voluntary standards. 1031.6 Section 1031.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  15. 16 CFR 1031.6 - Extent and form of Commission involvement in the development of voluntary standards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Extent and form of Commission involvement in the development of voluntary standards. 1031.6 Section 1031.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  16. 16 CFR 1031.6 - Extent and form of Commission involvement in the development of voluntary standards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Extent and form of Commission involvement in the development of voluntary standards. 1031.6 Section 1031.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES General Policies §...

  17. Dispensing death, desiring death: an exploration of medical roles and patient motivation during the period of legalized euthanasia in Australia.

    PubMed

    Street, A; Kissane, D W

    A qualitative case study was conducted to explore the clinical decision making processes that underpinned the practice of euthanasia under the Rights of the Terminally Ill (ROTI) Act. The key informant for this research was Philip Nitschke, the general practitioner responsible for the legal cases of euthanasia. His information was supported by extensive document analysis based on the public texts created by patients in the form of letters and documentaries. Further collaborating sources were those texts generated by the media, rights groups, politicians, the coroner's cort, and the literature on euthanasia and assisted suicide. A key study finding was that the ROTI legislation did not adequately provide for the specific medical situation in the Northern Territory, Australia. The medical roles, as proscribed by the legislation, carried many inherent assumptions about the health care context and the availability of appropriately qualified medical staff committed to providing euthanasia. These assumptions translated into difficulties in establishing clinical practices for the provision of euthanasia. A further finding concerned the motivations of those who requested euthanasia. This article addresses the medical roles and the motivations of those seeking euthanasia. PMID:12578011

  18. Voluntary Informed Consent in Paediatric Oncology Research.

    PubMed

    Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M

    2016-07-01

    In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. PMID:26686529

  19. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Animal care, well-being, husbandry, veterinary care, and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR CHIMPANZEES HELD IN THE FEDERALLY SUPPORTED SANCTUARY SYSTEM § 9.6 Animal care,...

  20. METHOD OF EUTHANASIA DOES NOT AFFECT SPERM MOTILITY IN THE LABORATORY RAT

    EPA Science Inventory

    To determine if anesthetic agents used in laboratory animal euthanasia affected sperm motion parameters, rats (n=10) were euthanized by one of 5 different methods: ecapitation alone, or decapitation following either ether, halothane, or nembutal anesthesia, or C02 asphyxiation. p...

  1. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Animal care, well-being, husbandry, veterinary care... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... animal health program? The sanctuary staff must provide sufficient resources of personnel,...

  2. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Animal care, well-being, husbandry, veterinary care... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... animal health program? The sanctuary staff must provide sufficient resources of personnel,...

  3. Assisted Suicide, Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience.

    ERIC Educational Resources Information Center

    Hendin, Herbert

    1995-01-01

    A study illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and encourages choosing death when faced with serious illness. The question of extending legal euthanasia to those not physically ill complicates the issue. Also, doctors may feel they can end a terminally-ill patient's life without consent.…

  4. Nurses and national socialism--a moral dilemma: one historical example of a route to euthanasia.

    PubMed

    Hoskins, Sylvia Anne

    2005-01-01

    If euthanasia were to be made legal in other countries apart from The Netherlands and Belgium, nurses would be faced with ethical dilemmas that could impact on their professional accountability and their personal moral beliefs. As a part of history has demonstrated, the introduction of the practice of euthanasia could also significantly change the relationship between nurses and patients. In Germany between 1940 and 1945, in response to a government directive, nurses participated in the practice of euthanasia and as a result many innocent German people were killed by what were considered to be 'mercy deaths'. It is important to try and understand the moral thinking and examine the complex issues at this historical junction that led German nurses to participate in the killing of thousands of innocent people. Such reflection may help to stimulate an awareness of the moral issues that nurses in the twenty-first century could confront if euthanasia were to be made legal in their own country. This has implications for future nursing practice. PMID:15685969

  5. Autonomy-based arguments against physician-assisted suicide and euthanasia: a critique.

    PubMed

    Sjöstrand, Manne; Helgesson, Gert; Eriksson, Stefan; Juth, Niklas

    2013-05-01

    Respect for autonomy is typically considered a key reason for allowing physician assisted suicide and euthanasia. However, several recent papers have claimed this to be grounded in a misconception of the normative relevance of autonomy. It has been argued that autonomy is properly conceived of as a value, and that this makes assisted suicide as well as euthanasia wrong, since they destroy the autonomy of the patient. This paper evaluates this line of reasoning by investigating the conception of valuable autonomy. Starting off from the current debate in end-of-life care, two different interpretations of how autonomy is valuable is discussed. According to one interpretation, autonomy is a personal prudential value, which may provide a reason why euthanasia and assisted suicide might be against a patient's best interests. According to a second interpretation, inspired by Kantian ethics, being autonomous is unconditionally valuable, which may imply a duty to preserve autonomy. We argue that both lines of reasoning have limitations when it comes to situations relevant for end-of life care. It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible. PMID:22161026

  6. Pereira’s attack on legalizing euthanasia or assisted suicide: smoke and mirrors

    PubMed Central

    Downie, J.; Chambaere, K.; Bernheim, J.L.

    2012-01-01

    Objective To review the empirical claims made in: Pereira J. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls. Curr Oncol 2011;18:e38–45. Design We collected all of the empirical claims made by Jose Pereira in “Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls.” We then collected all reference sources provided for those claims. We compared the claims with the sources (where sources were provided) and evaluated the level of support, if any, the sources provide for the claims. We also reviewed other available literature to assess the veracity of the empirical claims made in the paper. We then wrote the present paper using examples from the review. Results Pereira makes a number of factual statements without providing any sources. Pereira also makes a number of factual statements with sources, where the sources do not, in fact, provide support for the statements he made. Pereira also makes a number of false statements about the law and practice in jurisdictions that have legalized euthanasia or assisted suicide. Conclusions Pereira’s conclusions are not supported by the evidence he provided. His paper should not be given any credence in the public policy debate about the legal status of assisted suicide and euthanasia in Canada and around the world. PMID:22670091

  7. Euthanasia, Selective Abortion and Educability: A Survey of the Literature and the TASH Membership.

    ERIC Educational Resources Information Center

    Brown, Fredda

    The study explored what sources were responsible for exposing professionals to issues of euthanasia of handicapped infants, selective abortion of severely handicapped fetuses and the educability of profoundly retarded persons, and what sources professionals thought were most appropriate for the dissemination of information. The study consisted of…

  8. Experience with Euthanasia Is Associated with Fearlessness about Death in Veterinary Students

    ERIC Educational Resources Information Center

    Witte, Tracy K.; Correia, Christopher J.; Angarano, Donna

    2013-01-01

    Veterinarians have an increased risk for suicide compared with the general population, yet there is little consensus regarding why this might be. We hypothesized that veterinarians become relatively fearless about death due to their repeated exposure to euthanasia. Accordingly, we predicted that there would be a positive relationship between…

  9. Medicine, Rhetoric, and Euthanasia: A Case Study in the Workings of a Postmodern Discourse.

    ERIC Educational Resources Information Center

    Hyde, Michael J.

    1993-01-01

    Offers a critical reading of a controversial narrative on euthanasia that appeared in the "Journal of the American Medical Association," paying particular attention to what the narrative is doing rhetorically. Suggests the narrative is addressing topic and readers in a postmodern manner. (SR)

  10. An Overview of the Euthanasia Movement in the United States Today.

    ERIC Educational Resources Information Center

    Rock-Levinson, A. J.

    1979-01-01

    Outlines a cursory history and commentary on the euthanasia movement in the United States and emphasizes the growing demand for recognition of the individual's right to make informed treatment decisions. The growing numbers and isolation of the elderly and effects in insurance coverage on the care of the dying are also discussed. (Author)

  11. Control of robotic assistance using poststroke residual voluntary effort.

    PubMed

    Makowski, Nathaniel S; Knutson, Jayme S; Chae, John; Crago, Patrick E

    2015-03-01

    Poststroke hemiparesis limits the ability to reach, in part due to involuntary muscle co-activation (synergies). Robotic approaches are being developed for both therapeutic benefit and continuous assistance during activities of daily living. Robotic assistance may enable participants to exert less effort, thereby reducing expression of the abnormal co-activation patterns, which could allow participants to reach further. This study evaluated how well participants could perform a reaching task with robotic assistance that was either provided independent of effort in the vertical direction or in the sagittal plane in proportion to voluntary effort estimated from electromyograms (EMG) on the affected side. Participants who could not reach targets without assistance were enabled to reach further with assistance. Constant anti-gravity force assistance that was independent of voluntary effort did not reduce the quality of reach and enabled participants to exert less effort while maintaining different target locations. Force assistance that was proportional to voluntary effort on the affected side enabled participants to exert less effort and could be controlled to successfully reach targets, but participants had increased difficulty maintaining a stable position. These results suggest that residual effort on the affected side can produce an effective command signal for poststroke assistive devices. PMID:25373107

  12. Attitudes towards legalising physician provided euthanasia in Britain: the role of religion over time.

    PubMed

    Danyliv, Andriy; O'Neill, Ciaran

    2015-03-01

    Hastening the death of another whether through assisted suicide or euthanasia is the subject of intense debate in the UK and elsewhere. In this paper we use a nationally representative survey of public attitudes - the British Social Attitudes survey - to examine changes in attitudes to the legalisation of physician provided euthanasia (PPE) over almost 30 years (1983-2012) and the role of religious beliefs and religiosity in attitudes over time. Compatible questions about attitudes to euthanasia were available in the six years of 1983, 1984, 1989, 1994, 2005, and 2012. We study the trends in the support for legalisation through these time points and the relationship between attitudes, religious denomination and religiosity, controlling for a series of covariates. In total, 8099 individuals provided answers to the question about PPE in the six years of the study. The support for legalisation rose from around 76.95% in 1983 to 83.86% in 2012. This coincided with an increase in secularisation exhibited in the survey: the percentage of people with no religious affiliation increasing from 31% to 45.4% and those who do not attend a religious institution (e.g. church) increasing from 55.7% to 65.03%. The multivariate analysis demonstrates that religious affiliation and religiosity as measured by religious institution attendance frequency are the main contributors to attitudes towards euthanasia, and that the main increase in support happened among the group with least religious affiliation. Other socio-demographic characteristics do not seem to alter these attitudes systematically across the years. Our study demonstrates an increase in the support of euthanasia legalisation in Britain in the last 30 years coincided with increased secularisation. It does not follow, however, that trends in public support are immutable nor that a change in the law would improve on the current pragmatic approach toward hastening death by a physician adopted in England and Wales in terms of

  13. Under what conditions is euthanasia acceptable to lay people and health professionals?

    PubMed

    Teisseyre, Nathalie; Mullet, Etienne; Sorum, Paul Clay

    2005-01-01

    Euthanasia is legal only in the Netherlands and Belgium, but it is on occasion performed by physicians elsewhere. We recruited in France two convenience samples of 221 lay people and of 189 professionals (36 physicians, 92 nurses, 48 nurse's aides, and 13 psychologists) and asked them how acceptable it would be for a patient's physician to perform euthanasia in each of 72 scenarios. The scenarios were all combinations of three levels of the patient's life expectancy (3 days, 10 days, or 1 month), four levels of the patient's request for euthanasia (no request, unable to formulate a request because in a coma, some form of request, repeated formal requests), three of the family's attitude (do not uselessly prolong care, no opinion, try to keep the patient alive to the very end), and two of the patient's willingness to undergo organ donation (willing or not willing). We found that most lay people and health care professionals structure the factors in the patient scenarios in the same way: they assign most importance to the extent of requests for euthanasia by the patient and least importance (the lay people) or none (the health professionals) to the patient's willingness to donate organs. They also integrate the information from the different factors in the same way: the factors of patient request, patient life expectancy, and (for the lay people) organ donation are combined additively, and the family's attitude toward prolonging care interacts with patient request (playing a larger role when the patient can make no request). Thus we demonstrate a common cognitive foundation for future discussions, at the levels of both clinical care and public policy, of the conditions under which physician-performed euthanasia might be acceptable. PMID:15522491

  14. Breaking (through) the law--coming out of the silence: nursing, HIV/AIDS and euthanasia.

    PubMed

    Crock, E A

    1998-06-01

    This paper provides a nursing perspective on ethical, legal, professional and practical issues faced by nurses working in HIV/AIDS care in relation to euthanasia/assisted suicide. Nurses who care for PLWHA (People Living with HIV/AIDS) have been conspicuously silent in the recent debates about euthanasia in Australia. Many factors prevent nurses from openly acknowledging their participation in assisted suicide/euthanasia and contributing to important debates about this topic. Their commitment to client confidentiality and the illegality of the practices are clearly significant factors which inhibit nurses from speaking freely. In addition, however, nurses' well-documented precarious legal position (Johnstone, 1994-alpha) and their subordinate status within the health care system make their public silence almost inevitable. Naming and challenging the factors which contribute to nurses silence, this paper draws on the experiences of nurses who have cared for PLWHA who have requested assistance in dying. It identifies practical, ethical and legal issues and dilemmas which can arise for nurses who may be involved in these practices, highlighting their special skills, relationships with clients, responsibilities and the complexity of their role; it also elucidates, however, the serious professional and personal risks nurses face given the legal and legislative status quo. This paper suggests that nurses may play a central, though covert, role in assisted suicide/euthanasia in HIV/AIDS care, rendering it imperative that their perspectives be included in the debates about the legalization of assisted suicide/euthanasia. Moreover, the paper identifies and challenges some severe impediments nurses must confront and address if they are to be able to contribute fully to this debate and to those which may arise in the future. PMID:9743735

  15. 5 CFR 831.405 - Interest on voluntary contributions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Interest on voluntary contributions. 831.405 Section 831.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Voluntary Contributions § 831.405 Interest on voluntary contributions. (a) Interest on voluntary contributions...

  16. 5 CFR 831.405 - Interest on voluntary contributions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Interest on voluntary contributions. 831.405 Section 831.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Voluntary Contributions § 831.405 Interest on voluntary contributions. (a) Interest on voluntary contributions...

  17. 24 CFR 972.212 - Timing of voluntary conversion.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Timing of voluntary conversion. 972... URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Voluntary Conversion of Public Housing Developments Voluntary Conversion Procedure § 972.212 Timing of voluntary conversion. (a) A...

  18. 40 CFR 90.804 - Voluntary emissions recall.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Voluntary emissions recall. 90.804...-Related Defect Reporting Requirements, Voluntary Emission Recall Program, Ordered Recalls § 90.804 Voluntary emissions recall. (a) When any manufacturer initiates a voluntary emissions recall...

  19. 40 CFR 91.904 - Voluntary emission recall.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Voluntary emission recall. 91.904... Requirements, Voluntary Emission Recall Program § 91.904 Voluntary emission recall. (a) A manufacturer, prior to initiating a voluntary emission recall program, must submit to the EPA the following...

  20. 40 CFR 90.804 - Voluntary emissions recall.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Voluntary emissions recall. 90.804...-Related Defect Reporting Requirements, Voluntary Emission Recall Program, Ordered Recalls § 90.804 Voluntary emissions recall. (a) When any manufacturer initiates a voluntary emissions recall...

  1. 40 CFR 94.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Voluntary emissions recall reporting... Reporting Requirements, Voluntary Emission Recall Program § 94.404 Voluntary emissions recall reporting. (a) When any manufacturer initiates a voluntary emissions recall campaign involving an engine,...

  2. 40 CFR 92.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Voluntary emissions recall reporting... Defect Reporting Requirements, Voluntary Emission Recall Program § 92.404 Voluntary emissions recall reporting. (a) When any manufacturer or remanufacturer initiates a voluntary emissions recall...

  3. 40 CFR 91.904 - Voluntary emission recall.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Voluntary emission recall. 91.904... Requirements, Voluntary Emission Recall Program § 91.904 Voluntary emission recall. (a) A manufacturer, prior to initiating a voluntary emission recall program, must submit to the EPA the following...

  4. 40 CFR 94.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Voluntary emissions recall reporting... Reporting Requirements, Voluntary Emission Recall Program § 94.404 Voluntary emissions recall reporting. (a) When any manufacturer initiates a voluntary emissions recall campaign involving an engine,...

  5. 40 CFR 91.904 - Voluntary emission recall.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Voluntary emission recall. 91.904... Requirements, Voluntary Emission Recall Program § 91.904 Voluntary emission recall. (a) A manufacturer, prior to initiating a voluntary emission recall program, must submit to the EPA the following...

  6. 40 CFR 94.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Voluntary emissions recall reporting... Reporting Requirements, Voluntary Emission Recall Program § 94.404 Voluntary emissions recall reporting. (a) When any manufacturer initiates a voluntary emissions recall campaign involving an engine,...

  7. 40 CFR 90.804 - Voluntary emissions recall.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Voluntary emissions recall. 90.804...-Related Defect Reporting Requirements, Voluntary Emission Recall Program, Ordered Recalls § 90.804 Voluntary emissions recall. (a) When any manufacturer initiates a voluntary emissions recall...

  8. 40 CFR 94.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Voluntary emissions recall reporting... Reporting Requirements, Voluntary Emission Recall Program § 94.404 Voluntary emissions recall reporting. (a) When any manufacturer initiates a voluntary emissions recall campaign involving an engine,...

  9. 40 CFR 92.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Voluntary emissions recall reporting... Defect Reporting Requirements, Voluntary Emission Recall Program § 92.404 Voluntary emissions recall reporting. (a) When any manufacturer or remanufacturer initiates a voluntary emissions recall...

  10. 40 CFR 91.904 - Voluntary emission recall.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Voluntary emission recall. 91.904... Requirements, Voluntary Emission Recall Program § 91.904 Voluntary emission recall. (a) A manufacturer, prior to initiating a voluntary emission recall program, must submit to the EPA the following...

  11. 40 CFR 92.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Voluntary emissions recall reporting... Defect Reporting Requirements, Voluntary Emission Recall Program § 92.404 Voluntary emissions recall reporting. (a) When any manufacturer or remanufacturer initiates a voluntary emissions recall...

  12. 40 CFR 94.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Voluntary emissions recall reporting... Reporting Requirements, Voluntary Emission Recall Program § 94.404 Voluntary emissions recall reporting. (a) When any manufacturer initiates a voluntary emissions recall campaign involving an engine,...

  13. 40 CFR 92.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Voluntary emissions recall reporting... Defect Reporting Requirements, Voluntary Emission Recall Program § 92.404 Voluntary emissions recall reporting. (a) When any manufacturer or remanufacturer initiates a voluntary emissions recall...

  14. 40 CFR 92.404 - Voluntary emissions recall reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Voluntary emissions recall reporting... Defect Reporting Requirements, Voluntary Emission Recall Program § 92.404 Voluntary emissions recall reporting. (a) When any manufacturer or remanufacturer initiates a voluntary emissions recall...

  15. 40 CFR 91.904 - Voluntary emission recall.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Voluntary emission recall. 91.904... Requirements, Voluntary Emission Recall Program § 91.904 Voluntary emission recall. (a) A manufacturer, prior to initiating a voluntary emission recall program, must submit to the EPA the following...

  16. 40 CFR 90.804 - Voluntary emissions recall.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Voluntary emissions recall. 90.804...-Related Defect Reporting Requirements, Voluntary Emission Recall Program, Ordered Recalls § 90.804 Voluntary emissions recall. (a) When any manufacturer initiates a voluntary emissions recall...

  17. 40 CFR 90.804 - Voluntary emissions recall.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Voluntary emissions recall. 90.804...-Related Defect Reporting Requirements, Voluntary Emission Recall Program, Ordered Recalls § 90.804 Voluntary emissions recall. (a) When any manufacturer initiates a voluntary emissions recall...

  18. 42 CFR 460.162 - Voluntary disenrollment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A...

  19. 42 CFR 460.162 - Voluntary disenrollment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A...

  20. 42 CFR 460.162 - Voluntary disenrollment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A...

  1. 42 CFR 460.162 - Voluntary disenrollment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Participant Enrollment and Disenrollment § 460.162 Voluntary disenrollment. A...

  2. Contemplated Suicide Among Voluntary and Involuntary Retirees

    ERIC Educational Resources Information Center

    Peretti, Peter O.; Wilson, Cedric

    1978-01-01

    This study explored anomic and egoistic dimensions of contemplated suicide among voluntary and involuntary retired males. Results indicated a direct relationship between anomie and egoism on the one hand, and contemplation of suicide on the other. (Author)

  3. Gamma loop contributing to maximal voluntary contractions in man.

    PubMed

    Hagbarth, K E; Kunesch, E J; Nordin, M; Schmidt, R; Wallin, E U

    1986-11-01

    A local anaesthetic drug was injected around the peroneal nerve in healthy subjects in order to investigate whether the resulting loss in foot dorsiflexion power in part depended on a gamma-fibre block preventing 'internal' activation of spindle end-organs and thereby depriving the alpha-motoneurones of an excitatory spindle inflow during contraction. The motor outcome of maximal dorsiflexion efforts was assessed by measuring firing rates of individual motor units in the anterior tibial (t.a.) muscle, mean voltage e.m.g. from the pretibial muscles, dorsiflexion force and range of voluntary foot dorsiflexion movements. The tests were performed with and without peripheral conditioning stimuli, such as agonist or antagonist muscle vibration or imposed stretch of the contracting muscles. As compared to control values of t.a. motor unit firing rates in maximal isometric voluntary contractions, the firing rates were lower and more irregular during maximal dorsiflexion efforts performed during subtotal peroneal nerve blocks. During the development of paresis a gradual reduction of motor unit firing rates was observed before the units ceased responding to the voluntary commands. This change in motor unit behaviour was accompanied by a reduction of the mean voltage e.m.g. activity in the pretibial muscles. At a given stage of anaesthesia the e.m.g. responses to maximal voluntary efforts were more affected than the responses evoked by electric nerve stimuli delivered proximal to the block, indicating that impaired impulse transmission in alpha motor fibres was not the sole cause of the paresis. The inability to generate high and regular motor unit firing rates during peroneal nerve blocks was accentuated by vibration applied over the antagonistic calf muscles. By contrast, in eight out of ten experiments agonist stretch or vibration caused an enhancement of motor unit firing during the maximal force tasks. The reverse effects of agonist and antagonist vibration on the

  4. Neuronal correlates of voluntary facial movements

    PubMed Central

    Krippl, Martin; Karim, Ahmed A.; Brechmann, André

    2015-01-01

    Whereas the somatotopy of finger movements has been extensively studied with neuroimaging, the neural foundations of facial movements remain elusive. Therefore, we systematically studied the neuronal correlates of voluntary facial movements using the Facial Action Coding System (FACS, Ekman et al., 2002). The facial movements performed in the MRI scanner were defined as Action Units (AUs) and were controlled by a certified FACS coder. The main goal of the study was to investigate the detailed somatotopy of the facial primary motor area (facial M1). Eighteen participants were asked to produce the following four facial movements in the fMRI scanner: AU1+2 (brow raiser), AU4 (brow lowerer), AU12 (lip corner puller) and AU24 (lip presser), each in alternation with a resting phase. Our facial movement task induced generally high activation in brain motor areas (e.g., M1, premotor cortex, supplementary motor area, putamen), as well as in the thalamus, insula, and visual cortex. BOLD activations revealed overlapping representations for the four facial movements. However, within the activated facial M1 areas, we could find distinct peak activities in the left and right hemisphere supporting a rough somatotopic upper to lower face organization within the right facial M1 area, and a somatotopic organization within the right M1 upper face part. In both hemispheres, the order was an inverse somatotopy within the lower face representations. In contrast to the right hemisphere, in the left hemisphere the representation of AU4 was more lateral and anterior compared to the rest of the facial movements. Our findings support the notion of a partial somatotopic order within the M1 face area confirming the “like attracts like” principle (Donoghue et al., 1992). AUs which are often used together or are similar are located close to each other in the motor cortex. PMID:26578940

  5. Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study

    PubMed Central

    Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

    2015-01-01

    Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Design Retrospective analysis of data obtained through medical file review. Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years). Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request

  6. Attitudes of Psychiatric Nurses about the Request for Euthanasia on the Basis of Unbearable Mental Suffering(UMS)

    PubMed Central

    Wampers, Martien; De Lepeleire, Jan; Correll, Christophe U.

    2015-01-01

    Introduction When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses’ attitudes towards euthanasia motivated by unbearable mental suffering. Objectives The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient’s euthanasia request based on unbearable mental suffering (UMS). Method A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium. Results The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses. Conclusion The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations. PMID:26700007

  7. Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey

    PubMed Central

    Chambaere, Kenneth; Bilsen, Johan; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D.; Mortier, Freddy; Deliens, Luc

    2010-01-01

    Background Legalization of euthanasia and physician-assisted suicide has been heavily debated in many countries. To help inform this debate, we describe the practices of euthanasia and assisted suicide, and the use of life-ending drugs without an explicit request from the patient, in Flanders, Belgium, where euthanasia is legal. Methods We mailed a questionnaire regarding the use of life-ending drugs with or without explicit patient request to physicians who certified a representative sample (n = 6927) of death certificates of patients who died in Flanders between June and November 2007. Results The response rate was 58.4%. Overall, 208 deaths involving the use of life-ending drugs were reported: 142 (weighted prevalence 2.0%) were with an explicit patient request (euthanasia or assisted suicide) and 66 (weighted prevalence 1.8%) were without an explicit request. Euthanasia and assisted suicide mostly involved patients less than 80 years of age, those with cancer and those dying at home. Use of life-ending drugs without an explicit request mostly involved patients 80 years of older, those with a disease other than cancer and those in hospital. Of the deaths without an explicit request, the decision was not discussed with the patient in 77.9% of cases. Compared with assisted deaths with the patient’s explicit request, those without an explicit request were more likely to have a shorter length of treatment of the terminal illness, to have cure as a goal of treatment in the last week, to have a shorter estimated time by which life was shortened and to involve the administration of opioids. Interpretation Physician-assisted deaths with an explicit patient request (euthanasia and assisted suicide) and without an explicit request occurred in different patient groups and under different circumstances. Cases without an explicit request often involved patients whose diseases had unpredictable end-of-life trajectories. Although opioids were used in most of these cases

  8. Voluntary control of arm movement in athetotic patients

    PubMed Central

    Neilson, Peter D.

    1974-01-01

    Visual tracking tests have been employed to provide a quantitative description of voluntary control of arm movement in a group of patients suffering from athetoid cerebral palsy. Voluntary control was impaired in all patients in a characteristic manner. Maximum velocity and acceleration of arm movement were reduced to about 30-50% of their values in normal subjects and the time lag of the response to a visual stimulus was two or three times greater than in normals. Tracking transmission characteristics indicated a degree of underdamping which was not presnet in normal or spastic patients. This underdamping could be responsible for a low frequency (0·3-0·6 Hz) transient oscillation in elbow-angle movements associated with sudden voluntary movement. The maximum frequency at which patients could produce a coherent tracking response was only 50% of that in normal subjects and the relationship between the electromyogram and muscle contraction indicated that the mechanical load on the biceps muscle was abnormal, possibly due to increased stiffness of joint movement caused by involuntary activity in agonist and antagonist muscles acting across the joint. Images PMID:4362243

  9. [Mexico. Federal agreement for voluntary motherhood].

    PubMed

    1991-01-01

    In June 1991, the National Forum for Voluntary Motherhood and the Decriminalization of Abortion was convened in Tuxtla Gutierrez, Chiapas, Mexico. The forum culminated in the signing of a pact in which participants pledged to support the women of Chiapas in their efforts to win approval of legislation assuring the right to legal abortion. The action in Chiapas was viewed as the beginning of a national legislative process aimed at achieving juridical recognition of the sexual freedom of women. The participants planned to promote discussion in each community and state of existing abortion legislation and the proposed reforms to assure women the right to abortion. Space will be demanded in the mass media in order to inform the population. The movement will seek to develop a widespread local and national consensus on the right to voluntary maternity. Voluntary maternity implies recognition of the rights to women to make decisions regarding their own sexuality and fertility. It implies availability of sex education and contraception, as well as access to safe and legal abortions. Voluntary maternity implies elimination by society of morbidity and mortality due to causes associated with reproduction, and it implies generalized use of contraception and elimination of involuntary sterilization. Voluntary maternity requires that the state develop an ethic of protection of mothers and children, and that authoritarian demographic programs that do not recognize the humanity and autonomy of women be abandoned. Voluntary maternity requires protection by public institutions, and it requires that women and children have access to a decent standard of living. It requires as well that the daily care of children cease to be the exclusive responsibility of women and that it be shared by men. Women cannot be free as long as maternity is compulsory. It is proposed that the discussions and proposals made to local legislatures will eventually be brought before the national Congress in

  10. Status and Trends in U.S. Compliance and Voluntary Renewable Energy Certificate Markets (2010 Data)

    SciTech Connect

    Heeter, J.; Bird, L.

    2011-10-01

    This report documents the status and trends of 'compliance'--renewable energy certificate (REC) markets used to meet state renewable portfolio standard (RPS) requirements--and 'voluntary' markets--those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Today, 29 states and the District of Columbia have an RPS, more than half of all U.S. electricity customers have an option to purchase some type of green power product directly from a retail electricity provider, and all consumers have the option to purchase RECs. This report documents REC activities and trends in the United States. The compliance REC market analysis includes analysis of REC trading, regional REC markets, REC tracking systems, types of compliance RECs, compliance REC pricing trends, and an overview of compliance with RPS polices. The voluntary REC analysis presents data and analysis on voluntary market sales and customer participation, products and premiums, green pricing marketing and administrative expenses, voluntary REC pricing, and the voluntary carbon offsets market. The report concludes with a discussion of upcoming guidance from the Federal Trade Commission on green marketing claims, the emergence of community solar programs, and the potential impact of Dodd-Frank regulations on the REC market.

  11. A national survey of health professionals and volunteers working in voluntary hospice services in the UK. I. Attitudes to current issues affecting hospices and palliative care.

    PubMed

    Addington-Hall, Julia M; Karlsen, Saffron

    2005-01-01

    This paper reports results from a national survey in 1999 of voluntary hospice services in the UK. It focuses on volunteer and staff views of the purposes of hospice care, and on current debates within palliative care. Twenty-five hospice services, stratified by region, services provided (inpatient care, day care and/or home care) and number of beds were randomly sampled from amongst 175 voluntary hospices in the UK. Nineteen participated. Seventy per cent of a random sample of professional and voluntary staff within these hospices returned a postal questionnaire. Both volunteers and professionals considered care of the whole person, pain and symptom control, quality of life and dying peacefully to be important aspects of hospice care. Most doctors chose care of the whole person as the most important aspect, and they were more likely to choose this option than other staff. Hospice volunteers were less positive than hospice staff (particularly doctors and nurses) in their attitudes to extending hospice care to noncancer patients (where many volunteers held no strong view), to restricting care to patients with specialist palliative care needs, and less negative about euthanasia. These findings illustrate the importance of including hospice volunteers and the general public, as well as hospice staff, in debates about the future of hospice and palliative care in the UK. Further research is needed into lay and professional views of the role of hospices and palliative care services. PMID:15690867

  12. Voluntary sterilization in North Tyneside.

    PubMed

    Carnegie-Smith, K

    1984-04-01

    Since 1975, sterilization operations, on both men and women have been performed with increasing frequency within the National Health Service in the North Tyneside Area in northeast England. A prospective study was undertaken to discover some of the reasons why healthy young men and women chose surgical sterilization rather than use the established reversible methods of family planning available to them. The study examined some of the characteristics of those requesting sterilization, attempted to understand why they did so at that particular time, and assessed the patient-perceived morbidity resulting from this elective procedure. The study population included all individuals referred for consultation following the patient's request for voluntary sterilization by vasectomy or occlusive tubal surgery, during the period of 1 year (August 1, 1980-July 31, 1981). Women sterilized in association with a pregnancy outcome were not included in the study. Data on pregnancies and sterilizations in North Tyneside demonstrate a rapid increase in requests for vasectomy after 1975. Patients requesting sterilization were admitted to the study during the initial out-patient appointment with their surgeon. Couples seeking sterilization show similar age range for men (mean 34.2) and women (33.1). The proportion of patients who were not married at the time of the operation is perhaps a reflection of doctors' increasing willingness to perform sterilizations on the unmarried, and of individuals to seek such surgery in a committed manner. The increasing tendency for requests to be received from people still in their early 20s is seen as a problem. Data indicates that married people who request the operation at an early age are also those who were married under age 21, started a family immediately and with a 25% divorce rate. At the other end of the age range, couples who ahve been sucessfully using oral contraceptives have become concerned about its safety, especially after age 35. Data

  13. Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study

    PubMed Central

    2009-01-01

    Background An important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention. Methods We examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist. Results Physicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%). Conclusion Dutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on

  14. [Analysis of the Debate on Neonatal Euthanasia Using Present Bioethical Literature].

    PubMed

    Martín Hortigüela, María Elena

    2015-01-01

    Nowadays, most of the deaths in neonatal ages take place in neonatal intensive care units and a significative number of these are involved in decisions of withholding or withdrawing medical care. The growing complexity of the health care in neonatal settings entails that end-of-life decision-making occurs more frequently. Personal views and attitudes on the best care of the severely ill newborns can be different, since to define objectively the ″best interests″ for the infant is not easy at all. The question of how to best care for such infants is ongoing, and there remain deep divisions within the field. The aim of this issue is to review the different criteria used in the western world, Europe, especially in the Netherlands, and the EEUU and the current debate on neonatal euthanasia. Poor vital prognosis, current and future quality of life and, after the Groningen protocol, unbearable suffering are the criteria commonly used in neonatal end-of-life decisions, including euthanasia. It is necessary to distinguish the decisions, in which euthanasia is chosen, of which they are an appropriate limit of therapeutic effort. PMID:26378596

  15. The actuality and the historical background of covert Euthanasia in Albania.

    PubMed

    Boçari, Gëzim; Shaqiri, Elmaz; Vyshka, Gentian

    2010-12-01

    Euthanasia is not legal in Albania, yet there is strong evidence that euthanising a terminally ill patient is not an unknown concept for the Albanians. The first mentioned case of euthanasia is found in 7(th) century AD mythology and during the communist regime (1944-1989), allegations of euthanising political prisoners and possible rivals in the struggle for power have widely been formulated. There is a trend among relatives and laymen taking care of terminally ill patients to apply tranquilisers in an abusive dosage, or even against medical advice, aiming at sedating the ailing patient. These actions, the refusal to keep on consistently applying life prolonging treatment, and other data, suggest that covert euthanasia is a practice and legal interventions are needed towards formalising it. This might well improve end-of-life care standards, since the inadequacy of structures, such as hospices and residential asylums, is becoming a major drawback in the struggle for dignity and accessible socio-medical help for third age persons and terminal patients. PMID:21112942

  16. [Euthanasia: refusal requires alternatives. The home hospital model could be a solution for some cancer patients].

    PubMed

    Tanneberger, S

    1995-04-01

    Maybe more important than an emotional debate on "pro and con" of euthanasia is search of alternatives for all who would request for physician-assisted suicide. Obviously it is not easy to find such alternative approaches. However only these justify a position "contra euthanasia". As one alternative Franco Pannuti introduced 1985 the concept of Eubiosia. Eubiosia, what means, the set of qualities that give life dignity, was proposed as a fundamental right of all patients. And dying in dignity as part of life in dignity excludes euthanasia. In the same way as respecting beginning life we have to respect ending life. A possible approach to guarantee Eubiosia for cancer patients is the hospital at home. A hospital at home is a part of the health care system having his own structural and organisational characteristics. It guarantees for a certain group of patients clinical level of care at the comfort of their own homes. The evaluation of 10,236 patients admitted in the Bologna home hospital, show that a majority of patients favour this care model which additional can have economical advantages. PMID:7539192

  17. Ethical euthanasia and short-term anesthesia of the chick embryo.

    PubMed

    Aleksandrowicz, Ewa; Herr, Ingrid

    2015-01-01

    Fertilized chicken eggs are suggested as an alternative to mammalian models. The chorioallantoic membrane (CAM) of the chick embryo is widely used for examination of angiogenesis, xenotransplants and for virus production. Unfortunately, it is mostly not taken into account, that the chick embryo's ability to experience pain starts to develop at day 7 of breeding. In our view, this model is only in accordance with the 3 R principles, if an appropriate anesthesia of the chick embryo in potentially painful procedures is provided. Although many experimental approaches are performed on the none-innervated CAM, the euthanasia of the embryo strongly requires a more human technique than the usually used freezing at -20°C, decapitation or in ovo fixation with paraformaldehyde without prior anesthesia. However, protocols regarding feasible and ethical methods for anesthesia and euthanasia of avian embryos are currently not available. Therefore, we established an easy and reliable method for the euthanasia and short-term anesthesia of the chick embryo. PMID:25592390

  18. Premedication of dogs with acepromazine or pentazocine before euthanasia with carbon monoxide.

    PubMed Central

    Dallaire, A; Chalifoux, A

    1985-01-01

    Euthanasia of unwanted or sick animals should always be done in a humane manner. This study involving two groups of 12 dogs evaluated a two step method of euthanasia using first acepromazine or pentazocine then inhalation of carbon monoxide. During the experiment, behavioral reactions (anxiety, agitation, vocalization and sphincter relaxation) and physiological parameters (electro-encephalogram, electrocardiogram, arterial blood pressure, respiratory and heart rates and serum cortisol) were monitored. The results showed that both drugs modified many behavioral reactions and physiological changes associated with administration of carbon monoxide. Acepromazine and pentazocine reduced by 25% and 20% respectively the number of dogs that showed vocalization and agitation. In acepromazine premedicated dogs, the duration of these signs was significantly diminished and sphincter relaxation did not occur in more than 50% of cases. Furthermore, with the use of acepromazine, no significant peaks or drastic drops were noticed in the heart and respiratory rates and in the arterial blood pressure. These manifestations are usually related to stress. In light of these results, it is recommended to premedicate dogs with acepromazine before submitting them to euthanasia by carbon monoxide inhalation. PMID:4016584

  19. Voluntary reporting of greenhouse gases, 1995

    SciTech Connect

    1996-07-01

    The Voluntary Reporting Program for greenhouse gases is part of an attempt by the U.S. Government to develop innovative, low-cost, and nonregulatory approaches to limit emissions of greenhouse gases. It is one element in an array of such programs introduced in recent years as part of the effort being made by the United States to comply with its national commitment to stabilize emissions of greenhouse gases under the Framework Convention on Climate Change. The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report to the Energy Information Administration (EIA) on actions taken that have reduced or avoided emissions of greenhouse gases.

  20. Reporting of euthanasia in medical practice in Flanders, Belgium: cross sectional analysis of reported and unreported cases

    PubMed Central

    Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; Mortier, Freddy; Deliens, Luc

    2010-01-01

    Objectives To estimate the rate of reporting of euthanasia cases to the Federal Control and Evaluation Committee and to compare the characteristics of reported and unreported cases of euthanasia. Design Cross sectional analysis. Setting Flanders, Belgium. Participants A stratified at random sample was drawn of people who died between 1 June 2007 and 30 November 2007. The certifying physician of each death was sent a questionnaire on end of life decision making in the death concerned. Main outcome measures The rate of euthanasia cases reported to the Federal Control and Evaluation Committee; physicians’ reasons for not reporting cases of euthanasia; the relation between reporting and non-reporting and the characteristics of the physician and patient; the time by which life was shortened according to the physician; the labelling of the end of life decision by the physician involved; and differences in characteristics of due care between reported and unreported euthanasia cases. Results The survey response rate was 58.4% (3623/6202 eligible cases). The estimated total number of cases of euthanasia in Flanders in 2007 was 1040 (95% CI 970 to 1109), thus the incidence of euthanasia was estimated as 1.9% of all deaths (95% CI 1.6% to 2.3%). Approximately half (549/1040 (52.8%, 95% CI 43.9% to 60.5%)) of all estimated cases of euthanasia were reported to the Federal Control and Evaluation Committee. Physicians who perceived their case as euthanasia reported it in 93.1% (67/72) of cases. Cases of euthanasia were reported less often when the time by which life was shortened was less than one week compared with when the perceived life shortening was greater (37.3% v 74.1%; P<0.001). Unreported cases were generally dealt with less carefully than reported cases: a written request for euthanasia was more often absent (87.7% v 17.6% verbal request only; P<0.001), other physicians and caregivers specialised in palliative care were consulted less often (54.6% v 97.5%; 33.0% v 63

  1. Trends of psychology-related research on euthanasia: a qualitative software-based thematic analysis of journal abstracts.

    PubMed

    Caputo, Andrea

    2015-01-01

    Euthanasia has received increasing attention in both academic and public debates as one of the most controversial issues. However, the contribution of psychology-related themes to the topic has had little role on these ongoing debates. The aim of the present study is twofold: (1) to explore the main themes relating to euthanasia as provided by psychology-related research; (2) to analyze the temporal trends of psychology-related research on euthanasia over the last decades. A comprehensive search of academic literature was conducted on PsychINFO database. A qualitative software-based thematic analysis was carried out on 602 journal abstracts published from 1935 to 2014. This study highlighted four different thematic areas which characterized the scientific discourse on euthanasia: (1) moral values, in terms of religious, philosophical, and social implications concerning the individual's decision to die; (2) professional ethics, in terms of health and social workers' legal responsibility in death assistance; (3) end-of-life care, with regard to medical options provided to support individuals nearing death; and (4) patient's right to healthcare, in terms of access to palliative care and better quality of dying. Euthanasia discourse over the last decades seems to be overall characterized by two main dimensions: (1) the increasing trend of social legitimacy and acceptability of euthanasia over time, which moved from ethical to healthcare issues; and (2) the curvilinear temporal trend about the request/provision process in euthanasia, which moved from patient's decision for ending life (mainly characterizing the most past and recent research) to the role of health professionals (with a peak in the 1990s). The results suggest palliative care as a potential future research area which can provide healthcare providers with skills to 'connect' with patients, understand patients' hidden agendas, and grant a good quality of life and dying process. PMID:25530297

  2. Attitudes towards euthanasia in severely ill and dementia patients and cremation in Cyprus: a population-based survey

    PubMed Central

    2013-01-01

    Background Population studies on end-of-life decisions have not been conducted in Cyprus. Our study aim was to evaluate the beliefs and attitudes of Greek Cypriots towards end-of-life issues regarding euthanasia and cremation. Methods A population-based telephone survey was conducted in Cyprus. One thousand randomly selected individuals from the population of Cyprus age 20 years or older were invited to participate. Beliefs and attitudes on end-of-life decisions were collected using an anonymous and validated questionnaire. Statistical analyses included cross-tabulations, Pearson’s chi-square tests and multivariable-adjusted logistic regression models. Results A total of 308 males and 689 females participated in the survey. About 70% of the respondents did not support euthanasia for people with incurable illness and/or elders with dementia when requested by them and 77% did not support euthanasia for people with incurable illness and/or elders with dementia when requested by relatives. Regarding cremation, 78% were against and only 14% reported being in favor. Further statistical analyses showed that male gender, being single and having reached higher educational level were factors positively associated with support for euthanasia in a statistically significant fashion. On the contrary, the more religiosity expressed by study participants, the less support they reported for euthanasia or cremation. Conclusions The vast majority of Greek Cypriots does not support euthanasia for people with incurable illness and/or elders with dementia and also do not support cremation. Certain demographic characteristics such as age and education have a positive influence towards attitudes for euthanasia and cremation, while religiosity exerts a strong negative influence on the above. Family bonding as well as social and cultural traditions may also play a role although not comprehensively evaluated in the current study. PMID:24060291

  3. Premises and evidence in the rhetoric of assisted suicide and euthanasia.

    PubMed

    Mishara, Brian L; Weisstub, David N

    2013-01-01

    In debates about euthanasia and assisted suicide, it is rare to find an article that begins with an expression of neutral interest and then proceeds to examine the various arguments and data before drawing conclusions based upon the results of a scholarly investigation. Although authors frequently give the impression of being impartial in their introduction, they invariably reach their prior conclusions. Positions tend to be clearly dichotomized: either one believes that the practice of euthanasia or assisted suicide is totally acceptable or completely unacceptable in a just and moral society. Where there is some admission of a gray zone of incertitude, authors attempt to persuade us that their beliefs (preferences) are the only sensible way to resolve outstanding dilemmas. The practice of vehemently promoting a "pro" or "con" position may be useful when societies must decide to either legalize certain practices or not. Although only a handful of countries have thus far accepted the legal practice of euthanasia or assisted suicide (Belgium, Luxembourg, The Netherlands, the U.S. states of Montana, Oregon, Vermont and Washington, and Switzerland), scholarly articles in recent trends mainly promote legalization, to the point of recommending expansion of the current practices. Is this a case of the philosophers being ahead of their time in promoting and rationalizing the wave of the future? Alternatively, does the small number of countries that have legalized these practices indicate a substantial gap between the beliefs and desires of common citizens and the universe of the 'abstracted realm'? For the time being, what we do know is that more countries and states are debating legalization of euthanasia or assisted suicide, the nature of laws and legal practices vary greatly and both ethical and empirical assessments of current practices are the subject of much controversy. This article presents an examination of the premises and evidence in the rhetoric of assisted

  4. Adaptation to Coriolis perturbations of voluntary body sway transfers to preprogrammed fall-recovery behavior

    PubMed Central

    Ventura, Joel; DiZio, Paul; Lackner, James R.

    2013-01-01

    In a rotating environment, goal-oriented voluntary movements are initially disrupted in trajectory and endpoint, due to movement-contingent Coriolis forces, but accuracy is regained with additional movements. We studied whether adaptation acquired in a voluntary, goal-oriented postural swaying task performed during constant-velocity counterclockwise rotation (10 RPM) carries over to recovery from falling induced using a hold and release (H&R) paradigm. In H&R, standing subjects actively resist a force applied to their chest, which when suddenly released results in a forward fall and activation of an automatic postural correction. We tested H&R postural recovery in subjects (n = 11) before and after they made voluntary fore-aft swaying movements during 20 trials of 25 s each, in a counterclockwise rotating room. Their voluntary sway about their ankles generated Coriolis forces that initially induced clockwise deviations of the intended body sway paths, but fore-aft sway was gradually restored over successive per-rotation trials, and a counterclockwise aftereffect occurred during postrotation attempts to sway fore-aft. In H&R trials, we examined the initial 10- to 150-ms periods of movement after release from the hold force, when voluntary corrections of movement path are not possible. Prerotation subjects fell directly forward, whereas postrotation their forward motion was deviated significantly counterclockwise. The postrotation deviations were in a direction consistent with an aftereffect reflecting persistence of a compensation acquired per-rotation for voluntary swaying movements. These findings show that control and adaptation mechanisms adjusting voluntary postural sway to the demands of a new force environment also influence the automatic recovery of posture. PMID:24304863

  5. Adaptation to Coriolis perturbations of voluntary body sway transfers to preprogrammed fall-recovery behavior.

    PubMed

    Bakshi, Avijit; Ventura, Joel; DiZio, Paul; Lackner, James R

    2014-03-01

    In a rotating environment, goal-oriented voluntary movements are initially disrupted in trajectory and endpoint, due to movement-contingent Coriolis forces, but accuracy is regained with additional movements. We studied whether adaptation acquired in a voluntary, goal-oriented postural swaying task performed during constant-velocity counterclockwise rotation (10 RPM) carries over to recovery from falling induced using a hold and release (H&R) paradigm. In H&R, standing subjects actively resist a force applied to their chest, which when suddenly released results in a forward fall and activation of an automatic postural correction. We tested H&R postural recovery in subjects (n = 11) before and after they made voluntary fore-aft swaying movements during 20 trials of 25 s each, in a counterclockwise rotating room. Their voluntary sway about their ankles generated Coriolis forces that initially induced clockwise deviations of the intended body sway paths, but fore-aft sway was gradually restored over successive per-rotation trials, and a counterclockwise aftereffect occurred during postrotation attempts to sway fore-aft. In H&R trials, we examined the initial 10- to 150-ms periods of movement after release from the hold force, when voluntary corrections of movement path are not possible. Prerotation subjects fell directly forward, whereas postrotation their forward motion was deviated significantly counterclockwise. The postrotation deviations were in a direction consistent with an aftereffect reflecting persistence of a compensation acquired per-rotation for voluntary swaying movements. These findings show that control and adaptation mechanisms adjusting voluntary postural sway to the demands of a new force environment also influence the automatic recovery of posture. PMID:24304863

  6. A Phenomenographical Study of Voluntary Digital Exclusion

    ERIC Educational Resources Information Center

    Anderson, Derrick L.

    2012-01-01

    Traditionally scholars have used the digital divide and technology acceptance model definitions when examining why some people elect not to use certain information and communications technologies. When examining the phenomenon referred to as voluntary digital exclusion, the use of these classic definitions is woefully inadequate. They do not…

  7. Voluntary Oral Administration of Losartan in Rats.

    PubMed

    Diogo, Lucília N; Faustino, Inês V; Afonso, Ricardo A; Pereira, Sofia A; Monteiro, Emília C; Santos, Ana I

    2015-09-01

    Gavage is a widely performed technique for daily dosing in laboratory rodents. Although effective, gavage comprises a sequence of potentially stressful procedures for laboratory animals that may introduce bias into experimental results, especially when the drugs to be tested interfere with stress-dependent parameters. We aimed to test vehicles suitable for drug delivery by voluntary ingestion in rats. Specifically, Male Wistar rats (age, 2 to 3 mo) were used to test nut paste (NUT), peanut butter (PB), and sugar paste (SUG) as vehicles for long-term voluntary oral administration of losartan, an angiotensin II receptor blocker. Vehicles were administered for 28 d without drug to assess effects on the glucose level and serum lipid profile. Losartan was mixed with vehicles and either offered to the rats or administered by gavage (14 d) for subsequent quantification of losartan plasma levels by HPLC. After a 2-d acclimation period, all rats voluntarily ate the vehicles, either alone or mixed with losartan. NUT administration reduced blood glucose levels. The SUG group had higher concentrations of losartan than did the gavage group, without changes in lipid and glucose profiles. Our results showed that NUT, PB, and SUG all are viable for daily single-dose voluntary ingestion of losartan and that SUG was the best alternative overall. Drug bioavailability was not reduced after voluntary ingestion, suggesting that this method is highly effective for chronic oral administration of losartan to laboratory rodents. PMID:26424254

  8. 42 CFR 441.456 - Voluntary disenrollment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... return to a traditional service delivery system. (b) The State must specify in a section 1915(j) State... 42 Public Health 4 2010-10-01 2010-10-01 false Voluntary disenrollment. 441.456 Section 441.456 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  9. Voluntary Oral Administration of Losartan in Rats

    PubMed Central

    Diogo, Lucília N; Faustino, Inês V; Afonso, Ricardo A; Pereira, Sofia A; Monteiro, Emília C; Santos, Ana I

    2015-01-01

    Gavage is a widely performed technique for daily dosing in laboratory rodents. Although effective, gavage comprises a sequence of potentially stressful procedures for laboratory animals that may introduce bias into experimental results, especially when the drugs to be tested interfere with stress-dependent parameters. We aimed to test vehicles suitable for drug delivery by voluntary ingestion in rats. Specifically, Male Wistar rats (age, 2 to 3 mo) were used to test nut paste (NUT), peanut butter (PB), and sugar paste (SUG) as vehicles for long-term voluntary oral administration of losartan, an angiotensin II receptor blocker. Vehicles were administered for 28 d without drug to assess effects on the glucose level and serum lipid profile. Losartan was mixed with vehicles and either offered to the rats or administered by gavage (14 d) for subsequent quantification of losartan plasma levels by HPLC. After a 2-d acclimation period, all rats voluntarily ate the vehicles, either alone or mixed with losartan. NUT administration reduced blood glucose levels. The SUG group had higher concentrations of losartan than did the gavage group, without changes in lipid and glucose profiles. Our results showed that NUT, PB, and SUG all are viable for daily single-dose voluntary ingestion of losartan and that SUG was the best alternative overall. Drug bioavailability was not reduced after voluntary ingestion, suggesting that this method is highly effective for chronic oral administration of losartan to laboratory rodents. PMID:26424254

  10. 22 CFR 127.12 - Voluntary disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Voluntary disclosures. 127.12 Section 127.12 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS VIOLATIONS AND PENALTIES... pattern of violations, or reflects the absence of an effective compliance program, the Directorate...

  11. 22 CFR 127.12 - Voluntary disclosures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Voluntary disclosures. 127.12 Section 127.12 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS VIOLATIONS AND PENALTIES... pattern of violations, or reflects the absence of an effective compliance program, the Directorate...

  12. 22 CFR 127.12 - Voluntary disclosures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Voluntary disclosures. 127.12 Section 127.12 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS VIOLATIONS AND PENALTIES... board of directors). If the violation is a major violation, reveals a systemic pattern of violations,...

  13. Staff's perceptions of voluntary assertiveness skills training.

    PubMed

    McVanel, Sarah; Morris, Beth

    2010-01-01

    Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement. PMID:21119378

  14. 43 CFR 4.1111 - Voluntary dismissal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Voluntary dismissal. 4.1111 Section 4.1111 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals General Provisions § 4.1111...

  15. 43 CFR 4.1111 - Voluntary dismissal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Voluntary dismissal. 4.1111 Section 4.1111 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals General Provisions § 4.1111...

  16. 43 CFR 4.1111 - Voluntary dismissal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Voluntary dismissal. 4.1111 Section 4.1111 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals General Provisions § 4.1111...

  17. 43 CFR 4.1111 - Voluntary dismissal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Voluntary dismissal. 4.1111 Section 4.1111 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals General Provisions § 4.1111...

  18. 43 CFR 4.1111 - Voluntary dismissal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Voluntary dismissal. 4.1111 Section 4.1111 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Surface Coal Mining Hearings and Appeals General Provisions § 4.1111...

  19. Voluntary Environmental Programs: A Comparative Perspective

    ERIC Educational Resources Information Center

    Prakash, Aseem; Potoski, Matthew

    2012-01-01

    Voluntary environmental programs (VEPs) are institutions for inducing firms to produce environmental goods beyond legal requirements. A comparative perspective on VEPs shows how incentives to sponsor and participate in VEPs vary across countries in ways that reveal their potential and limitations. Our brief survey examines conditions under which…

  20. Voluntary Flammability Regulations for Residential Upholstered Furniture

    ERIC Educational Resources Information Center

    Waxman, Lisa K.; Moore, Mary Ann; Fox, Amy

    2008-01-01

    This article provides merchandising, housing, and design professionals, as well as educators, with a clear understanding of the program objectives and development of the Upholstered Furniture Action Council (UFAC), an industry-driven voluntary product safety association. The central mission of UFAC is to conduct research on cigarette-ignition…